Skip to content

Kirklin Solutions - STS Intermacs

Search
  • Home
  • Administration
    • STS Intermacs Leaders
    • Data and Clinical Coordinating Center
  • Research
    • Publications
    • Current Projects
    • Research Proposals
  • Participation
    • Join Intermacs
    • Intermacs Participating Centers
  • Intermacs Appendices
  • Reports
    • Quarterly Site Reports
    • Research SAS Datasets
    • Live Data/Form Downloads
    • Intermacs Reporting FAQ
    • Outcome Analytics
  • Pedimacs
    • Pedimacs Appendices
    • Pedimacs Participating Centers
    • Pedimacs Research Proposals
  • Contact Us
  • Home
  • Administration
    • STS Intermacs Leaders
    • Data and Clinical Coordinating Center
  • Research
    • Publications
    • Current Projects
    • Research Proposals
  • Participation
    • Join Intermacs
    • Intermacs Participating Centers
  • Intermacs Appendices
  • Reports
    • Quarterly Site Reports
    • Research SAS Datasets
    • Live Data/Form Downloads
    • Intermacs Reporting FAQ
    • Outcome Analytics
  • Pedimacs
    • Pedimacs Appendices
    • Pedimacs Participating Centers
    • Pedimacs Research Proposals
  • Contact Us

Kirklin Solutions - STS Intermacs

  • Home
  • Administration
    • STS Intermacs Leaders
    • Data and Clinical Coordinating Center
  • Research
    • Publications
    • Current Projects
    • Research Proposals
  • Participation
    • Join Intermacs
    • Intermacs Participating Centers
  • Intermacs Appendices
  • Reports
    • Quarterly Site Reports
    • Research SAS Datasets
    • Live Data/Form Downloads
    • Intermacs Reporting FAQ
    • Outcome Analytics
  • Pedimacs
    • Pedimacs Appendices
    • Pedimacs Participating Centers
    • Pedimacs Research Proposals
  • Contact Us

Intermacs Data Collection Forms Archive

Version 5.1

  • Screening Log
  • Demographics
  • Pre-Implant
  • Implant
  • Implant Discharge
  • 1 Week Follow-Up
  • 1 Month Follow-Up
  • 3 Month Follow-Up
  • 1 Year Post Recovery
  • Adverse Events
  • Patient Transfer Form
  • Withdraw Consent

Version 5.0

  • Screening Log
  • Demographics
  • Pre-Implant
  • Implant
  • Implant Discharge
  • 1 Week Follow-Up
  • 1 Month Follow-Up
  • 3 Month Follow-Up
  • 1 Year Post Recovery
  • Adverse Events
  • Patient Transfer Form
  • Withdraw Consent

Version 4.0

  • Screening Log
  • Demographics
  • Pre-Implant
  • Implant
  • Implant Discharge
  • 1 Week Follow-Up
  • 1 Month Follow-Up
  • 3 Month Follow-Up
  • 1 year Post Recovery
  • Adverse Events
  • Patient Registry Status

Version 3.0

  • Screening
  • Patient Demographics
  • Pre-Implant
  • Implant
  • Implant Discharge
  • 1 Week and 1 Month Follow-Up
  • 3 Month and 6 Month Follow-Up
  • Rehospitalization
  • Infection
  • Neurological Dysfunction
  • Device Malfunction
  • Bleeding
  • Other Adverse Events-AE Reminders
  • Death 
  • Explant
  • Patient Registry Status
  • Functional Capacity
  • QOL Pre-Implant
  • QOL 3 and 6 Month Follow-Up
  • KCCQ
  • Trailmaking

Version 2.3

  • Screening
  • Eligibility
  • Patient Demographics
  • Pre-Implant
  • Implant
  • 1 Week Followup
  • 1 Month Followup
  • 3 Month Followup
  • 6 Month Followup
  • Implant Discharge
  • Reshopitalization
  • AE Infection
  • AE Neurological Dysfunction
  • AE Device Malfunction
  • AE Bleeding
  • Death
  • Explant
  • AE Reminders
  • Functional Capacity
  • Quality of Life-Non Completion
  • Quality of Life
  • Trail Making

Copyright © 2023

Contact Us

Research Opportunities