Information:
Fel:
ID
20591
Beskrivning
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form Name: Poliklinik Anamnese
Nyckelord
Versioner (1)
- 2017-03-05 2017-03-05 -
Uppladdad den
5 mars 2017
DOI
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Licens
Creative Commons BY-NC 3.0
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Polyclinic Medical History University Hospital Cologne
Polyclinic Medical History University Hospital Cologne
- StudyEvent: ODM
Similar models
Polyclinic Medical History University Hospital Cologne
- StudyEvent: ODM
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Name
Item
Name:
text
C0027365 (UMLS CUI [1])
Surname
Item
Vorname:
text
C0421448 (UMLS CUI [1])
Date of birth
Item
Geb.-Datum:
date
C0421451 (UMLS CUI [1])
Case number
Item
Fallnummer.:
integer
C1698493 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
C0600091 (UMLS CUI [1,2])
Date
Item
Datum
date
C0011008 (UMLS CUI [1])
Time
Item
Uhrzeit
time
C0040223 (UMLS CUI [1])
Investigator
Item
Anamnese durch
text
C2826892 (UMLS CUI [1])
CL Item
Erstvorstellung (1)
CL Item
Wiedervorstellung (2)
Gynecologist
Item
Frauenarzt
text
C0237419 (UMLS CUI [1])
General Practitioners
Item
Hausarzt
text
C0017319 (UMLS CUI [1])
Occupations
Item
Beruf
text
C0028811 (UMLS CUI [1])
Telephone Number
Item
Tel. Pat./ Angehörige
text
C1515258 (UMLS CUI [1])
Telephone Number
Item
Tel. Pat./ Angehörige Mobil:
text
C1515258 (UMLS CUI [1])
Systolic blood pressure
Item
RR systolisch
float
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
RR diastolisch
float
C0428883 (UMLS CUI [1])
Heart rate
Item
Pulse
float
C0018810 (UMLS CUI [1])
Body temperature
Item
Temp
float
C0886414 (UMLS CUI [1])
hcg
Item
betaHCG
float
C0428402 (UMLS CUI [1])
CL Item
unauffällig (1)
CL Item
auffällig (2)
CL Item
Sonstiges (3)
Specification Of "Other"
Item
Sonstiges
text
C1521902 (UMLS CUI [1])
Family History
Item
Familienanamnese
boolean
C0241889 (UMLS CUI [1])
Specification
Item
Familienanamnese
text
C0241889 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,2])
Comorbidity
Item
Vorerkrankungen
boolean
C0009488 (UMLS CUI [1])
Specification
Item
Vorerkrankungen
text
C0009488 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,2])
Pharmaceutical Preparations
Item
Präparat
text
C0013227 (UMLS CUI [1])
dose
Item
Dosis
text
C3174092 (UMLS CUI [1])
Year
Item
Jahr
partialDate
C0439234 (UMLS CUI [1])
Surgical Procedure
Item
Operation
text
C0543467 (UMLS CUI [1])
Pregnancy
Item
Schwangerschaft
boolean
C0032961 (UMLS CUI [1])
date
Item
akt. Dat
date
C0011008 (UMLS CUI [1])
Menstruation
Item
letzte Periode
date
C0025344 (UMLS CUI [1])
Weeks Pregnant
Item
akt. Dat - letzte Periode = SSW
float
C1135241 (UMLS CUI [1])
Date of birth
Item
letzte Periode/Dat. = errechnetes Geburtsdatum
date
C0421451 (UMLS CUI [1])
Pregnancy
Item
Gravida
float
C0032961 (UMLS CUI [1])
Births
Item
Para
float
C1148523 (UMLS CUI [1])
Year
Item
Jahr
partialDate
C0439234 (UMLS CUI [1])
Type Of Birth
Item
Modus
text
C2239272 (UMLS CUI [1])
Comment
Item
Besonderheiten
text
C0947611 (UMLS CUI [1])
Body height
Item
Größe
float
C0005890 (UMLS CUI [1])
body weight
Item
Gewicht
float
C0005910 (UMLS CUI [1])
Blood group
Item
Blutgruppe
text
C0005810 (UMLS CUI [1])
Rhesus
Item
Rh
text
C0427641 (UMLS CUI [1])
Smoking Status
Item
Nikotin
boolean
C1519386 (UMLS CUI [1])
Comment
Item
Bemerkung
text
C0947611 (UMLS CUI [1])
Alcohol
Item
Alkohol
boolean
C0001948 (UMLS CUI [1])
comment
Item
Bemerkung
text
C0947611 (UMLS CUI [1])
Contraceptive Methods
Item
Kontrazeption
text
C0700589 (UMLS CUI [1])
Cancer Screening
Item
Krebsvorsorge
text
C0278974 (UMLS CUI [1])
Mammography
Item
Mammographie
text
C0024671 (UMLS CUI [1])
Allergy
Item
Allergien
boolean
C0020517 (UMLS CUI [1])
comment
Item
Bemerkung
text
C0947611 (UMLS CUI [1])
Lumbal puncture
Item
LP
text
C0553794 (UMLS CUI [1])
Menstrual cycle
Item
Zyklus
text
C0025329 (UMLS CUI [1])
Menopause
Item
Menopause
boolean
C0455962 (UMLS CUI [1])
Date Of Beginning Of Menopause
Item
Seit wann?
date
C0011008 (UMLS CUI [1])
Urination
Item
Miktion
text
C0042034 (UMLS CUI [1])
Defecation
Item
Stuhlgang
text
C0011135 (UMLS CUI [1])
Bleeding Risk
Item
Blutung-/Thromboseneigung
boolean
C3251812 (UMLS CUI [1])
comment
Item
Bemerkung
text
C0947611 (UMLS CUI [1])
External Genitalia
Item
Äußeres Genital
text
C0227605 (UMLS CUI [1])
Speculum
Item
Speculum
text
C0037816 (UMLS CUI [1])
pH
Item
pH
text
C0042044 (UMLS CUI [1])
Nativ
Item
Nativ
text
Smear Test
Item
Abstrich
boolean
C0444186 (UMLS CUI [1])
comment
Item
Bemerkung
text
C0947611 (UMLS CUI [1])
Palpation
Item
Tastbefund
text
C0030247 (UMLS CUI [1])
Uterus
Item
Uterus
text
C0042149 (UMLS CUI [1])
Ovary right
Item
Ovar// Adnexe rechts
text
C0029939 (UMLS CUI [1,1])
C0205090 (UMLS CUI [1,2])
C0205090 (UMLS CUI [1,2])
Ovary left
Item
Ovar// Adnexe links
text
C0029939 (UMLS CUI [1,1])
C0205091 (UMLS CUI [1,2])
C0205091 (UMLS CUI [1,2])
Extracavatio recto
Item
Douglasraum
text
C0013075 (UMLS CUI [1])
Ultrasonography
Item
Sono
text
C0041618 (UMLS CUI [1])
Breast
Item
Mammae
text
C0006141 (UMLS CUI [1])
Comment
Item
sonstiges
text
C0947611 (UMLS CUI [1])
Diagnosis
Item
Klinische Diagnose
text
C0011900 (UMLS CUI [1])
Procedure
Item
Procedere
text
C0087111 (UMLS CUI [1])
Signature Of Attending Physician
Item
Name/Unterschrift des behandelndes Arztes
text
C1519316 (UMLS CUI [1,1])
C2361125 (UMLS CUI [1,2])
C2361125 (UMLS CUI [1,2])
Signature Of Treating Physician
Item
Name/Unterschrift des behandelnden Facharztes
text
C1519316 (UMLS CUI [1,1])
C1710470 (UMLS CUI [1,2])
C1710470 (UMLS CUI [1,2])