Baseline and 6-monthly/annually Clinical Form

Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Indicate the patient's medical record number
Description

This number will not be shared with ICHOM. In the case patient-level data is submitted to ICHOM for benchmarking or research purposes, a separate ICHOM Patient Identifier will be created and cross-linking between the ICHOM Patient Identifier and the medical record number will only be known at the treating institution INCLUSION CRITERIA: All patients TIMING: On all forms REPORTING SOURCE: Administrative or clinical TYPE: Numerical RESPONSE OPTIONS: According to institution

Data type

integer

Alias
UMLS CUI [1]
C1269815
Time Relative to Baseline (e.g. 3 months follow-up, 6 months follow-up, 1 year follow-up, ...)
Description

This Item does not exist in the original standard set, instead it is asked to do the following: Please timestamp all variables. Some Standard Set variables are collected at multiple timepoints, and we will ask you to submit these variables in a concatenated VARIABLEID_TIMESTAMP form for future analyses. For example, VARIABLEID_BASE (baseline); VARIABLEID_6MO (6 month follow-up); VARIABLEID_1YR (1 year follow-up), etc. In this case 6 months, 1, and 2 years should be done, 3 months and 5 years follow-up are recommended, but not essential.

Data type

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C1442488
Treatment-Specific
Description

Treatment-Specific

Alias
UMLS CUI-1
C0087111
Which validated and internationally-accepted composite score for inflammatory disease activity did you use?
Description

INCLUSION CRITERIA: All patients TIMING: Baseline and 6-monthly if disease is active, baseline and annually if in remission REPORTING SOURCE: Clinical TYPE: Free Text

Data type

text

Alias
UMLS CUI [1,1]
C4065474
UMLS CUI [1,2]
C1290884
What was the clinical composite score?
Description

INCLUSION CRITERIA: All patients TIMING: Baseline and 6-monthly if disease is active, baseline and annually if in remission REPORTING SOURCE: Clinical TYPE: Free Text

Data type

text

Alias
UMLS CUI [1,1]
C4065474
UMLS CUI [1,2]
C1290884
UMLS CUI [1,3]
C1274040

Similar models

Baseline and 6-monthly/annually Clinical Form

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Patient ID
Item
Indicate the patient's medical record number
integer
C1269815 (UMLS CUI [1])
Time Relative to Baseline
Item
Time Relative to Baseline (e.g. 3 months follow-up, 6 months follow-up, 1 year follow-up, ...)
text
C0439564 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
Item Group
Treatment-Specific
C0087111 (UMLS CUI-1)
Inflammatory disease activity
Item
Which validated and internationally-accepted composite score for inflammatory disease activity did you use?
text
C4065474 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
Inflammatory disease activity result
Item
What was the clinical composite score?
text
C4065474 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C1274040 (UMLS CUI [1,3])