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Multiple Sclerosis - Patient Questionnaire (REGIMS)

1 forms  
General information
Description

General information

Alias
UMLS CUI-1
C1508263
Birth Year
Description

Birth Year

Data type

integer

Alias
UMLS CUI-1
C2826771
Age at disease onset
Data type

integer

Measurement units
  • Jahre
Alias
UMLS CUI-1
C0001779
UMLS CUI-2
C0277793
Jahre
Age at diagnosis
Data type

integer

Measurement units
  • Jahre
Alias
UMLS CUI-1
C1828181
Jahre
Medical Speciality
Data type

integer

Alias
UMLS CUI-1
C0037778
Medical Speciality
Data type

text

Alias
UMLS CUI-1
C0037778
First Symptoms
Description

First Symptoms

Alias
UMLS CUI-1
C0205435
UMLS CUI-2
C1457887
First symptoms
Data type

integer

Alias
UMLS CUI-1
C0205435
UMLS CUI-2
C1457887
First symptoms
Data type

text

Alias
UMLS CUI-1
C0205435
UMLS CUI-2
C1457887
Diagnostic procedure within the past 12 months
Description

Diagnostic procedure within the past 12 months

Alias
UMLS CUI-1
C0430022
UMLS CUI-2
C3843288
MRT Brain
Data type

boolean

Alias
UMLS CUI-1
C0024485
UMLS CUI-2
C0006104
MRT Spinal Cord
Data type

boolean

Alias
UMLS CUI-1
C0024485
UMLS CUI-2
C0037925
CT scan of brain
Data type

boolean

Alias
UMLS CUI-1
C0412585
Lumbar Puncture
Data type

boolean

Alias
UMLS CUI-1
C0037943
Echocardiography
Data type

boolean

Alias
UMLS CUI-1
C0013516
Elektrokardiogram (EKG)
Description

ECG

Data type

boolean

Alias
UMLS CUI-1
C1623258
Fatigability Multiple Sclerosis
Description

Fatigability Multiple Sclerosis

Alias
UMLS CUI-1
C0231230
UMLS CUI-2
C0026769
Fatigability Physical activity
Data type

integer

Alias
UMLS CUI-1
C0231230
UMLS CUI-2
C0026606
Fatigue interferes Work, Family, or Social Life
Data type

integer

Alias
UMLS CUI-1
C3830176
Mental Fatigue
Data type

integer

Alias
UMLS CUI-1
C0015676
Course
Description

Course

Alias
UMLS CUI-1
C0750729
Number of Hospital Stays
Data type

integer

Alias
UMLS CUI-1
C0237753
UMLS CUI-2
C3489408
Number of other hospital stays within past 12 months
Data type

integer

Number of outpatient visits within past 12 months
Data type

integer

Rehabilitation Days Within past 12 months
Data type

integer

Alias
UMLS CUI-1
C0034991
UMLS CUI-2
C3640790
UMLS CUI-3
C3843288
Aid, manufactured
Description

Aid, manufactured

Alias
UMLS CUI-1
C0449435
Crutch
Data type

boolean

Alias
UMLS CUI-1
C0180199
Rollator
Data type

boolean

Alias
UMLS CUI-1
C0184339
Housing modification
Data type

boolean

Alias
UMLS CUI-1
C0020056
UMLS CUI-2
C0392747
Car modification
Data type

boolean

Alias
UMLS CUI-1
C0004381
UMLS CUI-2
C0392747
Foot lifter cuff
Data type

boolean

Wheelchair
Data type

boolean

Alias
UMLS CUI-1
C0043143
Bed lift
Data type

boolean

Stairway lift
Data type

boolean

Alias
UMLS CUI-1
C1140673
Eyeglasses
Data type

boolean

Alias
UMLS CUI-1
C0015421
Incontinence pads
Data type

boolean

Alias
UMLS CUI-1
C0085099
Other aid
Data type

text

Alias
UMLS CUI-1
C0449435
Medical benefits
Description

Medical benefits

Medical benefits
Data type

integer

Paid by patient
Data type

boolean

Medical benefits past 12 months
Description

Medical benefits past 12 months

Nursing home visit
Data type

boolean

Alias
UMLS CUI-1
C0848616
Domestic helper
Data type

boolean

Alias
UMLS CUI-1
C0341652
Ambulance transport
Data type

boolean

Alias
UMLS CUI-1
C0809765
Taxi transportation
Data type

boolean

Alias
UMLS CUI-1
C0497715
Social counseling
Data type

boolean

Alias
UMLS CUI-1
C0474156
Copayment exemption
Data type

integer

Alias
UMLS CUI-1
C0680272
UMLS CUI-2
C2348482
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Similar models

Multiple Sclerosis - Patient Questionnaire (REGIMS)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
General information
C1508263 (UMLS CUI-1)
Birth Year
Item
Birth Year
integer
C2826771 (UMLS CUI-1)
Age at disease onset
Item
integer
C0001779 (UMLS CUI-1)
C0277793 (UMLS CUI-2)
Age at diagnosis
Item
integer
C1828181 (UMLS CUI-1)
Item
integer
C0037778 (UMLS CUI-1)
undefined item
Code List
Medical Speciality
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
Medical Speciality
Item
text
C0037778 (UMLS CUI-1)
Item Group
First Symptoms
C0205435 (UMLS CUI-1)
C1457887 (UMLS CUI-2)
Item
integer
C0205435 (UMLS CUI-1)
C1457887 (UMLS CUI-2)
First symptoms
Code List
First symptoms
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
CL Item
 (7)
CL Item
 (8)
CL Item
 (9)
CL Item
 (10)
CL Item
 (11)
CL Item
 (12)
CL Item
 (13)
CL Item
 (14)
CL Item
 (15)
CL Item
 (16)
CL Item
 (17)
First symptoms
Item
text
C0205435 (UMLS CUI-1)
C1457887 (UMLS CUI-2)
Item Group
Diagnostic procedure within the past 12 months
C0430022 (UMLS CUI-1)
C3843288 (UMLS CUI-2)
MRT Brain
Item
boolean
C0024485 (UMLS CUI-1)
C0006104 (UMLS CUI-2)
MRT Spinal Cord
Item
boolean
C0024485 (UMLS CUI-1)
C0037925 (UMLS CUI-2)
CT scan of brain
Item
boolean
C0412585 (UMLS CUI-1)
Lumbar Puncture
Item
boolean
C0037943 (UMLS CUI-1)
Echocardiography
Item
boolean
C0013516 (UMLS CUI-1)
ECG
Item
Elektrokardiogram (EKG)
boolean
C1623258 (UMLS CUI-1)
Item Group
Fatigability Multiple Sclerosis
C0231230 (UMLS CUI-1)
C0026769 (UMLS CUI-2)
Item
integer
C0231230 (UMLS CUI-1)
C0026606 (UMLS CUI-2)
undefined item
Code List
Fatigability Physical activity
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
CL Item
 (7)
Item
integer
C3830176 (UMLS CUI-1)
Fatigue interferes Work, Family, or Social Life
Code List
Fatigue interferes Work, Family, or Social Life
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
CL Item
 (7)
Item
integer
C0015676 (UMLS CUI-1)
undefined item
Code List
Mental Fatigue
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
CL Item
 (7)
Item Group
C0750729 (UMLS CUI-1)
Number of Hospital Stays
Item
integer
C0237753 (UMLS CUI-1)
C3489408 (UMLS CUI-2)
Number of other hospital stays within past 12 months
Item
integer
Number of outpatient visits within past 12 months
Item
integer
Rehabilitation Days Within past 12 months
Item
integer
C0034991 (UMLS CUI-1)
C3640790 (UMLS CUI-2)
C3843288 (UMLS CUI-3)
Item Group
C0449435 (UMLS CUI-1)
Crutch
Item
boolean
C0180199 (UMLS CUI-1)
Rollator
Item
boolean
C0184339 (UMLS CUI-1)
Housing modification
Item
boolean
C0020056 (UMLS CUI-1)
C0392747 (UMLS CUI-2)
Car modification
Item
boolean
C0004381 (UMLS CUI-1)
C0392747 (UMLS CUI-2)
Foot lifter cuff
Item
boolean
Wheelchair
Item
boolean
C0043143 (UMLS CUI-1)
Bed lift
Item
boolean
Stairway lift
Item
boolean
C1140673 (UMLS CUI-1)
Eyeglasses
Item
boolean
C0015421 (UMLS CUI-1)
Incontinence pads
Item
boolean
C0085099 (UMLS CUI-1)
Other aid
Item
text
C0449435 (UMLS CUI-1)
Item
integer
Medical benefits
Code List
Medical benefits
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
CL Item
 (6)
Paid by patient
Item
boolean
Nursing home visit
Item
boolean
C0848616 (UMLS CUI-1)
Domestic helper
Item
boolean
C0341652 (UMLS CUI-1)
Ambulance transport
Item
boolean
C0809765 (UMLS CUI-1)
Taxi transportation
Item
boolean
C0497715 (UMLS CUI-1)
Social counseling
Item
boolean
C0474156 (UMLS CUI-1)
Item
integer
C0680272 (UMLS CUI-1)
C2348482 (UMLS CUI-2)
Copayment exemption
Code List
Copayment exemption
CL Item
 (1)
CL Item
 (0)
CL Item
 (-1)
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