ID

16851

Beskrivning

https://www.hope-clara.de/ The HOPE Hospice and Palliative Care Recording standard documentation is used for documentation of palliative care and as an instrument for quality assurance in pallatiave wards, hospices and oncological wards as well as in ambulatory services and palliative teams. This questionnaire is designed to record tumor-specific therapies.

Länk

https://www.hope-clara.de/

Nyckelord

  1. 2016-08-10 2016-08-10 -
  2. 2021-09-17 2021-09-17 -
Uppladdad den

10 augusti 2016

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0

Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

Palliative and Hospice Care Tumor-specific Therapies in Palliative Care

Palliative and Hospice Care Tumor-specific Therapies in Palliative Care

Date
Beskrivning

Date

Date
Beskrivning

date of interview

Datatyp

date

Alias
UMLS CUI [1]
C0011008
Date
Beskrivning

date first metastasis

Datatyp

date

Alias
UMLS CUI [1,1]
C0027627
UMLS CUI [1,2]
C0011008
TT1. Type of therapy
Beskrivning

TT1. Type of therapy

Intravenous, cyclic or ccontinuous cytotoxic chemotherapy
Beskrivning

cytotoxic chemotherapy

Datatyp

text

Alias
UMLS CUI [1,1]
C0677881
UMLS CUI [1,2]
C0348016
Oral, cyclic or ccontinuous cytotoxic chemotherapy
Beskrivning

oral cytotoxic chemotherapy

Datatyp

text

Alias
UMLS CUI [1]
C4040137
Tumor-specific antibody
Beskrivning

tumor-specific antibody

Datatyp

text

Alias
UMLS CUI [1]
C0041361
Hormone therapy
Beskrivning

hormone therapy

Datatyp

text

Alias
UMLS CUI [1]
C0279025
Oral tyrosine-kinase inhibitor or other targeted therapy
Beskrivning

TKI or other targeted therapy

Datatyp

text

Alias
UMLS CUI [1,1]
C0879484
UMLS CUI [1,2]
C0001563
UMLS CUI [2]
C3854476
Radiotherapy
Beskrivning

radiotherapy

Datatyp

text

Alias
UMLS CUI [1]
C1522449
Endoscopic intervention
Beskrivning

endoscopic intervention

Datatyp

text

Alias
UMLS CUI [1]
C0014245
Nuclear medicine therapy
Beskrivning

nuclear medicine therapy

Datatyp

text

Alias
UMLS CUI [1]
C0203485
Operative intervention
Beskrivning

operative intervention

Datatyp

text

Alias
UMLS CUI [1]
C0543467
Other procedure (please specify:)
Beskrivning

other procedures

Datatyp

text

Alias
UMLS CUI [1]
C0393107
Other procedure (please specify:)
Beskrivning

other procedure specification

Datatyp

text

Alias
UMLS CUI [1]
C0393107
TT2. Number of previous treatments
Beskrivning

TT2. Number of previous treatments

Chemotherapy
Beskrivning

no. of previous treatments

Datatyp

integer

Alias
UMLS CUI [1,1]
C0392920
UMLS CUI [1,2]
C0750480
Hormone therapy
Beskrivning

no. of previous treatments

Datatyp

integer

Alias
UMLS CUI [1,1]
C0279025
UMLS CUI [1,2]
C0750480
TT3. Indications
Beskrivning

TT3. Indications

Reduction of tumor size to prevent symptoms and/or for prolongation of survival time
Beskrivning

reduction of tumor size

Datatyp

boolean

Alias
UMLS CUI [1]
C0475440
Mainly to control symptoms
Beskrivning

control symptoms

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0243148
Neurological compression + brain pressure
Beskrivning

neurological compression

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0849479
UMLS CUI [1,2]
C1395826
Pain
Beskrivning

pain

Datatyp

boolean

Alias
UMLS CUI [1]
C0030193
Shortness of breath
Beskrivning

shortness of breath

Datatyp

boolean

Alias
UMLS CUI [1]
C0013404
Gastrointestinal compression
Beskrivning

gastrointestinal compression

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0565514
UMLS CUI [1,2]
C0521362
Other:
Beskrivning

other indication

Datatyp

boolean

Alias
UMLS CUI [1,1]
C3146298
UMLS CUI [1,2]
C0205394
Other:
Beskrivning

other indication specification

Datatyp

text

Alias
UMLS CUI [1,1]
C3146298
UMLS CUI [1,2]
C0205394
TT4. Agents/Regime/Modus
Beskrivning

TT4. Agents/Regime/Modus

Agents/Regime/Modus
Beskrivning

agents regime and modus

Datatyp

text

Alias
UMLS CUI [1]
C0003392
UMLS CUI [2]
C1273869
UMLS CUI [3]
C0184661
TT5. Medical indication assessed by
Beskrivning

TT5. Medical indication assessed by

Medical indication assessed by
Beskrivning

medical indication assessed by

Datatyp

text

Alias
UMLS CUI [1]
C1444284
Pre-treating clinic:
Beskrivning

pre-treating clinic

Datatyp

text

Alias
UMLS CUI [1,1]
C0442592
UMLS CUI [1,2]
C2709094
TT6. Palliative prognostic index PPI in pre-treatment/ starting the new indicated tumor treatment
Beskrivning

TT6. Palliative prognostic index PPI in pre-treatment/ starting the new indicated tumor treatment

Palliative performance score
Beskrivning

palliative performance score

Datatyp

text

Alias
UMLS CUI [1,1]
C0449820
UMLS CUI [1,2]
C1518965
UMLS CUI [1,3]
C1285530
Oral intake
Beskrivning

oral intake

Datatyp

text

Alias
UMLS CUI [1]
C0518037
Edema
Beskrivning

edema

Datatyp

text

Alias
UMLS CUI [1]
C0013604
Dyspnoea at rest
Beskrivning

dyspnoea at rest

Datatyp

text

Alias
UMLS CUI [1]
C2712054
Delirium
Beskrivning

delirium

Datatyp

text

Alias
UMLS CUI [1]
C0011206
PPI Score
Beskrivning

PPI score

Datatyp

float

Alias
UMLS CUI [1,1]
C0449821
UMLS CUI [1,2]
C1285530
TT7. Was proceding/start of tumor therapy based on consensus in the palliative team?
Beskrivning

TT7. Was proceding/start of tumor therapy based on consensus in the palliative team?

Was proceding/start of tumor therapy based on consensus in the palliative team?
Beskrivning

consensus making decision

Datatyp

integer

Alias
UMLS CUI [1,1]
C0376298
UMLS CUI [1,2]
C4042877
Reasons:
Beskrivning

reasons for medical decision

Datatyp

text

Alias
UMLS CUI [1,1]
C0920425
UMLS CUI [1,2]
C0392360
TT8. What was the subjective success of the tumor therapy?
Beskrivning

TT8. What was the subjective success of the tumor therapy?

What was the subjective success of the tumor therapy?
Beskrivning

success of tumor therapy

Datatyp

text

Alias
UMLS CUI [1,1]
C0679864
UMLS CUI [1,2]
C0439655
TT9. Was the tumor therapy determined early?
Beskrivning

TT9. Was the tumor therapy determined early?

Was the tumor therapy determined early?
Beskrivning

early determination of tumor therapy

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0920425
UMLS CUI [1,2]
C0457454
TT10. If yes, what were the reasons for the discontinuation of tumor therapy?
Beskrivning

TT10. If yes, what were the reasons for the discontinuation of tumor therapy?

If yes, what were the reasons for the discontinuation of tumor therapy?
Beskrivning

reasons for the discontinuation

Datatyp

text

Alias
UMLS CUI [1,1]
C0920425
UMLS CUI [1,2]
C0457454
UMLS CUI [1,3]
C0392360
Type of toxicity/ side effects
Beskrivning

toxicity

Datatyp

text

Alias
UMLS CUI [1]
C0600688
UMLS CUI [2]
C0879626
TT11. Was discontinuation of tumor therapy based on consensus in the palliative team?
Beskrivning

TT11. Was discontinuation of tumor therapy based on consensus in the palliative team?

Was discontinuation of tumor therapy based on consensus in the palliative team?
Beskrivning

discontinuation decision

Datatyp

text

Alias
UMLS CUI [1,1]
C0920425
UMLS CUI [1,2]
C0457454
UMLS CUI [1,3]
C0376298
UMLS CUI [1,4]
C4042877
Reasons:
Beskrivning

discontinuation decision reason

Datatyp

text

Alias
UMLS CUI [1,1]
C0920425
UMLS CUI [1,2]
C0457454
UMLS CUI [1,3]
C0392360
TT12. Who completes this questionnaire?
Beskrivning

TT12. Who completes this questionnaire?

TT12. Who completes this questionnaire?
Beskrivning

person documenting

Datatyp

text

Alias
UMLS CUI [1]
C3258039
Medical field
Beskrivning

medical field documenting person

Datatyp

text

Alias
UMLS CUI [1,1]
C0037778
UMLS CUI [1,2]
C3258039
Other:
Beskrivning

other medical field

Datatyp

text

Alias
UMLS CUI [1,1]
C0037778
UMLS CUI [1,2]
C0205394

Similar models

Palliative and Hospice Care Tumor-specific Therapies in Palliative Care

Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Date
date of interview
Item
Date
date
C0011008 (UMLS CUI [1])
date first metastasis
Item
Date
date
C0027627 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
TT1. Type of therapy
Item
Intravenous, cyclic or ccontinuous cytotoxic chemotherapy
text
C0677881 (UMLS CUI [1,1])
C0348016 (UMLS CUI [1,2])
Code List
Intravenous, cyclic or ccontinuous cytotoxic chemotherapy
CL Item
 (fortgesetzt)
CL Item
 (neu)
Item
Oral, cyclic or ccontinuous cytotoxic chemotherapy
text
C4040137 (UMLS CUI [1])
Code List
Oral, cyclic or ccontinuous cytotoxic chemotherapy
CL Item
 (fortgesetzt)
CL Item
 (neu)
Item
Tumor-specific antibody
text
C0041361 (UMLS CUI [1])
Code List
Tumor-specific antibody
CL Item
 (fortgesetzt)
CL Item
 (neu)
Item
Hormone therapy
text
C0279025 (UMLS CUI [1])
Code List
Hormone therapy
CL Item
 (fortgesetzt)
CL Item
 (neu)
Item
Oral tyrosine-kinase inhibitor or other targeted therapy
text
C0879484 (UMLS CUI [1,1])
C0001563 (UMLS CUI [1,2])
C3854476 (UMLS CUI [2])
Code List
Oral tyrosine-kinase inhibitor or other targeted therapy
CL Item
 (fortgesetzt)
CL Item
 (neu)
Item
Radiotherapy
text
C1522449 (UMLS CUI [1])
Code List
Radiotherapy
CL Item
 (fortgesetzt)
CL Item
 (neu)
Item
Endoscopic intervention
text
C0014245 (UMLS CUI [1])
Code List
Endoscopic intervention
CL Item
 (fortgesetzt)
CL Item
 (neu)
Item
Nuclear medicine therapy
text
C0203485 (UMLS CUI [1])
Code List
Nuclear medicine therapy
CL Item
 (fortgesetzt)
CL Item
 (neu)
Item
Operative intervention
text
C0543467 (UMLS CUI [1])
Code List
Operative intervention
CL Item
 (fortgesetzt)
CL Item
 (neu)
Item
Other procedure (please specify:)
text
C0393107 (UMLS CUI [1])
Code List
Other procedure (please specify:)
CL Item
 (fortgesetzt)
CL Item
 (neu)
other procedure specification
Item
Other procedure (please specify:)
text
C0393107 (UMLS CUI [1])
Item Group
TT2. Number of previous treatments
chemotherapy number
Item
Chemotherapy
integer
C0392920 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
hormone therapy number
Item
Hormone therapy
integer
C0279025 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
Item Group
TT3. Indications
reduction of tumor size
Item
Reduction of tumor size to prevent symptoms and/or for prolongation of survival time
boolean
C0475440 (UMLS CUI [1])
control symptoms
Item
Mainly to control symptoms
boolean
C1457887 (UMLS CUI [1,1])
C0243148 (UMLS CUI [1,2])
neurological compression
Item
Neurological compression + brain pressure
boolean
C0849479 (UMLS CUI [1,1])
C1395826 (UMLS CUI [1,2])
pain
Item
Pain
boolean
C0030193 (UMLS CUI [1])
shortness of breath
Item
Shortness of breath
boolean
C0013404 (UMLS CUI [1])
gastrointestinal compression
Item
Gastrointestinal compression
boolean
C0565514 (UMLS CUI [1,1])
C0521362 (UMLS CUI [1,2])
other indication
Item
Other:
boolean
C3146298 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
other indication specification
Item
Other:
text
C3146298 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Item Group
TT4. Agents/Regime/Modus
agents regime and modus
Item
Agents/Regime/Modus
text
C0003392 (UMLS CUI [1])
C1273869 (UMLS CUI [2])
C0184661 (UMLS CUI [3])
Item Group
TT5. Medical indication assessed by
Item
Medical indication assessed by
text
C1444284 (UMLS CUI [1])
Code List
Medical indication assessed by
CL Item
 (Vorbehandelnde Abteilungen (bitte spezifizieren): )
CL Item
 (Eigene Indikationsstellung nach Rücksprache mit anderen Fachdisziplinen)
CL Item
 (Eigene Indikationsstellung)
pre-treating clinic
Item
Pre-treating clinic:
text
C0442592 (UMLS CUI [1,1])
C2709094 (UMLS CUI [1,2])
Item Group
TT6. Palliative prognostic index PPI in pre-treatment/ starting the new indicated tumor treatment
Item
Palliative performance score
text
C0449820 (UMLS CUI [1,1])
C1518965 (UMLS CUI [1,2])
C1285530 (UMLS CUI [1,3])
Code List
Palliative performance score
CL Item
4.0P (1PPS 0-20) (4.0P (1PPS 0-20))
CL Item
2.5P (PPS 20-50) (2.5P (PPS 20-50))
CL Item
0P (PPS>60) (0P (PPS>60))
Item
Oral intake
text
C0518037 (UMLS CUI [1])
Code List
Oral intake
CL Item
0P (normal) (0P (normal))
CL Item
 (2.5P (stark reduziert))
CL Item
 (1.0P (moderat reduziert))
Item
Edema
text
C0013604 (UMLS CUI [1])
Code List
Edema
CL Item
 (1.0P (ja))
CL Item
 (0P (nein))
Item
Dyspnoea at rest
text
C2712054 (UMLS CUI [1])
Code List
Dyspnoea at rest
CL Item
 (3.5P (ja))
CL Item
 (0P (nein))
Item
Delirium
text
C0011206 (UMLS CUI [1])
Code List
Delirium
CL Item
 (4.0P (ja))
CL Item
 (0P (nein))
PPI score
Item
PPI Score
float
C0449821 (UMLS CUI [1,1])
C1285530 (UMLS CUI [1,2])
Item Group
TT7. Was proceding/start of tumor therapy based on consensus in the palliative team?
Item
Was proceding/start of tumor therapy based on consensus in the palliative team?
integer
C0376298 (UMLS CUI [1,1])
C4042877 (UMLS CUI [1,2])
Code List
Was proceding/start of tumor therapy based on consensus in the palliative team?
CL Item
Clear divergence of opinion, difficult decision making (1)
CL Item
Rather consensus, but also votes against (2)
CL Item
Clear consensus (3)
reasons for medical decision
Item
Reasons:
text
C0920425 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Item Group
TT8. What was the subjective success of the tumor therapy?
Item
What was the subjective success of the tumor therapy?
text
C0679864 (UMLS CUI [1,1])
C0439655 (UMLS CUI [1,2])
Code List
What was the subjective success of the tumor therapy?
CL Item
 (sehr schlecht)
CL Item
 (schlecht)
CL Item
 (zufriedenstellend)
CL Item
 (gut)
CL Item
 (sehr gut)
Item Group
TT9. Was the tumor therapy determined early?
early determination of tumor therapy
Item
Was the tumor therapy determined early?
boolean
C0920425 (UMLS CUI [1,1])
C0457454 (UMLS CUI [1,2])
Item Group
TT10. If yes, what were the reasons for the discontinuation of tumor therapy?
Item
If yes, what were the reasons for the discontinuation of tumor therapy?
text
C0920425 (UMLS CUI [1,1])
C0457454 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
Code List
If yes, what were the reasons for the discontinuation of tumor therapy?
CL Item
 (Toxizitäten)
CL Item
 (Ineffizienz der Therapie)
CL Item
 (Verschlechterung des Allgemeinzustandes )
CL Item
 (Wunsch des Patienten)
toxicity
Item
Type of toxicity/ side effects
text
C0600688 (UMLS CUI [1])
C0879626 (UMLS CUI [2])
Item Group
TT11. Was discontinuation of tumor therapy based on consensus in the palliative team?
Item
Was discontinuation of tumor therapy based on consensus in the palliative team?
text
C0920425 (UMLS CUI [1,1])
C0457454 (UMLS CUI [1,2])
C0376298 (UMLS CUI [1,3])
C4042877 (UMLS CUI [1,4])
Code List
Was discontinuation of tumor therapy based on consensus in the palliative team?
CL Item
Clear divergence of opinion, difficult decision making (1)
CL Item
Rather consensus, but also votes against (2)
CL Item
Clear consensus (3)
discontinuation decision reason
Item
Reasons:
text
C0920425 (UMLS CUI [1,1])
C0457454 (UMLS CUI [1,2])
C0392360 (UMLS CUI [1,3])
Item Group
TT12. Who completes this questionnaire?
Item
TT12. Who completes this questionnaire?
text
C3258039 (UMLS CUI [1])
Code List
TT12. Who completes this questionnaire?
CL Item
 (Arzt/Ärztin)
CL Item
 (Pflegende)
CL Item
 (Andere Mitarbeiter)
Item
Medical field
text
C0037778 (UMLS CUI [1,1])
C3258039 (UMLS CUI [1,2])
Code List
Medical field
CL Item
 (Innere Medizin)
CL Item
 (Hämatologie/Onkologie)
CL Item
 (Anästhesie)
CL Item
 (Sonstige)
other medical field
Item
Other:
text
C0037778 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial