ID
42630
Beschreibung
MACULAR DEGENERATION DATA COLLECTION Version 3.0.1 Revised: April 10th, 2017, International Consortium for Health Outcomes Measurement (ICHOM), Source: http://www.ichom.org/ Conditions: Neovascular Macular Degeneration Neovascular Age Related Macular Degeneration | Polypoidal Choroidal Vasculopathy | Myopic Neovascular Macular Degeneration | Other Forms of Neovascular Macular Degeneration (includes Post-Traumatic, Inflammatory, Idiopathic, Macular Telangiectasia Type 2) Non-Neovascular Age Related Macular Degeneration Treatment Approaches: Intravitreal anti-VEGF treatment | Other intravitreal treatment | Photodynamic therapy | Thermal laser photocoagulation | Retinal radiation therapy | Transpupillary thermotherapy | Retinal surgical treatment Questionnaires used in this form: Brief IVI
Link
Stichworte
Versionen (9)
- 16.10.17 16.10.17 -
- 18.10.17 18.10.17 -
- 20.10.17 20.10.17 -
- 05.11.17 05.11.17 -
- 05.11.17 05.11.17 -
- 05.11.17 05.11.17 -
- 04.12.17 04.12.17 -
- 03.02.18 03.02.18 -
- 17.09.21 17.09.21 -
Rechteinhaber
ICHOM
Hochgeladen am
17. September 2021
DOI
Für eine Beantragung loggen Sie sich ein.
Lizenz
Creative Commons BY-NC 3.0
Modell Kommentare :
Hier können Sie das Modell kommentieren. Über die Sprechblasen an den Itemgruppen und Items können Sie diese spezifisch kommentieren.
Itemgroup Kommentare für :
Item Kommentare für :
Um Formulare herunterzuladen müssen Sie angemeldet sein. Bitte loggen Sie sich ein oder registrieren Sie sich kostenlos.
ICHOM Macular Degeneration
ICHOM Macular Degeneration
- StudyEvent: ODM
Beschreibung
Baseline Functional Status
Alias
- UMLS CUI-1
- C0031809
- UMLS CUI-2
- C0042812
Beschreibung
Distance visual acuity (best of uncorrected, corrected using glasses or contact lenses, or pinhole) in the affected eye INCLUSION CRITERIA: ALl patients TIMING: Baseline REPORTING SOURCE: Clinical RESPONSE OPTIONS: Numerical value preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. Please refer to page 13 for a Snellen to LogMAR conversion table.
Datentyp
integer
Alias
- UMLS CUI [1]
- C0429537
Beschreibung
Distance visual acuity (best of uncorrected, corrected using glasses or contact lenses, or pinhole) in the fellow eye INCLUSION CRITERIA: ALl patients TIMING: Baseline REPORTING SOURCE: Clinical RESPONSE OPTIONS: Numerical value preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. Please refer to page 13 for a Snellen to LogMAR conversion table.
Datentyp
integer
Alias
- UMLS CUI [1]
- C0429537
Beschreibung
Results preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. INCLUSION CRITERIA: ALl patients TIMING: Baseline REPORTING SOURCE: Clinical
Datentyp
integer
Alias
- UMLS CUI [1]
- C1302978
Beschreibung
INCLUSION CRITERIA: ALl patients TIMING: Baseline REPORTING SOURCE: Clinical RESPONSE OPTIONS: Record details of the distance at which visual acuity is measured
Datentyp
integer
Alias
- UMLS CUI [1]
- C0429537
Beschreibung
Baseline clinical status
Alias
- UMLS CUI-1
- C0449440
Beschreibung
INCLUSION CRITERIA: ALl patients TIMING: Baseline Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0024437
Beschreibung
Geographic atrophy is defined as an area of hypopigmentation or hyperfluorescence of at least 250 μm in its minimum linear dimension with 2 of the 3 following characteristics: (i) circular shape, (ii) sharp borders, or (iii) visibility of choroidal vessels within the area of geographic atrophy INCLUSION CRITERIA: ALl patients TIMING: Baseline Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C1536085
Beschreibung
Abnormal thickening of the subretinal tissue complex (material between Bruch's membrane and outer retina) anywhere in the macular area INCLUSION CRITERIA: ALl patients TIMING: Baseline Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0423434
Beschreibung
Discrete elevations of the retinal pigment epithelium (RPE) anywhere in the macular area with solid (fibrovascular or haemorrhagic PED) or fluid (serous PED) matter below the corresponding retinal pigment epithelium INCLUSION CRITERIA: ALl patients TIMING: Baseline Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0339546
Beschreibung
Solid (fibrovascular or haemorrhagic) or fluid (Serous) PED below the corresponding retinal pigment epithelium INCLUSION CRITERIA: All patients If answered '1' or '2' on Pigment epithelial detachment (PED) TIMING: Baseline Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0339546
Beschreibung
Associated clinical history
Alias
- UMLS CUI-1
- C0262926
Beschreibung
Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline Annually from baseline REPORTING SOURCE: Clinical TYPE: Multiple answers Separate multiple entries with "";""
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0009488
- UMLS CUI [1,2]
- C1299003
Beschreibung
Select all that apply INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Clinical TYPE: Multiple answers Separate multiple entries with "";""
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0024437
- UMLS CUI [1,2]
- C0087111
Beschreibung
Other ocular treatments
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C0015392
Beschreibung
INCLUSION CRITERIA: ALl patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C2939459
Beschreibung
INCLUSION CRITERIA: All patients If answered 'yes' on cataract surgery (CATSURGTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical
Datentyp
date
Maßeinheiten
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C2939459
Beschreibung
INCLUSION CRITERIA: All patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0579255
Beschreibung
INCLUSION CRITERIA: All patients If answered 'yes' on YAG laser capsulotomy (YAGLASERTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical
Datentyp
date
Maßeinheiten
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0579255
Beschreibung
i.e. for macular edema or diabetic retinopathy INCLUSION CRITERIA: All patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0438670
Beschreibung
INCLUSION CRITERIA: All patients If answered 'yes' on retinal laser (RETLASERTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical
Datentyp
date
Maßeinheiten
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0438670
Beschreibung
INCLUSION CRITERIA: All patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single Answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0042903
Beschreibung
INCLUSION CRITERIA: All patients If answered 'yes' on vitrectomy (VITRTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical
Datentyp
date
Maßeinheiten
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0042903
Beschreibung
i.e. graft, pterygium INCLUSION CRITERIA: All patients TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical TYPE: Single Answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0197402
Beschreibung
INCLUSION CRITERIA: All patients If answered 'yes' on corneal surgery (CORNSURGTX) TIMING: Each clinical visit to check for change REPORTING SOURCE: Clinical
Datentyp
date
Maßeinheiten
- DD/MM/YYYY
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0197402
Beschreibung
Treatment variables
Alias
- UMLS CUI-1
- C0087111
Beschreibung
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical or administrative data TYPE: Multiple answers Separate multiple entries with "";""
Datentyp
integer
Alias
- UMLS CUI [1]
- C0087111
Beschreibung
Burden of treatment
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C2828008
Beschreibung
Complications of treatment
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C0009566
Beschreibung
Severe intra-ocular inflammation within 3 months of last intra-ocular treatment, due to infectious or non-infectious causes INCLUSION CRITERIA: Neovascular macular disease patients receiving treatment TIMING: Each clinical visit REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0014236
Beschreibung
Disease activity
Alias
- UMLS CUI-1
- C0544450
Beschreibung
Presence of intraretinal or subretinal fluid or hemorrhage that is attributable to activity of the neovascular lesion as determined by the treating ophthalmologist. This could be based on clinical examination or imaging INCLUSION CRITERIA: Neovascular macular disease patients receiving treatment TIMING: Each clinical visit REPORTING SOURCE: Clinical TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0242420
- UMLS CUI [2]
- C0035317
Beschreibung
Visual functioning and health related quality of life
Alias
- UMLS CUI-1
- C4279947
- UMLS CUI-2
- C0042792
Beschreibung
Distance visual acuity (best of uncorrected, corrected using glasses or contact lenses, or pinhole) in the affected eye INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical RESPONSE OPTIONS: Numerical value preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. Please refer to page 13 for a Snellen to LogMAR conversion table. Change in distance visual acuity should be calculated from baseline and previous visual acuity assessments.
Datentyp
integer
Alias
- UMLS CUI [1]
- C0429537
Beschreibung
Results preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical RESPONSE OPTIONS: Numerical value preferably reported in LogMAR. Snellen may be used but needs to be converted to LogMAR. Please refer to page 13 for a Snellen to LogMAR conversion table. Change in distance visual acuity should be calculated from baseline and previous visual acuity assessments.
Datentyp
integer
Alias
- UMLS CUI [1]
- C1302978
Beschreibung
INCLUSION CRITERIA: All patients TIMING: Each clinical visit REPORTING SOURCE: Clinical RESPONSE OPTIONS: Record details of the distance at which visual acuity is measured
Datentyp
integer
Alias
- UMLS CUI [1]
- C0429537
Beschreibung
Question 1 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C1287256
Beschreibung
Question 2 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C3261557
Beschreibung
Question 3 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C0563675
Beschreibung
Question 4 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C0221188
Beschreibung
Question 5 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C3174971
Beschreibung
Question 6 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C1736075
Beschreibung
Question 7 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C0520947
Beschreibung
Question 8 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C1736075
Beschreibung
Question 9 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C3827573
Beschreibung
Question 10 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C3260675
Beschreibung
Question 11 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C4086303
Beschreibung
Question 12 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C0558171
Beschreibung
Question 13 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C0562507
Beschreibung
Question 14 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C0557911
Beschreibung
Question 14 of Brief IVI - Reading and accessing information INCLUSION CRITERIA: All patients TIMING: Baseline 1 year post initiation of treatment and tracked ongoing annually while under follow-up REPORTING SOURCE: Patient-reported TYPE: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0042792
- UMLS CUI [1,2]
- C3482969
Ähnliche Modelle
ICHOM Macular Degeneration
- StudyEvent: ODM
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C0205430 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C0042812 (UMLS CUI-2)
C1446199 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C1299003 (UMLS CUI [1,2])
C0035298 (UMLS CUI-2)
(Comment:en)
(Comment:en)
C3887709 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
C0087111 (UMLS CUI [1,2])
C3895948 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C0442379 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
C2939459 (UMLS CUI [1,2])
C0579255 (UMLS CUI [1,2])
C0438670 (UMLS CUI [1,2])
C0042903 (UMLS CUI [1,2])
C0197402 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C0442379 (UMLS CUI-2)
(Comment:en)
C2828008 (UMLS CUI [1,2])
C0009566 (UMLS CUI-2)
(Comment:en)
(Comment:en)
(Comment:en)
C0035317 (UMLS CUI [2])
C0042792 (UMLS CUI-2)
C1446199 (UMLS CUI-2)
(Comment:en)
(Comment:en)
C1287256 (UMLS CUI [1,2])
C3261557 (UMLS CUI [1,2])
C0563675 (UMLS CUI [1,2])
C0221188 (UMLS CUI [1,2])
C3174971 (UMLS CUI [1,2])
C1736075 (UMLS CUI [1,2])
C0520947 (UMLS CUI [1,2])
C1736075 (UMLS CUI [1,2])
C3827573 (UMLS CUI [1,2])
C3260675 (UMLS CUI [1,2])
C4086303 (UMLS CUI [1,2])
C0558171 (UMLS CUI [1,2])
C0562507 (UMLS CUI [1,2])
C0557911 (UMLS CUI [1,2])
C3482969 (UMLS CUI [1,2])