Informed consent Routine documentation in German hospitals DMI

General information
Description

General information

Alias
UMLS CUI-1
C1508263
Informing physician
Description

Physician

Data type

text

Alias
UMLS CUI [1]
C2826892
Diagnosis
Description

Diagnosis

Data type

text

Alias
UMLS CUI [1]
C0011900
Designated surgery/medical procedure
Description

medical procedure

Data type

text

Alias
UMLS CUI [1]
C0199171
Scheduled date
Description

Scheduled date

Data type

date

Alias
UMLS CUI [1,1]
C0430022
UMLS CUI [1,2]
C2986272
General risks of surgery
Description

General risks of surgery

Alias
UMLS CUI-1
C0274310
Postoperative hemorrhage
Description

Postoperative hemorrhage

Data type

boolean

Alias
UMLS CUI [1]
C0032788
Wound infection
Description

Wound infection

Data type

boolean

Alias
UMLS CUI [1]
C0043241
Wound healing disorder
Description

Wound healing disorder

Data type

boolean

Alias
UMLS CUI [1]
C1096106
Hematoma/Seroma
Description

Hematoma

Data type

boolean

Alias
UMLS CUI [1]
C0018944
Neural and vascular lesions
Description

Neural lesions; vascular lesions

Data type

boolean

Alias
UMLS CUI [1]
C1337100
UMLS CUI [2]
C1402315
Thrombosis
Description

Thrombosis

Data type

boolean

Alias
UMLS CUI [1]
C0040053
Pulmonary embolism
Description

Pulmonary embolism

Data type

boolean

Alias
UMLS CUI [1]
C0034065
Reoperation/revision of surgical area
Description

Reoperation

Data type

boolean

Alias
UMLS CUI [1]
C0558347
Procedure-specific information
Description

Procedure-specific information

Alias
UMLS CUI-1
C1533716
UMLS CUI-2
C0184661
Possible procedure-specific complications
Description

complications

Data type

text

Alias
UMLS CUI [1]
C0009566
Surgical scheme
Description

surgery

Data type

text

Alias
UMLS CUI [1]
C0543467
Consent
Description

Consent

Alias
UMLS CUI-1
C1511481
Location
Description

Location

Data type

text

Alias
UMLS CUI [1]
C0450429
Date
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
Time
Description

Time

Data type

time

Alias
UMLS CUI [1]
C0040223
Signature of patient or legal representative
Description

Signature patient

Data type

text

Alias
UMLS CUI [1,1]
C1519316
UMLS CUI [1,2]
C0030705
Signature of informing physician
Description

Signature of physician

Data type

text

Alias
UMLS CUI [1]
C0807938

Similar models

Informed consent Routine documentation in German hospitals DMI

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
General information
C1508263 (UMLS CUI-1)
Physician
Item
Informing physician
text
C2826892 (UMLS CUI [1])
Diagnosis
Item
Diagnosis
text
C0011900 (UMLS CUI [1])
medical procedure
Item
Designated surgery/medical procedure
text
C0199171 (UMLS CUI [1])
Scheduled date
Item
Scheduled date
date
C0430022 (UMLS CUI [1,1])
C2986272 (UMLS CUI [1,2])
Item Group
General risks of surgery
C0274310 (UMLS CUI-1)
Postoperative hemorrhage
Item
Postoperative hemorrhage
boolean
C0032788 (UMLS CUI [1])
Wound infection
Item
Wound infection
boolean
C0043241 (UMLS CUI [1])
Wound healing disorder
Item
Wound healing disorder
boolean
C1096106 (UMLS CUI [1])
Hematoma
Item
Hematoma/Seroma
boolean
C0018944 (UMLS CUI [1])
Neural lesions; vascular lesions
Item
Neural and vascular lesions
boolean
C1337100 (UMLS CUI [1])
C1402315 (UMLS CUI [2])
Thrombosis
Item
Thrombosis
boolean
C0040053 (UMLS CUI [1])
Pulmonary embolism
Item
Pulmonary embolism
boolean
C0034065 (UMLS CUI [1])
Reoperation
Item
Reoperation/revision of surgical area
boolean
C0558347 (UMLS CUI [1])
Item Group
Procedure-specific information
C1533716 (UMLS CUI-1)
C0184661 (UMLS CUI-2)
complications
Item
Possible procedure-specific complications
text
C0009566 (UMLS CUI [1])
surgery
Item
Surgical scheme
text
C0543467 (UMLS CUI [1])
Item Group
Consent
C1511481 (UMLS CUI-1)
Location
Item
Location
text
C0450429 (UMLS CUI [1])
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Time
Item
Time
time
C0040223 (UMLS CUI [1])
Signature patient
Item
Signature of patient or legal representative
text
C1519316 (UMLS CUI [1,1])
C0030705 (UMLS CUI [1,2])
Signature of physician
Item
Signature of informing physician
text
C0807938 (UMLS CUI [1])