English

Annually - Clinical Form

1 forms  
Administrative Data
Description

Administrative Data

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

SUPPORTING DEFINITION: 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]
C2348585
Time relative to Baseline
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_AT (After treatment); VARIABLEID_AS (After surgery); VARIABLEID_UPDATE (Update at least annually), etc.

Data type

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C1442488
Associated clinical history
Description

Associated clinical history

Alias
UMLS CUI-1
C0262926
Indicate ocular comorbidities 1 = Retinal vascular disease (presence of any retinal vascular disease such as diabetic retinopathy, retinal vein occlusion, retinal artery occlusion)
Description

SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""

Data type

boolean

Alias
UMLS CUI [1,1]
C0009488
UMLS CUI [1,2]
C1299003
UMLS CUI [1,3]
C0154833
UMLS CUI [2]
C0011884
UMLS CUI [3]
C0035328
UMLS CUI [4]
C0035302
Indicate ocular comorbidities 2 = Other macular pathology (presence of any other macular pathology such as , diabetic macular edema, epiretinal membrane, macular hole, macular dystrophy etc.)
Description

SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""

Data type

boolean

Alias
UMLS CUI [1,1]
C0009488
UMLS CUI [1,2]
C1299003
UMLS CUI [1,3]
C0730362
UMLS CUI [1,4]
C1518912
UMLS CUI [2]
C0730285
UMLS CUI [3]
C0339543
UMLS CUI [4]
C0024441
UMLS CUI [5]
C0026850
Indicate ocular comorbidities 3 = Glaucoma or other optic neuropathy (confirmed diagnosis of glaucoma or other optic neuropathy has been made)
Description

SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""

Data type

boolean

Alias
UMLS CUI [1,1]
C0009488
UMLS CUI [1,2]
C1299003
UMLS CUI [2]
C0017601
UMLS CUI [3,1]
C3887709
UMLS CUI [3,2]
C0205394
Indicate ocular comorbidities 4 = Amblyopia (presence of amblyopia)
Description

SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""

Data type

boolean

Alias
UMLS CUI [1,1]
C0009488
UMLS CUI [1,2]
C1299003
UMLS CUI [2]
C0002418
Indicate ocular comorbidities 5 = Media opacity (presence of media opacity from cataract or corneal pathology etc.)
Description

SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""

Data type

boolean

Alias
UMLS CUI [1,1]
C0009488
UMLS CUI [1,2]
C1299003
UMLS CUI [2]
C0086543
UMLS CUI [3]
C0010038
Indicate ocular comorbidities 888 = Other
Description

SUPPORTING DEFINITION: Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline, Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers. Separate multiple entries with "";""

Data type

boolean

Alias
UMLS CUI [1,1]
C0009488
UMLS CUI [1,2]
C1299003
UMLS CUI [1,3]
C0205394
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Similar models

Annually - Clinical Form

1 forms
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
C2348585 (UMLS CUI [1])
Time relative to Baseline
Item
Time relative to Baseline
text
C0439564 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
Item Group
Associated clinical history
C0262926 (UMLS CUI-1)
Ocular comorbidities: Retinal vascular disease
Item
Indicate ocular comorbidities 1 = Retinal vascular disease (presence of any retinal vascular disease such as diabetic retinopathy, retinal vein occlusion, retinal artery occlusion)
boolean
C0009488 (UMLS CUI [1,1])
C1299003 (UMLS CUI [1,2])
C0154833 (UMLS CUI [1,3])
C0011884 (UMLS CUI [2])
C0035328 (UMLS CUI [3])
C0035302 (UMLS CUI [4])
Ocular comorbidities: Other macular pathology
Item
Indicate ocular comorbidities 2 = Other macular pathology (presence of any other macular pathology such as , diabetic macular edema, epiretinal membrane, macular hole, macular dystrophy etc.)
boolean
C0009488 (UMLS CUI [1,1])
C1299003 (UMLS CUI [1,2])
C0730362 (UMLS CUI [1,3])
C1518912 (UMLS CUI [1,4])
C0730285 (UMLS CUI [2])
C0339543 (UMLS CUI [3])
C0024441 (UMLS CUI [4])
C0026850 (UMLS CUI [5])
Ocular comorbidities: Glaucoma or other optic neuropathy
Item
Indicate ocular comorbidities 3 = Glaucoma or other optic neuropathy (confirmed diagnosis of glaucoma or other optic neuropathy has been made)
boolean
C0009488 (UMLS CUI [1,1])
C1299003 (UMLS CUI [1,2])
C0017601 (UMLS CUI [2])
C3887709 (UMLS CUI [3,1])
C0205394 (UMLS CUI [3,2])
Ocular comorbidities: Amblyopia
Item
Indicate ocular comorbidities 4 = Amblyopia (presence of amblyopia)
boolean
C0009488 (UMLS CUI [1,1])
C1299003 (UMLS CUI [1,2])
C0002418 (UMLS CUI [2])
Ocular comorbidities: Media opacity
Item
Indicate ocular comorbidities 5 = Media opacity (presence of media opacity from cataract or corneal pathology etc.)
boolean
C0009488 (UMLS CUI [1,1])
C1299003 (UMLS CUI [1,2])
C0086543 (UMLS CUI [2])
C0010038 (UMLS CUI [3])
Ocular comorbidities: Other
Item
Indicate ocular comorbidities 888 = Other
boolean
C0009488 (UMLS CUI [1,1])
C1299003 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
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