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| ID | Type | Description | Link |
|---|---|---|---|
| B1821007 |
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The primary objective of this observational study is to collect safety data on reformulated BeneFIX as prescribed in routine clinical practice conditions in France. The secondary objectives are to collect data on the clinical course of individuals treated with reformulated BeneFIX and on the ease of reformulated BeneFIX.
No sampling
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| BeneFIX |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No intervention | Other | As it is a non interventional study, patient receives his usual treatment (BeneFIX) as determined by the physician |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) Prior to Safety Amendment | A treatment-related AE was any untoward medical occurrence attributed to study drug in a participant who received study drug. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. AEs included SAEs as well as non-serious AEs which occurred prior to safety amendment. Prior to safety amendment, only AEs/SAEs deemed related to BeneFIX as per participating physician were collected. | Baseline up to Year 3.5 |
| Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) by Relationship After Safety Amendment | AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. A treatment-related AE was any untoward medical occurrence attributed to study drug in a participant who received study drug as per participating physician. AEs included SAEs as well as non-serious AEs which occurred after the safety amendment. After the safety amendment, all AEs/SAEs were collected irrespective of their relationship to BeneFIX. | Year 3.5 up to 4.75 |
| Number of Participants With Events of Special Interest | Events of special interest included allergic reactions, red blood cell (RBC) agglutination phenomena, lack of efficacy/low recovery, thrombotic events and onset of factor IX (FIX) inhibitor. Participants may be represented in more than 1 category. | Baseline up to Year 4.75 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Bleeding Episodes | Number of bleeding episode during prophylaxis and on demand period were reported. All periods with at least one injection per week were considered as prophylaxis period. All prophylaxis periods of less than a month were reviewed and cross-checked with the treatment scheme planned at the previous visit to confirm if they were real prophylaxis periods or preventive injections periods. On demand treatment period included the total duration of follow up excluding duration of both prophylaxis and preventive injection treatment scheme. Efficacy population included only those participants who were previously treated with BeneFIX. Here, 'n' signifies participants evaluable for this measure during the specified treatment period. Participants may be represented in more than 1 category. |
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Inclusion Criteria:
Exclusion Criteria:
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Hemophilia B patients already receiving or starting treatment with reformulated BeneFIX
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| Name | Affiliation | Role |
|---|---|---|
| Pfizer CT.gov Call Center | Pfizer | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pfizer Investigational Site | Chamberry | Cedex | 73011 | France | ||
| Pfizer Investigational Site |
Not provided
| Label | URL |
|---|---|
| To obtain contact information for a study center near you, click here. | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | BeneFIX (Previously Treated Participants) | Participants with hemophilia B who were previously treated with reformulated BeneFIX, received reformulated BeneFIX intravenous injection per routine clinical practice and were observed for up to 5 years. |
| FG001 | BeneFIX (Previously Untreated Participants) | Participants with hemophilia B who were previously untreated with reformulated BeneFIX, received reformulated BeneFIX intravenous injection as per routine clinical practice and were observed for up to 5 years. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Safety population included all participants who received at least one dose of BeneFIX.
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | BeneFIX (Previously Treated Participants) | Participants with hemophilia B who were previously treated with reformulated BeneFIX, received reformulated BeneFIX intravenous injection per routine clinical practice and were observed for up to 5 years. |
| BG001 | BeneFIX (Previously Untreated Participants) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) Prior to Safety Amendment | A treatment-related AE was any untoward medical occurrence attributed to study drug in a participant who received study drug. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. AEs included SAEs as well as non-serious AEs which occurred prior to safety amendment. Prior to safety amendment, only AEs/SAEs deemed related to BeneFIX as per participating physician were collected. | Safety population included all participants who received at least one dose of BeneFIX. | Posted | Number | participants | Baseline up to Year 3.5 |
|
Not provided
The same event may appear as both an AE and a SAE. However, what is presented are distinct events. An event may be categorized as serious in one subject and as nonserious in another subject, or one subject may have experienced both a serious and nonserious event during the study.
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | BeneFIX (Previously Treated Participants) | Participants with hemophilia B who were previously treated with reformulated BeneFIX, received reformulated BeneFIX intravenous injection per routine clinical practice and were observed for up to 5 years. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Factor IX inhibition | Blood and lymphatic system disorders | MedDRA 12.1 | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anaemia | Blood and lymphatic system disorders | MedDRA 12.1 | Non-systematic Assessment |
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Pfizer ClinicalTrials.gov Call Center | Pfizer, Inc. | 1-800-718-1021 | ClinicalTrials.gov_Inquiries@pfizer.com |
Not provided
| ID | Term |
|---|---|
| D002836 | Hemophilia B |
| ID | Term |
|---|---|
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
Not provided
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| Baseline up to Year 4.75 |
| Number of Bleeding Episodes Requiring Treatment by Injection | Number of injections (1, 2, 3 or greater than or equal to [>= 4]) required to treat the bleeding episodes during prophylaxis and on demand period were reported. All periods with at least one injection per week were considered as prophylaxis period. All prophylaxis periods of less than a month were reviewed and cross-checked with the treatment scheme planned at the previous visit to confirm if they were real prophylaxis periods or preventive injections periods. On demand treatment period included the total duration of follow up excluding duration of both prophylaxis and preventive injection treatment scheme. | Baseline up to Year 4.75 |
| Total Consumption of BeneFIX | Total consumption of BeneFIX included consumption during prophylaxis, on demand, during bleeding episodes, preventive injections, surgeries or immune tolerance. | Baseline up to Year 4.75 |
| Subjective Assessment of Efficacy by Participant | Participants assessed efficacy of BeneFIX as very good, good, moderate and bad at each follow-up visit. Results were summarized for the latest (most recent), worst and best assessment of BeneFIX done by the participant. | Baseline up to Year 4.75 |
| Dose Per Injection of BeneFIX | Dose per injection during prophylaxis and on demand period were reported. All periods with at least one injection per week were considered as prophylaxis period. All prophylaxis periods of less than a month were reviewed and cross-checked with the treatment scheme planned at the previous visit to confirm if they were real prophylaxis periods or preventive injections periods. On demand treatment period included the total duration of follow up excluding duration of both prophylaxis and preventive injection treatment scheme. Participants may be represented in more than 1 category. | Baseline up to Year 4.75 |
| Subjective Assessment of Efficacy by Physician | Participating physician assessed efficacy of BeneFIX as very good, good, moderate and bad at follow-up visit. Results were summarized for the latest (most recent), worst and best assessment of BeneFIX done by the physician. | Baseline up to Year 4.75 |
| Subjective Assessment of Ease of Use by Participant | Participants assessed ease of use of BeneFIX as very good, good, moderate and bad at each follow-up visit. Results were summarized for the latest (most recent), worst and best assessment of BeneFIX done by the participant. | Baseline up to Year 4.75 |
| Le Chesnay |
| Cedex |
| 78157 |
| France |
| Pfizer Investigational Site | Caen | 14033 | France |
| Pfizer Investigational Site | Clermont-Ferrand | 63003 | France |
| Pfizer Investigational Site | Dijon | 21070 | France |
| Pfizer Investigational Site | leKremlin-Bicetre | 94275 | France |
| Pfizer Investigational Site | Lyon | 69003 | France |
| Pfizer Investigational Site | Marseille | 13385 | France |
| Pfizer Investigational Site | Montmorency | 95160 | France |
| Pfizer Investigational Site | Montpellier | 34 34295 | France |
| Pfizer Investigational Site | Nantes | 44093 | France |
| Pfizer Investigational Site | Paris | 75014 | France |
| Pfizer Investigational Site | Paris | F-75015 | France |
| Pfizer Investigational Site | Rouen | 76031 | France |
| Pfizer Investigational Site | Saint-Priest-en-Jarez | 42277 | France |
| Pfizer Investigational Site | Tours | 37044 | France |
| Pfizer Investigational Site | Vandœuvre-lès-Nancy | 54511 | France |
| Other |
|
| Withdrawal by Subject |
|
Participants with hemophilia B who were previously untreated with reformulated BeneFIX, received reformulated BeneFIX intravenous injection as per routine clinical practice and were observed for up to 5 years. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
Participants with hemophilia B who were previously treated with reformulated BeneFIX, received reformulated BeneFIX intravenous injection per routine clinical practice and were observed for up to 5 years.
| OG001 | BeneFIX (Previously Untreated Participants) | Participants with hemophilia B who were previously untreated with reformulated BeneFIX, received reformulated BeneFIX intravenous injection as per routine clinical practice and were observed for up to 5 years. |
|
|
| Primary | Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) by Relationship After Safety Amendment | AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. A treatment-related AE was any untoward medical occurrence attributed to study drug in a participant who received study drug as per participating physician. AEs included SAEs as well as non-serious AEs which occurred after the safety amendment. After the safety amendment, all AEs/SAEs were collected irrespective of their relationship to BeneFIX. | Safety population included all participants who received at least one dose of BeneFIX. Previously untreated participants were not evaluable for this outcome measure due to discontinuation prior to safety amendment. | Posted | Number | participants | Year 3.5 up to 4.75 |
|
|
|
| Primary | Number of Participants With Events of Special Interest | Events of special interest included allergic reactions, red blood cell (RBC) agglutination phenomena, lack of efficacy/low recovery, thrombotic events and onset of factor IX (FIX) inhibitor. Participants may be represented in more than 1 category. | Safety population included all participants who received at least one dose of BeneFIX. | Posted | Number | participants | Baseline up to Year 4.75 |
|
|
|
| Secondary | Number of Bleeding Episodes | Number of bleeding episode during prophylaxis and on demand period were reported. All periods with at least one injection per week were considered as prophylaxis period. All prophylaxis periods of less than a month were reviewed and cross-checked with the treatment scheme planned at the previous visit to confirm if they were real prophylaxis periods or preventive injections periods. On demand treatment period included the total duration of follow up excluding duration of both prophylaxis and preventive injection treatment scheme. Efficacy population included only those participants who were previously treated with BeneFIX. Here, 'n' signifies participants evaluable for this measure during the specified treatment period. Participants may be represented in more than 1 category. | Efficacy population: participants with basal FIX activity less than or equal to (<=) 1 percent (%) with real exposure days in diary at least 70% of planned exposure days for prophylaxis period, and without FIX inhibitor before or during study (no FIX inhibitor history at baseline; FIX inhibitor titer <0.6 Bethesda Unit [BU] during follow up). | Posted | Number | bleeding episodes | Baseline up to Year 4.75 |
|
|
|
| Secondary | Number of Bleeding Episodes Requiring Treatment by Injection | Number of injections (1, 2, 3 or greater than or equal to [>= 4]) required to treat the bleeding episodes during prophylaxis and on demand period were reported. All periods with at least one injection per week were considered as prophylaxis period. All prophylaxis periods of less than a month were reviewed and cross-checked with the treatment scheme planned at the previous visit to confirm if they were real prophylaxis periods or preventive injections periods. On demand treatment period included the total duration of follow up excluding duration of both prophylaxis and preventive injection treatment scheme. | Efficacy population. Efficacy population included only those participants who were previously treated with BeneFIX. Here, 'number of bleeding episodes analyzed' signifies episodes evaluable for this measure. 'n' signifies those bleeding episodes with injection data available during specified period. | Posted | Number | bleeding episodes | Baseline up to Year 4.75 | bleeding episodes | Participants |
|
|
|
| Secondary | Total Consumption of BeneFIX | Total consumption of BeneFIX included consumption during prophylaxis, on demand, during bleeding episodes, preventive injections, surgeries or immune tolerance. | Safety population included all participants who received at least one dose of BeneFIX. Participants with at least one follow-up visit were evaluable for this outcome measure. | Posted | Mean | Standard Deviation | International Unit (IU) | Baseline up to Year 4.75 |
|
|
|
| Secondary | Subjective Assessment of Efficacy by Participant | Participants assessed efficacy of BeneFIX as very good, good, moderate and bad at each follow-up visit. Results were summarized for the latest (most recent), worst and best assessment of BeneFIX done by the participant. | Efficacy population. Efficacy population included only those participants who were previously treated with BeneFIX. | Posted | Number | participants | Baseline up to Year 4.75 |
|
|
|
| Secondary | Dose Per Injection of BeneFIX | Dose per injection during prophylaxis and on demand period were reported. All periods with at least one injection per week were considered as prophylaxis period. All prophylaxis periods of less than a month were reviewed and cross-checked with the treatment scheme planned at the previous visit to confirm if they were real prophylaxis periods or preventive injections periods. On demand treatment period included the total duration of follow up excluding duration of both prophylaxis and preventive injection treatment scheme. Participants may be represented in more than 1 category. | Efficacy population. Efficacy population included only those participants who were previously treated with BeneFIX. Here, 'n' signifies participants evaluable for this measure during the specified treatment period. | Posted | Mean | Standard Deviation | IU/kg | Baseline up to Year 4.75 |
|
|
|
| Secondary | Subjective Assessment of Efficacy by Physician | Participating physician assessed efficacy of BeneFIX as very good, good, moderate and bad at follow-up visit. Results were summarized for the latest (most recent), worst and best assessment of BeneFIX done by the physician. | Efficacy population. Efficacy population included only those participants who were previously treated with BeneFIX. | Posted | Number | participants | Baseline up to Year 4.75 |
|
|
|
| Secondary | Subjective Assessment of Ease of Use by Participant | Participants assessed ease of use of BeneFIX as very good, good, moderate and bad at each follow-up visit. Results were summarized for the latest (most recent), worst and best assessment of BeneFIX done by the participant. | Efficacy population. Efficacy population included only those participants who were previously treated with BeneFIX. | Posted | Number | participants | Baseline up to Year 4.75 |
|
|
|
| 10 |
| 57 |
| 21 |
| 57 |
| EG001 | BeneFIX (Previously Untreated Participants) | Participants with hemophilia B who were previously untreated with reformulated BeneFIX, received reformulated BeneFIX intravenous injection as per routine clinical practice and were observed for up to 5 years. | 1 | 1 | 0 | 1 |
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Haemarthrosis | Musculoskeletal and connective tissue disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Haemophilic arthropathy | Musculoskeletal and connective tissue disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Muscle haemorrhage | Musculoskeletal and connective tissue disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Device failure | General disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Hyperthermia | General disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Pyrexia | General disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Otitis media | Ear and labyrinth disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Tympanic membrane perforation | Ear and labyrinth disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Congenital genitourinary abnormality | Congenital, familial and genetic disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Appendicitis | Infections and infestations | MedDRA 12.1 | Non-systematic Assessment |
|
| Branchial cyst | Congenital, familial and genetic disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Ear infection | Ear and labyrinth disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Conjunctivitis | Eye disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Abdominal pain upper | Gastrointestinal disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Diarrhoea | Gastrointestinal disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Asthenia | General disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Malaise | General disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Mucosal dryness | General disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Pyrexia | General disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Chronic sinusitis | Infections and infestations | MedDRA 12.1 | Non-systematic Assessment |
|
| Influenza | Infections and infestations | MedDRA 12.1 | Non-systematic Assessment |
|
| Varicella | Infections and infestations | MedDRA 12.1 | Non-systematic Assessment |
|
| Wound | Injury, poisoning and procedural complications | MedDRA 12.1 | Non-systematic Assessment |
|
| Vitamin D increased | Investigations | MedDRA 12.1 | Non-systematic Assessment |
|
| Decreased appetite | Metabolism and nutrition disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Vitamin D deficiency | Metabolism and nutrition disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Carpal tunnel syndrome | Nervous system disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Dysgeusia | Nervous system disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Headache | Nervous system disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Loss of consciousness | Nervous system disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Speech disorder | Nervous system disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Sleep disorder | Psychiatric disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Haematuria | Renal and urinary disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Haematospermia | Reproductive system and breast disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Asthma exercise induced | Respiratory, thoracic and mediastinal disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Bronchitis | Respiratory, thoracic and mediastinal disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Lung disorder | Respiratory, thoracic and mediastinal disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Throat irritation | Respiratory, thoracic and mediastinal disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Epistaxis | Vascular disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Haemorrhoids | Vascular disorders | MedDRA 12.1 | Non-systematic Assessment |
|
| Rectal haemorrhage | Vascular disorders | MedDRA 12.1 | Non-systematic Assessment |
|
Pfizer has the right to review disclosures, requesting a delay of less than 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), less than 12 months from study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.
| D020147 | Coagulation Protein Disorders |
| D006474 | Hemorrhagic Disorders |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D040181 | Genetic Diseases, X-Linked |
| Title | Measurements |
|---|
|
| Treatment-related SAE |
|
| RBC agglutination |
|
| Lack of efficacy/ low recovery |
|
| Thrombotic event |
|
| Title | Measurements |
|---|---|
|
| On demand: 2 Injection (n = 694) |
|
| Prophylaxis: 3 Injection (n = 261) |
|
| On demand: 3 Injection (n = 694) |
|
| Prophylaxis: >=4 Injection (n = 261) |
|
| On demand: >=4 Injection (n = 694) |
|
| Title | Measurements |
|---|---|
|
| Latest assessment: Moderate |
|
| Latest assessment: Bad |
|
| Worst assessment: Missing Values |
|
| Worst assessment: Very Good |
|
| Worst assessment: Good |
|
| Worst assessment: Moderate |
|
| Worst assessment: Bad |
|
| Best assessment: Missing Values |
|
| Best assessment: Very Good |
|
| Best assessment: Good |
|
| Best assessment: Moderate |
|
| Best assessment: Bad |
|
| Title | Measurements |
|---|---|
|
| Latest assessment: Bad |
|
| Worst assessment: Very Good |
|
| Worst assessment: Good |
|
| Worst assessment: Moderate |
|
| Worst assessment: Bad |
|
| Best assessment: Very Good |
|
| Best assessment: Good |
|
| Best assessment: Moderate |
|
| Best assessment: Bad |
|
| Title | Measurements |
|---|---|
|
| Latest assessment: Moderate |
|
| Latest assessment: Bad |
|
| Worst assessment: Missing Value |
|
| Worst assessment: Very Good |
|
| Worst assessment: Good |
|
| Worst assessment: Moderate |
|
| Worst assessment: Bad |
|
| Best assessment: Missing Values |
|
| Best assessment: Very Good |
|
| Best assessment: Good |
|
| Best assessment: Moderate |
|
| Best assessment: Bad |
|