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Registration for Kidney transplantation Transplant centre Essen

1 forms  
Personal Information
Description

Personal Information

Alias
UMLS CUI-1
C2983694
Patient surname
Description

Patient surname

Data type

text

Alias
UMLS CUI [1]
C0421448
Patient first name
Description

Patient first name

Data type

text

Alias
UMLS CUI [1]
C1443235
Date of birth
Description

Date of birth

Data type

date

Alias
UMLS CUI [1]
C0421451
First day of dialysis
Description

dialysis first day

Data type

date

Alias
UMLS CUI [1]
C3262256
Primary kidney disease
Description

Please enclose:  Current medical report with diagnosis list and examination findings, laboratory results and medication plan  Questionnaire for registration for renal transplantation

Data type

text

Alias
UMLS CUI [1]
C0022658
Blood group
Description

Blood group

Data type

text

Alias
UMLS CUI [1]
C0005810
Body height
Description

Body height

Data type

float

Alias
UMLS CUI [1]
C0005890
Body weight
Description

Body weight

Data type

float

Alias
UMLS CUI [1]
C0005910
Nephrology centre
Description

Nephrology centre

Data type

text

Alias
UMLS CUI [1]
C0587474
Date of registration
Description

date registration

Data type

date

Alias
UMLS CUI [1,1]
C1514821
UMLS CUI [1,2]
C0011008
Questionnaire for registration for renal transplantation
Description

Questionnaire for registration for renal transplantation

Alias
UMLS CUI-1
C0034394
Patient name
Description

Patient name

Data type

text

Alias
UMLS CUI [1]
C1299487
Date
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
1. Coronary heart disease
Description

Coronary heart disease

Data type

boolean

Alias
UMLS CUI [1]
C0010068
Stents or bypasses
Description

Stents; heart bypass

Data type

boolean

Alias
UMLS CUI [1]
C0038257
UMLS CUI [2,1]
C0242838
UMLS CUI [2,2]
C0242839
2. Heart failure
Description

Heart failure

Data type

boolean

Alias
UMLS CUI [1]
C0018801
NYHA
Description

NYHA classification

Data type

text

Alias
UMLS CUI [1]
C1275491
3. Heart Valve disease
Description

Heart Valve disease

Data type

boolean

Alias
UMLS CUI [1]
C0018824
4. Peripheral arterial disease
Description

Peripheral arterial disease

Data type

boolean

Alias
UMLS CUI [1]
C1704436
Vascular prosthesis or peripheral bypass
Description

Vascular prosthesis; peripheral bypass

Data type

boolean

Alias
UMLS CUI [1]
C1534896
UMLS CUI [2]
C0810134
5. Hepatitis B
Description

Hepatitis B

Data type

boolean

Alias
UMLS CUI [1]
C0019163
Hepatitis C
Description

Hepatitis C

Data type

boolean

Alias
UMLS CUI [1]
C0019196
6. Prior abdominal surgery or inguinal surgery
Description

abdominal surgery; inguinal surgery

Data type

boolean

Alias
UMLS CUI [1]
C0198482
UMLS CUI [2]
C0745328
7. Recurrent thrombosis
Description

Recurrent thrombosis

Data type

boolean

Alias
UMLS CUI [1]
C3550150
8. Hemorrhage
Description

Hemorrhage

Data type

boolean

Alias
UMLS CUI [1]
C0019080
9. Recurrent urinary tract infection
Description

Recurrent urinary tract infection

Data type

boolean

Alias
UMLS CUI [1]
C0262655
10. Tuberculosis
Description

Tuberculosis

Data type

boolean

Alias
UMLS CUI [1]
C0041296
11. Psychotic reactions
Description

Psychotic reactions

Data type

boolean

Alias
UMLS CUI [1]
C0236122
12. Number of operations for dialysis access (Shunt, atrial catheter, peritoneal dialysis)
Description

Shunt; peritoneal dialysis

Data type

integer

Alias
UMLS CUI [1]
C0542331
UMLS CUI [2]
C0031139
Medical Examination (Checklist)
Description

Medical Examination (Checklist)

Alias
UMLS CUI-1
C0582103
Urology
Description

Appointment date Urology

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0042077
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Dentist optional
Description

Appointment date Dentist

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0011441
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date gynecology
Description

Appointment date gynecology

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0018417
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Sonography Abdomen
Description

Appointment date Sonography Abdomen

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0203464
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Doppler pelvic and leg and closure pressures
Description

Appointment date Doppler pelvic

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0203478
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Doppler carotid
Description

Appointment date Doppler carotid

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0741988
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Chest x-ray
Description

Appointment date Chest x-ray

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0039985
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date lung function
Description

Appointment date lung function

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0024119
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Stress ECG (at least 100 watts) alternatively Myocardial Scintigraphy or stress echo
Description

Appointment date Stress ECG Myocardial Scintigraphy

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0015260
UMLS CUI [1,3]
C2350391
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date echocardiography
Description

Appointment date echocardiography

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0013516
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Coronary angiography (from 60 years and older)
Description

Appointment date Coronary angiography

Data type

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0085532
Appointment met?
Description

Appointment status

Data type

boolean

Alias
UMLS CUI [1]
C0586344
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Similar models

Registration for Kidney transplantation Transplant centre Essen

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Personal Information
C2983694 (UMLS CUI-1)
Patient surname
Item
Patient surname
text
C0421448 (UMLS CUI [1])
Patient first name
Item
Patient first name
text
C1443235 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
dialysis first day
Item
First day of dialysis
date
C3262256 (UMLS CUI [1])
primary kidney disease
Item
Primary kidney disease
text
C0022658 (UMLS CUI [1])
Blood group
Item
Blood group
text
C0005810 (UMLS CUI [1])
Body height
Item
Body height
float
C0005890 (UMLS CUI [1])
Body weight
Item
Body weight
float
C0005910 (UMLS CUI [1])
Nephrology centre
Item
Nephrology centre
text
C0587474 (UMLS CUI [1])
date registration
Item
Date of registration
date
C1514821 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
Questionnaire for registration for renal transplantation
C0034394 (UMLS CUI-1)
Patient name
Item
Patient name
text
C1299487 (UMLS CUI [1])
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Coronary heart disease
Item
1. Coronary heart disease
boolean
C0010068 (UMLS CUI [1])
Stents; heart bypass
Item
Stents or bypasses
boolean
C0038257 (UMLS CUI [1])
C0242838 (UMLS CUI [2,1])
C0242839 (UMLS CUI [2,2])
Heart failure
Item
2. Heart failure
boolean
C0018801 (UMLS CUI [1])
Item
NYHA
text
C1275491 (UMLS CUI [1])
NYHA classification
Code List
NYHA
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
Heart Valve disease
Item
3. Heart Valve disease
boolean
C0018824 (UMLS CUI [1])
Peripheral arterial disease
Item
4. Peripheral arterial disease
boolean
C1704436 (UMLS CUI [1])
Vascular prosthesis; peripheral bypass
Item
Vascular prosthesis or peripheral bypass
boolean
C1534896 (UMLS CUI [1])
C0810134 (UMLS CUI [2])
Hepatitis B
Item
5. Hepatitis B
boolean
C0019163 (UMLS CUI [1])
Hepatitis C
Item
Hepatitis C
boolean
C0019196 (UMLS CUI [1])
abdominal surgery; inguinal surgery
Item
6. Prior abdominal surgery or inguinal surgery
boolean
C0198482 (UMLS CUI [1])
C0745328 (UMLS CUI [2])
Recurrent thrombosis
Item
7. Recurrent thrombosis
boolean
C3550150 (UMLS CUI [1])
Hemorrhage
Item
8. Hemorrhage
boolean
C0019080 (UMLS CUI [1])
Recurrent urinary tract infection
Item
9. Recurrent urinary tract infection
boolean
C0262655 (UMLS CUI [1])
Tuberculosis
Item
10. Tuberculosis
boolean
C0041296 (UMLS CUI [1])
Psychotic reactions
Item
11. Psychotic reactions
boolean
C0236122 (UMLS CUI [1])
Shunt; peritoneal dialysis
Item
12. Number of operations for dialysis access (Shunt, atrial catheter, peritoneal dialysis)
integer
C0542331 (UMLS CUI [1])
C0031139 (UMLS CUI [2])
Item Group
Medical Examination (Checklist)
C0582103 (UMLS CUI-1)
Appointment date Urology
Item
Urology
date
C0585085 (UMLS CUI [1,1])
C0042077 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Dentist
Item
Dentist optional
date
C0585085 (UMLS CUI [1,1])
C0011441 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date gynecology
Item
Appointment date gynecology
date
C0585085 (UMLS CUI [1,1])
C0018417 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Sonography Abdomen
Item
Appointment date Sonography Abdomen
date
C0585085 (UMLS CUI [1,1])
C0203464 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Doppler pelvic
Item
Appointment date Doppler pelvic and leg and closure pressures
date
C0585085 (UMLS CUI [1,1])
C0203478 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Doppler carotid
Item
Appointment date Doppler carotid
date
C0585085 (UMLS CUI [1,1])
C0741988 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Chest x-ray
Item
Appointment date Chest x-ray
date
C0585085 (UMLS CUI [1,1])
C0039985 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date lung function
Item
Appointment date lung function
date
C0585085 (UMLS CUI [1,1])
C0024119 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Stress ECG Myocardial Scintigraphy
Item
Stress ECG (at least 100 watts) alternatively Myocardial Scintigraphy or stress echo
date
C0585085 (UMLS CUI [1,1])
C0015260 (UMLS CUI [1,2])
C2350391 (UMLS CUI [1,3])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date echocardiography
Item
Appointment date echocardiography
date
C0585085 (UMLS CUI [1,1])
C0013516 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Coronary angiography
Item
Appointment date Coronary angiography (from 60 years and older)
date
C0585085 (UMLS CUI [1,1])
C0085532 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
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