ID

11767

Descrição

ODM form derived from Humangenetik Senologie UKM. Used as a routine documentation by the University Hospital Muenster, Germany.

Palavras-chave

Versões (1)
  1. 30/07/2015 30/07/2015 -
Transferido a

30 de julho de 2015

DOI

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Licença

Creative Commons BY-NC 3.0 Legacy
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Checklist for genetic disposition breast cancer and/or Ovarian cancer

Alemão ( localization.languageCode.DE ) Inglês

Checklist for genetic disposition breast cancer and/or Ovarian cancer

1 Formulários  
Patient demographics
Descrição

Patient demographics

Date of birth
Descrição

Date of birth

Tipo de dados

date

Case #
Descrição

Case #

Tipo de dados

integer

Gender
Descrição

Gender

Tipo de dados

text

Alias
UMLS CUI-1
C0079399
Stationary admission
Descrição

Stationary admission

Tipo de dados

text

Registration date
Descrição

Registration date

Tipo de dados

date

Registered by
Descrição

Registered by

Tipo de dados

text

A. Patient and her siblings / children
Descrição

A. Patient and her siblings / children

Breast cancer prior to the age of 36
Descrição

Breast cancer prior to the age of 36

Tipo de dados

integer

Alias
UMLS CUI-1
C0678222
Unilateral breast canster prior to the age of 51
Descrição

Unilateral breast canster prior to the age of 51

Tipo de dados

integer

Bilateral breast canster prior to the age of 51
Descrição

Bilateral breast canster prior to the age of 51

Tipo de dados

integer

Alias
UMLS CUI-1
C0238767
UMLS CUI-2
C0007104
Unilateral or Bilateral breast canster after the age of 50
Descrição

Unilateral or Bilateral breast canster after the age of 50

Tipo de dados

integer

Alias
UMLS CUI-1
C0238767
UMLS CUI-2
C0007104
Ovarian cancer or a primary peritonitis carcinomatosa
Descrição

Ovarian cancer or a primary peritonitis carcinomatosa

Tipo de dados

integer

Alias
UMLS CUI-1
C1611183
UMLS CUI-2
C0029925
Sister/daughter has breast cancer prior to the age of 36
Descrição

Sister/daughter has breast cancer prior to the age of 36

Tipo de dados

integer

Sisiter/ daughter has unilateral breast canster prior to the age of 51
Descrição

Sisiter/ daughter has unilateral breast canster prior to the age of 51

Tipo de dados

integer

Sister/ daughter has bilateral breast canster prior to the age of 51
Descrição

Sister/ daughter has bilateral breast canster prior to the age of 51

Tipo de dados

integer

Sister/ daughter has unilateral or blateral breast canster after the age of 50
Descrição

Sister/ daughter has unilateral or blateral breast canster after the age of 50

Tipo de dados

integer

Brother/ son has breast cancer
Descrição

Brother/ son has breast cancer

Tipo de dados

integer

Sister/ daughter has ovarian cancer or a primary peritonitis carcinomatosa
Descrição

Sister/ daughter has ovarian cancer or a primary peritonitis carcinomatosa

Tipo de dados

integer

Total
Descrição

Total

Tipo de dados

integer

B. Matrilineality
Descrição

B. Matrilineality

Relatuve has breast cancer prior to the age of 36
Descrição

Relatuve has breast cancer prior to the age of 36

Tipo de dados

integer

Relative has unilateral breast canster prior to the age of 51
Descrição

Relative has unilateral breast canster prior to the age of 51

Tipo de dados

integer

Relative has bilateral breast canster prior to the age of 51
Descrição

Relative has bilateral breast canster prior to the age of 51

Tipo de dados

integer

Relative has unilateral or blateral breast canster after the age of 50
Descrição

Relative has unilateral or blateral breast canster after the age of 50

Tipo de dados

integer

Male relative has breast cancer
Descrição

Male relative has breast cancer

Tipo de dados

integer

Relative has ovarian cancer or a primary peritonitis carcinomatosa
Descrição

Relative has ovarian cancer or a primary peritonitis carcinomatosa

Tipo de dados

integer

Total
Descrição

Total

Tipo de dados

integer

Patrilineality
Descrição

Patrilineality

Relative has breast cancer prior to the age of 36
Descrição

Relative has breast cancer prior to the age of 36

Tipo de dados

integer

Relative has unilateral breast canster prior to the age of 51
Descrição

Relative has unilateral breast canster prior to the age of 51

Tipo de dados

integer

Relative has bilateral breast canster prior to the age of 51
Descrição

Relative has bilateral breast canster prior to the age of 51

Tipo de dados

integer

Relative has unilateral or blateral breast canster after the age of 50
Descrição

Relative has unilateral or blateral breast canster after the age of 50

Tipo de dados

integer

Male relative has breast cancer
Descrição

Male relative has breast cancer

Tipo de dados

integer

Relative has ovarian cancer or a primary peritonitis carcinomatosa
Descrição

Relative has ovarian cancer or a primary peritonitis carcinomatosa

Tipo de dados

integer

Total
Descrição

Total

Tipo de dados

integer

D. Higher score B. matrilineality or C. patrilineality
Descrição

D. Higher score B. matrilineality or C. patrilineality

E. Total A+D
Descrição

E. Total A+D

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Similar models

Checklist for genetic disposition breast cancer and/or Ovarian cancer

1 Formulários
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Patient demographics
Date of birth
Item
Date of birth
date
Case #
Item
Case #
integer
Gender
Item
Gender
text
C0079399 (UMLS CUI-1)
Stationary admission
Item
Stationary admission
text
Registration date
Item
Registration date
date
Registered by
Item
Registered by
text
Item Group
A. Patient and her siblings / children
Item
Breast cancer prior to the age of 36
integer
C0678222 (UMLS CUI-1)
Breast cancer
Code List
Breast cancer prior to the age of 36
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Unilateral breast canster prior to the age of 51
integer
Breast cancer
Code List
Unilateral breast canster prior to the age of 51
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Bilateral breast canster prior to the age of 51
integer
C0238767 (UMLS CUI-1)
C0007104 (UMLS CUI-2)
Breast cancer
Code List
Bilateral breast canster prior to the age of 51
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Unilateral or Bilateral breast canster after the age of 50
integer
C0238767 (UMLS CUI-1)
C0007104 (UMLS CUI-2)
Breast cancer
Code List
Unilateral or Bilateral breast canster after the age of 50
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Ovarian cancer or a primary peritonitis carcinomatosa
integer
C1611183 (UMLS CUI-1)
C0029925 (UMLS CUI-2)
Breast cancer
Code List
Ovarian cancer or a primary peritonitis carcinomatosa
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Sister/daughter has breast cancer prior to the age of 36
integer
Breast cancer
Code List
Sister/daughter has breast cancer prior to the age of 36
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Sisiter/ daughter has unilateral breast canster prior to the age of 51
integer
Breast cancer
Code List
Sisiter/ daughter has unilateral breast canster prior to the age of 51
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Sister/ daughter has bilateral breast canster prior to the age of 51
integer
Breast cancer
Code List
Sister/ daughter has bilateral breast canster prior to the age of 51
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Sister/ daughter has unilateral or blateral breast canster after the age of 50
integer
Breast cancer
Code List
Sister/ daughter has unilateral or blateral breast canster after the age of 50
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Brother/ son has breast cancer
integer
Breast cancer
Code List
Brother/ son has breast cancer
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Sister/ daughter has ovarian cancer or a primary peritonitis carcinomatosa
integer
Breast cancer
Code List
Sister/ daughter has ovarian cancer or a primary peritonitis carcinomatosa
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Total
Item
Total
integer
Item Group
B. Matrilineality
Item
Relatuve has breast cancer prior to the age of 36
integer
Breast cancer
Code List
Relatuve has breast cancer prior to the age of 36
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Relative has unilateral breast canster prior to the age of 51
integer
Breast cancer
Code List
Relative has unilateral breast canster prior to the age of 51
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Relative has bilateral breast canster prior to the age of 51
integer
Breast cancer
Code List
Relative has bilateral breast canster prior to the age of 51
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Relative has unilateral or blateral breast canster after the age of 50
integer
Breast cancer
Code List
Relative has unilateral or blateral breast canster after the age of 50
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Male relative has breast cancer
integer
Breast cancer
Code List
Male relative has breast cancer
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Relative has ovarian cancer or a primary peritonitis carcinomatosa
integer
Breast cancer
Code List
Relative has ovarian cancer or a primary peritonitis carcinomatosa
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Total
Item
Total
integer
Item Group
Patrilineality
Item
Relative has breast cancer prior to the age of 36
integer
Breast cancer
Code List
Relative has breast cancer prior to the age of 36
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Relative has unilateral breast canster prior to the age of 51
integer
Breast cancer
Code List
Relative has unilateral breast canster prior to the age of 51
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Relative has bilateral breast canster prior to the age of 51
integer
Breast cancer
Code List
Relative has bilateral breast canster prior to the age of 51
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Relative has unilateral or blateral breast canster after the age of 50
integer
Breast cancer
Code List
Relative has unilateral or blateral breast canster after the age of 50
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Male relative has breast cancer
integer
Breast cancer
Code List
Male relative has breast cancer
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Item
Relative has ovarian cancer or a primary peritonitis carcinomatosa
integer
Breast cancer
Code List
Relative has ovarian cancer or a primary peritonitis carcinomatosa
CL Item
Amount (1)
CL Item
Weighting  (2)
CL Item
Result (3)
Total
Item
Total
integer
Item Group
D. Higher score B. matrilineality or C. patrilineality
Item Group
E. Total A+D
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