ID

21919

Description

Urological 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.

Mots-clés

Versions (1)
  1. 08/05/2017 08/05/2017 -
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8 mai 2017

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Urological tumor board Oncology Form University Hospital Cologne

Allemand ( localization.languageCode.DE )

Urological tumor board Oncology Form University Hospital Cologne

1 Formulaires  
Urologisches Tumorboard Anforderung
Description

Urologisches Tumorboard Anforderung

Alias
UMLS CUI-1
C2985541
UMLS CUI-2
C0042077
UMLS CUI-3
C0006826
UMLS CUI-4
C1272683
Patient
Description

patient

Type de données

text

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

date of birth

Type de données

date

Alias
UMLS CUI [1]
C0421451
Auftragsnummer
Description

request identifier

Type de données

text

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

Case ID

Type de données

integer

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

PID

Type de données

integer

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

status

Type de données

text

Alias
UMLS CUI [1]
C0449438
Dringlichkeit
Description

urgency

Type de données

text

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

requested procedure

Type de données

text

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

requested procedure

Type de données

text

Alias
UMLS CUI [1,1]
C0430022
UMLS CUI [1,2]
C1272683
Auftragsdatum
Description

date of request

Type de données

date

Alias
UMLS CUI [1,1]
C1272683
UMLS CUI [1,2]
C0011008
Anf. Fachabteilung
Description

requesting department

Type de données

text

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

requesting department

Type de données

text

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

Ordering physician

Type de données

text

Alias
UMLS CUI [1]
C1709334
Terminwunsch
Description

requested appointment

Type de données

date

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

comment

Type de données

text

Alias
UMLS CUI [1]
C0947611
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0042077
Mobilität
Description

mobility

Type de données

text

Alias
UMLS CUI [1]
C0449580
Vorbefunde
Description

previous findings

Type de données

text

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

conference information

Type de données

text

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

ICD

Type de données

text

Alias
UMLS CUI [1,1]
C2598420
UMLS CUI [1,2]
C1274082
UMLS CUI [2,1]
C0042077
UMLS CUI [2,2]
C0006826
Freitextdiagnose
Description

diagnosis

Type de données

text

Alias
UMLS CUI [1]
C0011900
UMLS CUI [2,1]
C0042077
UMLS CUI [2,2]
C0006826
Erstdiagnose-Zeitpunkt (Monat / Jahr)
Description

diagnosis date

Type de données

date

Alias
UMLS CUI [1,1]
C3172269
UMLS CUI [1,2]
C0011008
UMLS CUI [2,1]
C0042077
UMLS CUI [2,2]
C0006826
Komorbiditäten/Nebendiagnosen
Description

comorbidity and secondary diagnosis

Type de données

text

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

ECOG

Type de données

integer

Alias
UMLS CUI [1]
C1520224
Verlauf
Description

progression

Type de données

text

Alias
UMLS CUI [1,1]
C0242656
UMLS CUI [1,2]
C0006826
UMLS CUI [1,3]
C0042077
Bildgebung, die präsentiert werden soll: Datum
Description

diagnostic imaging date

Type de données

date

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

diagnostic imaging type

Type de données

text

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

diagnostic imaging description

Type de données

text

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

diagnostic imaging external

Type de données

text

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

diagnostic imaging RIS

Type de données

text

Alias
UMLS CUI [1,1]
C0034601
UMLS CUI [1,2]
C0011923
cTNM (klinisch) : T
Description

cTNM

Type de données

integer

Alias
UMLS CUI [1]
C0475455
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0042077
cTNM (klinisch) : N
Description

cTNM

Type de données

integer

Alias
UMLS CUI [1]
C0449393
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0042077
cTNM (klinisch) : M
Description

cTNM

Type de données

integer

Alias
UMLS CUI [1]
C0456533
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0042077
pTNM (pathologisch) : T
Description

pTNM

Type de données

text

Alias
UMLS CUI [1]
C1272834
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0042077
pTNM (pathologisch) : N
Description

pTNM

Type de données

integer

Alias
UMLS CUI [1]
C1272833
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0042077
pTNM (pathologisch) : M
Description

pTNM

Type de données

integer

Alias
UMLS CUI [1]
C1269798
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0042077
pTNM Resektionsstatus
Description

pTNM resection

Type de données

integer

Alias
UMLS CUI [1,1]
C0728940
UMLS CUI [1,2]
C1319019
UMLS CUI [2,1]
C0006826
UMLS CUI [2,2]
C0042077
TNM-Stadium
Description

TNM Stage

Type de données

text

Alias
UMLS CUI [1,1]
C0456885
UMLS CUI [1,2]
C0006826
UMLS CUI [1,3]
C0042077
IPSS
Description

IPSS

Type de données

text

Alias
UMLS CUI [1]
C1998280
IEEF
Description

IEEF

Type de données

text

Alias
UMLS CUI [1]
C3641331
initialer PSA-Wert:
Description

PSA

Type de données

integer

Alias
UMLS CUI [1]
C0201544
Gleasson-Score Wert 1
Description

gleason score

Type de données

integer

Alias
UMLS CUI [1]
C3203027
Gleasson-Score Wert 2
Description

gleason score

Type de données

integer

Alias
UMLS CUI [1]
C3203027
Gleasson-Score Gesamt
Description

gleason score

Type de données

integer

Alias
UMLS CUI [1]
C3203027
Fragestellung
Description

question

Type de données

text

Alias
UMLS CUI [1,1]
C1522634
UMLS CUI [1,2]
C0006826
UMLS CUI [1,3]
C0042077
Ansprechpartner
Description

contact person

Type de données

text

Alias
UMLS CUI [1,1]
C0337611
UMLS CUI [1,2]
C0006826
UMLS CUI [1,3]
C0042077
Ansprechpartner Funknummer
Description

contact person pager number

Type de données

integer

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

referring physician

Type de données

text

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

referring physician address

Type de données

text

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

clinical trial participation

Type de données

text

Alias
UMLS CUI [1,1]
C0337611
UMLS CUI [1,2]
C0008976
UMLS CUI [2,1]
C0042077
UMLS CUI [2,2]
C0006826
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Similar models

Urological tumor board Oncology Form University Hospital Cologne

1 Formulaires
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Urologisches Tumorboard Anforderung
C2985541 (UMLS CUI-1)
C0042077 (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])
date of request
Item
Auftragsdatum
date
C1272683 (UMLS CUI [1,1])
C0011008 (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])
C0006826 (UMLS CUI [2,1])
C0042077 (UMLS CUI [2,2])
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])
C0042077 (UMLS CUI [2,1])
C0006826 (UMLS CUI [2,2])
diagnosis
Item
Freitextdiagnose
text
C0011900 (UMLS CUI [1])
C0042077 (UMLS CUI [2,1])
C0006826 (UMLS CUI [2,2])
diagnosis date
Item
Erstdiagnose-Zeitpunkt (Monat / Jahr)
date
C3172269 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0042077 (UMLS CUI [2,1])
C0006826 (UMLS CUI [2,2])
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])
progression
Item
Verlauf
text
C0242656 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0042077 (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])
Item
cTNM (klinisch) : T
integer
C0475455 (UMLS CUI [1])
C0006826 (UMLS CUI [2,1])
C0042077 (UMLS CUI [2,2])
undefined item
Code List
cTNM (klinisch) : T
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
X (5)
CL Item
is (6)
CL Item
y (7)
Item
cTNM (klinisch) : N
integer
C0449393 (UMLS CUI [1])
C0006826 (UMLS CUI [2,1])
C0042077 (UMLS CUI [2,2])
undefined item
Code List
cTNM (klinisch) : N
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
X (4)
Item
cTNM (klinisch) : M
integer
C0456533 (UMLS CUI [1])
C0006826 (UMLS CUI [2,1])
C0042077 (UMLS CUI [2,2])
cTNM
Code List
cTNM (klinisch) : M
CL Item
0 (0)
CL Item
1 (1)
CL Item
X (2)
Item
pTNM (pathologisch) : T
text
C1272834 (UMLS CUI [1])
C0006826 (UMLS CUI [2,1])
C0042077 (UMLS CUI [2,2])
undefined item
Code List
pTNM (pathologisch) : T
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
X (5)
CL Item
is (6)
CL Item
y (7)
Item
pTNM (pathologisch) : N
integer
C1272833 (UMLS CUI [1])
C0006826 (UMLS CUI [2,1])
C0042077 (UMLS CUI [2,2])
undefined item
Code List
pTNM (pathologisch) : N
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
X (4)
CL Item
sn (5)
Item
pTNM (pathologisch) : M
integer
C1269798 (UMLS CUI [1])
C0006826 (UMLS CUI [2,1])
C0042077 (UMLS CUI [2,2])
pTNM
Code List
pTNM (pathologisch) : M
CL Item
0 (0)
CL Item
1 (1)
CL Item
X (2)
pTNM resection
Item
pTNM Resektionsstatus
integer
C0728940 (UMLS CUI [1,1])
C1319019 (UMLS CUI [1,2])
C0006826 (UMLS CUI [2,1])
C0042077 (UMLS CUI [2,2])
TNM Stage
Item
TNM-Stadium
text
C0456885 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0042077 (UMLS CUI [1,3])
IPSS
Item
IPSS
text
C1998280 (UMLS CUI [1])
IEEF
Item
IEEF
text
C3641331 (UMLS CUI [1])
PSA
Item
initialer PSA-Wert:
integer
C0201544 (UMLS CUI [1])
gleason score
Item
Gleasson-Score Wert 1
integer
C3203027 (UMLS CUI [1])
gleason score
Item
Gleasson-Score Wert 2
integer
C3203027 (UMLS CUI [1])
gleason score
Item
Gleasson-Score Gesamt
integer
C3203027 (UMLS CUI [1])
question
Item
Fragestellung
text
C1522634 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0042077 (UMLS CUI [1,3])
contact person
Item
Ansprechpartner
text
C0337611 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0042077 (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 participation
Item
Kontakt Studienteilnahme
text
C0337611 (UMLS CUI [1,1])
C0008976 (UMLS CUI [1,2])
C0042077 (UMLS CUI [2,1])
C0006826 (UMLS CUI [2,2])
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