
Get Igg4 Rd Responder Index Form
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Igg4 Rd Responder Index Form online
The Igg4 Rd Responder Index Form is an essential document used to assess disease activity related to IgG4-related disease. This guide will provide you with clear, step-by-step instructions on how to accurately complete the form online, ensuring that all necessary information is captured effectively.
Follow the steps to successfully complete the form.
- Click 'Get Form' button to obtain the form and open it for editing.
- Fill in the date when the form was completed in the appropriate format (e.g., 7 / July / 2050).
- Enter the case number in the space provided to uniquely identify the patient or case being reported.
- For each organ or site listed, evaluate and score the disease activity based on the scoring rules (0-4).
- Indicate whether the manifestations are symptomatic by selecting 'Yes' or 'No' for each organ/site.
- Mark if there is damage associated with the organ/system by selecting 'Yes' or 'No' and if the disease is urgent.
- Complete the remaining sections by specifying symptoms and organ involvement as required, using the provided options and specifying any other relevant details.
- Calculate the Total Activity Score by adding organ/site scores and the serum IgG4 score, and document the total number of urgent and damaged organs.
- Finally, enter the steroid dose at the time of assessment and the cumulative steroid dose in the past 28 days.
- After verifying all the information is correct, you can save changes, download, print, or share the completed form.
Take the next step in documenting your information by completing the Igg4 Rd Responder Index Form online today.
The IgG4-RD responder index (RI) is a disease activity tool modeled by Stone et al. [5, 6], wherein the sum of organ sites' score (each organ/site graded on a 0–4 scale) plus the serum IgG4 concentration score (0–4) yields the total RI score.
Fill Igg4 Rd Responder Index Form
IgG4-RD Disease Responder Index4. Please complete at time of referral - only complete if the diagnosis of IgG4 is known, or highly likely.
Industry-leading security and compliance
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.