ID

14658

Description

Item used as routine documentation by the University hospital Essen, Transplant centre, Information leaflet. ODM derived from original form “ANMELDUNG ZUR NIERENTRANSPLANTATION” University hospital Essen, Transplant centre, Hufelandstr. 55, 45122 Essen, Germany.

Mots-clés

Versions (1)
  1. 25/04/2016 25/04/2016 -
Téléchargé le

25 avril 2016

DOI

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Licence

Creative Commons BY-NC 3.0
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Registration for Kidney transplantation Transplant centre Essen University Hospital Essen

Anglais

Registration for Kidney transplantation Transplant centre Essen

1 Formulaires  
Personal Information
Description

Personal Information

Alias
UMLS CUI-1
C2983694
Patient surname
Description

Patient surname

Type de données

text

Alias
UMLS CUI [1]
C0421448
Patient first name
Description

Patient first name

Type de données

text

Alias
UMLS CUI [1]
C1443235
Date of birth
Description

Date of birth

Type de données

date

Alias
UMLS CUI [1]
C0421451
First day of dialysis
Description

dialysis first day

Type de données

date

Alias
UMLS CUI [1]
C3262256
Primary kidney disease
Description

Please enclose:  Current medical report with diagnosis list and examination findings, laboratory results and medication plan  Questionnaire for registration for renal transplantation

Type de données

text

Alias
UMLS CUI [1]
C0022658
Blood group
Description

Blood group

Type de données

text

Alias
UMLS CUI [1]
C0005810
Body height
Description

Body height

Type de données

float

Alias
UMLS CUI [1]
C0005890
Body weight
Description

Body weight

Type de données

float

Alias
UMLS CUI [1]
C0005910
Nephrology centre
Description

Nephrology centre

Type de données

text

Alias
UMLS CUI [1]
C0587474
Date of registration
Description

date registration

Type de données

date

Alias
UMLS CUI [1,1]
C1514821
UMLS CUI [1,2]
C0011008
Questionnaire for registration for renal transplantation
Description

Questionnaire for registration for renal transplantation

Alias
UMLS CUI-1
C0034394
Patient name
Description

Patient name

Type de données

text

Alias
UMLS CUI [1]
C1299487
Date
Description

Date

Type de données

date

Alias
UMLS CUI [1]
C0011008
1. Coronary heart disease
Description

Coronary heart disease

Type de données

boolean

Alias
UMLS CUI [1]
C0010068
Stents or bypasses
Description

Stents; heart bypass

Type de données

boolean

Alias
UMLS CUI [1]
C0038257
UMLS CUI [2,1]
C0242838
UMLS CUI [2,2]
C0242839
2. Heart failure
Description

Heart failure

Type de données

boolean

Alias
UMLS CUI [1]
C0018801
NYHA
Description

NYHA classification

Type de données

text

Alias
UMLS CUI [1]
C1275491
3. Heart Valve disease
Description

Heart Valve disease

Type de données

boolean

Alias
UMLS CUI [1]
C0018824
4. Peripheral arterial disease
Description

Peripheral arterial disease

Type de données

boolean

Alias
UMLS CUI [1]
C1704436
Vascular prosthesis or peripheral bypass
Description

Vascular prosthesis; peripheral bypass

Type de données

boolean

Alias
UMLS CUI [1]
C1534896
UMLS CUI [2]
C0810134
5. Hepatitis B
Description

Hepatitis B

Type de données

boolean

Alias
UMLS CUI [1]
C0019163
Hepatitis C
Description

Hepatitis C

Type de données

boolean

Alias
UMLS CUI [1]
C0019196
6. Prior abdominal surgery or inguinal surgery
Description

abdominal surgery; inguinal surgery

Type de données

boolean

Alias
UMLS CUI [1]
C0198482
UMLS CUI [2]
C0745328
7. Recurrent thrombosis
Description

Recurrent thrombosis

Type de données

boolean

Alias
UMLS CUI [1]
C3550150
8. Hemorrhage
Description

Hemorrhage

Type de données

boolean

Alias
UMLS CUI [1]
C0019080
9. Recurrent urinary tract infection
Description

Recurrent urinary tract infection

Type de données

boolean

Alias
UMLS CUI [1]
C0262655
10. Tuberculosis
Description

Tuberculosis

Type de données

boolean

Alias
UMLS CUI [1]
C0041296
11. Psychotic reactions
Description

Psychotic reactions

Type de données

boolean

Alias
UMLS CUI [1]
C0236122
12. Number of operations for dialysis access (Shunt, atrial catheter, peritoneal dialysis)
Description

Shunt; peritoneal dialysis

Type de données

integer

Alias
UMLS CUI [1]
C0542331
UMLS CUI [2]
C0031139
Medical Examination (Checklist)
Description

Medical Examination (Checklist)

Alias
UMLS CUI-1
C0582103
Urology
Description

Appointment date Urology

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0042077
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Dentist optional
Description

Appointment date Dentist

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0011441
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date gynecology
Description

Appointment date gynecology

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0018417
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Sonography Abdomen
Description

Appointment date Sonography Abdomen

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0203464
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Doppler pelvic and leg and closure pressures
Description

Appointment date Doppler pelvic

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0203478
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Doppler carotid
Description

Appointment date Doppler carotid

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0741988
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Chest x-ray
Description

Appointment date Chest x-ray

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0039985
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date lung function
Description

Appointment date lung function

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0024119
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Stress ECG (at least 100 watts) alternatively Myocardial Scintigraphy or stress echo
Description

Appointment date Stress ECG Myocardial Scintigraphy

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0015260
UMLS CUI [1,3]
C2350391
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date echocardiography
Description

Appointment date echocardiography

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0013516
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Appointment date Coronary angiography (from 60 years and older)
Description

Appointment date Coronary angiography

Type de données

date

Alias
UMLS CUI [1,1]
C0585085
UMLS CUI [1,2]
C0085532
Appointment met?
Description

Appointment status

Type de données

boolean

Alias
UMLS CUI [1]
C0586344
Retour au début de la page

Similar models

Registration for Kidney transplantation Transplant centre Essen

1 Formulaires
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Personal Information
C2983694 (UMLS CUI-1)
Patient surname
Item
Patient surname
text
C0421448 (UMLS CUI [1])
Patient first name
Item
Patient first name
text
C1443235 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
dialysis first day
Item
First day of dialysis
date
C3262256 (UMLS CUI [1])
primary kidney disease
Item
Primary kidney disease
text
C0022658 (UMLS CUI [1])
Blood group
Item
Blood group
text
C0005810 (UMLS CUI [1])
Body height
Item
Body height
float
C0005890 (UMLS CUI [1])
Body weight
Item
Body weight
float
C0005910 (UMLS CUI [1])
Nephrology centre
Item
Nephrology centre
text
C0587474 (UMLS CUI [1])
date registration
Item
Date of registration
date
C1514821 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
Questionnaire for registration for renal transplantation
C0034394 (UMLS CUI-1)
Patient name
Item
Patient name
text
C1299487 (UMLS CUI [1])
Date
Item
Date
date
C0011008 (UMLS CUI [1])
Coronary heart disease
Item
1. Coronary heart disease
boolean
C0010068 (UMLS CUI [1])
Stents; heart bypass
Item
Stents or bypasses
boolean
C0038257 (UMLS CUI [1])
C0242838 (UMLS CUI [2,1])
C0242839 (UMLS CUI [2,2])
Heart failure
Item
2. Heart failure
boolean
C0018801 (UMLS CUI [1])
Item
NYHA
text
C1275491 (UMLS CUI [1])
NYHA classification
Code List
NYHA
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
Heart Valve disease
Item
3. Heart Valve disease
boolean
C0018824 (UMLS CUI [1])
Peripheral arterial disease
Item
4. Peripheral arterial disease
boolean
C1704436 (UMLS CUI [1])
Vascular prosthesis; peripheral bypass
Item
Vascular prosthesis or peripheral bypass
boolean
C1534896 (UMLS CUI [1])
C0810134 (UMLS CUI [2])
Hepatitis B
Item
5. Hepatitis B
boolean
C0019163 (UMLS CUI [1])
Hepatitis C
Item
Hepatitis C
boolean
C0019196 (UMLS CUI [1])
abdominal surgery; inguinal surgery
Item
6. Prior abdominal surgery or inguinal surgery
boolean
C0198482 (UMLS CUI [1])
C0745328 (UMLS CUI [2])
Recurrent thrombosis
Item
7. Recurrent thrombosis
boolean
C3550150 (UMLS CUI [1])
Hemorrhage
Item
8. Hemorrhage
boolean
C0019080 (UMLS CUI [1])
Recurrent urinary tract infection
Item
9. Recurrent urinary tract infection
boolean
C0262655 (UMLS CUI [1])
Tuberculosis
Item
10. Tuberculosis
boolean
C0041296 (UMLS CUI [1])
Psychotic reactions
Item
11. Psychotic reactions
boolean
C0236122 (UMLS CUI [1])
Shunt; peritoneal dialysis
Item
12. Number of operations for dialysis access (Shunt, atrial catheter, peritoneal dialysis)
integer
C0542331 (UMLS CUI [1])
C0031139 (UMLS CUI [2])
Item Group
Medical Examination (Checklist)
C0582103 (UMLS CUI-1)
Appointment date Urology
Item
Urology
date
C0585085 (UMLS CUI [1,1])
C0042077 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Dentist
Item
Dentist optional
date
C0585085 (UMLS CUI [1,1])
C0011441 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date gynecology
Item
Appointment date gynecology
date
C0585085 (UMLS CUI [1,1])
C0018417 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Sonography Abdomen
Item
Appointment date Sonography Abdomen
date
C0585085 (UMLS CUI [1,1])
C0203464 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Doppler pelvic
Item
Appointment date Doppler pelvic and leg and closure pressures
date
C0585085 (UMLS CUI [1,1])
C0203478 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Doppler carotid
Item
Appointment date Doppler carotid
date
C0585085 (UMLS CUI [1,1])
C0741988 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Chest x-ray
Item
Appointment date Chest x-ray
date
C0585085 (UMLS CUI [1,1])
C0039985 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date lung function
Item
Appointment date lung function
date
C0585085 (UMLS CUI [1,1])
C0024119 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Stress ECG Myocardial Scintigraphy
Item
Stress ECG (at least 100 watts) alternatively Myocardial Scintigraphy or stress echo
date
C0585085 (UMLS CUI [1,1])
C0015260 (UMLS CUI [1,2])
C2350391 (UMLS CUI [1,3])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date echocardiography
Item
Appointment date echocardiography
date
C0585085 (UMLS CUI [1,1])
C0013516 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Appointment date Coronary angiography
Item
Appointment date Coronary angiography (from 60 years and older)
date
C0585085 (UMLS CUI [1,1])
C0085532 (UMLS CUI [1,2])
Appointment status
Item
Appointment met?
boolean
C0586344 (UMLS CUI [1])
Retour au début de la page 

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