ID

41539

Beschreibung

Study ID: 111476 Clinical Study ID: 111476 Study Title: An open, single-arm trial to assess the clinical activity of recMAGE-A3 + AS15 in patients with unresectable MAGE-A3-positive metastatic cutaneous melanoma Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00942162 Sponsor: GlaxoSmithKline Phase: Phase 2 Study Recruitment Status: Completed Generic Name: Antigen-Specific Cancer Immunotherapeutic Study Indication: Melanoma

Stichworte

Versionen (2)
  1. 15.10.20 15.10.20 -
  2. 03.11.20 03.11.20 -
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GlaxoSmithKline

Hochgeladen am

3. November 2020

DOI

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Clinical activity of recMAGE-A3 + AS15 in patients with metastatic cutaneous melanoma NCT00942162

Englisch

IMD Report - (Glomerulo)Nephritis; Inflammatory Skin Diseases; Autoimmune Myocarditis (Report Final and Annex Report 2 Final)

1 Formulare  
Administrative
Beschreibung

Administrative

Alias
UMLS CUI-1
C1320722
Centre Number
Beschreibung

Centre Number

Datentyp

text

Alias
UMLS CUI [1,1]
C0600091
UMLS CUI [1,2]
C0019994
Patient Number
Beschreibung

Patient Number

Datentyp

text

Alias
UMLS CUI [1]
C2348585
(Glomerulo)Nephritis
Beschreibung

(Glomerulo)Nephritis

Alias
UMLS CUI-1
C0017658
(Glomerulo)Nephritis - Diagnosis
Beschreibung

(Glomerulo)Nephritis - Diagnosis

Datentyp

integer

Alias
UMLS CUI [1,1]
C0017658
UMLS CUI [1,2]
C0011900
(Glomerulo)Nephritis - Specify other diagnosis
Beschreibung

(Glomerulo)Nephritis - Specify other diagnosis

Datentyp

text

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0011900
UMLS CUI [2,2]
C0205394
Please specify related adverse event: SAE Case No.
Beschreibung

In case of serious adverse event

Datentyp

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0237753
Please specify related adverse event: AE No.
Beschreibung

In case of non-serious adverse event

Datentyp

integer

Alias
UMLS CUI [1,1]
C1518404
UMLS CUI [1,2]
C0237753
Date of final diagnosis:
Beschreibung

Date of final diagnosis:

Datentyp

date

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C1546485
(Glomerulo)Nephritis - Signs and Symptoms
Beschreibung

(Glomerulo)Nephritis - Signs and Symptoms

Alias
UMLS CUI-1
C0017658
UMLS CUI-2
C0037088
(Glomerulo)Nephritis - Signs and Symptoms
Beschreibung

(Glomerulo)Nephritis - Signs and Symptoms

Datentyp

integer

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C0037088
(Glomerulo)Nephritis - Signs and Symptoms present
Beschreibung

(Glomerulo)Nephritis - Signs and Symptoms present

Datentyp

text

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0150312
(Glomerulo)Nephritis - Signs and Symptoms start date
Beschreibung

(Glomerulo)Nephritis - Signs and Symptoms start date

Datentyp

date

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0808070
(Glomerulo)Nephritis - Signs and Symptoms end date
Beschreibung

(Glomerulo)Nephritis - Signs and Symptoms end date

Datentyp

date

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0806020
(Glomerulo)Nephritis - Signs and Symptoms continuing at end of study
Beschreibung

(Glomerulo)Nephritis - Signs and Symptoms continuing at end of study

Datentyp

integer

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C0037088
UMLS CUI [3,1]
C0549178
UMLS CUI [3,2]
C0444496
(Glomerulo)Nephritis - Other signs and symptoms
Beschreibung

(Glomerulo)Nephritis - Other signs and symptoms

Alias
UMLS CUI-1
C0017658
UMLS CUI-2
C0037088
UMLS CUI-3
C0205394
If any other signs and symptoms, please tick the box and complete below
Beschreibung

If any other signs and symptoms, please tick the box and complete below

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037088
UMLS CUI [1,2]
C0205394
(Glomerulo)Nephritis - Other signs and symptoms
Beschreibung

(Glomerulo)Nephritis - Other signs and symptoms

Alias
UMLS CUI-1
C0017658
UMLS CUI-2
C0037088
UMLS CUI-3
C0205394
(Glomerulo)Nephritis - Other signs and symptoms
Beschreibung

(Glomerulo)Nephritis - Other signs and symptoms

Datentyp

text

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
(Glomerulo)Nephritis - Other signs and symptoms start date
Beschreibung

(Glomerulo)Nephritis - Other signs and symptoms start date

Datentyp

date

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
UMLS CUI [3]
C0808070
(Glomerulo)Nephritis - Other signs and symptoms end date
Beschreibung

(Glomerulo)Nephritis - Other signs and symptoms end date

Datentyp

date

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
UMLS CUI [3]
C0806020
(Glomerulo)Nephritis - Other signs and symptoms continuing at end of study
Beschreibung

(Glomerulo)Nephritis - Other signs and symptoms continuing at end of study

Datentyp

integer

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
UMLS CUI [3,1]
C0549178
UMLS CUI [3,2]
C0444496
(Glomerulo)Nephritis - Diagnostic Test Results
Beschreibung

(Glomerulo)Nephritis - Diagnostic Test Results

Alias
UMLS CUI-1
C0017658
UMLS CUI-2
C0456984
UMLS CUI-3
C0430022
(Glomerulo)Nephritis - Test
Beschreibung

(Glomerulo)Nephritis - Test

Datentyp

integer

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C2826273
(Glomerulo)Nephritis - Test done
Beschreibung

(Glomerulo)Nephritis - Test done

Datentyp

text

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0022885
UMLS CUI [2,2]
C1272695
(Glomerulo)Nephritis - Test date
Beschreibung

(Glomerulo)Nephritis - Test date

Datentyp

date

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C2826247
(Glomerulo)Nephritis - Test Result
Beschreibung

(Glomerulo)Nephritis - Test Result

Datentyp

float

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C0587081
(Glomerulo)Nephritis - Test Units
Beschreibung

(Glomerulo)Nephritis - Test Units

Datentyp

text

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C1519795
(Glomerulo)Nephritis - Low Norm
Beschreibung

(Glomerulo)Nephritis - Low Norm

Datentyp

float

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205251
(Glomerulo)Nephritis - High Norm
Beschreibung

(Glomerulo)Nephritis - High Norm

Datentyp

float

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205250
(Glomerulo)Nephritis - Other Diagnostic Test Results
Beschreibung

(Glomerulo)Nephritis - Other Diagnostic Test Results

Alias
UMLS CUI-1
C0017658
UMLS CUI-2
C0456984
UMLS CUI-3
C0430022
UMLS CUI-4
C0205394
If any other diagnostic test results are available, please tick the box and complete below
Beschreibung

If any other diagnostic test results are available, please tick the box and complete below

Datentyp

integer

Alias
UMLS CUI [1,1]
C0456984
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C0205394
(Glomerulo)Nephritis - Other Diagnostic Test Results
Beschreibung

(Glomerulo)Nephritis - Other Diagnostic Test Results

Alias
UMLS CUI-1
C0017658
UMLS CUI-2
C0456984
UMLS CUI-3
C0430022
UMLS CUI-4
C0205394
(Glomerulo)Nephritis - Test
Beschreibung

(Glomerulo)Nephritis - Test

Datentyp

text

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C2826273
(Glomerulo)Nephritis - Test date
Beschreibung

Idiopathic Thrombocytopenic Purpura - Test date

Datentyp

date

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C2826247
(Glomerulo)Nephritis - Test Result
Beschreibung

(Glomerulo)Nephritis - Test Result

Datentyp

float

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C0587081
(Glomerulo)Nephritis - Test Units
Beschreibung

(Glomerulo)Nephritis - Test Units

Datentyp

text

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2]
C1519795
(Glomerulo)Nephritis - Low Norm
Beschreibung

(Glomerulo)Nephritis - Low Norm

Datentyp

float

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205251
(Glomerulo)Nephritis - High Norm
Beschreibung

(Glomerulo)Nephritis - High Norm

Datentyp

float

Alias
UMLS CUI [1]
C0017658
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205250
(Glomerulo)Nephritis - Other diagnostic Procedure
Beschreibung

(Glomerulo)Nephritis - Other diagnostic Procedure

Alias
UMLS CUI-1
C0017658
UMLS CUI-2
C0430022
UMLS CUI-3
C0205394
Describe any other diagnostic procedure supporting the diagnosis (Pyelography, Kidney ultra-sound, Kidney tomography, Kidney biopsy)
Beschreibung

Describe any other diagnostic procedure supporting the diagnosis

Datentyp

text

Alias
UMLS CUI [1,1]
C0430022
UMLS CUI [1,2]
C0205394
UMLS CUI [2]
C0011900
UMLS CUI [3]
C0034185
UMLS CUI [4,1]
C1456803
UMLS CUI [4,2]
C0022646
UMLS CUI [5,1]
C0040405
UMLS CUI [5,2]
C0022646
UMLS CUI [6,1]
C0005558
UMLS CUI [6,2]
C0022646
Inflammatory skin diseases
Beschreibung

Inflammatory skin diseases

Alias
UMLS CUI-1
C0037274
UMLS CUI-2
C1290884
Inflammatory skin diseases diagnosis
Beschreibung

Please tick appropriate diagnosis

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0011900
Inflammatory skin diseases - Specify other diagnosis
Beschreibung

Inflammatory skin diseases - Specify other diagnosis

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0011900
UMLS CUI [2,2]
C0205394
Please specify related adverse event: SAE Case No.
Beschreibung

In case of serious adverse event

Datentyp

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0237753
Please specify related adverse event: AE No.
Beschreibung

In case of non-serious adverse event

Datentyp

integer

Alias
UMLS CUI [1,1]
C1518404
UMLS CUI [1,2]
C0237753
Date of final diagnosis:
Beschreibung

Date of final diagnosis:

Datentyp

date

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C1546485
Inflammatory skin diseases - Signs and symptoms
Beschreibung

Inflammatory skin diseases - Signs and symptoms

Alias
UMLS CUI-1
C0037274
UMLS CUI-2
C1290884
UMLS CUI-3
C0037088
UMLS CUI-4
C1546485
Inflammatory skin diseases - Signs and symptoms
Beschreibung

Inflammatory skin diseases - Signs and symptoms

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0037088
Inflammatory skin diseases - Signs and symptoms present
Beschreibung

Inflammatory skin diseases - Signs and symptoms present

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0037088
UMLS CUI [3]
C0150312
Inflammatory skin diseases - Signs and symptoms Start Date
Beschreibung

Inflammatory skin diseases - Signs and symptoms Start Date

Datentyp

date

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0037088
UMLS CUI [3]
C0808070
Inflammatory skin diseases - Signs and symptoms End date
Beschreibung

Inflammatory skin diseases - Signs and symptoms End date

Datentyp

date

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0037088
UMLS CUI [3]
C0806020
Inflammatory skin diseases - Signs and symptoms continuing at the end of study
Beschreibung

Inflammatory skin diseases - Signs and symptoms continuing at the end of study

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0037088
UMLS CUI [3,1]
C0549178
UMLS CUI [3,2]
C0444496
Inflammatory skin diseases - Signs and symptoms (skin lesions)
Beschreibung

Inflammatory skin diseases - Signs and symptoms (skin lesions)

Alias
UMLS CUI-1
C0037274
UMLS CUI-2
C1290884
UMLS CUI-3
C0037088
UMLS CUI-4
C0037284
Inflammatory skin diseases - Signs and symptoms present (skin lesions)
Beschreibung

Inflammatory skin diseases - Signs and symptoms present (skin lesions)

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0037088
UMLS CUI [3]
C0150312
UMLS CUI [4]
C0037284
Inflammatory skin diseases - Signs and symptoms Start Date (skin lesions)
Beschreibung

Inflammatory skin diseases - Signs and symptoms Start Date (skin lesions)

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0037088
UMLS CUI [3]
C0808070
UMLS CUI [4]
C0037284
Inflammatory skin diseases - Signs and symptoms End date (skin lesions)
Beschreibung

Inflammatory skin diseases - Signs and symptoms End date (skin lesions)

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0037088
UMLS CUI [3]
C0806020
UMLS CUI [4]
C0037284
Inflammatory skin diseases - Signs and symptoms continuing at the end of study (skin lesions)
Beschreibung

Inflammatory skin diseases - Signs and symptoms continuing at the end of study (skin lesions)

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0037088
UMLS CUI [3,1]
C0549178
UMLS CUI [3,2]
C0444496
UMLS CUI [4]
C0037284
If skin lesions, please specify
Beschreibung

If skin lesions, please specify

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037284
UMLS CUI [1,2]
C2348235
Skin lesion - specify localisation (Scalp, Face, Neck, Trunc, Segmental , Dermatome, Upper limbs, Lower limbs, Palms, Soles, Nails, Fingers, Footfingers, Anterior, surface of the lower extremities), specify
Beschreibung

Skin lesion - specify localisation

Datentyp

text

Alias
UMLS CUI [1]
C0037284
UMLS CUI [2]
C0475264
UMLS CUI [3]
C0036270
UMLS CUI [4]
C0015450
UMLS CUI [5]
C0027530
UMLS CUI [6]
C0460005
UMLS CUI [7]
C0205122
UMLS CUI [8]
C0448733
UMLS CUI [9]
C1140618
UMLS CUI [10]
C0023216
UMLS CUI [11]
C0817662
UMLS CUI [12]
C0230463
UMLS CUI [13]
C0027342
UMLS CUI [14]
C0016129
UMLS CUI [15]
C0040357
UMLS CUI [16]
C0205094
UMLS CUI [17,1]
C0023216
UMLS CUI [17,2]
C0005902
Inflammatory skin diseases - Number of skin lesions
Beschreibung

Inflammatory skin diseases - Number of skin lesions

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0037284
UMLS CUI [2,2]
C0237753
Inflammatory skin diseases - % body affected
Beschreibung

Inflammatory skin diseases - % body affected

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0392760
UMLS CUI [2,2]
C0439165
UMLS CUI [2,3]
C0005902
Inflammatory skin diseases - Other Signs and symptoms
Beschreibung

Inflammatory skin diseases - Other Signs and symptoms

Alias
UMLS CUI-1
C0037274
UMLS CUI-2
C1290884
UMLS CUI-3
C0037088
UMLS CUI-4
C0205394
If any other signs and symptoms, please tick the box and complete below
Beschreibung

If any other signs and symptoms, please tick the box and complete below

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037088
UMLS CUI [1,2]
C0205394
Inflammatory skin diseases - Other Signs and symptoms
Beschreibung

Inflammatory skin diseases - Other Signs and symptoms

Alias
UMLS CUI-1
C0037274
UMLS CUI-2
C1290884
UMLS CUI-3
C0037088
UMLS CUI-4
C0205394
Inflammatory skin diseases - Other Signs and symptoms
Beschreibung

Inflammatory skin diseases - Other Signs and symptoms

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
Inflammatory skin diseases - Other Signs and symptoms Start Date
Beschreibung

Inflammatory skin diseases - Other Signs and symptoms Start Date

Datentyp

date

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
UMLS CUI [3]
C0808070
Inflammatory skin diseases - Other Signs and symptoms End Date
Beschreibung

Inflammatory skin diseases - Other Signs and symptoms End Date

Datentyp

date

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
UMLS CUI [3]
C0806020
Inflammatory skin diseases - Diagnostic Test Results
Beschreibung

Inflammatory skin diseases - Diagnostic Test Results

Alias
UMLS CUI-1
C0037274
UMLS CUI-2
C1290884
UMLS CUI-3
C0430022
UMLS CUI-4
C0456984
Inflammatory skin diseases - Test
Beschreibung

Inflammatory skin diseases - Test

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C2826273
Inflammatory skin diseases - Test done
Beschreibung

Inflammatory skin diseases - Test done

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0022885
UMLS CUI [2,2]
C1272695
Inflammatory skin diseases - Test date
Beschreibung

Inflammatory skin diseases - Test date

Datentyp

date

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C2826247
Inflammatory skin diseases - Test Result
Beschreibung

Inflammatory skin diseases - Test Result

Datentyp

float

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0587081
Inflammatory skin diseases - Test Units
Beschreibung

Inflammatory skin diseases - Test Units

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C1519795
Inflammatory skin diseases - Low Norm
Beschreibung

Inflammatory skin diseases - Low Norm

Datentyp

float

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205251
Inflammatory skin diseases - High Norm
Beschreibung

Inflammatory skin diseases - High Norm

Datentyp

float

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205250
Inflammatory skin diseases - Other Diagnostic Test Results
Beschreibung

Inflammatory skin diseases - Other Diagnostic Test Results

Alias
UMLS CUI-1
C0037274
UMLS CUI-2
C1290884
UMLS CUI-3
C0456984
UMLS CUI-4
C0430022
UMLS CUI-5
C0205394
If any other diagnostic test results are available, please tick the box and complete below
Beschreibung

If any other diagnostic test results are available, please tick the box and complete below

Datentyp

integer

Alias
UMLS CUI [1,1]
C0456984
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C0205394
Inflammatory skin diseases - Other Diagnostic Test Results
Beschreibung

Inflammatory skin diseases - Other Diagnostic Test Results

Alias
UMLS CUI-1
C0037274
UMLS CUI-2
C1290884
UMLS CUI-3
C0456984
UMLS CUI-4
C0430022
UMLS CUI-5
C0205394
Inflammatory skin diseases - Test
Beschreibung

Inflammatory skin diseases - Test

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C2826273
Inflammatory skin diseases - Test date
Beschreibung

Inflammatory skin diseases - Test date

Datentyp

date

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C2826247
Inflammatory skin diseases - Test Result
Beschreibung

Inflammatory skin diseases - Test Result

Datentyp

float

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C0587081
Inflammatory skin diseases - Test Units
Beschreibung

Inflammatory skin diseases - Test Units

Datentyp

text

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2]
C1519795
Inflammatory skin diseases - Low Norm
Beschreibung

Inflammatory skin diseases - Low Norm

Datentyp

float

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205251
Inflammatory skin diseases - High Norm
Beschreibung

Inflammatory skin diseases - High Norm

Datentyp

float

Alias
UMLS CUI [1,1]
C0037274
UMLS CUI [1,2]
C1290884
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205250
Inflammatory skin diseases - Other diagnostic Procedure
Beschreibung

Inflammatory skin diseases - Other diagnostic Procedure

Alias
UMLS CUI-1
C0037274
UMLS CUI-2
C1290884
UMLS CUI-3
C0430022
UMLS CUI-4
C0205394
Describe any other diagnostic procedure supporting the diagnosis (Skin biopsy, Direct immunofluorescence on skin biopsy, Koebner phenomenon (psoriasis), Skin inspection with a Wood lamp (for vitiligo), other)
Beschreibung

Describe any other diagnostic procedure supporting the diagnosis

Datentyp

text

Alias
UMLS CUI [1,1]
C0430022
UMLS CUI [1,2]
C0205394
UMLS CUI [2]
C0011900
UMLS CUI [3]
C0150866
UMLS CUI [4,1]
C0079603
UMLS CUI [4,2]
C0150866
UMLS CUI [5]
C0033860
UMLS CUI [6,1]
C1123023
UMLS CUI [6,2]
C0199219
UMLS CUI [6,3]
C0042900
Autoimmune Myocarditis
Beschreibung

Autoimmune Myocarditis

Alias
UMLS CUI-1
C1608389
Please specify related adverse event: SAE Case No.
Beschreibung

In case of serious adverse event

Datentyp

integer

Alias
UMLS CUI [1,1]
C1519255
UMLS CUI [1,2]
C0237753
Please specify related adverse event: AE No.
Beschreibung

In case of non-serious adverse event

Datentyp

text

Alias
UMLS CUI [1,1]
C1518404
UMLS CUI [1,2]
C0237753
Date of final diagnosis:
Beschreibung

Date of final diagnosis:

Datentyp

date

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C1546485
Autoimmune Myocarditis - Signs and symptoms
Beschreibung

Autoimmune Myocarditis - Signs and symptoms

Alias
UMLS CUI-1
C1608389
UMLS CUI-2
C0037088
UMLS CUI-3
C1546485
Autoimmune Myocarditis - Signs and symptoms
Beschreibung

Autoimmune Myocarditis - Signs and symptoms

Datentyp

integer

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C0037088
Autoimmune Myocarditis - Signs and symptoms present
Beschreibung

Autoimmune Myocarditis - Signs and symptoms present

Datentyp

text

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C0037088
UMLS CUI [3]
C0150312
Autoimmune Myocarditis - Signs and symptoms Start Date
Beschreibung

Autoimmune Myocarditis - Signs and symptoms Start Date

Datentyp

date

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C0037088
UMLS CUI [3]
C0808070
Autoimmune Myocarditis - Signs and symptoms End date
Beschreibung

Autoimmune Myocarditis - Signs and symptoms End date

Datentyp

date

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C0037088
UMLS CUI [3]
C0806020
Autoimmune Myocarditis - Signs and symptoms continuing at the end of study
Beschreibung

Autoimmune Myocarditis - Signs and symptoms continuing at the end of study

Datentyp

integer

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C0037088
UMLS CUI [3,1]
C0549178
UMLS CUI [3,2]
C0444496
Autoimmune Myocarditis - Other Signs and symptoms
Beschreibung

Autoimmune Myocarditis - Other Signs and symptoms

Alias
UMLS CUI-1
C1608389
UMLS CUI-2
C0037088
UMLS CUI-3
C0205394
If any other signs and symptoms, please tick the box and complete below
Beschreibung

If any other signs and symptoms, please tick the box and complete below

Datentyp

integer

Alias
UMLS CUI [1,1]
C0037088
UMLS CUI [1,2]
C0205394
Autoimmune Myocarditis - Other Signs and symptoms
Beschreibung

Autoimmune Myocarditis - Other Signs and symptoms

Alias
UMLS CUI-1
C1608389
UMLS CUI-2
C0037088
UMLS CUI-3
C0205394
Autoimmune Myocarditis - Other Signs and symptoms
Beschreibung

Autoimmune Myocarditis - Other Signs and symptoms

Datentyp

text

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
Autoimmune Myocarditis - Other Signs and symptoms Start Date
Beschreibung

Autoimmune Myocarditis - Other Signs and symptoms Start Date

Datentyp

date

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
UMLS CUI [3]
C0808070
Autoimmune Myocarditis - Other Signs and symptoms End Date
Beschreibung

Autoimmune Myocarditis - Other Signs and symptoms End Date

Datentyp

date

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
UMLS CUI [3]
C0806020
Autoimmune Myocarditis - Other signs and symptoms continuing at the end of study
Beschreibung

Autoimmune Myocarditis - Other signs and symptoms continuing at the end of study

Datentyp

text

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0037088
UMLS CUI [2,2]
C0205394
UMLS CUI [3,1]
C0549178
UMLS CUI [3,2]
C0444496
Autoimmune Myocarditis - Diagnostic Test Results
Beschreibung

Autoimmune Myocarditis - Diagnostic Test Results

Alias
UMLS CUI-1
C1608389
UMLS CUI-2
C0456984
Autoimmune Myocarditis - Test
Beschreibung

Autoimmune Myocarditis - Test

Datentyp

integer

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C2826273
Autoimmune Myocarditis - Test done
Beschreibung

Autoimmune Myocarditis - Test done

Datentyp

text

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0022885
UMLS CUI [2,2]
C1272695
Autoimmune Myocarditis - Test date
Beschreibung

Autoimmune Myocarditis - Test date

Datentyp

date

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C2826247
Autoimmune Myocarditis - Test Result
Beschreibung

Autoimmune Myocarditis - Test Result

Datentyp

float

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C0587081
Autoimmune Myocarditis - Test Units
Beschreibung

Autoimmune Myocarditis - Test Units

Datentyp

text

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C1519795
Autoimmune Myocarditis - Low Norm
Beschreibung

Autoimmune Myocarditis - Low Norm

Datentyp

float

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205251
Autoimmune Myocarditis - High Norm
Beschreibung

Autoimmune Myocarditis - High Norm

Datentyp

float

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205250
Autoimmune Myocarditis - Other Diagnostic Test Results
Beschreibung

Autoimmune Myocarditis - Other Diagnostic Test Results

Alias
UMLS CUI-1
C1608389
UMLS CUI-2
C0456984
UMLS CUI-3
C0430022
UMLS CUI-4
C0205394
If any other diagnostic test results are available please tick the box and complete below
Beschreibung

If any other diagnostic test results are available, please tick the box and complete below

Datentyp

integer

Alias
UMLS CUI [1,1]
C0456984
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C0205394
Autoimmune Myocarditis - Other Diagnostic Test Results
Beschreibung

Autoimmune Myocarditis - Other Diagnostic Test Results

Alias
UMLS CUI-1
C1608389
UMLS CUI-2
C0456984
UMLS CUI-3
C0430022
UMLS CUI-4
C0205394
Autoimmune Myocarditis - Test
Beschreibung

Autoimmune Myocarditis - Test

Datentyp

text

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C2826273
Autoimmune Myocarditis - Test date
Beschreibung

Autoimmune Myocarditis - Test date

Datentyp

date

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C2826247
Autoimmune Myocarditis - Test Result
Beschreibung

Autoimmune Myocarditis - Test Result

Datentyp

float

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C0587081
Autoimmune Myocarditis - Test Units
Beschreibung

Autoimmune Myocarditis - Test Units

Datentyp

text

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2]
C1519795
Autoimmune Myocarditis - Low Norm
Beschreibung

Autoimmune Myocarditis - Low Norm

Datentyp

float

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205251
Autoimmune Myocarditis - High Norm
Beschreibung

Autoimmune Myocarditis - High Norm

Datentyp

float

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0086715
UMLS CUI [2,2]
C0205250
Autoimmune Myocarditis - Other diagnostic Procedure
Beschreibung

Autoimmune Myocarditis - Other diagnostic Procedure

Alias
UMLS CUI-1
C1608389
UMLS CUI-2
C0430022
UMLS CUI-3
C0205394
UMLS CUI-4
C0011900
Describe any other diagnostic procedure supporting the diagnosis (Chest X-Ray, Electrocardiogram, Echocardiography, Cardiac MRI, Cardiac angiography, Cardiac Biopsy, Viral serology)
Beschreibung

Describe any other diagnostic procedure supporting the diagnosis

Datentyp

text

Alias
UMLS CUI [1]
C1608389
UMLS CUI [2,1]
C0430022
UMLS CUI [2,2]
C0205394
UMLS CUI [3]
C0011900
UMLS CUI [4]
C0039985
UMLS CUI [5]
C1623258
UMLS CUI [6]
C0013516
UMLS CUI [7]
C0412692
UMLS CUI [8]
C0002971
UMLS CUI [9]
C0189784
UMLS CUI [10,1]
C0036743
UMLS CUI [10,2]
C0521026
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Ähnliche Modelle

IMD Report - (Glomerulo)Nephritis; Inflammatory Skin Diseases; Autoimmune Myocarditis (Report Final and Annex Report 2 Final)

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative
C1320722 (UMLS CUI-1)
Centre Number
Item
Centre Number
text
C0600091 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
Patient Number
Item
Patient Number
text
C2348585 (UMLS CUI [1])
Item Group
(Glomerulo)Nephritis
C0017658 (UMLS CUI-1)
Item
(Glomerulo)Nephritis - Diagnosis
integer
C0017658 (UMLS CUI [1,1])
C0011900 (UMLS CUI [1,2])
(Glomerulo)Nephritis - Diagnosis
Code List
(Glomerulo)Nephritis - Diagnosis
CL Item
Idiopathic Glomerulonephritis (1)
CL Item
IgA nephropathy (2)
CL Item
Goodpasture syndrome (3)
CL Item
Glomerulonephritis secondary to systemic diseases (systemic lupus erythematosus, rheumatoid arthritis, vasculitis, Wegener’s disease, periarteritis nodosa, Goodpasture syndrome, Henoch-Schonlein purpura, diabetes mellitus…) (4)
CL Item
Glomerulonephritis secondary to infection (Strepto., Staphylo, viral…) (5)
CL Item
Other, specify (6)
(Glomerulo)Nephritis - Specify other diagnosis
Item
(Glomerulo)Nephritis - Specify other diagnosis
text
C0017658 (UMLS CUI [1])
C0011900 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
Please specify related adverse event: SAE Case No.
Item
Please specify related adverse event: SAE Case No.
integer
C1519255 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Please specify related adverse event: AE No.
Item
Please specify related adverse event: AE No.
integer
C1518404 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Date of final diagnosis:
Item
Date of final diagnosis:
date
C2316983 (UMLS CUI [1,1])
C1546485 (UMLS CUI [1,2])
Item Group
(Glomerulo)Nephritis - Signs and Symptoms
C0017658 (UMLS CUI-1)
C0037088 (UMLS CUI-2)
Item
(Glomerulo)Nephritis - Signs and Symptoms
integer
C0017658 (UMLS CUI [1])
C0037088 (UMLS CUI [2])
Signs and Symptoms
Code List
(Glomerulo)Nephritis - Signs and Symptoms
CL Item
Flank tenderness (1)
CL Item
Renal colic (2)
CL Item
Bladder tenderness (3)
CL Item
Oliguria (4)
CL Item
Anuria (5)
CL Item
Polyuria (6)
CL Item
Miction urgency (7)
CL Item
Hematuria (8)
CL Item
Edema (9)
CL Item
Hypertension (10)
CL Item
Fever (11)
CL Item
Increased prostate (12)
CL Item
Arthralgia (13)
CL Item
Arthritis (14)
CL Item
Respiratory tract infection (15)
CL Item
Rash (16)
CL Item
Purpura (17)
CL Item
Impetigo (18)
Item
(Glomerulo)Nephritis - Signs and Symptoms present
text
C0017658 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0150312 (UMLS CUI [2,2])
Signs and symptoms present
Code List
(Glomerulo)Nephritis - Signs and Symptoms present
CL Item
Yes (Y)
CL Item
No (N)
CL Item
Unknown (U)
CL Item
Not Applicable (NA)
(Glomerulo)Nephritis - Signs and Symptoms start date
Item
(Glomerulo)Nephritis - Signs and Symptoms start date
date
C0017658 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0808070 (UMLS CUI [2,2])
(Glomerulo)Nephritis - Signs and Symptoms end date
Item
(Glomerulo)Nephritis - Signs and Symptoms end date
date
C0017658 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0806020 (UMLS CUI [2,2])
Item
(Glomerulo)Nephritis - Signs and Symptoms continuing at end of study
integer
C0017658 (UMLS CUI [1])
C0037088 (UMLS CUI [2])
C0549178 (UMLS CUI [3,1])
C0444496 (UMLS CUI [3,2])
Signs and symptoms continuing at end of study
Code List
(Glomerulo)Nephritis - Signs and Symptoms continuing at end of study
CL Item
Continuing at end of study (1)
Item Group
(Glomerulo)Nephritis - Other signs and symptoms
C0017658 (UMLS CUI-1)
C0037088 (UMLS CUI-2)
C0205394 (UMLS CUI-3)
Item
If any other signs and symptoms, please tick the box and complete below
integer
C0037088 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
If any other signs and symptoms, please tick the box and complete below
Code List
If any other signs and symptoms, please tick the box and complete below
CL Item
Other signs and symptoms (1)
Item Group
(Glomerulo)Nephritis - Other signs and symptoms
C0017658 (UMLS CUI-1)
C0037088 (UMLS CUI-2)
C0205394 (UMLS CUI-3)
(Glomerulo)Nephritis - Other signs and symptoms
Item
(Glomerulo)Nephritis - Other signs and symptoms
text
C0017658 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
(Glomerulo)Nephritis - Other signs and symptoms start date
Item
(Glomerulo)Nephritis - Other signs and symptoms start date
date
C0017658 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0808070 (UMLS CUI [3])
(Glomerulo)Nephritis - Other signs and symptoms end date
Item
(Glomerulo)Nephritis - Other signs and symptoms end date
date
C0017658 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0806020 (UMLS CUI [3])
Item
(Glomerulo)Nephritis - Other signs and symptoms continuing at end of study
integer
C0017658 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0549178 (UMLS CUI [3,1])
C0444496 (UMLS CUI [3,2])
Signs and symptoms continuing at end of study
Code List
(Glomerulo)Nephritis - Other signs and symptoms continuing at end of study
CL Item
Continuing at end of study (1)
Item Group
(Glomerulo)Nephritis - Diagnostic Test Results
C0017658 (UMLS CUI-1)
C0456984 (UMLS CUI-2)
C0430022 (UMLS CUI-3)
Item
(Glomerulo)Nephritis - Test
integer
C0017658 (UMLS CUI [1])
C2826273 (UMLS CUI [2])
Test
Code List
(Glomerulo)Nephritis - Test
CL Item
White Blood Cells (1)
CL Item
Neutrophils (2)
CL Item
Lymphocytes (3)
CL Item
Monocytes (4)
CL Item
Eosinophils (5)
CL Item
Basophils (6)
CL Item
Red blood cells (7)
CL Item
Platelets (8)
CL Item
Erythrocyte Sedimentation Rate (ESR) (9)
CL Item
Serum C-reactive protein (CRP) (10)
CL Item
Serum urea nitrogen (11)
CL Item
Serum creatinine (12)
CL Item
Serum electrolytes (13)
CL Item
Serum albumin (14)
CL Item
Serum lipids (15)
CL Item
Albuminuria (16)
CL Item
LMW proteinuria (17)
CL Item
Hematuria (18)
CL Item
Pyuria (19)
CL Item
Urine sediment (20)
CL Item
Bacteriuria (21)
CL Item
Anti-Glomerular Basement (22)
CL Item
Membrane antibodies (anti-GBM) (23)
CL Item
Anti-neutrophil cytoplasmic autoantibodies (ANCAs) (24)
CL Item
Anti-nuclear antibodies (ANA) (25)
CL Item
Anti dsDNA (26)
CL Item
Serum C3 complement (27)
CL Item
Antistreptolysin ADNase (28)
Item
(Glomerulo)Nephritis - Test done
text
C0017658 (UMLS CUI [1])
C0022885 (UMLS CUI [2,1])
C1272695 (UMLS CUI [2,2])
Test done
Code List
(Glomerulo)Nephritis - Test done
CL Item
Yes (Y)
CL Item
No (N)
CL Item
Unknown (U)
CL Item
Not Applicable (NA)
(Glomerulo)Nephritis - Test date
Item
(Glomerulo)Nephritis - Test date
date
C0017658 (UMLS CUI [1])
C2826247 (UMLS CUI [2])
(Glomerulo)Nephritis - Test Result
Item
(Glomerulo)Nephritis - Test Result
float
C0017658 (UMLS CUI [1])
C0587081 (UMLS CUI [2])
(Glomerulo)Nephritis - Test Units
Item
(Glomerulo)Nephritis - Test Units
text
C0017658 (UMLS CUI [1])
C1519795 (UMLS CUI [2])
(Glomerulo)Nephritis - Low Norm
Item
(Glomerulo)Nephritis - Low Norm
float
C0017658 (UMLS CUI [1])
C0086715 (UMLS CUI [2,1])
C0205251 (UMLS CUI [2,2])
(Glomerulo)Nephritis - High Norm
Item
(Glomerulo)Nephritis - High Norm
float
C0017658 (UMLS CUI [1])
C0086715 (UMLS CUI [2,1])
C0205250 (UMLS CUI [2,2])
Item Group
(Glomerulo)Nephritis - Other Diagnostic Test Results
C0017658 (UMLS CUI-1)
C0456984 (UMLS CUI-2)
C0430022 (UMLS CUI-3)
C0205394 (UMLS CUI-4)
Item
If any other diagnostic test results are available, please tick the box and complete below
integer
C0456984 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
If any other diagnostic test results are available, please tick the box and complete below
Code List
If any other diagnostic test results are available, please tick the box and complete below
CL Item
Other diagnostic test results available (1)
Item Group
(Glomerulo)Nephritis - Other Diagnostic Test Results
C0017658 (UMLS CUI-1)
C0456984 (UMLS CUI-2)
C0430022 (UMLS CUI-3)
C0205394 (UMLS CUI-4)
(Glomerulo)Nephritis - Test
Item
(Glomerulo)Nephritis - Test
text
C0017658 (UMLS CUI [1])
C2826273 (UMLS CUI [2])
Idiopathic Thrombocytopenic Purpura - Test date
Item
(Glomerulo)Nephritis - Test date
date
C0017658 (UMLS CUI [1])
C2826247 (UMLS CUI [2])
(Glomerulo)Nephritis - Test Result
Item
(Glomerulo)Nephritis - Test Result
float
C0017658 (UMLS CUI [1])
C0587081 (UMLS CUI [2])
(Glomerulo)Nephritis - Test Units
Item
(Glomerulo)Nephritis - Test Units
text
C0017658 (UMLS CUI [1])
C1519795 (UMLS CUI [2])
(Glomerulo)Nephritis - Low Norm
Item
(Glomerulo)Nephritis - Low Norm
float
C0017658 (UMLS CUI [1])
C0086715 (UMLS CUI [2,1])
C0205251 (UMLS CUI [2,2])
(Glomerulo)Nephritis - High Norm
Item
(Glomerulo)Nephritis - High Norm
float
C0017658 (UMLS CUI [1])
C0086715 (UMLS CUI [2,1])
C0205250 (UMLS CUI [2,2])
Item Group
(Glomerulo)Nephritis - Other diagnostic Procedure
C0017658 (UMLS CUI-1)
C0430022 (UMLS CUI-2)
C0205394 (UMLS CUI-3)
Describe any other diagnostic procedure supporting the diagnosis
Item
Describe any other diagnostic procedure supporting the diagnosis (Pyelography, Kidney ultra-sound, Kidney tomography, Kidney biopsy)
text
C0430022 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0011900 (UMLS CUI [2])
C0034185 (UMLS CUI [3])
C1456803 (UMLS CUI [4,1])
C0022646 (UMLS CUI [4,2])
C0040405 (UMLS CUI [5,1])
C0022646 (UMLS CUI [5,2])
C0005558 (UMLS CUI [6,1])
C0022646 (UMLS CUI [6,2])
Item Group
Inflammatory skin diseases
C0037274 (UMLS CUI-1)
C1290884 (UMLS CUI-2)
Item
Inflammatory skin diseases diagnosis
integer
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0011900 (UMLS CUI [2])
Inflammatory skin diseases diagnosis
Code List
Inflammatory skin diseases diagnosis
CL Item
Pemphigus (1)
CL Item
Bullous pemphigoid (2)
CL Item
Dermatitis herpetiformis (3)
CL Item
Stevens-Johnson syndrome (4)
CL Item
Psoriasis (5)
CL Item
Vitiligo (6)
CL Item
Raynaud's phenomenon secondary to autoimmune disease (7)
CL Item
Raynaud’s phenomenon secondary to other disorders (vibratory injury, infection, neoplasm, hematologic, metabolic, drugs, carpal tunnel syndrome, … ) (8)
CL Item
Raynaud disease (vasospasm alone) (9)
CL Item
Erythema nodosum (10)
CL Item
Other, specify (11)
Inflammatory skin diseases - Specify other diagnosis
Item
Inflammatory skin diseases - Specify other diagnosis
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0011900 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
Please specify related adverse event: SAE Case No.
Item
Please specify related adverse event: SAE Case No.
integer
C1519255 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Please specify related adverse event: AE No.
Item
Please specify related adverse event: AE No.
integer
C1518404 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Date of final diagnosis:
Item
Date of final diagnosis:
date
C2316983 (UMLS CUI [1,1])
C1546485 (UMLS CUI [1,2])
Item Group
Inflammatory skin diseases - Signs and symptoms
C0037274 (UMLS CUI-1)
C1290884 (UMLS CUI-2)
C0037088 (UMLS CUI-3)
C1546485 (UMLS CUI-4)
Item
Inflammatory skin diseases - Signs and symptoms
integer
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2])
Myasthenia Gravis - Signs and symptoms
Code List
Inflammatory skin diseases - Signs and symptoms
CL Item
Skin discoloration (1)
CL Item
Erythema (2)
CL Item
Vesicules (3)
CL Item
Pustules (4)
CL Item
Bullous lesions (5)
CL Item
Desquamation (6)
CL Item
Erosion (7)
CL Item
Ulceration (8)
CL Item
Nodule (9)
CL Item
Pruritis (10)
CL Item
Cutaneous pain (11)
CL Item
Mucous membrane lesions - Oral cavity lesions (12)
CL Item
Mucous membrane lesions - Conjunctive lesions (13)
CL Item
Mucous membrane lesions - Esophagous lesions (14)
CL Item
Mucous membrane lesions - Labial lesions (15)
CL Item
Mucous membrane lesions - Vaginal lesions (16)
CL Item
Mucous membrane lesions - Cervix lesions (17)
CL Item
Mucous membrane lesions - Penis lesions (18)
CL Item
Mucous membrane lesions - Urethral lesions (19)
CL Item
Mucous membrane lesions - Anus lesions (20)
CL Item
Mucous membrane lesion sudden onset (21)
CL Item
Mucous membrane lesion progressive onset (22)
CL Item
Secondary skin infection (23)
CL Item
Dactylitis (24)
CL Item
Arthritis (25)
CL Item
Fever (26)
CL Item
Migraine (27)
CL Item
Upper respiratory tract infections (28)
Item
Inflammatory skin diseases - Signs and symptoms present
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2])
C0150312 (UMLS CUI [3])
Myasthenia Gravis - Signs and symptoms present
Code List
Inflammatory skin diseases - Signs and symptoms present
CL Item
Yes (Y)
CL Item
No (N)
CL Item
Unknown (U)
CL Item
Not Applicable (NA)
Inflammatory skin diseases - Signs and symptoms Start Date
Item
Inflammatory skin diseases - Signs and symptoms Start Date
date
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2])
C0808070 (UMLS CUI [3])
Inflammatory skin diseases - Signs and symptoms End date
Item
Inflammatory skin diseases - Signs and symptoms End date
date
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2])
C0806020 (UMLS CUI [3])
Item
Inflammatory skin diseases - Signs and symptoms continuing at the end of study
integer
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2])
C0549178 (UMLS CUI [3,1])
C0444496 (UMLS CUI [3,2])
Myasthenia Gravis - Signs and symptoms continuing at the end of study
Code List
Inflammatory skin diseases - Signs and symptoms continuing at the end of study
CL Item
Continuing at end of study (1)
Item Group
Inflammatory skin diseases - Signs and symptoms (skin lesions)
C0037274 (UMLS CUI-1)
C1290884 (UMLS CUI-2)
C0037088 (UMLS CUI-3)
C0037284 (UMLS CUI-4)
Item
Inflammatory skin diseases - Signs and symptoms present (skin lesions)
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2])
C0150312 (UMLS CUI [3])
C0037284 (UMLS CUI [4])
Inflammatory skin diseases - Signs and symptoms present (skin lesions)
Code List
Inflammatory skin diseases - Signs and symptoms present (skin lesions)
CL Item
Yes (Y)
CL Item
No (N)
CL Item
Unknown (U)
CL Item
Not Applicable (NA)
Inflammatory skin diseases - Signs and symptoms Start Date (skin lesions)
Item
Inflammatory skin diseases - Signs and symptoms Start Date (skin lesions)
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2])
C0808070 (UMLS CUI [3])
C0037284 (UMLS CUI [4])
Inflammatory skin diseases - Signs and symptoms End date (skin lesions)
Item
Inflammatory skin diseases - Signs and symptoms End date (skin lesions)
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2])
C0806020 (UMLS CUI [3])
C0037284 (UMLS CUI [4])
Item
Inflammatory skin diseases - Signs and symptoms continuing at the end of study (skin lesions)
integer
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2])
C0549178 (UMLS CUI [3,1])
C0444496 (UMLS CUI [3,2])
C0037284 (UMLS CUI [4])
Inflammatory skin diseases - Signs and symptoms continuing at the end of study (skin lesions)
Code List
Inflammatory skin diseases - Signs and symptoms continuing at the end of study (skin lesions)
CL Item
Continuing at end of study (1)
Item
If skin lesions, please specify
integer
C0037284 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
If skin lesions, please specify
Code List
If skin lesions, please specify
CL Item
Skin lesions > 1 cm (1)
CL Item
Skin lesions < 1 cm (2)
CL Item
Skin lesions Drop size (3)
CL Item
Skin lesions circumscribed (4)
CL Item
Skin lesions diffuse (5)
CL Item
Skin lesions symmetric (6)
CL Item
Skin lesions asymmetric (7)
Skin lesion - specify localisation
Item
Skin lesion - specify localisation (Scalp, Face, Neck, Trunc, Segmental , Dermatome, Upper limbs, Lower limbs, Palms, Soles, Nails, Fingers, Footfingers, Anterior, surface of the lower extremities), specify
text
C0037284 (UMLS CUI [1])
C0475264 (UMLS CUI [2])
C0036270 (UMLS CUI [3])
C0015450 (UMLS CUI [4])
C0027530 (UMLS CUI [5])
C0460005 (UMLS CUI [6])
C0205122 (UMLS CUI [7])
C0448733 (UMLS CUI [8])
C1140618 (UMLS CUI [9])
C0023216 (UMLS CUI [10])
C0817662 (UMLS CUI [11])
C0230463 (UMLS CUI [12])
C0027342 (UMLS CUI [13])
C0016129 (UMLS CUI [14])
C0040357 (UMLS CUI [15])
C0205094 (UMLS CUI [16])
C0023216 (UMLS CUI [17,1])
C0005902 (UMLS CUI [17,2])
Inflammatory skin diseases - Number of skin lesions
Item
Inflammatory skin diseases - Number of skin lesions
integer
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037284 (UMLS CUI [2,1])
C0237753 (UMLS CUI [2,2])
Inflammatory skin diseases - % body affected
Item
Inflammatory skin diseases - % body affected
integer
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0392760 (UMLS CUI [2,1])
C0439165 (UMLS CUI [2,2])
C0005902 (UMLS CUI [2,3])
Item Group
Inflammatory skin diseases - Other Signs and symptoms
C0037274 (UMLS CUI-1)
C1290884 (UMLS CUI-2)
C0037088 (UMLS CUI-3)
C0205394 (UMLS CUI-4)
Item
If any other signs and symptoms, please tick the box and complete below
integer
C0037088 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
If any other signs and symptoms, please tick the box and complete below
Code List
If any other signs and symptoms, please tick the box and complete below
CL Item
Other signs and symptoms (1)
Item Group
Inflammatory skin diseases - Other Signs and symptoms
C0037274 (UMLS CUI-1)
C1290884 (UMLS CUI-2)
C0037088 (UMLS CUI-3)
C0205394 (UMLS CUI-4)
Inflammatory skin diseases - Other Signs and symptoms
Item
Inflammatory skin diseases - Other Signs and symptoms
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
Inflammatory skin diseases - Other Signs and symptoms Start Date
Item
Inflammatory skin diseases - Other Signs and symptoms Start Date
date
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0808070 (UMLS CUI [3])
Inflammatory skin diseases - Other Signs and symptoms End Date
Item
Inflammatory skin diseases - Other Signs and symptoms End Date
date
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0806020 (UMLS CUI [3])
Item Group
Inflammatory skin diseases - Diagnostic Test Results
C0037274 (UMLS CUI-1)
C1290884 (UMLS CUI-2)
C0430022 (UMLS CUI-3)
C0456984 (UMLS CUI-4)
Item
Inflammatory skin diseases - Test
integer
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C2826273 (UMLS CUI [2])
Test
Code List
Inflammatory skin diseases - Test
CL Item
White Blood Cells (1)
CL Item
Neutrophils (2)
CL Item
Lymphocytes (3)
CL Item
Monocytes (4)
CL Item
Eosinophils (5)
CL Item
Basophils (6)
CL Item
Red blood cells (7)
CL Item
Platelets (8)
CL Item
Erythrocyte Sedimentation Rate (ESR) (9)
CL Item
Serum C-reactive protein (CRP) (10)
CL Item
Serum sodium (11)
CL Item
Serum chloride (12)
CL Item
Serum calcium (13)
CL Item
Anti-nuclear antibodies (ANA) (14)
CL Item
Rheumatoid factor (RF) (15)
CL Item
Serum anti-epididermis intercellular space autoantibodies (16)
CL Item
Serum anti-desmoglein 1 antibodies (17)
CL Item
Anti-skin basement membrane protein (18)
CL Item
Anti-BP1 protein (19)
CL Item
Anti-BP2 protein (20)
CL Item
IgA endomysial antibodies (21)
CL Item
Anti-transglutaminase antibodies (22)
CL Item
Anti-melanocyte antibodies (23)
CL Item
Serum urea nitrogen (24)
CL Item
Serum creatinine (25)
CL Item
Proteinuria (26)
Item
Inflammatory skin diseases - Test done
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0022885 (UMLS CUI [2,1])
C1272695 (UMLS CUI [2,2])
Test done
Code List
Inflammatory skin diseases - Test done
CL Item
Yes  (Y)
CL Item
No  (N)
CL Item
Unknown  (U)
CL Item
Not Applicable (NA)
Inflammatory skin diseases - Test date
Item
Inflammatory skin diseases - Test date
date
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C2826247 (UMLS CUI [2])
Inflammatory skin diseases - Test Result
Item
Inflammatory skin diseases - Test Result
float
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0587081 (UMLS CUI [2])
Inflammatory skin diseases - Test Units
Item
Inflammatory skin diseases - Test Units
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C1519795 (UMLS CUI [2])
Inflammatory skin diseases - Low Norm
Item
Inflammatory skin diseases - Low Norm
float
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0086715 (UMLS CUI [2,1])
C0205251 (UMLS CUI [2,2])
Inflammatory skin diseases - High Norm
Item
Inflammatory skin diseases - High Norm
float
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0086715 (UMLS CUI [2,1])
C0205250 (UMLS CUI [2,2])
Item Group
Inflammatory skin diseases - Other Diagnostic Test Results
C0037274 (UMLS CUI-1)
C1290884 (UMLS CUI-2)
C0456984 (UMLS CUI-3)
C0430022 (UMLS CUI-4)
C0205394 (UMLS CUI-5)
Item
If any other diagnostic test results are available, please tick the box and complete below
integer
C0456984 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
If any other diagnostic test results are available, please tick the box and complete below
Code List
If any other diagnostic test results are available, please tick the box and complete below
CL Item
Other diagnostic test results available (1)
Item Group
Inflammatory skin diseases - Other Diagnostic Test Results
C0037274 (UMLS CUI-1)
C1290884 (UMLS CUI-2)
C0456984 (UMLS CUI-3)
C0430022 (UMLS CUI-4)
C0205394 (UMLS CUI-5)
Inflammatory skin diseases - Test
Item
Inflammatory skin diseases - Test
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C2826273 (UMLS CUI [2])
Inflammatory skin diseases - Test date
Item
Inflammatory skin diseases - Test date
date
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C2826247 (UMLS CUI [2])
Inflammatory skin diseases - Test Result
Item
Inflammatory skin diseases - Test Result
float
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0587081 (UMLS CUI [2])
Inflammatory skin diseases - Test Units
Item
Inflammatory skin diseases - Test Units
text
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C1519795 (UMLS CUI [2])
Inflammatory skin diseases - Low Norm
Item
Inflammatory skin diseases - Low Norm
float
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0086715 (UMLS CUI [2,1])
C0205251 (UMLS CUI [2,2])
Inflammatory skin diseases - High Norm
Item
Inflammatory skin diseases - High Norm
float
C0037274 (UMLS CUI [1,1])
C1290884 (UMLS CUI [1,2])
C0086715 (UMLS CUI [2,1])
C0205250 (UMLS CUI [2,2])
Item Group
Inflammatory skin diseases - Other diagnostic Procedure
C0037274 (UMLS CUI-1)
C1290884 (UMLS CUI-2)
C0430022 (UMLS CUI-3)
C0205394 (UMLS CUI-4)
Describe any other diagnostic procedure supporting the diagnosis
Item
Describe any other diagnostic procedure supporting the diagnosis (Skin biopsy, Direct immunofluorescence on skin biopsy, Koebner phenomenon (psoriasis), Skin inspection with a Wood lamp (for vitiligo), other)
text
C0430022 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0011900 (UMLS CUI [2])
C0150866 (UMLS CUI [3])
C0079603 (UMLS CUI [4,1])
C0150866 (UMLS CUI [4,2])
C0033860 (UMLS CUI [5])
C1123023 (UMLS CUI [6,1])
C0199219 (UMLS CUI [6,2])
C0042900 (UMLS CUI [6,3])
Item Group
Autoimmune Myocarditis
C1608389 (UMLS CUI-1)
Please specify related adverse event: SAE Case No.
Item
Please specify related adverse event: SAE Case No.
integer
C1519255 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Please specify related adverse event: AE No.
Item
Please specify related adverse event: AE No.
text
C1518404 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Date of final diagnosis:
Item
Date of final diagnosis:
date
C2316983 (UMLS CUI [1,1])
C1546485 (UMLS CUI [1,2])
Item Group
Autoimmune Myocarditis - Signs and symptoms
C1608389 (UMLS CUI-1)
C0037088 (UMLS CUI-2)
C1546485 (UMLS CUI-3)
Item
Autoimmune Myocarditis - Signs and symptoms
integer
C1608389 (UMLS CUI [1])
C0037088 (UMLS CUI [2])
Uveitis - Signs and symptoms
Code List
Autoimmune Myocarditis - Signs and symptoms
CL Item
Chest pain (1)
CL Item
Fatigue (2)
CL Item
Fever (3)
CL Item
Dyspnea (4)
CL Item
Palpitation (5)
CL Item
Tachycardia (6)
CL Item
Ventricular arrhythmia (7)
CL Item
Atrioventricular block (8)
CL Item
Galop (9)
CL Item
Mitral valve regurgitation (10)
CL Item
Peripheral edema (11)
Item
Autoimmune Myocarditis - Signs and symptoms present
text
C1608389 (UMLS CUI [1])
C0037088 (UMLS CUI [2])
C0150312 (UMLS CUI [3])
Myasthenia Gravis - Signs and symptoms present
Code List
Autoimmune Myocarditis - Signs and symptoms present
CL Item
Yes  (Y)
CL Item
No  (N)
CL Item
Unknown  (U)
CL Item
Not Applicable (NA)
Autoimmune Myocarditis - Signs and symptoms Start Date
Item
Autoimmune Myocarditis - Signs and symptoms Start Date
date
C1608389 (UMLS CUI [1])
C0037088 (UMLS CUI [2])
C0808070 (UMLS CUI [3])
Autoimmune Myocarditis - Signs and symptoms End date
Item
Autoimmune Myocarditis - Signs and symptoms End date
date
C1608389 (UMLS CUI [1])
C0037088 (UMLS CUI [2])
C0806020 (UMLS CUI [3])
Item
Autoimmune Myocarditis - Signs and symptoms continuing at the end of study
integer
C1608389 (UMLS CUI [1])
C0037088 (UMLS CUI [2])
C0549178 (UMLS CUI [3,1])
C0444496 (UMLS CUI [3,2])
Myasthenia Gravis - Signs and symptoms continuing at the end of study
Code List
Autoimmune Myocarditis - Signs and symptoms continuing at the end of study
CL Item
Continuing at end of study (1)
Item Group
Autoimmune Myocarditis - Other Signs and symptoms
C1608389 (UMLS CUI-1)
C0037088 (UMLS CUI-2)
C0205394 (UMLS CUI-3)
Item
If any other signs and symptoms, please tick the box and complete below
integer
C0037088 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
If any other signs and symptoms, please tick the box and complete below
Code List
If any other signs and symptoms, please tick the box and complete below
CL Item
Other signs and symptoms (1)
Item Group
Autoimmune Myocarditis - Other Signs and symptoms
C1608389 (UMLS CUI-1)
C0037088 (UMLS CUI-2)
C0205394 (UMLS CUI-3)
Autoimmune Myocarditis - Other Signs and symptoms
Item
Autoimmune Myocarditis - Other Signs and symptoms
text
C1608389 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
Autoimmune Myocarditis - Other Signs and symptoms Start Date
Item
Autoimmune Myocarditis - Other Signs and symptoms Start Date
date
C1608389 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0808070 (UMLS CUI [3])
Autoimmune Myocarditis - Other Signs and symptoms End Date
Item
Autoimmune Myocarditis - Other Signs and symptoms End Date
date
C1608389 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0806020 (UMLS CUI [3])
Item
Autoimmune Myocarditis - Other signs and symptoms continuing at the end of study
text
C1608389 (UMLS CUI [1])
C0037088 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0549178 (UMLS CUI [3,1])
C0444496 (UMLS CUI [3,2])
Autoimmune Myocarditis - Other signs and symptoms continuing at the end of study
Code List
Autoimmune Myocarditis - Other signs and symptoms continuing at the end of study
CL Item
Continuing at end of study (1)
Item Group
Autoimmune Myocarditis - Diagnostic Test Results
C1608389 (UMLS CUI-1)
C0456984 (UMLS CUI-2)
Item
Autoimmune Myocarditis - Test
integer
C1608389 (UMLS CUI [1])
C2826273 (UMLS CUI [2])
Myasthenia Gravis - Test
Code List
Autoimmune Myocarditis - Test
CL Item
White Blood Cells (1)
CL Item
Neutrophils (2)
CL Item
Lymphocytes (3)
CL Item
Monocytes (4)
CL Item
Eosinophils (5)
CL Item
Basophils (6)
CL Item
Red blood cells (7)
CL Item
Platelets (8)
CL Item
Serum C-reactive protein (CRP) (9)
CL Item
Erythrocyte Sedimentation Rate (ESR) (10)
CL Item
Serum creatine kinase (CK) (11)
CL Item
Serum creatine kinase MB (12)
CL Item
Serum cardiac troponin (13)
CL Item
Serum calcemia (14)
CL Item
Calciuria (24h) (15)
CL Item
Serum urea nitrogen (16)
CL Item
Serum creatinine (17)
CL Item
Proteinuria (18)
CL Item
Albuminuria (19)
CL Item
LMW proteinuria (20)
CL Item
Hematuria (21)
CL Item
Anti-nuclear antibodies (ANA) (22)
CL Item
Rheumatoid factor (RF) (23)
Item
Autoimmune Myocarditis - Test done
text
C1608389 (UMLS CUI [1])
C0022885 (UMLS CUI [2,1])
C1272695 (UMLS CUI [2,2])
Myasthenia Gravis - Test done
Code List
Autoimmune Myocarditis - Test done
CL Item
Yes  (Y)
CL Item
No  (N)
CL Item
Unknown  (U)
CL Item
Not Applicable (NA)
Autoimmune Myocarditis - Test date
Item
Autoimmune Myocarditis - Test date
date
C1608389 (UMLS CUI [1])
C2826247 (UMLS CUI [2])
Autoimmune Myocarditis - Test Result
Item
Autoimmune Myocarditis - Test Result
float
C1608389 (UMLS CUI [1])
C0587081 (UMLS CUI [2])
Autoimmune Myocarditis - Test Units
Item
Autoimmune Myocarditis - Test Units
text
C1608389 (UMLS CUI [1])
C1519795 (UMLS CUI [2])
Autoimmune Myocarditis - Low Norm
Item
Autoimmune Myocarditis - Low Norm
float
C1608389 (UMLS CUI [1])
C0086715 (UMLS CUI [2,1])
C0205251 (UMLS CUI [2,2])
Autoimmune Myocarditis - High Norm
Item
Autoimmune Myocarditis - High Norm
float
C1608389 (UMLS CUI [1])
C0086715 (UMLS CUI [2,1])
C0205250 (UMLS CUI [2,2])
Item Group
Autoimmune Myocarditis - Other Diagnostic Test Results
C1608389 (UMLS CUI-1)
C0456984 (UMLS CUI-2)
C0430022 (UMLS CUI-3)
C0205394 (UMLS CUI-4)
Item
If any other diagnostic test results are available please tick the box and complete below
integer
C0456984 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
If any other diagnostic test results are available, please tick the box and complete below
Code List
If any other diagnostic test results are available please tick the box and complete below
CL Item
Other diagnostic test results available (1)
Item Group
Autoimmune Myocarditis - Other Diagnostic Test Results
C1608389 (UMLS CUI-1)
C0456984 (UMLS CUI-2)
C0430022 (UMLS CUI-3)
C0205394 (UMLS CUI-4)
Autoimmune Myocarditis - Test
Item
Autoimmune Myocarditis - Test
text
C1608389 (UMLS CUI [1])
C2826273 (UMLS CUI [2])
Autoimmune Myocarditis - Test date
Item
Autoimmune Myocarditis - Test date
date
C1608389 (UMLS CUI [1])
C2826247 (UMLS CUI [2])
Autoimmune Myocarditis - Test Result
Item
Autoimmune Myocarditis - Test Result
float
C1608389 (UMLS CUI [1])
C0587081 (UMLS CUI [2])
Autoimmune Myocarditis - Test Units
Item
Autoimmune Myocarditis - Test Units
text
C1608389 (UMLS CUI [1])
C1519795 (UMLS CUI [2])
Autoimmune Myocarditis - Low Norm
Item
Autoimmune Myocarditis - Low Norm
float
C1608389 (UMLS CUI [1])
C0086715 (UMLS CUI [2,1])
C0205251 (UMLS CUI [2,2])
Autoimmune Myocarditis - High Norm
Item
Autoimmune Myocarditis - High Norm
float
C1608389 (UMLS CUI [1])
C0086715 (UMLS CUI [2,1])
C0205250 (UMLS CUI [2,2])
Item Group
Autoimmune Myocarditis - Other diagnostic Procedure
C1608389 (UMLS CUI-1)
C0430022 (UMLS CUI-2)
C0205394 (UMLS CUI-3)
C0011900 (UMLS CUI-4)
Describe any other diagnostic procedure supporting the diagnosis
Item
Describe any other diagnostic procedure supporting the diagnosis (Chest X-Ray, Electrocardiogram, Echocardiography, Cardiac MRI, Cardiac angiography, Cardiac Biopsy, Viral serology)
text
C1608389 (UMLS CUI [1])
C0430022 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0011900 (UMLS CUI [3])
C0039985 (UMLS CUI [4])
C1623258 (UMLS CUI [5])
C0013516 (UMLS CUI [6])
C0412692 (UMLS CUI [7])
C0002971 (UMLS CUI [8])
C0189784 (UMLS CUI [9])
C0036743 (UMLS CUI [10,1])
C0521026 (UMLS CUI [10,2])
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