Contents |
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Purpose
Chronic GVHD - Composite Assessment Scale eCRF
Field Name |
Description / Instructions |
Format |
---|---|---|
Visit Date |
The Visit Date is required. |
DD-MMM-YYYY |
Components (Skin) | For each pre-defined component, select the respective score from the pick list. | Pre-defined |
CAS Score (Skin) |
|
Use pick list |
Components (Eyes) | For each pre-defined component, select the respective score from the pick list. | Pre-defined |
CAS Score (Eyes) |
|
Use pick list |
Components (Mouth) | For each pre-defined component, select the respective score from the pick list. | Pre-defined |
CAS Score (Mouth) |
|
Use pick list |
CAS Score (Mouse - Schubert) |
Type in the score for component "MOUTH - SCHUBERT ORAL MUCOSITIS RATING SCALE". |
Number (999) |
Components (Liver) | For each pre-defined component, select the respective score from the pick list. | Pre-defined |
CAS Score (Liver) |
|
Use pick list |
Components (GI) | For each pre-defined component, select the respective score from the pick list. | Pre-defined |
CAS Score (GI) |
|
Use pick list |
Components (Lungs) | For each pre-defined component, select the respective score from the pick list. | Pre-defined |
CAS Score (Lungs) |
|
Use pick list |
Components (Function) | For each pre-defined component, select the respective score from the pick list. | Pre-defined |
CAS Score (Function) |
|
Use pick list |
(HAP) Criteria | For each pre-defined component, type in the the respective score. | Pre-defined |
(HAP) Score | Type in the HAP component's score. | Number (9999) |
Components (PLT Count) | For each pre-defined component, select the respective score from the pick list. | Pre-defined |
CAS Score (PLT Count) |
|
Use pick list |
Components (Vulvar/Vaginal) | For each pre-defined component, select the respective score from the pick list. | Pre-defined |
CAS Score (Vulvar/Vaginal) |
|
Use pick list |
Symptoms 1-6 (Vulvar/Vaginal) |
Select from 1 to 6 symptoms fro the pick list.
|
Use pick list |
Total CAS Score | Type in the Total CAS Score. | Number (999) |
Legend: (d) derived field, (m) RDC mandatory, (c) for CTEP reporting only.
Validations
Code |
Description |
Resolutions |
---|---|---|
There are no validations. |
Derivations
Code |
Field Name |
Description |
---|---|---|
There are no derivations. |
Overview
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