ID

21874

Description

Head or neck tumors 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.

Keywords

Versions (1)
  1. 5/5/17 5/5/17 -
Uploaded on

May 5, 2017

DOI

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License

Creative Commons BY-NC 3.0
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Head or neck tumors tumor board Oncology Form University Hospital Cologne

German ( localization.languageCode.DE )

Head or neck tumors tumor board Oncology Form University Hospital Cologne

1 forms  
Kopf-Hals-Tumorboard Anforderung
Description

Kopf-Hals-Tumorboard Anforderung

Alias
UMLS CUI-1
C2985541
UMLS CUI-2
C0018671
Patient
Description

patient

Data type

text

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

date of birth

Data type

date

Alias
UMLS CUI [1]
C0421451
Auftragsnummer
Description

request identifier

Data type

text

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

Case ID

Data type

integer

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

PID

Data type

integer

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

status

Data type

text

Alias
UMLS CUI [1]
C0449438
Dringlichkeit
Description

urgency

Data type

text

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

requested procedure

Data type

text

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

requested procedure

Data type

text

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

requested procedure quantity

Data type

integer

Alias
UMLS CUI [1,1]
C1265611
UMLS CUI [1,2]
C0430022
UMLS CUI [1,3]
C1272683
Leistende Stelle
Description

performing department

Data type

text

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

requesting department

Data type

text

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

requesting department

Data type

text

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

Ordering physician

Data type

text

Alias
UMLS CUI [1]
C1709334
Terminwunsch
Description

requested appointment

Data type

date

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

comment

Data type

text

Alias
UMLS CUI [1]
C0947611
Mobilität
Description

mobility

Data type

text

Alias
UMLS CUI [1]
C0449580
Vorbefunde
Description

previous findings

Data type

text

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

conference information

Data type

text

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

ICD

Data type

text

Alias
UMLS CUI [1,1]
C2598420
UMLS CUI [1,2]
C1274082
UMLS CUI [2]
C0018671
Freitextdiagnose
Description

diagnosis

Data type

text

Alias
UMLS CUI [1]
C0011900
UMLS CUI [2]
C0018671
Erstdiagnose-Zeitpunkt (Monat / Jahr)
Description

diagnosis date

Data type

date

Alias
UMLS CUI [1,1]
C3172269
UMLS CUI [1,2]
C0011008
UMLS CUI [2]
C0018671
Komorbiditäten/Nebendiagnosen
Description

comorbidity and secondary diagnosis

Data type

text

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

ECOG

Data type

integer

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

pathology and tumor staging

Data type

text

Alias
UMLS CUI [1,1]
C0030664
UMLS CUI [1,2]
C0006826
UMLS CUI [2]
C0027646
UMLS CUI [3]
C0018671
Verlauf
Description

progression

Data type

text

Alias
UMLS CUI [1,1]
C0242656
UMLS CUI [1,2]
C2985541
Bildgebung, die präsentiert werden soll: Datum
Description

diagnostic imaging date

Data type

date

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

diagnostic imaging type

Data type

text

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

diagnostic imaging description

Data type

text

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

diagnostic imaging external

Data type

text

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

diagnostic imaging RIS

Data type

text

Alias
UMLS CUI [1,1]
C0034601
UMLS CUI [1,2]
C0011923
Patient angebunden an folgende Fachrichtung:
Description

patient treated by

Data type

integer

Nebenerkrankungen
Description

accompanying illnesses

Data type

text

Alias
UMLS CUI [1]
C0009488
Hals-Kopf-Ops
Description

head neck surgeries

Data type

text

Alias
UMLS CUI [1]
C1512343
früh. Bestrahlungen
Description

prior radiation

Data type

text

Alias
UMLS CUI [1]
C1522449
früh. Chemoth.
Description

prior chemotherapy

Data type

text

Alias
UMLS CUI [1]
C1514457
Histologie
Description

histology

Data type

text

Alias
UMLS CUI [1,1]
C0019638
UMLS CUI [1,2]
C0018671
cTNM (klinisch) : T
Description

cTNM

Data type

integer

Alias
UMLS CUI [1,1]
C0475455
UMLS CUI [1,2]
C0018671
cTNM (klinisch) : N
Description

cTNM

Data type

integer

Alias
UMLS CUI [1,1]
C0449393
UMLS CUI [1,2]
C0018671
cTNM (klinisch) : M
Description

cTNM

Data type

integer

Alias
UMLS CUI [1,1]
C0456533
UMLS CUI [1,2]
C0018671
cTNM Stadium
Description

cTNM stage

Data type

integer

Alias
UMLS CUI [1,1]
C1300072
UMLS CUI [1,2]
C1275866
UMLS CUI [2]
C0018671
pTNM (pathologisch) : T
Description

pTNM

Data type

text

Alias
UMLS CUI [1,1]
C1272834
UMLS CUI [1,2]
C0018671
pTNM (pathologisch) : N
Description

pTNM

Data type

integer

Alias
UMLS CUI [1,1]
C1272833
UMLS CUI [1,2]
C0018671
pTNM (pathologisch) : M
Description

pTNM

Data type

integer

Alias
UMLS CUI [1,1]
C1269798
UMLS CUI [1,2]
C0018671
pTNM (pathologisch), Tumor Ausmaß
Description

tumor extent

Data type

integer

Alias
UMLS CUI [1,1]
C0475437
UMLS CUI [1,2]
C0018671
R: Resektionsstatus
Description

resection outcome

Data type

integer

Alias
UMLS CUI [1,1]
C0728940
UMLS CUI [1,2]
C1274040
UMLS CUI [1,3]
C0018671
TNM-Stadium
Description

TNM Stage

Data type

text

Alias
UMLS CUI [1,1]
C0456885
UMLS CUI [1,2]
C0018671
TNM-Stadium, operabel?
Description

operability

Data type

integer

Alias
UMLS CUI [1,1]
C0205188
UMLS CUI [1,2]
C0018671
Alte Empfehlungen
Description

prior recommendations

Data type

text

Alias
UMLS CUI [1]
C0034866
Alte Empfehlungen Datum
Description

date of prior suggestions

Data type

date

Alias
UMLS CUI [1,1]
C0034866
UMLS CUI [1,2]
C0011008
Fragestellung
Description

question

Data type

text

Alias
UMLS CUI [1,1]
C1522634
UMLS CUI [1,2]
C0018671
Ansprechpartner
Description

contact person

Data type

text

Alias
UMLS CUI [1,1]
C0337611
UMLS CUI [1,2]
C0018671
Ansprechpartner Funknummer
Description

contact person pager number

Data type

integer

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

referring physician

Data type

text

Alias
UMLS CUI [1]
C1709880
Kontakt
Description

contact clinical trial

Data type

text

Alias
UMLS CUI [1,1]
C0337611
UMLS CUI [1,2]
C0008976
UMLS CUI [2]
C0018671
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Similar models

Head or neck tumors tumor board Oncology Form University Hospital Cologne

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Kopf-Hals-Tumorboard Anforderung
C2985541 (UMLS CUI-1)
C0018671 (UMLS CUI-2)
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])
requested procedure quantity
Item
Gewünschte Untersuchung Anzahl
integer
C1265611 (UMLS CUI [1,1])
C0430022 (UMLS CUI [1,2])
C1272683 (UMLS CUI [1,3])
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])
C0018671 (UMLS CUI [2])
diagnosis
Item
Freitextdiagnose
text
C0011900 (UMLS CUI [1])
C0018671 (UMLS CUI [2])
diagnosis date
Item
Erstdiagnose-Zeitpunkt (Monat / Jahr)
date
C3172269 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0018671 (UMLS CUI [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])
pathology and tumor staging
Item
vorhandene Pathologie/Tumorgrading
text
C0030664 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0027646 (UMLS CUI [2])
C0018671 (UMLS CUI [3])
progression
Item
Verlauf
text
C0242656 (UMLS CUI [1,1])
C2985541 (UMLS CUI [1,2])
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
Patient angebunden an folgende Fachrichtung:
integer
patient treated by
Code List
Patient angebunden an folgende Fachrichtung:
CL Item
HNO (1)
CL Item
MKG (2)
accompanying illnesses
Item
Nebenerkrankungen
text
C0009488 (UMLS CUI [1])
head neck surgeries
Item
Hals-Kopf-Ops
text
C1512343 (UMLS CUI [1])
prior radiation
Item
früh. Bestrahlungen
text
C1522449 (UMLS CUI [1])
prior chemotherapy
Item
früh. Chemoth.
text
C1514457 (UMLS CUI [1])
histology
Item
Histologie
text
C0019638 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
Item
cTNM (klinisch) : T
integer
C0475455 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
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)
Item
cTNM (klinisch) : N
integer
C0449393 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
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 [1,1])
C0018671 (UMLS CUI [1,2])
cTNM
Code List
cTNM (klinisch) : M
CL Item
0 (0)
CL Item
1 (1)
CL Item
X (2)
Item
cTNM Stadium
integer
C1300072 (UMLS CUI [1,1])
C1275866 (UMLS CUI [1,2])
C0018671 (UMLS CUI [2])
cTNM stage
Code List
cTNM Stadium
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
Item
pTNM (pathologisch) : T
text
C1272834 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
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)
Item
pTNM (pathologisch) : N
integer
C1272833 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
undefined item
Code List
pTNM (pathologisch) : N
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
2a (3)
CL Item
2b (4)
CL Item
2c (5)
CL Item
3 (6)
CL Item
X (7)
Item
pTNM (pathologisch) : M
integer
C1269798 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
pTNM
Code List
pTNM (pathologisch) : M
CL Item
0 (0)
CL Item
1 (1)
CL Item
X (2)
Item
pTNM (pathologisch), Tumor Ausmaß
integer
C0475437 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
pTNM
Code List
pTNM (pathologisch), Tumor Ausmaß
CL Item
lymphangiomatosis/hämangiomatosis Carcinomatosa (1)
CL Item
Kapsel-Durchbruch (2)
Item
R: Resektionsstatus
integer
C0728940 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
C0018671 (UMLS CUI [1,3])
pTNM stage
Code List
R: Resektionsstatus
CL Item
R1 (1)
CL Item
R2 (2)
CL Item
R2 (2)
CL Item
R0 (3)
CL Item
X (4)
TNM Stage
Item
TNM-Stadium
text
C0456885 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
Item
TNM-Stadium, operabel?
integer
C0205188 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
operability
Code List
TNM-Stadium, operabel?
CL Item
Ja (1)
CL Item
Nein (2)
prior recommendations
Item
Alte Empfehlungen
text
C0034866 (UMLS CUI [1])
date of prior suggestions
Item
Alte Empfehlungen Datum
date
C0034866 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
question
Item
Fragestellung
text
C1522634 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
contact person
Item
Ansprechpartner
text
C0337611 (UMLS CUI [1,1])
C0018671 (UMLS CUI [1,2])
contact person pager number
Item
Ansprechpartner Funknummer
integer
C0337611 (UMLS CUI [1,1])
C1515258 (UMLS CUI [1,2])
referring physician
Item
Einweiser
text
C1709880 (UMLS CUI [1])
contact clinical trial
Item
Kontakt
text
C0337611 (UMLS CUI [1,1])
C0008976 (UMLS CUI [1,2])
C0018671 (UMLS CUI [2])
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