ID

21855

Beschrijving

Gynecological tumor board request form at the endocrinology polyclinic department University Hospital Cologne. Asking questions regarding basic patient information, tumor board organisation, diagnosis and comorbidity, pathology and tumor staging as well as diagnostic imaging. ODM derived from routine documentation of University Hospital Cologne.

Trefwoorden

Versies (1)
  1. 04-05-17 04-05-17 -
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4 mei 2017

DOI

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Creative Commons BY-NC 3.0
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Gynecological tumor board Oncology Form University Hospital Cologne

Duits ( localization.languageCode.DE )

Gynecological tumor board Oncology Form University Hospital Cologne

1 Formulieren  
Tumorboard Gynäkologie Krebszentrum Anforderung
Beschrijving

Tumorboard Gynäkologie Krebszentrum Anforderung

Alias
UMLS CUI-1
C2985541
UMLS CUI-2
C0018417
UMLS CUI-3
C0006826
UMLS CUI-4
C1272683
Patient
Beschrijving

patient

Datatype

text

Alias
UMLS CUI [1]
C1299487
Geb.Dat.
Beschrijving

date of birth

Datatype

date

Alias
UMLS CUI [1]
C0421451
Auftragsnummer
Beschrijving

request identifier

Datatype

text

Alias
UMLS CUI [1,1]
C1300638
UMLS CUI [1,2]
C1272683
Fall-Nr.
Beschrijving

Case ID

Datatype

integer

Alias
UMLS CUI [1,1]
C1698493
UMLS CUI [1,2]
C0600091
PID
Beschrijving

PID

Datatype

integer

Alias
UMLS CUI [1,1]
C0030705
UMLS CUI [1,2]
C1300638
Status
Beschrijving

status

Datatype

text

Alias
UMLS CUI [1]
C0449438
Dringlichkeit
Beschrijving

urgency

Datatype

text

Alias
UMLS CUI [1]
C4049774
Gew. Unters./Lstg.
Beschrijving

requested procedure

Datatype

text

Alias
UMLS CUI [1,1]
C0430022
UMLS CUI [1,2]
C1272683
Gewünschte Untersuchung Zusatz
Beschrijving

requested procedure

Datatype

text

Alias
UMLS CUI [1,1]
C0430022
UMLS CUI [1,2]
C1272683
Leistende Stelle
Beschrijving

performing department

Datatype

text

Alias
UMLS CUI [1,1]
C0587450
UMLS CUI [1,2]
C0884358
Anf. Fachabteilung
Beschrijving

requesting department

Datatype

text

Alias
UMLS CUI [1,1]
C0587450
UMLS CUI [1,2]
C1272683
Anfordernde Stelle
Beschrijving

requesting department

Datatype

text

Alias
UMLS CUI [1,1]
C0587450
UMLS CUI [1,2]
C1272683
Anforderer
Beschrijving

Ordering physician

Datatype

text

Alias
UMLS CUI [1]
C1709334
Terminwunsch
Beschrijving

requested appointment

Datatype

date

Alias
UMLS CUI [1,1]
C0430022
UMLS CUI [1,2]
C0011008
Kommentar
Beschrijving

comment

Datatype

text

Alias
UMLS CUI [1]
C0947611
Mobilität
Beschrijving

mobility

Datatype

text

Alias
UMLS CUI [1]
C0449580
Vorbefunde
Beschrijving

previous findings

Datatype

text

Alias
UMLS CUI [1,1]
C0243095
UMLS CUI [1,2]
C0205156
Konferenz Informationen
Beschrijving

Donnerstags, 15:30 Uhr - Kolloquiumraum der Frauenklinik (Geb. 47), EG, Raum 39 Vorstellende Ärzte müssen anwesend sein. Patienten sollen NICHT persönlich erscheinen.

Datatype

text

Alias
UMLS CUI [1,1]
C2985541
UMLS CUI [1,2]
C1533716
ICD
Beschrijving

ICD

Datatype

text

Alias
UMLS CUI [1,1]
C2598420
UMLS CUI [1,2]
C1274082
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0018417
Freitextdiagnose
Beschrijving

diagnosis

Datatype

text

Alias
UMLS CUI [1]
C0011900
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0018417
Erstdiagnose-Zeitpunkt (Monat / Jahr)
Beschrijving

diagnosis date

Datatype

date

Alias
UMLS CUI [1,1]
C3172269
UMLS CUI [1,2]
C0011008
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0018417
Tumor-Stadium[Klassifikation]
Beschrijving

tumor stage classification

Datatype

text

Alias
UMLS CUI [1]
C0474927
Komorbiditäten/Nebendiagnosen
Beschrijving

comorbidity and secondary diagnosis

Datatype

text

Alias
UMLS CUI [1]
C0009488
UMLS CUI [2]
C0332138
Index zur Lebensqualität ('ECOG Perfomance Status')
Beschrijving

ECOG

Datatype

integer

Alias
UMLS CUI [1]
C1520224
vorhandene Pathologie/Tumorgrading
Beschrijving

pathology and tumor staging

Datatype

text

Alias
UMLS CUI [1]
C0030664
UMLS CUI [2]
C0027646
UMLS CUI [3,1]
C0006826
UMLS CUI [3,2]
C0018417
Verlauf
Beschrijving

progression

Datatype

text

Alias
UMLS CUI [1,1]
C0242656
UMLS CUI [1,2]
C0006826
UMLS CUI [1,3]
C0018417
Bildgebung, die präsentiert werden soll: Datum
Beschrijving

diagnostic imaging date

Datatype

date

Alias
UMLS CUI [1,1]
C0011923
UMLS CUI [1,2]
C0011008
Bildgebung, die präsentiert werden soll: Rö-Art
Beschrijving

diagnostic imaging type

Datatype

text

Alias
UMLS CUI [1,1]
C0011923
UMLS CUI [1,2]
C0332307
Bildgebung, die präsentiert werden soll: Bezeichnung
Beschrijving

diagnostic imaging description

Datatype

text

Alias
UMLS CUI [1,1]
C0011923
UMLS CUI [1,2]
C0678257
Bildgebung, die präsentiert werden soll: Hinweis Externbefund
Beschrijving

diagnostic imaging external

Datatype

text

Alias
UMLS CUI [1,1]
C0011923
UMLS CUI [1,2]
C3844314
Bildgebung, die präsentiert werden soll: RIS
Beschrijving

diagnostic imaging RIS

Datatype

text

Alias
UMLS CUI [1,1]
C0034601
UMLS CUI [1,2]
C0011923
CA 15-3
Beschrijving

CA 15-3

Datatype

float

Maateenheden
  • kU/l
Alias
UMLS CUI [1]
C0201547
kU/l
CEA
Beschrijving

CEA

Datatype

float

Maateenheden
  • μg/l
Alias
UMLS CUI [1]
C0201933
μg/l
SCC
Beschrijving

SCC

Datatype

float

Maateenheden
  • μg/l
Alias
UMLS CUI [1]
C0075091
μg/l
CA 125
Beschrijving

CA 125

Datatype

float

Maateenheden
  • kU/l
Alias
UMLS CUI [1]
C0201549
kU/l
Monat/Jahr CA 15-3
Beschrijving

Date of CA 15-3 measurement

Datatype

date

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C0201547
Monat/Jahr CEA
Beschrijving

Date of CEA measurement

Datatype

date

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C0201933
Monat/Jahr CA 125
Beschrijving

Date of CA 125 measurement

Datatype

date

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C0201549
Monat/Jahr SCC
Beschrijving

Date of SCC measurement

Datatype

date

Alias
UMLS CUI [1,1]
C1254595
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C0075091
Menopausenstatus
Beschrijving

menopause finding

Datatype

integer

Alias
UMLS CUI [1]
C0455962
Familienanamnese
Beschrijving

family medical history

Datatype

text

Alias
UMLS CUI [1,1]
C0241889
UMLS CUI [1,2]
C0262926
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0018417
Diagnosedatum Metastase mit Lokalisation
Beschrijving

date of metastasis diagnosis

Datatype

text

Alias
UMLS CUI [1,1]
C0027627
UMLS CUI [1,2]
C0011008
Fragestellung
Beschrijving

question

Datatype

text

Alias
UMLS CUI [1,1]
C1522634
UMLS CUI [1,2]
C0006826
UMLS CUI [1,3]
C0018417
Ansprechpartner
Beschrijving

contact person

Datatype

text

Alias
UMLS CUI [1,1]
C0337611
UMLS CUI [1,2]
C0006826
UMLS CUI [1,3]
C0018417
Ansprechpartner Funknummer
Beschrijving

contact person pager number

Datatype

integer

Alias
UMLS CUI [1,1]
C0337611
UMLS CUI [1,2]
C1515258
Einweiser/Überweiser
Beschrijving

referring physician

Datatype

text

Alias
UMLS CUI [1]
C1709880
Einweiser/Überweiser Adresse
Beschrijving

referring physician address

Datatype

text

Alias
UMLS CUI [1,1]
C1442065
UMLS CUI [1,2]
C1709880
Kontakt Studienteilnahme
Beschrijving

Kontakt: Sekretariat Fr. Pfeil, Tel 82108 Fax 82372 online-Anmeldung bis Montag, 12:00 Uhr, Nachmeldungen möglich nach telefonischer Rücksprache

Datatype

text

Alias
UMLS CUI [1,1]
C0337611
UMLS CUI [1,2]
C0008976
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0018417
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Similar models

Gynecological tumor board Oncology Form University Hospital Cologne

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Tumorboard Gynäkologie Krebszentrum Anforderung
C2985541 (UMLS CUI-1)
C0018417 (UMLS CUI-2)
C0006826 (UMLS CUI-3)
C1272683 (UMLS CUI-4)
patient
Item
Patient
text
C1299487 (UMLS CUI [1])
date of birth
Item
Geb.Dat.
date
C0421451 (UMLS CUI [1])
request identifier
Item
Auftragsnummer
text
C1300638 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
Case ID
Item
Fall-Nr.
integer
C1698493 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
PID
Item
PID
integer
C0030705 (UMLS CUI [1,1])
C1300638 (UMLS CUI [1,2])
status
Item
Status
text
C0449438 (UMLS CUI [1])
urgency
Item
Dringlichkeit
text
C4049774 (UMLS CUI [1])
requested procedure
Item
Gew. Unters./Lstg.
text
C0430022 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
requested procedure
Item
Gewünschte Untersuchung Zusatz
text
C0430022 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
performing department
Item
Leistende Stelle
text
C0587450 (UMLS CUI [1,1])
C0884358 (UMLS CUI [1,2])
requesting department
Item
Anf. Fachabteilung
text
C0587450 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
requesting department
Item
Anfordernde Stelle
text
C0587450 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
Ordering physician
Item
Anforderer
text
C1709334 (UMLS CUI [1])
requested appointment
Item
Terminwunsch
date
C0430022 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
comment
Item
Kommentar
text
C0947611 (UMLS CUI [1])
mobility
Item
Mobilität
text
C0449580 (UMLS CUI [1])
previous findings
Item
Vorbefunde
text
C0243095 (UMLS CUI [1,1])
C0205156 (UMLS CUI [1,2])
conference information
Item
Konferenz Informationen
text
C2985541 (UMLS CUI [1,1])
C1533716 (UMLS CUI [1,2])
ICD
Item
ICD
text
C2598420 (UMLS CUI [1,1])
C1274082 (UMLS CUI [1,2])
C0006826 (UMLS CUI [2,1])
C0018417 (UMLS CUI [2,2])
diagnosis
Item
Freitextdiagnose
text
C0011900 (UMLS CUI [1])
C0006826 (UMLS CUI [2,1])
C0018417 (UMLS CUI [2,2])
diagnosis date
Item
Erstdiagnose-Zeitpunkt (Monat / Jahr)
date
C3172269 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0006826 (UMLS CUI [2,1])
C0018417 (UMLS CUI [2,2])
tumor stage classification
Item
Tumor-Stadium[Klassifikation]
text
C0474927 (UMLS CUI [1])
comorbidity and secondary diagnosis
Item
Komorbiditäten/Nebendiagnosen
text
C0009488 (UMLS CUI [1])
C0332138 (UMLS CUI [2])
ECOG
Item
Index zur Lebensqualität ('ECOG Perfomance Status')
integer
C1520224 (UMLS CUI [1])
pathology and tumor staging
Item
vorhandene Pathologie/Tumorgrading
text
C0030664 (UMLS CUI [1])
C0027646 (UMLS CUI [2])
C0006826 (UMLS CUI [3,1])
C0018417 (UMLS CUI [3,2])
progression
Item
Verlauf
text
C0242656 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0018417 (UMLS CUI [1,3])
diagnostic imaging date
Item
Bildgebung, die präsentiert werden soll: Datum
date
C0011923 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
diagnostic imaging type
Item
Bildgebung, die präsentiert werden soll: Rö-Art
text
C0011923 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
diagnostic imaging description
Item
Bildgebung, die präsentiert werden soll: Bezeichnung
text
C0011923 (UMLS CUI [1,1])
C0678257 (UMLS CUI [1,2])
diagnostic imaging external
Item
Bildgebung, die präsentiert werden soll: Hinweis Externbefund
text
C0011923 (UMLS CUI [1,1])
C3844314 (UMLS CUI [1,2])
diagnostic imaging RIS
Item
Bildgebung, die präsentiert werden soll: RIS
text
C0034601 (UMLS CUI [1,1])
C0011923 (UMLS CUI [1,2])
CA 15-3
Item
CA 15-3
float
C0201547 (UMLS CUI [1])
CEA
Item
CEA
float
C0201933 (UMLS CUI [1])
SCC
Item
SCC
float
C0075091 (UMLS CUI [1])
CA 125
Item
CA 125
float
C0201549 (UMLS CUI [1])
Date of CA 15-3 measurement
Item
Monat/Jahr CA 15-3
date
C1254595 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0201547 (UMLS CUI [1,3])
Date of CEA measurement
Item
Monat/Jahr CEA
date
C1254595 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0201933 (UMLS CUI [1,3])
Date of CA 125 measurement
Item
Monat/Jahr CA 125
date
C1254595 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0201549 (UMLS CUI [1,3])
Date of SCC measurement
Item
Monat/Jahr SCC
date
C1254595 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0075091 (UMLS CUI [1,3])
Item
Menopausenstatus
integer
C0455962 (UMLS CUI [1])
menopause finding
Code List
Menopausenstatus
CL Item
prämenopausal (1)
CL Item
postmenopausal (2)
CL Item
unbekannt (3)
family medical history
Item
Familienanamnese
text
C0241889 (UMLS CUI [1,1])
C0262926 (UMLS CUI [1,2])
C0006826 (UMLS CUI [2,1])
C0018417 (UMLS CUI [2,2])
date of metastasis diagnosis
Item
Diagnosedatum Metastase mit Lokalisation
text
C0027627 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
question
Item
Fragestellung
text
C1522634 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0018417 (UMLS CUI [1,3])
contact person
Item
Ansprechpartner
text
C0337611 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0018417 (UMLS CUI [1,3])
contact person pager number
Item
Ansprechpartner Funknummer
integer
C0337611 (UMLS CUI [1,1])
C1515258 (UMLS CUI [1,2])
referring physician
Item
Einweiser/Überweiser
text
C1709880 (UMLS CUI [1])
referring physician address
Item
Einweiser/Überweiser Adresse
text
C1442065 (UMLS CUI [1,1])
C1709880 (UMLS CUI [1,2])
clinical trial contact
Item
Kontakt Studienteilnahme
text
C0337611 (UMLS CUI [1,1])
C0008976 (UMLS CUI [1,2])
C0006826 (UMLS CUI [2,1])
C0018417 (UMLS CUI [2,2])
Terug naar het begin van de pagina 

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