Protocol for Imaging in Takayasu's Arteritis

Demographics (19)

Reproductive Health (2)

  • pregnancytest - If the subject is a woman of childbearing potential is she willing to undergo a serum pregnancy test prior to imaging (phv00404643.v1.p1)
  • Waspregnancytestingdonetoday - Q2. Was pregnancy testing done today (phv00404693.v1.p1)

Other (125)

  • AbleToGiveInformedConsent - Is the subject or subject's legal representative able to give informed consent (phv00404644.v1.p1)
  • ActionTakenbyMDInvestigator - Action taken by MD investigator (phv00404666.v1.p1)
  • Activedisea_MusculoskelSympWInfl - Active disease: Musculoskeletal symptoms (with inflammatory features including joint swelling or morning stiffness) in combination with an ESR of > 40 mm in the first hour by the Westergren method or a CRP measurement above the laboratory normal limit (phv00404652.v1.p1)
  • Activediseas_MusculoskelSymptoms - Active disease: Musculoskeletal symptoms (phv00404651.v1.p1)
  • Activedisease_Headachethatisapre - Active disease: Headache that is a) present for more than one day; b) non-fleeting; c) not fully relieved with non-narcotic analgesics; and d) not typical for any pre-existing form of headaches the patient may have experienced (such as migraines or tension) (phv00404647.v1.p1)
  • Activedisease_Ischemicretinopath - Active disease: Ischemic retinopathy, optic neuropathy, or visual loss (phv00404648.v1.p1)
  • Activedisease_Malaiseandfatigue - Active disease: Malaise and fatigue (phv00404649.v1.p1)
  • Activedisease_MalaiseFatigueWESR - Active disease: Malaise and fatigue in combination with an ESR of more than 40 mm in the first hour by the Westergren method or a CRP measurement above the laboratory normal limit (phv00404650.v1.p1)
  • Activedisease_Newsignssymptomsof - Active disease: New signs/symptoms of limb ischemia, including pain, claudication, new pulselessness, or diminished pulse (phv00404653.v1.p1)
  • Activedisease_Othersymptomsign - Active disease: Other symptoms/signs attributed by the investigator to Takayasu's arteritis that necessitate reinstitution or increase in GC for the treatment of Takayasu's Arteritis (phv00404654.v1.p1)
  • Activedisease_Sustainedfeverof38 - Active disease: Sustained fever of more than 380 C for more than 1 week (phv00404655.v1.p1)
  • Activedisease_Tonguejawpainandor - Active disease: Tongue/jaw pain and/or claudication (phv00404656.v1.p1)
  • Activedisease_Transientcerebrali - Active disease: Transient cerebral ischemia or stroke (phv00404657.v1.p1)
  • Activedisease_Vascularpaintender - Active disease: Vascular pain/tenderness producing symptoms such as carotidynia, scalp tenderness, or temporal artery abnormalities (tenderness or nodularity). Such vascular symptoms should be present for more than one day and be non-fleeting. (phv00404658.v1.p1)
  • AnyIncidentalFindings - Were there any incidental findings (phv00404664.v1.p1)
  • complywithimagingstudies - Is the subject willing to comply with the schedule for imaging studies and follow-up procedures (phv00404646.v1.p1)
  • consent - Consent group (phv00404556.v1.p1)
  • consentformsigned - Was the consent form signed and dated by the subject or subjects legal representative (phv00404645.v1.p1)
  • DeathCertificateReceived - Has the death certificate been received (phv00404594.v1.p1)
  • DeathPlace - Place of death (phv00404593.v1.p1)
  • DeathSourceNotificat_Coroner - Death source notification: Coroner (phv00404623.v1.p1)
  • DeathSourceNotificat_Friend - Death source notification: Friend (phv00404624.v1.p1)
  • DeathSourceNotificat_Funeralparl - Death source notification: Funeral parlor/home (phv00404625.v1.p1)
  • DeathSourceNotificat_Healthcarep - Death source notification: Health care provider (phv00404626.v1.p1)
  • DeathSourceNotificat_Medicalexam - Death source notification: Medical examiner (phv00404627.v1.p1)
  • DeathSourceNotificat_Medicalreco - Death source notification: Medical record (phv00404628.v1.p1)
  • DeathSourceNotificat_Newspaper - Death source notification: Newspaper (phv00404629.v1.p1)
  • DeathSourceNotificat_Other - Death source notification: Other (phv00404630.v1.p1)
  • DeathSourceNotificat_Patientsfam - Death source notification: Patient's family (phv00404631.v1.p1)
  • DocumentationType - Type of documentation (phv00404619.v1.p1)
  • DoesNotWishToPartcip_CompFamSit - Does not wish to participate: Complicated family situation (phv00404569.v1.p1)
  • DoesNotWishToPartcip_CostExpense - Does not wish to participate: Cost / expense to the family (phv00404570.v1.p1)
  • DoesNotWishToPartcip_FamilyPriva - Does not wish to participate: Family concern regarding privacy / confidentiality (phv00404571.v1.p1)
  • DoesNotWishToPartcip_InconvTravl - Does not wish to participate: Inconvenience to travel (phv00404572.v1.p1)
  • DoesNotWishToPartcip_OtherSpecif - Does not wish to participate: Other (Specify reason): (phv00404573.v1.p1)
  • DoesNotWishToPartcip_SubjFamCon - Does not wish to participate: Subject / family withdrew consent (phv00404575.v1.p1)
  • DoesNotWishToPartcip_SubjFamTim - Does not wish to participate: Subject/family lacks time required on study (phv00404574.v1.p1)
  • DoesNotWishToPartcip_Testingdiff - Does not wish to participate: Testing difficult / traumatic for the subject (phv00404576.v1.p1)
  • DoNotWishPaticipateReasonOther - Subject family does not wish to participate in further study: Reasons, other (phv00404559.v1.p1)
  • form_name - Form name (phv00404632.v1.p1)
  • form_name - Form Name (phv00404582.v1.p1)
  • form_name - Form Name (phv00404659.v1.p1)
  • form_name - Form name (phv00404668.v1.p1)
  • form_name - Form name (phv00404678.v1.p1)
  • form_name - Form name (phv00404697.v1.p1)
  • Form_Status - Form status (phv00404635.v1.p1)
  • Form_Status - Form Status (phv00404585.v1.p1)
  • Form_Status - Form Status (phv00404661.v1.p1)
  • Form_Status - Form status (phv00404670.v1.p1)
  • Form_Status - Form status (phv00404681.v1.p1)
  • Form_Status - Form status (phv00404699.v1.p1)
  • Has5503InfoSpecimenBeenCollected - Q1. Have the 5503 VCRC Longitudinal Protocol for Takayasus Arteritis information and specimens been collected (phv00404691.v1.p1)
  • ICD10CauseOfDeath - ICD10 code for cause of death (phv00404563.v1.p1)
  • IfNoWhyNot - Have the 5503 VCRC Longitudinal Protocol for Takayasus Arteritis information and specimens been collected. If no, please explain why not (phv00404692.v1.p1)
  • IfYesPleaseIndicateReason - If no, please indicate reason (phv00404695.v1.p1)
  • Ifyesresults - If yes, results (phv00404694.v1.p1)
  • IfYesWhichTreatmentWasParticip - If yes which study treatment was the participant on (phv00404621.v1.p1)
  • ImmCauseOfDeath1 - Immediate cause of death 1 (phv00404609.v1.p1)
  • ImmCauseOfDeath2 - Immediate cause of death 2 (phv00404611.v1.p1)
  • ImmCauseOfDeath3 - Immediate cause of death 3 (phv00404613.v1.p1)
  • ImmCauseOfDeath4 - Immediate cause of death 4 (phv00404615.v1.p1)
  • ImmCauseOfDeathCode1 - Immediate cause of death code 1 (phv00404610.v1.p1)
  • ImmCauseOfDeathCode2 - Immediate cause of death code 2 (phv00404612.v1.p1)
  • ImmCauseOfDeathCode3 - Immediate cause of death code 3 (phv00404614.v1.p1)
  • ImmCauseOfDeathCode4 - Immediate cause of death code 4 (phv00404616.v1.p1)
  • InfRegardingCauseOfDeath - Information regarding cause of death (phv00404620.v1.p1)
  • InvestigatorDecisionSpecify - Investigator decision specify (phv00404676.v1.p1)
  • MannerOfDeath - Manner of death (phv00404608.v1.p1)
  • maskid - Masked participant identifier (phv00404592.v1.p1)
  • maskid - Masked Participant Identifier (phv00404557.v1.p1)
  • maskid - Masked Participant Identifier (phv00404638.v1.p1)
  • maskid - Masked participant identifier (phv00404663.v1.p1)
  • maskid - Masked participant identifier (phv00404674.v1.p1)
  • maskid - Masked participant identifier (phv00404690.v1.p1)
  • maskid - Masked Participant Identifier (phv00404685.v1.p1)
  • maskid - (Masked) Subject Identifier (unique key) (phv00404555.v1.p1)
  • MDInvestigatorNotified - MD investigator notified (phv00404667.v1.p1)
  • Participant_Cycle_Number - Participant cycle # (phv00404633.v1.p1)
  • Participant_Cycle_Number - Participant cycle # (phv00404583.v1.p1)
  • Participant_Cycle_Number - Participant cycle # (phv00404679.v1.p1)
  • ParticipantAlsoRcvingPrednison - Was the participant also receiving prednisone (phv00404622.v1.p1)
  • PhysicianOpinionOnDeathInput - Study physicians opinion as to immediate cause of death input (phv00404595.v1.p1)
  • PhysicianOpinionOnDeathOutput - Study physicians opinion as to immediate cause of death output (phv00404596.v1.p1)
  • PhysOpinionContribCauseInput1 - Study physicians opinion as to contributing causes of death input 1 (phv00404597.v1.p1)
  • PhysOpinionContribCauseInput2 - Study physicians opinion as to contributing causes of death input 2 (phv00404598.v1.p1)
  • PhysOpinionContribCauseInput3 - Study physicians opinion as to contributing causes of death input 3 (phv00404599.v1.p1)
  • PhysOpinionContribCauseOutput1 - Study physicians opinion as to contributing causes of death output 1 (phv00404600.v1.p1)
  • PhysOpinionContribCauseOutput2 - Study physicians opinion as to contributing causes of death output 2 (phv00404601.v1.p1)
  • PhysOpinionContribCauseOutput3 - Study physicians opinion as to contributing causes of death output 3 (phv00404602.v1.p1)
  • PIRemovedSubjectFrom_OtherSpecif - PI removed subject from study: Other (Specify reason): (phv00404577.v1.p1)
  • PIRemovedSubjectFrom_Studystoppe - PI removed subject from : Study stopped by sponsor/IRB/DSMB (phv00404578.v1.p1)
  • PIRemovedSubjectFrom_Subjecthass - PI removed subject from: Subject has stable disease (phv00404579.v1.p1)
  • PIRemovedSubjectFrom_Subjectnolo - PI removed subject from Subject no longer has disease (phv00404580.v1.p1)
  • PIRemovedSubjectFrom_Unsafeforsu - PI removed subject from: Unsafe for subject to remain in study (phv00404581.v1.p1)
  • PIRemovedSubjectFromStudy - PI removed subject from study (phv00404568.v1.p1)
  • PIRemovedSubjectFromStudyReaso2 - PI removed subject from study: Reasons, other (phv00404562.v1.p1)
  • PleaseSpecifyTheAbnormalities - Please specify the abnormalities below (phv00404665.v1.p1)
  • PresenceofACR - Presence of adapted American College of Rheumatology ACR criteria for classification of TAK as defined by the 5503 VCRC Longitudinal Protocol for Takayasu's Arteritis (phv00404639.v1.p1)
  • Protocol - RDCRN Protocol# (phv00404687.v1.p1)
  • question2checked - Are any of the items in question 2 checked (phv00404640.v1.p1)
  • reason - Reason (phv00404696.v1.p1)
  • ReasonThatParticipationTermina - Reason that participation in protocol terminated (phv00404675.v1.p1)
  • RevisedDiagnosis - Revised diagnosis please indicate the revision (phv00404677.v1.p1)
  • Status - Participant Status (phv00404686.v1.p1)
  • StudyCenterChange - Change of study center (phv00404564.v1.p1)
  • StudyCenterChangeReason - Reason for change (phv00404558.v1.p1)
  • SubjCauseOfDeathCode - Cause of death code (phv00404561.v1.p1)
  • SubjectCauseOfDeath - Cause of death (phv00404560.v1.p1)
  • SubjectDied - Subject died (phv00404565.v1.p1)
  • subjectenrolledin5503 - Is the subject enrolled in the VCRC Longitudinal Protocol 5503 VCRC Longitudinal Protocol for Takayasus Arteritis (phv00404641.v1.p1)
  • SubjectRejoinedStudy - Subject rejoined the study as of (phv00404567.v1.p1)
  • SubjLostToFollowup - Subject lost to follow-up (phv00404566.v1.p1)
  • UnderlyingCauseOfDeath - Underlying cause of death (phv00404617.v1.p1)
  • UnderlyingCauseOfDeathCode - Underlying cause of death code (phv00404618.v1.p1)
  • Visit - Visit (phv00404634.v1.p1)
  • Visit - Visit (phv00404584.v1.p1)
  • Visit - Visit (phv00404660.v1.p1)
  • Visit - Visit (phv00404669.v1.p1)
  • Visit - Visit (phv00404680.v1.p1)
  • Visit - Visit (phv00404698.v1.p1)
  • WasPatientOnExpTreatAtTimeDeath - Was patient on experimental treatment at time of death (phv00404607.v1.p1)
  • WasVasFactorInCauseOfDeath - Was vasculitis a factor in the cause of death (phv00404603.v1.p1)
  • WasVasFactorInCauseOfDeathExpl - Was vasculitis a factor in the cause of death explain (phv00404604.v1.p1)
  • WasVasTreatFactorInCauseOfDeath - Was vasculitis treatment a factor in the cause of death (phv00404605.v1.p1)
  • WasVasTxFactorInCauseOfDeathExpl - Was vasculitis treatment a factor in the cause of death explain (phv00404606.v1.p1)