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ID
15027
Description
Request for general histologic assessment, Pathology UKM Please use this form for requests of general histologic assessment. Gerhard-Domagk-Institute of Pathology Univ.-Prof.Dr.med.Eva Wardelmann Albert-Schweitzer-Campus 1 Building D17 48149 Münster Phone:0251-83-57550 Fax:0251-83-55481 E-mail:pathologie@ukmuenster.de
Keywords
Versions (2)
- 5/11/16 5/11/16 -
- 5/11/16 5/11/16 -
Uploaded on
May 11, 2016
DOI
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License
Creative Commons BY-NC 3.0
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Request for general histologic assessment, Pathology UKM
Request for general histologic assessment
- StudyEvent: ODM
Similar models
Request for general histologic assessment
- StudyEvent: ODM
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Patient Name
Item
Patient Name
text
C1299487 (UMLS CUI [1])
Patient ID
Item
Patient ID
integer
C1269815 (UMLS CUI [1])
Birth Date
Item
Patient Birth Date
date
C0421451 (UMLS CUI [1])
Case ID
Item
Case ID
integer
C0868928 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
C0600091 (UMLS CUI [1,2])
Patient insurance
Item
Patient insurance
text
C1548070 (UMLS CUI [1])
Request ID
Item
Request ID
text
C1272683 (UMLS CUI [1,1])
C1299222 (UMLS CUI [1,2])
C1299222 (UMLS CUI [1,2])
Request status
Item
Request status
text
C0586246 (UMLS CUI [1])
Urgency
Item
Urgency of procedure
text
C2188402 (UMLS CUI [1])
Performing hospital department
Item
Performing hospital department
text
C2986180 (UMLS CUI [1,1])
C0019961 (UMLS CUI [1,2])
C0019961 (UMLS CUI [1,2])
Date of request
Item
Date and time of request
datetime
C1272683 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Referring hospital department
Item
Referring hospital department
text
C0019961 (UMLS CUI [1,1])
C0205543 (UMLS CUI [1,2])
C0205543 (UMLS CUI [1,2])
Referring medical department
Item
Referring medical department
text
C0587450 (UMLS CUI [1,1])
C0205543 (UMLS CUI [1,2])
C0205543 (UMLS CUI [1,2])
Referring Physician
Item
Referring Physician name
text
C1709880 (UMLS CUI [1])
Desired date
Item
Desired date
date
C0011008 (UMLS CUI [1])
Comments
Item
Comments
text
C0947611 (UMLS CUI [1])
Cave
Item
Cave
text
C0871599 (UMLS CUI [1])
Mobility
Item
Mobility
text
C0449580 (UMLS CUI [1])
Preliminary examination results
Item
Preliminary examination results
text
C1548161 (UMLS CUI [1])
CL Item
None (1)
CL Item
Unknown (2)
CL Item
Hep B (3)
CL Item
Hep C (4)
CL Item
Tbc (5)
CL Item
HIV (6)
CL Item
VRE (7)
CL Item
MRSA (8)
CL Item
Other (9)
Infectivity
Item
Infectivity:please specify other infectious disease
text
C0030657 (UMLS CUI [1])
Item
Inpatient insurance status
integer
C0021562 (UMLS CUI [1,1])
C0376629 (UMLS CUI [1,2])
C0376629 (UMLS CUI [1,2])
CL Item
Standard care (1)
CL Item
Elective care/ choice of physician (2)
Item
Outpatient insurance status
integer
C0029921 (UMLS CUI [1,1])
C0376629 (UMLS CUI [1,2])
C0376629 (UMLS CUI [1,2])
CL Item
Beneficial insurance (1)
CL Item
Privat insurance (2)
CL Item
Frozen section (1)
CL Item
Tissue (2)
CL Item
Puncture fluid (3)
CL Item
Smear (4)
Clinical Diagnosis
Item
Clinical Diagnosis
text
C0332140 (UMLS CUI [1])
CL Item
HE (1)
CL Item
PAS (2)
CL Item
Ma (3)
Number of stainings
Item
Number of HE stainings
integer
C0200673 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,2])
Number of stainings
Item
Number of PAS stainings
integer
C0523213 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,2])
Number of stainings
Item
Number of Ma stainings
integer
C0487602 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,2])
Specific prior treatment
Item
Specific prior treatment
text
C1514463 (UMLS CUI [1])
Current question
Item
Current question
text
C1522634 (UMLS CUI [1])
Responsible physician
Item
Responsible physician name
text
C1710470 (UMLS CUI [1])
Phone contact
Item
Please enter a phone number for contact
integer
C3476398 (UMLS CUI [1])
Fax number
Item
Fax number
integer
C1710470 (UMLS CUI [1,1])
C1549619 (UMLS CUI [1,2])
C1549619 (UMLS CUI [1,2])