Patient Admission and Medical History Bridging UK Essen

1 forms

StudyEvent: ODM
1. Patient Admission and Medical History Bridging UK Essen

Name

Type

Description | Question | Decode (Coded Value)

Data type

Alias

Patient administration

Item Group

Patientendaten

C2707520 (UMLS CUI-1)

Patient ID

Item

Patientennummer

integer

C2348585 (UMLS CUI [1])

adress

Item

Anrede

integer

C0079399 (UMLS CUI [1])

adress

Code List

Anrede

CL Item

Herr (1)

CL Item

Frau (2)

last name

Item

Nachname

text

C1301584 (UMLS CUI [1])

First name

Item

Vorname

text

C1443235 (UMLS CUI [1])

date of birht

Item

Geburtsdatum

date

C0421451 (UMLS CUI [1])

phone number

Item

Telefon

integer

C1515258 (UMLS CUI [1])

Fax

Item

Fax

integer

C1549619 (UMLS CUI [1])

mobile phone

Item

Mobil

integer

C3273868 (UMLS CUI [1])

postal address

Item

Adresse

text

C0421449 (UMLS CUI [1])

city of residence

Item

Ort

text

C2316883 (UMLS CUI [1,1])
C0421449 (UMLS CUI [1,2])

comment

Item

Bemerkung

text

C0947611 (UMLS CUI [1])

Medical History

Item Group

Anamnese

C0262926 (UMLS CUI-1)

last name

Item

Zurn Nachlesen: Narne

text

C1301584 (UMLS CUI [1])

Patient ID

Item

Patientennummer

text

C2348585 (UMLS CUI [1])

date of informed consent

Item

Datum Einverständnis

date

C2985782 (UMLS CUI [1])

date of medical history taken

Item

Datum Anamnese

date

C2826918 (UMLS CUI [1])

relevant disease in medical history

Item

Interessierende Erkrankungen in der Anamnese?

boolean

C0811727 (UMLS CUI [1])

if yes

Item

wenn ja

text

Disease 1

Item

Erkrankungen 1

text

C0012634 (UMLS CUI [1])

Disease 2

Item

Erkrankungen 2

text

C0012634 (UMLS CUI [1])

Disease 3

Item

Erkrankungen 3

text

C0012634 (UMLS CUI [1])

Disease 4

Item

Erkrankungen 4

text

C0012634 (UMLS CUI [1])

long-term medication

Item

Dauermedikation

boolean

C0420257 (UMLS CUI [1])

if yes

Item

wenn ja

text

long-term medication 1

Item

Dauermedikation 1

text

C0420257 (UMLS CUI [1])

long-term medication 2

Item

Dauermedikation 2

text

C0420257 (UMLS CUI [1])

long-term medication 3

Item

Dauermedikation 3

text

C0420257 (UMLS CUI [1])

long-term medication 4

Item

Dauermedikation 4

text

C0420257 (UMLS CUI [1])

long-term medication 5

Item

Dauermedikation 5

text

C0420257 (UMLS CUI [1])

thrombosis in medical history

Item

Thrombosen in der Anamnese?

boolean

C0811727 (UMLS CUI [1,1])
C0040053 (UMLS CUI [1,2])

if yes

Item

wenn ja

text

date of thrombosis 1

Item

1) wann (möglichst genaues Datum)

date

C2924285 (UMLS CUI [1])

date of thrombosis 2

Item

2) wann (möglichst genaues Datum)

date

C2924285 (UMLS CUI [1])

date of thrombosis 3

Item

3) wann (möglichst genaues Datum)

date

C2924285 (UMLS CUI [1])

date of thrombosis 4

Item

4) wann (möglichst genaues Datum)

date

C2924285 (UMLS CUI [1])

anticoagulation, aggregation inhibitors or anti-imflammatories in medial history?

Item

Antikoagulation / Antiaggregation / Antiphlogistika in der Anamnese?

boolean

C0262926 (UMLS CUI [1,1])
C0003281 (UMLS CUI [1,2])
C0262926 (UMLS CUI [2,1])
C0032177 (UMLS CUI [2,2])
C0262926 (UMLS CUI [3,1])
C0003209 (UMLS CUI [3,2])

Comment

Item

Bemerkungen

text

C0947611 (UMLS CUI [1])

Anticoagulation, platelet aggregation inhibitors or anti-imflammatories in medial history

Item Group

Antikoagulation / -a ggregation / -phlogistika in der Anamnese

C0262926 (UMLS CUI-1)
C0003281 (UMLS CUI-2)
C0262926 (UMLS CUI-4)
C0032177 (UMLS CUI-5)
C0262926 (UMLS CUI-7)
C0003209 (UMLS CUI-8)

Patient ID

Item

Patientennummer

integer

C2348585 (UMLS CUI [1])

last name

Item

Zum Nachlesen: Name

text

C1301584 (UMLS CUI [1])

Marcumar in medical history

Item

Marcumar in Anamnese?

boolean

C0262926 (UMLS CUI [1,1])
C0918269 (UMLS CUI [1,2])

marcoumar indication

Item

Grund Marcumargabe

text

C3146298 (UMLS CUI [1,1])
C0918269 (UMLS CUI [1,2])

marcoumar therapy start date

Item

Seit wann Marcumar?

date

C0918269 (UMLS CUI [1,1])
C3173309 (UMLS CUI [1,2])

duration of marcoumar therapy

Item

bisherige Dauer Marc.-Gabe in Jahren:

integer

C0444921 (UMLS CUI [1,1])
C0918269 (UMLS CUI [1,2])

marcoumar withdrew

Item

Wurde Marcumar abgesetzt?

boolean

C0918269 (UMLS CUI [1,1])
C0949878 (UMLS CUI [1,2])

if yes, date of withdrawal

Item

wenn ja, wann (Datum):

date

C0011008 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
C0918269 (UMLS CUI [1,3])

heparin in medical history

Item

Heparin in Anamnese?

boolean

C0262926 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])

if yes

Item

wenn ja

text

indication for heparin therapy

Item

Grund Heparingabe

text

C3146298 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])

heparin therapy start date

Item

Seit wann Heparin

date

C0019134 (UMLS CUI [1,1])
C3173309 (UMLS CUI [1,2])

duration of heparin therapy

Item

Bisherige Dauer

integer

C0444921 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])

heparin preparation

Item

Heparin: Präparat

text

C0019134 (UMLS CUI [1])

daily heparin dose

Item

Tagesdosis:

integer

C2348070 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])

for the use of unfractioned heparin

Item

bei UFH: Applikation:

text

C2825026 (UMLS CUI [1,1])
C0185125 (UMLS CUI [1,2])

Platelet inhibitors or Anti-inflammatory agents in medical history

Item

Antiaggregantien I Antiphlogistika in Anamnese?

boolean

C0262926 (UMLS CUI [1,1])
C0032177 (UMLS CUI [1,2])
C0262926 (UMLS CUI [2,1])
C0003209 (UMLS CUI [2,2])

if yes

Item

wenn ja

text

substance

Item

Wirkstoff

text

C0439861 (UMLS CUI [1])

daily dose

Item

Tagesdosis:

float

C2348070 (UMLS CUI [1])

Therapy start date

Item

seit wann:

date

C0032177 (UMLS CUI [1,1])
C3173309 (UMLS CUI [1,2])
C0003209 (UMLS CUI [2,1])
C3173309 (UMLS CUI [2,2])

duration of anti-inflammatory or platelet aggregation inhibition therapy

Item

Bisherige Dauer

integer

C0444921 (UMLS CUI [1,1])
C0032177 (UMLS CUI [1,2])
C0444921 (UMLS CUI [2,1])
C0003209 (UMLS CUI [2,2])

Comments

Item

Bemerkungen

text

C0947611 (UMLS CUI [1])

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