Check Points

SR.
No
1.

Question
number

2.
3.
4.
5.
6.
7.
8.
9.

2
2
3
4
5
5
5

10.
11.
12.

7
7

13.
14.
15.
16.
17.
18.
19.
20.
21.
22.

8
1,8
9
10
10
11
11
11
12

23.
24.

14
15

13

Query
Only one Response should be specified for Question 1. (For both Newly Diagnosed and Chronic
Cases)
Sum of Patient population in different age group should be near to 100% 25.
Only one Response should be specified for Question 2 for each age group.
At least 1 response should be ticked for question number 3. Multiple responses are acceptable.
Same response should not be repeated for (Preferences 1,2,3 ) for Early RA and Established RA
At least 1 response should be ticked for question number 5. Multiple ticks are acceptable.
If any other is ticked for Question number 5 then Please specify' should be provided.
If any other is not ticked for question number 5 then Please specify' should not be provided.
Same response should not be repeated for (Choice 1,2,3 and 4 ) for Early RA and same applies to
Established RA
At least 1 response should be ticked for question number 7.
If any other is ticked for Question number 7 then Please specify' should be provided.
If any other is not ticked for question number 7 then Please specify' should not be provided.
Multiple responses are acceptable.
At least 1 response should be ticked for question number 8.
Response for Question 8 should not more than the total of adult patients with RA of Question 1.
Only One response should be provided for each of the reasons for question number 9.
Only One response should be provided for each of the regimen for question number 10
Percentage of patient should be 25 of 100 % however will not be equal to 100 %.
All the boxes have to be responded for preference
If any other is ticked for Question number 11 then Please specify' should be provided.
If any other is not ticked for question number 11 then Please specify' should not be provided.
At least 1 response should be ticked for question number 12.
Either not applicable or one option each for dose of glucocorticoids and Duration of treatment
should be ticked.
At least 1 response should be ticked for question number 14. Multiple responses are acceptable.
Only One response should be provided for question number 15.

25.
26.
27.
28.
29.
30.
31.
32.
33.

16
17
17
17
18
19
19
19
20

Prepared by : (TO - DM)

Reviewed by : (TO - PM)
Approved by : (Sponsor)

Only one response should be specified for question number 16.

At least 1 response should be ticked for question number 17. Multiple responses are acceptable.
If any other is ticked for Question number 17 then Please specify' should be provided.
If any other is not ticked for question number 17 then Please specify' should not be provided.
At least one response should be provided for each of the parameter for management of adult RA
patients.
If response for question number 19 for AE / parameters is blank or no response is provided then
none will be ticked for the same.
If yes is ticked for any of the parameter then If yes number of patients should be provided.
If yes number of patients is provided for any of the parameters then Yes should be ticked.
At least one response should be provided for each of the parameter.

Name
Rajat Sharma
Mahesh Bhirud

Dated Signature: