Informações:
Falhas:
ID
16491
Descrição
Medical history form, Study hospital, Medical Faculty Münster derived from Medical history form by Dr. Schusdziarra
Palavras-chave
Versões (2)
- 18/07/2016 18/07/2016 -
- 19/07/2016 19/07/2016 -
Transferido a
19 de julho de 2016
DOI
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Licença
Creative Commons BY-NC 3.0
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Medical History Form, Study Hospital of Medical Faculty Münster
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Medical History Form
- StudyEvent: ODM
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Patient Name
Item
Patient Name
text
C1299487 (UMLS CUI [1])
Date of Birth
Item
Patient date of birth
date
C0421451 (UMLS CUI [1])
Physical Examination Date
Item
Physical Examination Date
date
C0031809 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Physician
Item
Treating Physician
text
C1710470 (UMLS CUI [1])
Symptoms
Item
Type of symptoms
text
C1457887 (UMLS CUI [1])
Localization
Item
Localization of symptoms
text
C0475264 (UMLS CUI [1])
Onset of symptoms
Item
First onset of symptoms
text
C0277793 (UMLS CUI [1])
Item
Are your symptoms permanent or intermittent?
integer
C2745955 (UMLS CUI [1,1])
C0037088 (UMLS CUI [1,2])
C0037088 (UMLS CUI [1,2])
CL Item
Permanent (1)
CL Item
Intermittent (2)
Duration of symptoms and symptom free interval
Item
Duration of symptoms and symptom free interval
text
C0449238 (UMLS CUI [1,1])
C0037088 (UMLS CUI [1,2])
C1272706 (UMLS CUI [1,3])
C0037088 (UMLS CUI [1,2])
C1272706 (UMLS CUI [1,3])
Intensity and character
Item
Intensity and character of symptoms/complaints
text
C0518690 (UMLS CUI [1,1])
C0221563 (UMLS CUI [1,2])
C0221563 (UMLS CUI [1,2])
Dependency of symptoms
Item
Dependency of symptoms
text
C1701901 (UMLS CUI [1])
Impairment of general health
Item
Intensity of impairment of patients general health by described symptoms
text
C0231171 (UMLS CUI [1,1])
C0516984 (UMLS CUI [1,2])
C0516984 (UMLS CUI [1,2])
Diagnostic procedures
Item
What other diagnostic procedures so far?
text
C0430022 (UMLS CUI [1])
Childhood diseases
Item
Childhood diseases
text
C0489532 (UMLS CUI [1])
Diseases in adulthood
Item
Diseases in adulthood
text
C0012634 (UMLS CUI [1,1])
C0700597 (UMLS CUI [1,2])
C0700597 (UMLS CUI [1,2])
Hospitalization
Item
Hospitalizations?
text
C0019993 (UMLS CUI [1])
Surgery
Item
Surgery
text
C0543467 (UMLS CUI [1])
Injuries
Item
Injuries
text
C3263723 (UMLS CUI [1])
Mental disorders
Item
Psychiatric disorder
text
C0004936 (UMLS CUI [1])
Immunization
Item
Active and passive Immunizations
text
C0020971 (UMLS CUI [1])
Other medical conditions
Item
Did the patient expericence any other relevant medical conditions
text
C3843040 (UMLS CUI [1])
Type of medication
Item
Type of medication
text
C0013227 (UMLS CUI [1])
Dosage
Item
Dosage
text
C0178602 (UMLS CUI [1])
Duration
Item
How long does the patient take this medication?
text
C0449238 (UMLS CUI [1])
Previously taken medication
Item
Previously taken medication
text
C0013227 (UMLS CUI [1,1])
C0205156 (UMLS CUI [1,2])
C0205156 (UMLS CUI [1,2])
Over the counter medication
Item
Over the counter medication
text
C2347852 (UMLS CUI [1,1])
C0013231 (UMLS CUI [1,2])
C0013231 (UMLS CUI [1,2])
Hypersensitivity to Pharmaceutical Preparations
Item
Hypersensitivity to Pharmaceutical Preparations
text
C0020517 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,2])
Learned occupation
Item
Learned occupation
text
C0421456 (UMLS CUI [1])
Current occupation
Item
Current occupation
text
C0421456 (UMLS CUI [1])
Occupational stressors
Item
Occupational stressors
text
C0597127 (UMLS CUI [1])
Occupational exposure
Item
Occupational exposure to toxic agents
text
C0853965 (UMLS CUI [1])
Occupational satisfaction
Item
Occupational satisfaction
text
C0683792 (UMLS CUI [1])
Reliability of employment
Item
Reliability of employment
text
C0242271 (UMLS CUI [1,1])
C2347947 (UMLS CUI [1,2])
C2347947 (UMLS CUI [1,2])
Family situation
Item
Family situation
text
C0015576 (UMLS CUI [1])
Frequent diseases in family
Item
Frequent diseases in family
text
C0012634 (UMLS CUI [1,1])
C0439660 (UMLS CUI [1,2])
C0439660 (UMLS CUI [1,2])
Diabetes mellitus
Item
Diabetes mellitus
text
C0011849 (UMLS CUI [1])
Hypertension
Item
Hypertensive disease
text
C0020538 (UMLS CUI [1])
Blood coagulation disorders
Item
Blood coagulation disorders
text
C0005779 (UMLS CUI [1])
Neoplasms
Item
Neoplasms
text
C0027651 (UMLS CUI [1])
Dyslipidemia
Item
Dyslipidemia
text
C0242339 (UMLS CUI [1])
Arteriosclerosis
Item
Arteriosclerosis
text
C0003850 (UMLS CUI [1])
Symptoms of hypersensitivity
Item
Symptoms of hypersensitivity
text
C0020517 (UMLS CUI [1])
Allergy testing
Item
Allergy testing
text
C0199747 (UMLS CUI [1])
Hypersensitivity to contrast agents
Item
Hypersensitivity to contrast agents
text
C0020517 (UMLS CUI [1,1])
C0009924 (UMLS CUI [1,2])
C0009924 (UMLS CUI [1,2])
Hypersensitivity to Pharmaceutical Preparations
Item
Hypersensitivity to Pharmaceutical Preparations
text
C0020517 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,2])
CL Item
Appetite normal (1)
CL Item
Decrease in appetite (2)
CL Item
Normal (1)
CL Item
Increased (2)
CL Item
Decreased (3)
Cravings
Item
Cravings for certain food or fluids
text
C0870371 (UMLS CUI [1])
Fluid intake
Item
Amount of fluid intake
text
C0429791 (UMLS CUI [1])
Type of fluids
Item
Type of fluids
text
C0332307 (UMLS CUI [1,1])
C2013463 (UMLS CUI [1,2])
C2013463 (UMLS CUI [1,2])
Vomiting
Item
Vomiting
boolean
C0042963 (UMLS CUI [1])
Vomiting
Item
Vomiting conditional to food consumption or type of food?
text
C0042963 (UMLS CUI [1])
Vomiting
Item
Appearance and taste of vomit
text
C0042963 (UMLS CUI [1])
Dieting
Item
Dieting
boolean
C2945766 (UMLS CUI [1])
Type of diet
Item
Type of diet
text
C1550392 (UMLS CUI [1])
Reason for diet
Item
Reason for diet
text
C0566251 (UMLS CUI [1,1])
C2945766 (UMLS CUI [1,2])
C2945766 (UMLS CUI [1,2])
Micturition
Item
Micturition frequency
text
C2584336 (UMLS CUI [1])
Urine colour
Item
Urine colour
text
C0278030 (UMLS CUI [1])
Micturition disorders
Item
Micturition disorders
text
C0042035 (UMLS CUI [1])
Urine amount
Item
Urine amount
text
C1822256 (UMLS CUI [1])
Nocturia frequency
Item
Nocturia frequency
text
C0028734 (UMLS CUI [1])
Bowel movement frequency
Item
Bowel movement frequency
text
C0426642 (UMLS CUI [1])
Amount of stool
Item
Amount of stool
text
C4069675 (UMLS CUI [1])
Consistency of stool
Item
Consistency of stool
text
C0426740 (UMLS CUI [1])
Stool colour
Item
Stool colour
text
C0578538 (UMLS CUI [1])
Appearance of stool
Item
Appearance of stool
text
C1286372 (UMLS CUI [1])
Irregular stool contents
Item
Irregular stool contents
text
C0426744 (UMLS CUI [1,1])
C0205271 (UMLS CUI [1,2])
C0205271 (UMLS CUI [1,2])
First menstrual period
Item
First menstrual period
text
C0025274 (UMLS CUI [1])
Menstrual period
Item
Menstrual period: regular cycle?
boolean
C0025329 (UMLS CUI [1])
Contraception
Item
Oral contraception?
boolean
C0700589 (UMLS CUI [1])
Menopausal
Item
Menopausal
boolean
C0455962 (UMLS CUI [1])
Parity
Item
Parity
integer
C0030563 (UMLS CUI [1])
Pregnancy complications
Item
Pregnancy complications?
text
C0032962 (UMLS CUI [1])
Abortion or miscarriage
Item
Abortion or miscarriage
text
C0429914 (UMLS CUI [1])
Preventive medical examination
Item
Last preventive medical examination
text
C0033144 (UMLS CUI [1])
Patient Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Height
Item
Height
float
C0005890 (UMLS CUI [1])
Weight gain
Item
Weight gain amount and duration
text
C0043094 (UMLS CUI [1])
Item
Weight gain unintentional or intentional
integer
C2367670 (UMLS CUI [1,1])
C3714343 (UMLS CUI [1,2])
C3714343 (UMLS CUI [1,2])
CL Item
intentional (1)
CL Item
unintentional (2)
Dietary treatment
Item
Dietary treatment
text
C1258068 (UMLS CUI [1])
Weight loss
Item
Weight loss amount and duration
text
C1262477 (UMLS CUI [1])
Item
Weight loss unintentional or intentional
integer
C2169614 (UMLS CUI [1,1])
C2363736 (UMLS CUI [1,2])
C2363736 (UMLS CUI [1,2])
CL Item
intentional (1)
CL Item
unintentional (2)
Reducing diet
Item
Reducing diet
text
C0012167 (UMLS CUI [1])
General endurance
Item
General endurance
text
C0518031 (UMLS CUI [1])
Sleeping disorders
Item
Sleeping disorders
text
C0037317 (UMLS CUI [1])
Duration of sleep
Item
Duration of sleep
text
C0424574 (UMLS CUI [1])
Sleeping behavior
Item
At what time does the patient go to sleep?
text
C0474396 (UMLS CUI [1])
Cough
Item
Duration of coughing
text
C0010200 (UMLS CUI [1])
Cough
Item
At what time occurs the coughing?
text
C0010200 (UMLS CUI [1])
Sputum
Item
Colour of Sputum
text
C0038056 (UMLS CUI [1])
Sputum
Item
Consistency of sputum
text
C0425519 (UMLS CUI [1])
Expectoration
Item
Expectoration:Time of day
text
C0038056 (UMLS CUI [1])
Bloody sputum
Item
Bloody sputum
boolean
C0748941 (UMLS CUI [1])
Productive cough frequency
Item
Productive cough frequency
text
C0239134 (UMLS CUI [1,1])
C0422341 (UMLS CUI [1,2])
C0422341 (UMLS CUI [1,2])
Productive cough duration
Item
Productive cough duration
text
C0239134 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,2])
Fever duration
Item
Fever duration
text
C0015967 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,2])
Fever course
Item
Fever course
text
C0015967 (UMLS CUI [1,1])
C1292729 (UMLS CUI [1,2])
C1292729 (UMLS CUI [1,2])
Perspiration
Item
Nightly perspiration
boolean
C0038990 (UMLS CUI [1])
Perspiration
Item
Perspiration dependent on activity
boolean
C0038990 (UMLS CUI [1])
Dyspnea at rest
Item
Dyspnea at rest
boolean
C0743330 (UMLS CUI [1])
Dyspnea on exertion
Item
Dyspnea on exertion
boolean
C0231807 (UMLS CUI [1])
Nighttime dyspnea
Item
Nighttime dyspnea
text
C2127200 (UMLS CUI [1])
Pruritus
Item
Itching,why?
text
C0033774 (UMLS CUI [1])
Pruritus
Item
Itching conditional with clothes or food?
text
C0033774 (UMLS CUI [1])
Seizures
Item
Convulsion
text
C0036572 (UMLS CUI [1])
Sexually Transmitted Diseases
Item
Sexually Transmitted Diseases: Risk groups, HIV-Testing
text
C0036916 (UMLS CUI [1])
Alcohol consumption
Item
Daily/Weekly alcohol consumption
text
C0001948 (UMLS CUI [1])
Substance use
Item
Nicotine use
text
C0038586 (UMLS CUI [1])
Invalidity
Item
Invalidity
text
C0012605 (UMLS CUI [1])