ID

16858

Beschrijving

Provided by Prof. Keil Source: Kotseva K, Wood D, De Backer G, De Bacquer D, Pyörälä K, Keil U; EUROASPIRE Study Group. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet. 2009 Mar 14;373(9667):929-40. doi: 10.1016/S0140-6736(09)60330-5. PubMed PMID: 19286092

Trefwoorden

  1. 11-08-16 11-08-16 -
  2. 11-08-16 11-08-16 -
Geüploaded op

11 augustus 2016

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0

Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

EUROASPIRE III - Peripheral arterial occlusive disease Patient Interview Questionnaire

Peripheral arterial occlusive disease Patient Interview Questionnaire

Demographic Information
Beschrijving

Demographic Information

Patient ID
Beschrijving

Patient ID

Datatype

text

Alias
UMLS CUI [1]
C1269815
Date of interview
Beschrijving

Date of interview

Datatype

date

Alias
UMLS CUI [1,1]
C0683518
UMLS CUI [1,2]
C0011008
How many years have you spent in full-time education? (99 = insufficient data)
Beschrijving

Educational status

Datatype

integer

Maateenheden
  • yrs
Alias
UMLS CUI [1]
C0013658
yrs
What is the highest level of education you have completed?
Beschrijving

Educational status

Datatype

integer

Alias
UMLS CUI [1]
C0013658
Prior to the diagnosis of peripheral artery occlusive disease were you:
Beschrijving

Employment status

Datatype

integer

Alias
UMLS CUI [1]
C0242271
If retired
Beschrijving

Retirement

Datatype

integer

Alias
UMLS CUI [1]
C0035345
Now at least 6 months after the diagnosis of peripheral artery occlusive disease, are you:
Beschrijving

Employment status

Datatype

integer

Alias
UMLS CUI [1]
C0242271
If retired
Beschrijving

Retirement

Datatype

integer

Alias
UMLS CUI [1]
C0035345
Smoking
Beschrijving

Smoking

Have you ever smoked?
Beschrijving

If NO, proceed to Question 10, If YES, please specify in following questions

Datatype

boolean

Alias
UMLS CUI [1]
C0038586
For how many years in total have you smoked?
Beschrijving

Substance use disorder, duration

Datatype

integer

Maateenheden
  • yrs
Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C0449238
yrs
Were you smoking in the month prior to the diagnosis of your peripheral artery occlusive disease?
Beschrijving

Substance use disorder

Datatype

boolean

Alias
UMLS CUI [1]
C0038586
Do you smoke now?
Beschrijving

Substance use disorder

Datatype

boolean

Alias
UMLS CUI [1]
C0038586
If smoking now, what type of tobacco-product?
Beschrijving

Substance use disorder

Datatype

integer

Alias
UMLS CUI [1]
C0038586
How many cigarettes per day?
Beschrijving

Substance use disorder, quantity

Datatype

integer

Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C1265611
How much pipe tobacco in g/week?
Beschrijving

Substance use disorder, quantity

Datatype

integer

Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C1265611
How many cigars per day?
Beschrijving

Substance use disorder, quantity

Datatype

integer

Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C1265611
If not smoking now, did you quit within the last 6 months
Beschrijving

Substance Use Disorders, Former smoker

Datatype

boolean

Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C0337671
If not smoking now, did you quit more than 6 months ago?
Beschrijving

Substance Use Disorders, Former smoker

Datatype

boolean

Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C0337671
If not smoking now, at what age did you stop? (99 = unknown)
Beschrijving

Substance Use Disorders, Former smoker

Datatype

integer

Maateenheden
  • yrs
Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C0337671
yrs
If smoking now In the last year, how many times have you quit smoking for at least 24 hours?
Beschrijving

Substance use disorder

Datatype

integer

Alias
UMLS CUI [1]
C0038586
If smoking now: Are you seriously thinking of quitting smoking?
Beschrijving

Substance use disorder

Datatype

integer

Alias
UMLS CUI [1]
C0038586
Risk factor awareness and targets
Beschrijving

Risk factor awareness and targets

Was your blood pressure measured since discharge from hospital or since last contact with our outpatient clinic?
Beschrijving

Risk factor monitoring

Datatype

integer

Alias
UMLS CUI [1,1]
C0850624
UMLS CUI [1,2]
C0150369
Was your total cholesterol measured since discharge from hospital or since last contact with our outpatient clinic?
Beschrijving

Risk factor monitoring

Datatype

integer

Alias
UMLS CUI [1,1]
C0850624
UMLS CUI [1,2]
C0150369
Was your blood glucose measured since discharge from hospital or since last contact with our outpatient clinic?
Beschrijving

Risk factor monitoring

Datatype

integer

Alias
UMLS CUI [1,1]
C0850624
UMLS CUI [1,2]
C0150369
Was your HbA1c (in diabetics) measured since discharge from hospital or since last contact with our outpatient clinic?
Beschrijving

Risk factor monitoring

Datatype

integer

Alias
UMLS CUI [1,1]
C0850624
UMLS CUI [1,2]
C0150369
Are you aware of your latest weight?
Beschrijving

Risk factor awareness

Datatype

integer

Alias
UMLS CUI [1,1]
C0850624
UMLS CUI [1,2]
C0004448
Current Body weight
Beschrijving

Body weight

Datatype

float

Maateenheden
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Are you aware of your target weight?
Beschrijving

Target weight

Datatype

integer

Alias
UMLS CUI [1]
C1272247
What is your target weight?
Beschrijving

Target weight

Datatype

float

Maateenheden
  • kg
Alias
UMLS CUI [1]
C1272247
kg
Are you aware of your blood pressure level?
Beschrijving

Risk factor awareness

Datatype

integer

Alias
UMLS CUI [1,1]
C0850624
UMLS CUI [1,2]
C0004448
Current blood pressure
Beschrijving

Blood pressure

Datatype

integer

Maateenheden
  • mmHg
Alias
UMLS CUI [1]
C0005823
mmHg
Are you aware of your blood pressure target?
Beschrijving

Blood pressure target

Datatype

integer

Alias
UMLS CUI [1,1]
C0005823
UMLS CUI [1,2]
C1521840
What is your blood pressure target?
Beschrijving

Blood pressure target

Datatype

integer

Maateenheden
  • mmHg
Alias
UMLS CUI [1,1]
C0005823
UMLS CUI [1,2]
C1521840
mmHg
Are you aware of your total cholesterol level?
Beschrijving

Risk factor awareness

Datatype

integer

Alias
UMLS CUI [1,1]
C0850624
UMLS CUI [1,2]
C0004448
Total cholesterol measurement
Beschrijving

Total cholesterol measurement

Datatype

float

Maateenheden
  • mmol/l
Alias
UMLS CUI [1]
C1445957
mmol/l
Are you aware of your total cholesterol target?
Beschrijving

Total cholesterol target

Datatype

integer

Alias
UMLS CUI [1,1]
C1445957
UMLS CUI [1,2]
C1521840
What is your total cholesterol target?
Beschrijving

Total cholesterol target

Datatype

float

Maateenheden
  • mmol/l
Alias
UMLS CUI [1,1]
C1445957
UMLS CUI [1,2]
C1521840
mmol/l
Are you aware of your latest blood glucose level?
Beschrijving

Risk factor awareness

Datatype

integer

Alias
UMLS CUI [1,1]
C0850624
UMLS CUI [1,2]
C0004448
Blood glucose measurement
Beschrijving

Blood glucose measurement

Datatype

integer

Maateenheden
  • mmol/l
Alias
UMLS CUI [1]
C0392201
mmol/l
Are you aware of your blood glucose target?
Beschrijving

Blood glucose target

Datatype

integer

Alias
UMLS CUI [1,1]
C0392201
UMLS CUI [1,2]
C1521840
What is your blood glucose target?
Beschrijving

Blood glucose target

Datatype

integer

Maateenheden
  • mmol/l
Alias
UMLS CUI [1,1]
C0392201
UMLS CUI [1,2]
C1521840
mmol/l
Are you aware of your latest HbA1c level?
Beschrijving

Risk factor awareness

Datatype

integer

Alias
UMLS CUI [1,1]
C0850624
UMLS CUI [1,2]
C0004448
HbA1c measurement
Beschrijving

HbA1c measurement

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C0373638
%
Are you aware of your HbA1c target?
Beschrijving

HbA1c target

Datatype

integer

Alias
UMLS CUI [1,1]
C0373638
UMLS CUI [1,2]
C1521840
What is your HbA1c target?
Beschrijving

HbA1c target

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1,1]
C0373638
UMLS CUI [1,2]
C1521840
%
Lifestyle changes
Beschrijving

Lifestyle changes

Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on stopping smoking?
Beschrijving

Lifestyle changes smoking

Datatype

integer

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0453996
What type of advice did you receive for stopping smoking?
Beschrijving

Lifestyle changes smoking

Datatype

integer

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0453996
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on a healthy diet?
Beschrijving

Lifestyle changes healthy diet

Datatype

integer

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0811813
What type of advice did you receive concerning a healthy diet?
Beschrijving

Lifestyle changes healthy diet

Datatype

integer

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0811813
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on weight loss?
Beschrijving

Lifestyle changes weight loss

Datatype

integer

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0555962
What type of advice did you receive concerning weight loss?
Beschrijving

Lifestyle changes Weight loss

Datatype

integer

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0555962
What type of advice did you receive concerning weight loss?
Beschrijving

Lifestyle changes Weight loss

Datatype

integer

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0555962
Please specify other type of advice you received concerning weight loss?
Beschrijving

Lifestyle changes Weight loss

Datatype

text

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0555962
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on increase of physical activity?
Beschrijving

Lifestyle changes increase of physical activity

Datatype

integer

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0511855
What type of advice did you receive concerning increase of physical activity?
Beschrijving

Lifestyle changes increase of physical activity

Datatype

integer

Alias
UMLS CUI [1,1]
C0870811
UMLS CUI [1,2]
C0511855
Family history of cardiovascular disease
Beschrijving

Family history of cardiovascular disease

History of cardiovascular disease of brother
Beschrijving

History of cardiovascular disease of brother

Datatype

integer

Alias
UMLS CUI [1,1]
C0455539
UMLS CUI [1,2]
C0337527
Age of brother at diagnosis of cardiovascular disease
Beschrijving

Age of brother at diagnosis

Datatype

integer

Alias
UMLS CUI [1,1]
C1828181
UMLS CUI [1,2]
C0337527
Age of brother at diagnosis of cardiovascular disease unknown
Beschrijving

Age of brother at diagnosis

Datatype

boolean

Alias
UMLS CUI [1,1]
C1828181
UMLS CUI [1,2]
C0337527
Brother died of cardiovascular disease (if applicable)
Beschrijving

Cause of death brother

Datatype

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0337527
Age at death from cardiovascular disease of brother (if applicable)
Beschrijving

Age at Death brother

Datatype

integer

Alias
UMLS CUI [1,1]
C1546180
UMLS CUI [1,2]
C0337527
Age at death from cardiovascular disease of brother unknown (if applicable)
Beschrijving

Age at Death brother

Datatype

boolean

Alias
UMLS CUI [1,1]
C1546180
UMLS CUI [1,2]
C0337527
History of cardiovascular disease of sister
Beschrijving

History of cardiovascular disease of sister

Datatype

integer

Alias
UMLS CUI [1,1]
C0455539
UMLS CUI [1,2]
C0337514
Age of sister at diagnosis of cardiovascular disease
Beschrijving

Age of sister at diagnosis

Datatype

integer

Alias
UMLS CUI [1,1]
C1828181
UMLS CUI [1,2]
C0337514
Age of sister at diagnosis of cardiovascular disease unknown
Beschrijving

Age of sister at diagnosis unknown

Datatype

boolean

Alias
UMLS CUI [1,1]
C1828181
UMLS CUI [1,2]
C0337514
Sister died of cardiovascular disease (if applicable)
Beschrijving

Cause of Death sister

Datatype

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0337514
Age at death from cardiovascular disease of sister (if applicable)
Beschrijving

Age at Death sister

Datatype

integer

Alias
UMLS CUI [1,1]
C1546180
UMLS CUI [1,2]
C0337514
Age at death from cardiovascular disease of sister unknown
Beschrijving

Age at Death sister

Datatype

boolean

Alias
UMLS CUI [1,1]
C1546180
UMLS CUI [1,2]
C0337514
General Health assessment
Beschrijving

General Health assessment

SF-12 Physical health summary measure
Beschrijving

To obtain the SF-12 questionnaire, please refer to the holder of copyright

Datatype

integer

Alias
UMLS CUI [1]
C1519135
SF-12 Mental health summary measure
Beschrijving

To obtain the SF-12 questionnaire, please refer to the holder of copyright

Datatype

integer

Alias
UMLS CUI [1]
C1519135

Similar models

Peripheral arterial occlusive disease Patient Interview Questionnaire

Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Demographic Information
Patient ID
Item
Patient ID
text
C1269815 (UMLS CUI [1])
Date of interview
Item
Date of interview
date
C0683518 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Educational status
Item
How many years have you spent in full-time education? (99 = insufficient data)
integer
C0013658 (UMLS CUI [1])
Item
What is the highest level of education you have completed?
integer
C0013658 (UMLS CUI [1])
Code List
What is the highest level of education you have completed?
CL Item
No formal schooling (1)
CL Item
Less than primary school  (2)
CL Item
Primary school completed (3)
CL Item
Secondary school completed (4)
CL Item
High school completed (5)
CL Item
Collage/ University completed (6)
CL Item
Post graduate degree (7)
CL Item
Insufficient data (unknown) (8)
Item
Prior to the diagnosis of peripheral artery occlusive disease were you:
integer
C0242271 (UMLS CUI [1])
Code List
Prior to the diagnosis of peripheral artery occlusive disease were you:
CL Item
Full time employed (1)
CL Item
Part time employed (2)
CL Item
Self employed (3)
CL Item
Unemployed (4)
CL Item
House person (5)
CL Item
Full time education (6)
CL Item
Retired (7)
CL Item
Insufficient data (unknown) (8)
Item
If retired
integer
C0035345 (UMLS CUI [1])
Code List
If retired
CL Item
Age related (1)
CL Item
Heart disease related (2)
CL Item
Other illness (3)
CL Item
Personal choice (4)
CL Item
Insufficient data (unknown) (5)
Item
Now at least 6 months after the diagnosis of peripheral artery occlusive disease, are you:
integer
C0242271 (UMLS CUI [1])
Code List
Now at least 6 months after the diagnosis of peripheral artery occlusive disease, are you:
CL Item
Full time employed (1)
CL Item
Part time employed (2)
CL Item
Self employed (3)
CL Item
Unemployed (4)
CL Item
House person (5)
CL Item
Full time education (6)
CL Item
Retired (7)
CL Item
Insufficient data (unknown) (8)
Item
If retired
integer
C0035345 (UMLS CUI [1])
Code List
If retired
CL Item
Age related (1)
CL Item
Heart disease related (2)
CL Item
Other illness (3)
CL Item
Personal choice (4)
CL Item
Insufficient data (unknown) (5)
Item Group
Smoking
Substance use
Item
Have you ever smoked?
boolean
C0038586 (UMLS CUI [1])
Substance use disorder, duration
Item
For how many years in total have you smoked?
integer
C0038586 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
Substance use disorder
Item
Were you smoking in the month prior to the diagnosis of your peripheral artery occlusive disease?
boolean
C0038586 (UMLS CUI [1])
Substance use disorder
Item
Do you smoke now?
boolean
C0038586 (UMLS CUI [1])
Item
If smoking now, what type of tobacco-product?
integer
C0038586 (UMLS CUI [1])
Code List
If smoking now, what type of tobacco-product?
CL Item
Cigarettes (1)
CL Item
Pipe (2)
CL Item
Cigars (3)
Substance use disorder, quantity
Item
How many cigarettes per day?
integer
C0038586 (UMLS CUI [1,1])
C1265611 (UMLS CUI [1,2])
Substance use disorder, quantity
Item
How much pipe tobacco in g/week?
integer
C0038586 (UMLS CUI [1,1])
C1265611 (UMLS CUI [1,2])
Substance use disorder, quantity
Item
How many cigars per day?
integer
C0038586 (UMLS CUI [1,1])
C1265611 (UMLS CUI [1,2])
Substance Use Disorders, Former smoker
Item
If not smoking now, did you quit within the last 6 months
boolean
C0038586 (UMLS CUI [1,1])
C0337671 (UMLS CUI [1,2])
Substance Use Disorders, Former smoker
Item
If not smoking now, did you quit more than 6 months ago?
boolean
C0038586 (UMLS CUI [1,1])
C0337671 (UMLS CUI [1,2])
Substance Use Disorders, Former smoker
Item
If not smoking now, at what age did you stop? (99 = unknown)
integer
C0038586 (UMLS CUI [1,1])
C0337671 (UMLS CUI [1,2])
Substance use disorder
Item
If smoking now In the last year, how many times have you quit smoking for at least 24 hours?
integer
C0038586 (UMLS CUI [1])
Item
If smoking now: Are you seriously thinking of quitting smoking?
integer
C0038586 (UMLS CUI [1])
Code List
If smoking now: Are you seriously thinking of quitting smoking?
CL Item
Yes, within the next 30 days (1)
CL Item
Yes, within the next 6 months (2)
CL Item
No, not thinking of quitting (3)
CL Item
Don’t know/ Unsure (4)
Item Group
Risk factor awareness and targets
Item
Was your blood pressure measured since discharge from hospital or since last contact with our outpatient clinic?
integer
C0850624 (UMLS CUI [1,1])
C0150369 (UMLS CUI [1,2])
Code List
Was your blood pressure measured since discharge from hospital or since last contact with our outpatient clinic?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Item
Was your total cholesterol measured since discharge from hospital or since last contact with our outpatient clinic?
integer
C0850624 (UMLS CUI [1,1])
C0150369 (UMLS CUI [1,2])
Code List
Was your total cholesterol measured since discharge from hospital or since last contact with our outpatient clinic?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Item
Was your blood glucose measured since discharge from hospital or since last contact with our outpatient clinic?
integer
C0850624 (UMLS CUI [1,1])
C0150369 (UMLS CUI [1,2])
Code List
Was your blood glucose measured since discharge from hospital or since last contact with our outpatient clinic?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Item
Was your HbA1c (in diabetics) measured since discharge from hospital or since last contact with our outpatient clinic?
integer
C0850624 (UMLS CUI [1,1])
C0150369 (UMLS CUI [1,2])
Code List
Was your HbA1c (in diabetics) measured since discharge from hospital or since last contact with our outpatient clinic?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Item
Are you aware of your latest weight?
integer
C0850624 (UMLS CUI [1,1])
C0004448 (UMLS CUI [1,2])
Code List
Are you aware of your latest weight?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Body weight
Item
Current Body weight
float
C0005910 (UMLS CUI [1])
Item
Are you aware of your target weight?
integer
C1272247 (UMLS CUI [1])
Code List
Are you aware of your target weight?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Target weight
Item
What is your target weight?
float
C1272247 (UMLS CUI [1])
Item
Are you aware of your blood pressure level?
integer
C0850624 (UMLS CUI [1,1])
C0004448 (UMLS CUI [1,2])
Code List
Are you aware of your blood pressure level?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Blood pressure
Item
Current blood pressure
integer
C0005823 (UMLS CUI [1])
Item
Are you aware of your blood pressure target?
integer
C0005823 (UMLS CUI [1,1])
C1521840 (UMLS CUI [1,2])
Code List
Are you aware of your blood pressure target?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Blood pressure target
Item
What is your blood pressure target?
integer
C0005823 (UMLS CUI [1,1])
C1521840 (UMLS CUI [1,2])
Item
Are you aware of your total cholesterol level?
integer
C0850624 (UMLS CUI [1,1])
C0004448 (UMLS CUI [1,2])
Code List
Are you aware of your total cholesterol level?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Total cholesterol measurement
Item
Total cholesterol measurement
float
C1445957 (UMLS CUI [1])
Item
Are you aware of your total cholesterol target?
integer
C1445957 (UMLS CUI [1,1])
C1521840 (UMLS CUI [1,2])
Code List
Are you aware of your total cholesterol target?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Total cholesterol target
Item
What is your total cholesterol target?
float
C1445957 (UMLS CUI [1,1])
C1521840 (UMLS CUI [1,2])
Item
Are you aware of your latest blood glucose level?
integer
C0850624 (UMLS CUI [1,1])
C0004448 (UMLS CUI [1,2])
Code List
Are you aware of your latest blood glucose level?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Blood glucose measurement
Item
Blood glucose measurement
integer
C0392201 (UMLS CUI [1])
Item
Are you aware of your blood glucose target?
integer
C0392201 (UMLS CUI [1,1])
C1521840 (UMLS CUI [1,2])
Code List
Are you aware of your blood glucose target?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Blood glucose target
Item
What is your blood glucose target?
integer
C0392201 (UMLS CUI [1,1])
C1521840 (UMLS CUI [1,2])
Item
Are you aware of your latest HbA1c level?
integer
C0850624 (UMLS CUI [1,1])
C0004448 (UMLS CUI [1,2])
Code List
Are you aware of your latest HbA1c level?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
HbA1c measurement
Item
HbA1c measurement
integer
C0373638 (UMLS CUI [1])
Item
Are you aware of your HbA1c target?
integer
C0373638 (UMLS CUI [1,1])
C1521840 (UMLS CUI [1,2])
Code List
Are you aware of your HbA1c target?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
HbA1c target
Item
What is your HbA1c target?
integer
C0373638 (UMLS CUI [1,1])
C1521840 (UMLS CUI [1,2])
Item Group
Lifestyle changes
Item
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on stopping smoking?
integer
C0870811 (UMLS CUI [1,1])
C0453996 (UMLS CUI [1,2])
Code List
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on stopping smoking?
CL Item
Yes since the index event or procedure  (1)
CL Item
Yes since before the index event or procedure  (2)
CL Item
No  (3)
CL Item
Unsure/ Don’t know (4)
Item
What type of advice did you receive for stopping smoking?
integer
C0870811 (UMLS CUI [1,1])
C0453996 (UMLS CUI [1,2])
Code List
What type of advice did you receive for stopping smoking?
CL Item
verbal (1)
CL Item
written materials (2)
CL Item
referral to smoking cessation clinic/ course (3)
CL Item
Nicotine replacement therapy (4)
CL Item
Bupropion (5)
CL Item
other (6)
Item
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on a healthy diet?
integer
C0870811 (UMLS CUI [1,1])
C0811813 (UMLS CUI [1,2])
Code List
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on a healthy diet?
CL Item
Yes since the index event or procedure  (1)
CL Item
Yes since before the index event or procedure  (2)
CL Item
No  (3)
CL Item
Unsure/ Don’t know (4)
Item
What type of advice did you receive concerning a healthy diet?
integer
C0870811 (UMLS CUI [1,1])
C0811813 (UMLS CUI [1,2])
Code List
What type of advice did you receive concerning a healthy diet?
CL Item
reduction of salt intake (1)
CL Item
reduction of fat intake (2)
CL Item
changing type of fat intake (3)
CL Item
reduction of calorie intake (4)
CL Item
eating more fruits and vegetables (5)
CL Item
eating more fish (6)
CL Item
eating more oily fish (7)
CL Item
reducing sugar (8)
CL Item
reducing excessive alcohol intake (9)
Item
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on weight loss?
integer
C0870811 (UMLS CUI [1,1])
C0555962 (UMLS CUI [1,2])
Code List
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on weight loss?
CL Item
Yes since the index event or procedure  (1)
CL Item
Yes since before the index event or procedure  (2)
CL Item
No  (3)
CL Item
Unsure/ Don’t know (4)
Item
What type of advice did you receive concerning weight loss?
integer
C0870811 (UMLS CUI [1,1])
C0555962 (UMLS CUI [1,2])
Code List
What type of advice did you receive concerning weight loss?
CL Item
following dietary recommendations (1)
CL Item
participating in regular physical activity (2)
CL Item
weight reducing drugs (3)
CL Item
other (please specify) (4)
Item
What type of advice did you receive concerning weight loss?
integer
C0870811 (UMLS CUI [1,1])
C0555962 (UMLS CUI [1,2])
Code List
What type of advice did you receive concerning weight loss?
CL Item
following dietary recommendations (1)
CL Item
participating in regular physical activity (2)
CL Item
weight reducing drugs (3)
CL Item
other (please specify) (4)
Lifestyle changes Weight loss
Item
Please specify other type of advice you received concerning weight loss?
text
C0870811 (UMLS CUI [1,1])
C0555962 (UMLS CUI [1,2])
Item
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on increase of physical activity?
integer
C0870811 (UMLS CUI [1,1])
C0511855 (UMLS CUI [1,2])
Code List
Since before or after your diagnosis of peripheral artery occlusive disease, were you offered any personal advice by a doctor or other health professional on increase of physical activity?
CL Item
Yes since the index event or procedure  (1)
CL Item
Yes since before the index event or procedure  (2)
CL Item
No  (3)
CL Item
Unsure/ Don’t know (4)
Item
What type of advice did you receive concerning increase of physical activity?
integer
C0870811 (UMLS CUI [1,1])
C0511855 (UMLS CUI [1,2])
Code List
What type of advice did you receive concerning increase of physical activity?
CL Item
following specific exercise advice from a health or exercise professional (1)
CL Item
attending a fitness club or leisure centre (2)
CL Item
trying to do more general everyday physical activities (3)
CL Item
joining a community walking group (4)
CL Item
other (5)
Item Group
Family history of cardiovascular disease
Item
History of cardiovascular disease of brother
integer
C0455539 (UMLS CUI [1,1])
C0337527 (UMLS CUI [1,2])
Code List
History of cardiovascular disease of brother
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Age of brother at diagnosis
Item
Age of brother at diagnosis of cardiovascular disease
integer
C1828181 (UMLS CUI [1,1])
C0337527 (UMLS CUI [1,2])
Age of brother at diagnosis
Item
Age of brother at diagnosis of cardiovascular disease unknown
boolean
C1828181 (UMLS CUI [1,1])
C0337527 (UMLS CUI [1,2])
Item
Brother died of cardiovascular disease (if applicable)
integer
C0007465 (UMLS CUI [1,1])
C0337527 (UMLS CUI [1,2])
Code List
Brother died of cardiovascular disease (if applicable)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Age at Death brother
Item
Age at death from cardiovascular disease of brother (if applicable)
integer
C1546180 (UMLS CUI [1,1])
C0337527 (UMLS CUI [1,2])
Age at Death brother
Item
Age at death from cardiovascular disease of brother unknown (if applicable)
boolean
C1546180 (UMLS CUI [1,1])
C0337527 (UMLS CUI [1,2])
Item
History of cardiovascular disease of sister
integer
C0455539 (UMLS CUI [1,1])
C0337514 (UMLS CUI [1,2])
Code List
History of cardiovascular disease of sister
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Age of sister at diagnosis
Item
Age of sister at diagnosis of cardiovascular disease
integer
C1828181 (UMLS CUI [1,1])
C0337514 (UMLS CUI [1,2])
Age of sister at diagnosis unknown
Item
Age of sister at diagnosis of cardiovascular disease unknown
boolean
C1828181 (UMLS CUI [1,1])
C0337514 (UMLS CUI [1,2])
Item
Sister died of cardiovascular disease (if applicable)
integer
C0007465 (UMLS CUI [1,1])
C0337514 (UMLS CUI [1,2])
Code List
Sister died of cardiovascular disease (if applicable)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Don´t know/ Unsure (3)
Age at Death sister
Item
Age at death from cardiovascular disease of sister (if applicable)
integer
C1546180 (UMLS CUI [1,1])
C0337514 (UMLS CUI [1,2])
Age at Death sister
Item
Age at death from cardiovascular disease of sister unknown
boolean
C1546180 (UMLS CUI [1,1])
C0337514 (UMLS CUI [1,2])
Item Group
General Health assessment
SF-12 physical health
Item
SF-12 Physical health summary measure
integer
C1519135 (UMLS CUI [1])
SF-12 mental health
Item
SF-12 Mental health summary measure
integer
C1519135 (UMLS CUI [1])

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

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