Information:
Error:
ID
15031
Description
This protocol is a self- or proxy-administered personal health record from the American Health Information Management Association (AHIMA). The respondent is asked to provide details on the following categories: Medical History, Infectious Diseases, Immunizations, Allergies/Drug Sensitivities, Health Log, Doctor Visits, Hospitalizations, Surgeries, Lab or Imaging, Medical Devices, and Physical/Occupational Therapy. ODM derived from: https://cde.nlm.nih.gov Primary source: https://www.phenxtoolkit.org/ Recent publication: Hendershot, T., Pan, H., Haines, J., Harlan, W.R., Marazita, M.L., McCarty, C.A., Ramos, E.M., and Hamilton, C.M. (2015) Using the PhenX toolkit to add standard measures to a study. Curr. Protoc. Hum. Genet. 86:1.21.1-1.21.17. doi: 10.1002/0471142905.hg0121s86 Permission to publish granted by Carol M. Hamilton.
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Versions (1)
- 9/27/17 9/27/17 -
Uploaded on
September 27, 2017
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License
Creative Commons BY-NC 3.0
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Personal History of Allergies, Infectious Diseases, and Immunizations - Adult PhenX Toolkit
Personal History of Allergies, Infectious Diseases, and Immunizations - Adult PhenX Toolkit
Similar models
Personal History of Allergies, Infectious Diseases, and Immunizations - Adult PhenX Toolkit
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
PhenX - personal medical history of allergies, infectious diseases, and immunizations - adult protocol
C3171895 (UMLS CUI-1)
noninfectious major illness
Item
Noninfectious major illness [PhenX]
text
C3177165 (UMLS CUI [1])
date first disease
Item
Date first Dx Unspecified body region
date
C3259273 (UMLS CUI [1])
CL Item
Managing physician unknown or ID number not assigned (Managing physician unknown or ID number not assigned)
nature of health problems
Item
Noninfectious Major Illness 1 - Nature of Health Problems
text
C3261281 (UMLS CUI [1])
Item
Age range at onset of disease [USSG-FHT]
text
C0150907 (UMLS CUI [1])
CL Item
Pre-Birth (Pre-Birth)
CL Item
Newborn (Newborn)
CL Item
Infancy (Infancy)
CL Item
Childhood (Childhood)
CL Item
Adolescence (Adolescence)
CL Item
20-29 (20-29)
CL Item
30-39 (30-39)
CL Item
40-49 (40-49)
CL Item
50-59 (50-59)
CL Item
over 60 (over 60)
CL Item
unknown (unknown)
condition status
Item
Noninfectious Major Illness - Condition Status
text
C3176928 (UMLS CUI [1])
service comment
Item
Service comment
text
C0485795 (UMLS CUI [1])
doctor visit sequence
Item
Doctor visit sequence [PhenX]
text
C3259401 (UMLS CUI [1])
assessment reference date
Item
Assessment reference date
date
C1719096 (UMLS CUI [1])
physician
Item
Physician [Identifier]
text
C0031831 (UMLS CUI [1])
reason for visit
Item
Reason for visit
text
C1704447 (UMLS CUI [1])
diagnosis
Item
Diagnosis
text
C0011900 (UMLS CUI [1])
hospitalization sequence
Item
Hospitalization sequence [PhenX]
text
C3261282 (UMLS CUI [1])
hospitalization type
Item
Hospitalization - Type
text
C3177060 (UMLS CUI [1])
hospital admission date
Item
Hospital Admission Date
date
C0806429 (UMLS CUI [1])
hospital discharge date
Item
Hospital Discharge Date
date
C2361123 (UMLS CUI [1])
physician
Item
Physician [Identifier]
text
C0031831 (UMLS CUI [1])
name hospital
Item
Hospitalized at
text
C0019994 (UMLS CUI [1])
CL Item
Improper medication administration, medication side effects, toxicity, anaphylaxis (Improper medication administration, medication side effects, toxicity, anaphylaxis )
CL Item
Injury caused by fall or accident at home (Injury caused by fall or accident at home )
CL Item
Respiratory problems (SOB, infection, obstruction) (Respiratory problems (SOB, infection, obstruction) )
CL Item
Wound or tube site infection, deteriorating wound status, new lesion/ulcer (Wound or tube site infection, deteriorating wound status, new lesion/ulcer )
CL Item
Hypo/Hyperglycemia, diabetes out of control (Hypo/Hyperglycemia, diabetes out of control)
CL Item
GI bleeding, obstruction (GI bleeding, obstruction)
CL Item
Exacerbation of CHF, fluid overload, heart failure (Exacerbation of CHF, fluid overload, heart failure )
CL Item
Myocardial infarction, stroke (Myocardial infarction, stroke)
CL Item
Chemotherapy (Chemotherapy )
CL Item
Scheduled surgical procedure (Scheduled surgical procedure )
CL Item
Urinary tract infection (Urinary tract infection)
CL Item
IV catheter-related infection (IV catheter-related infection )
CL Item
Deep vein thrombosis, pulmonary embolus (Deep vein thrombosis, pulmonary embolus)
CL Item
Uncontrolled pain (Uncontrolled pain )
CL Item
Psychotic episode (Psychotic episode)
CL Item
Other than above reasons (Other than above reasons)
hospital admission diagnosis
Item
Hospital admission diagnosis
text
C0184666 (UMLS CUI [1,1])
C0011900 (UMLS CUI [1,2])
C0011900 (UMLS CUI [1,2])
complications
Item
Complications
text
C0009566 (UMLS CUI [1])
surgery sequence
Item
Surgery sequence [PhenX]
text
C3259403 (UMLS CUI [1])
surgery date
Item
Please specify date.
date
C1628561 (UMLS CUI [1])
physician
Item
Physician [Identifier]
text
C0031831 (UMLS CUI [1])
hospital name
Item
Hospitalized at
text
C0019994 (UMLS CUI [1])
surgery procedure
Item
Surgery procedure
text
C0543467 (UMLS CUI [1])
surgery description
Item
Surgery description
text
C0543467 (UMLS CUI [1])
operative note findings
Item
Operative note findings
text
C0488623 (UMLS CUI [1])
service comment
Item
Service comment
text
C0485795 (UMLS CUI [1])
lab or imaging sequence
Item
Lab or Imaging - Instance
text
C3259404 (UMLS CUI [1])
date of observation
Item
Date of observation
date
C3176356 (UMLS CUI [1])
ordering practitioner name
Item
Ordering practitioner name
text
C0807182 (UMLS CUI [1])
reason for test procedure
Item
Lab or Imaging 1 - Reason
text
C3258099 (UMLS CUI [1])
service comment
Item
Service comment
text
C0485795 (UMLS CUI [1])
vendor device name
Item
Vendor device name
text
C1636181 (UMLS CUI [1])
medical device type
Item
Medical Device - Device Type
text
C3177146 (UMLS CUI [1])
physician
Item
Physician [Identifier]
text
C0031831 (UMLS CUI [1])
hospital name
Item
Hospitalized at
text
C0019994 (UMLS CUI [1])
date of observation
Item
Date of observation
date
C3176356 (UMLS CUI [1])
therapy sequence
Item
Physical/Occupational therapy sequence [PhenX]
text
C3259407 (UMLS CUI [1])
therapy type
Item
Physical/Occupation Therapy - Therapy Type
text
C0087111 (UMLS CUI [1,1])
C0521127 (UMLS CUI [1,2])
C0521127 (UMLS CUI [1,2])
physical therapy start date
Item
Physical Therapy - Therapy Start Date
date
C0808070 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0521127 (UMLS CUI [1,3])
C0087111 (UMLS CUI [1,2])
C0521127 (UMLS CUI [1,3])
physical therapy treatment plan end date
Item
Physical therapy treatment plan, End date
date
C0806020 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0521127 (UMLS CUI [1,3])
C0087111 (UMLS CUI [1,2])
C0521127 (UMLS CUI [1,3])
Item
Physical therapy treatment plan, Visit frequency TQ2
text
C0808393 (UMLS CUI [1])
CL Item
Day (Day)
CL Item
Week (Week)
CL Item
Month (Month)
CL Item
Quarter (Quarter)
CL Item
As needed (As needed)
therapist
Item
Physical/Occupation Therapy 1 - Therapist
text
C0028807 (UMLS CUI [1])