ID

14658

Beschrijving

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.

Trefwoorden

Versies (1)
  1. 25-04-16 25-04-16 -
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25 april 2016

DOI

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Creative Commons BY-NC 3.0
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Registration for Kidney transplantation Transplant centre Essen University Hospital Essen

Engels

Registration for Kidney transplantation Transplant centre Essen

1 Formulieren  
Personal Information
Beschrijving

Personal Information

Alias
UMLS CUI-1
C2983694
Patient surname
Beschrijving

Patient surname

Datatype

text

Alias
UMLS CUI [1]
C0421448
Patient first name
Beschrijving

Patient first name

Datatype

text

Alias
UMLS CUI [1]
C1443235
Date of birth
Beschrijving

Date of birth

Datatype

date

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

dialysis first day

Datatype

date

Alias
UMLS CUI [1]
C3262256
Primary kidney disease
Beschrijving

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

Datatype

text

Alias
UMLS CUI [1]
C0022658
Blood group
Beschrijving

Blood group

Datatype

text

Alias
UMLS CUI [1]
C0005810
Body height
Beschrijving

Body height

Datatype

float

Alias
UMLS CUI [1]
C0005890
Body weight
Beschrijving

Body weight

Datatype

float

Alias
UMLS CUI [1]
C0005910
Nephrology centre
Beschrijving

Nephrology centre

Datatype

text

Alias
UMLS CUI [1]
C0587474
Date of registration
Beschrijving

date registration

Datatype

date

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

Questionnaire for registration for renal transplantation

Alias
UMLS CUI-1
C0034394
Patient name
Beschrijving

Patient name

Datatype

text

Alias
UMLS CUI [1]
C1299487
Date
Beschrijving

Date

Datatype

date

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

Coronary heart disease

Datatype

boolean

Alias
UMLS CUI [1]
C0010068
Stents or bypasses
Beschrijving

Stents; heart bypass

Datatype

boolean

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

Heart failure

Datatype

boolean

Alias
UMLS CUI [1]
C0018801
NYHA
Beschrijving

NYHA classification

Datatype

text

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

Heart Valve disease

Datatype

boolean

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

Peripheral arterial disease

Datatype

boolean

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

Vascular prosthesis; peripheral bypass

Datatype

boolean

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

Hepatitis B

Datatype

boolean

Alias
UMLS CUI [1]
C0019163
Hepatitis C
Beschrijving

Hepatitis C

Datatype

boolean

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

abdominal surgery; inguinal surgery

Datatype

boolean

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

Recurrent thrombosis

Datatype

boolean

Alias
UMLS CUI [1]
C3550150
8. Hemorrhage
Beschrijving

Hemorrhage

Datatype

boolean

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

Recurrent urinary tract infection

Datatype

boolean

Alias
UMLS CUI [1]
C0262655
10. Tuberculosis
Beschrijving

Tuberculosis

Datatype

boolean

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

Psychotic reactions

Datatype

boolean

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

Shunt; peritoneal dialysis

Datatype

integer

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

Medical Examination (Checklist)

Alias
UMLS CUI-1
C0582103
Urology
Beschrijving

Appointment date Urology

Datatype

date

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

Appointment status

Datatype

boolean

Alias
UMLS CUI [1]
C0586344
Dentist optional
Beschrijving

Appointment date Dentist

Datatype

date

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

Appointment status

Datatype

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date gynecology
Beschrijving

Appointment date gynecology

Datatype

date

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

Appointment status

Datatype

boolean

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

Appointment date Sonography Abdomen

Datatype

date

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

Appointment status

Datatype

boolean

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

Appointment date Doppler pelvic

Datatype

date

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

Appointment status

Datatype

boolean

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

Appointment date Doppler carotid

Datatype

date

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

Appointment status

Datatype

boolean

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

Appointment date Chest x-ray

Datatype

date

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

Appointment status

Datatype

boolean

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

Appointment date lung function

Datatype

date

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

Appointment status

Datatype

boolean

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

Appointment date Stress ECG Myocardial Scintigraphy

Datatype

date

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

Appointment status

Datatype

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date echocardiography
Beschrijving

Appointment date echocardiography

Datatype

date

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

Appointment status

Datatype

boolean

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

Appointment date Coronary angiography

Datatype

date

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

Appointment status

Datatype

boolean

Alias
UMLS CUI [1]
C0586344
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Similar models

Registration for Kidney transplantation Transplant centre Essen

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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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