ID

14658

Beschreibung

Item used as routine documentation by the University hospital Essen, Transplant centre, Information leaflet. ODM derived from original form “ANMELDUNG ZUR NIERENTRANSPLANTATION” University hospital Essen, Transplant centre, Hufelandstr. 55, 45122 Essen, Germany.

Stichworte

Versionen (1)
  1. 25.04.16 25.04.16 -
Hochgeladen am

25. April 2016

DOI

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Registration for Kidney transplantation Transplant centre Essen University Hospital Essen

Englisch

Registration for Kidney transplantation Transplant centre Essen

1 Formulare  
Personal Information
Beschreibung

Personal Information

Alias
UMLS CUI-1
C2983694
Patient surname
Beschreibung

Patient surname

Datentyp

text

Alias
UMLS CUI [1]
C0421448
Patient first name
Beschreibung

Patient first name

Datentyp

text

Alias
UMLS CUI [1]
C1443235
Date of birth
Beschreibung

Date of birth

Datentyp

date

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

dialysis first day

Datentyp

date

Alias
UMLS CUI [1]
C3262256
Primary kidney disease
Beschreibung

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

Datentyp

text

Alias
UMLS CUI [1]
C0022658
Blood group
Beschreibung

Blood group

Datentyp

text

Alias
UMLS CUI [1]
C0005810
Body height
Beschreibung

Body height

Datentyp

float

Alias
UMLS CUI [1]
C0005890
Body weight
Beschreibung

Body weight

Datentyp

float

Alias
UMLS CUI [1]
C0005910
Nephrology centre
Beschreibung

Nephrology centre

Datentyp

text

Alias
UMLS CUI [1]
C0587474
Date of registration
Beschreibung

date registration

Datentyp

date

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

Questionnaire for registration for renal transplantation

Alias
UMLS CUI-1
C0034394
Patient name
Beschreibung

Patient name

Datentyp

text

Alias
UMLS CUI [1]
C1299487
Date
Beschreibung

Date

Datentyp

date

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

Coronary heart disease

Datentyp

boolean

Alias
UMLS CUI [1]
C0010068
Stents or bypasses
Beschreibung

Stents; heart bypass

Datentyp

boolean

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

Heart failure

Datentyp

boolean

Alias
UMLS CUI [1]
C0018801
NYHA
Beschreibung

NYHA classification

Datentyp

text

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

Heart Valve disease

Datentyp

boolean

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

Peripheral arterial disease

Datentyp

boolean

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

Vascular prosthesis; peripheral bypass

Datentyp

boolean

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

Hepatitis B

Datentyp

boolean

Alias
UMLS CUI [1]
C0019163
Hepatitis C
Beschreibung

Hepatitis C

Datentyp

boolean

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

abdominal surgery; inguinal surgery

Datentyp

boolean

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

Recurrent thrombosis

Datentyp

boolean

Alias
UMLS CUI [1]
C3550150
8. Hemorrhage
Beschreibung

Hemorrhage

Datentyp

boolean

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

Recurrent urinary tract infection

Datentyp

boolean

Alias
UMLS CUI [1]
C0262655
10. Tuberculosis
Beschreibung

Tuberculosis

Datentyp

boolean

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

Psychotic reactions

Datentyp

boolean

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

Shunt; peritoneal dialysis

Datentyp

integer

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

Medical Examination (Checklist)

Alias
UMLS CUI-1
C0582103
Urology
Beschreibung

Appointment date Urology

Datentyp

date

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

Appointment status

Datentyp

boolean

Alias
UMLS CUI [1]
C0586344
Dentist optional
Beschreibung

Appointment date Dentist

Datentyp

date

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

Appointment status

Datentyp

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date gynecology
Beschreibung

Appointment date gynecology

Datentyp

date

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

Appointment status

Datentyp

boolean

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

Appointment date Sonography Abdomen

Datentyp

date

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

Appointment status

Datentyp

boolean

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

Appointment date Doppler pelvic

Datentyp

date

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

Appointment status

Datentyp

boolean

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

Appointment date Doppler carotid

Datentyp

date

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

Appointment status

Datentyp

boolean

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

Appointment date Chest x-ray

Datentyp

date

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

Appointment status

Datentyp

boolean

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

Appointment date lung function

Datentyp

date

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

Appointment status

Datentyp

boolean

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

Appointment date Stress ECG Myocardial Scintigraphy

Datentyp

date

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

Appointment status

Datentyp

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date echocardiography
Beschreibung

Appointment date echocardiography

Datentyp

date

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

Appointment status

Datentyp

boolean

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

Appointment date Coronary angiography

Datentyp

date

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

Appointment status

Datentyp

boolean

Alias
UMLS CUI [1]
C0586344
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Ähnliche Modelle

Registration for Kidney transplantation Transplant centre Essen

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
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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