ID

16021

Beschrijving

https://www.hope-clara.de/ The HOPE Hospice and Palliative Care Recording standard documentation is used for documentation of palliative care and as an instrument for quality assurance in pallatiave wards, hospices and oncological wards as well as in ambulatory services and palliative teams.

Link

https://www.hope-clara.de/

Trefwoorden

Versies (2)
  1. 26-06-16 26-06-16 -
  2. 26-06-16 26-06-16 -
Geüploaded op

26 juni 2016

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0
Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Terug naar het model Commentaren
Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Palliative and Hospice Care Paliative and Hospice Care Prognosis

Engels

Palliative and Hospice Care Prognosis

1 Formulieren  
Administrative Data
Beschrijving

Administrative Data

Alias
UMLS CUI-1
C1320722
Basis documentation No.
Beschrijving

basis documentation number

Datatype

integer

1. IDNR
Beschrijving

IDNR

Datatype

text

Alias
UMLS CUI [1]
C1549734
13. Date
Beschrijving

date

Datatype

date

Alias
UMLS CUI [1]
C2985720
PR1. Palliative Prognostic Score (PAP-S)
Beschrijving

PR1. Palliative Prognostic Score (PAP-S)

Dyspnea
Beschrijving

dyspnea

Datatype

boolean

Alias
UMLS CUI [1]
C0013404
Score
Beschrijving

dyspnea score

Datatype

float

Alias
UMLS CUI [1,1]
C0449820
UMLS CUI [1,2]
C0013404
Anorexia
Beschrijving

anorexia

Datatype

boolean

Alias
UMLS CUI [1]
C0003123
Score
Beschrijving

anorexia score

Datatype

text

Alias
UMLS CUI [1,1]
C0449820
UMLS CUI [1,2]
C0003123
PR2. Karnofsky Performance Status
Beschrijving

PR2. Karnofsky Performance Status

Alias
UMLS CUI-1
C0206065
No complaints; no evidence of disease - 100% Able to carry on normal activity; minor signs or symptoms of disease - 90% Normal activity with effort; some signs or symptoms of disease - 80% Cares for self; unable to carry on normal activity or to do active work - 70% Requires occasional assistance but is able to care for most personal needs - 60% Requires considerable assistance and frequent medical care - 50% Disabled; requires special care and assistance - 40% Severely disabled; hospital admission indicated although death not imminent - 30%
Beschrijving

Score 0

Datatype

integer

Alias
UMLS CUI [1]
C0206065
Very sick; hospital admission necessary; active supportive treatment necessary - 20% Moribund; fatal processes progressing rapidly - 10% Dead - 0%
Beschrijving

Score 2,5

Datatype

integer

Alias
UMLS CUI [1]
C0206065
Score
Beschrijving

KI total score

Datatype

float

Alias
UMLS CUI [1,1]
C0206065
UMLS CUI [1,2]
C0449820
PR3. Clinical prognosis of survival
Beschrijving

PR3. Clinical prognosis of survival

Clinical prognosis of survival
Beschrijving

clinical prognosis of survival

Datatype

text

Alias
UMLS CUI [1,1]
C0033325
UMLS CUI [1,2]
C2919552
Score
Beschrijving

clinical prognosis score

Datatype

float

Alias
UMLS CUI [1,1]
C0449820
UMLS CUI [1,2]
C0033325
UMLS CUI [1,3]
C2919552
PR4. Hemogram
Beschrijving

PR4. Hemogram

Leucocytes
Beschrijving

WBC

Datatype

text

Alias
UMLS CUI [1]
C0023508
Score
Beschrijving

WBC score

Datatype

float

Alias
UMLS CUI [1,1]
C0449820
UMLS CUI [1,2]
C0023508
Lymphocytes
Beschrijving

lymphocytes

Datatype

text

Alias
UMLS CUI [1]
C0024264
Score
Beschrijving

lymphocytes score

Datatype

float

Alias
UMLS CUI [1,1]
C0024264
UMLS CUI [1,2]
C0024264
PaP Score (maximal 17.5 Points)
Beschrijving

PaP Score (maximal 17.5 Points)

PaP Score
Beschrijving

PaP score

Datatype

float

PR5. Palliative Performance Scale
Beschrijving

PR5. Palliative Performance Scale

PPS 60%-100% Score 0
Beschrijving

Ambulation: Full Activity & Evidence of Disease: Normal activity & work No evidence of disease Self Care: Full Intake: Normal Conscious Level: Full 100% Ambulation: Full Activity & Evidence of Disease: Normal activity & work Some evidence of disease Self Care: Full Intake: Normal Conscious Level: Full 90% Ambulation: Full Activity & Evidence of Disease: Normal activity with effort Some evidence of disease Self Care: Full Intake: Normal or reduced Conscious Level: Full 80% Ambulation: Reduced Activity & Evidence of Disease: Normal activity with effort Some evidence of disease Self Care: Full Intake: Normal or reduced Conscious Level: Full 70% Ambulation: Reduced Activity & Evidence of Disease: Unable hobby/house work Significant disease Self Care: Occasional assistance necessary Intake: Normal or reduced Conscious Level: Full or confusion 60%

Datatype

boolean

PPS 30%-50% Score 2,5
Beschrijving

Ambulation: Mainly Sit/Lie Activity & Evidence of Disease: Unable to do any work Extensive disease Self Care: Considerable assistance required Intake: Normal or reduced Conscious Level: Full or confusion 50% Ambulation: Mainly in Bed Activity & Evidence of Disease: Unable to do most activity Extensive disease Self Care: Mainly assistance Intake: Normal or reduced Conscious Level: Full or Drowsy +/- Confusion 40% Ambulation: Totally Bed Bound Activity & Evidence of Disease: Unable to do any activity Extensive disease Self Care: Total Care Intake: Normal or reduced Conscious Level: Full or Drowsy +/- Confusion 30%

Datatype

boolean

PPS 10%-20% Score 4
Beschrijving

Ambulation: Totally Bed Bound Activity & Evidence of Disease: Unable to do any activity Extensive disease Self Care: Total Care Intake: Minimal to sips Conscious Level: Full or Drowsy +/- Confusion 20% Ambulation: Totally Bed Bound Activity & Evidence of Disease: Unable to do any activity Extensive disease Self Care: Total Care Intake: Mouth care only Conscious Level: Full or Drowsy +/- Confusion 10%

Datatype

boolean

PPS 0%
Beschrijving

Ambulation: Death 0%

Datatype

boolean

Life expectancy of 6 months 10% in case of < 50% PPS
Beschrijving

life expectancy

Datatype

boolean

Alias
UMLS CUI [1]
C3845482
Total Score PPS
Beschrijving

total score PPS

Datatype

float

Alias
UMLS CUI [1]
C2964552
PR6. Oral Intake
Beschrijving

PR6. Oral Intake

Oral intake: Normal Score: 0
Beschrijving

normal oral intake

Datatype

boolean

Alias
UMLS CUI [1,1]
C0518037
UMLS CUI [1,2]
C0205307
Oral intake: Sligthly reduced (> entire mouth) Score: 1
Beschrijving

slightly reduced oral intake

Datatype

boolean

Alias
UMLS CUI [1,1]
C0518037
UMLS CUI [1,2]
C0392756
UMLS CUI [1,3]
C0750482
Oral intake: Clearly reduced (<= entire mouth) Score: 2,5
Beschrijving

clearly reduced oral intake

Datatype

boolean

Alias
UMLS CUI [1,1]
C0518037
UMLS CUI [1,2]
C0392756
Total Score:
Beschrijving

total score oral intake

Datatype

float

Alias
UMLS CUI [1,1]
C0518037
UMLS CUI [1,2]
C2964552
PR7. Symptoms
Beschrijving

PR7. Symptoms

Edema
Beschrijving

edema

Datatype

boolean

Alias
UMLS CUI [1]
C0013604
Shortness of breath at rest
Beschrijving

shortness of breath

Datatype

boolean

Alias
UMLS CUI [1]
C0748649
Delir
Beschrijving

delir

Datatype

boolean

Alias
UMLS CUI [1]
C0011206
Palliative Prognostic Index
Beschrijving

Palliative Prognostic Index

Palliative Prognostic Index (maximal 15 Points)
Beschrijving

Life expectancy of 3 weeks 20%: >6 points Life expectancy of 6 weeks 20%: >4 points

Datatype

float

Terug naar het begin van de pagina

Similar models

Palliative and Hospice Care Prognosis

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
basis documentation number
Item
Basis documentation No.
integer
IDNR
Item
1. IDNR
text
C1549734 (UMLS CUI [1])
date
Item
13. Date
date
C2985720 (UMLS CUI [1])
Item Group
PR1. Palliative Prognostic Score (PAP-S)
dyspnea
Item
Dyspnea
boolean
C0013404 (UMLS CUI [1])
dyspnea score
Item
Score
float
C0449820 (UMLS CUI [1,1])
C0013404 (UMLS CUI [1,2])
anorexia
Item
Anorexia
boolean
C0003123 (UMLS CUI [1])
anorexia score
Item
Score
text
C0449820 (UMLS CUI [1,1])
C0003123 (UMLS CUI [1,2])
Item Group
PR2. Karnofsky Performance Status
C0206065 (UMLS CUI-1)
Item
No complaints; no evidence of disease - 100% Able to carry on normal activity; minor signs or symptoms of disease - 90% Normal activity with effort; some signs or symptoms of disease - 80% Cares for self; unable to carry on normal activity or to do active work - 70% Requires occasional assistance but is able to care for most personal needs - 60% Requires considerable assistance and frequent medical care - 50% Disabled; requires special care and assistance - 40% Severely disabled; hospital admission indicated although death not imminent - 30%
integer
C0206065 (UMLS CUI [1])
KI100-KI30
Code List
No complaints; no evidence of disease - 100% Able to carry on normal activity; minor signs or symptoms of disease - 90% Normal activity with effort; some signs or symptoms of disease - 80% Cares for self; unable to carry on normal activity or to do active work - 70% Requires occasional assistance but is able to care for most personal needs - 60% Requires considerable assistance and frequent medical care - 50% Disabled; requires special care and assistance - 40% Severely disabled; hospital admission indicated although death not imminent - 30%
CL Item
0 (1)
Item
Very sick; hospital admission necessary; active supportive treatment necessary - 20% Moribund; fatal processes progressing rapidly - 10% Dead - 0%
integer
C0206065 (UMLS CUI [1])
KI20-0
Code List
Very sick; hospital admission necessary; active supportive treatment necessary - 20% Moribund; fatal processes progressing rapidly - 10% Dead - 0%
CL Item
2.5 (1)
KI total score
Item
Score
float
C0206065 (UMLS CUI [1,1])
C0449820 (UMLS CUI [1,2])
Item Group
PR3. Clinical prognosis of survival
Item
Clinical prognosis of survival
text
C0033325 (UMLS CUI [1,1])
C2919552 (UMLS CUI [1,2])
clinical prognosis of survival
Code List
Clinical prognosis of survival
CL Item
>12 weeks (>12 weeks)
CL Item
11-12 weeks (11-12 weeks)
CL Item
9-10 weeks (9-10 weeks)
CL Item
7-8 weeks (7-8 weeks)
CL Item
5-6 weeks (5-6 weeks)
CL Item
3-4 weeks (3-4 weeks)
CL Item
1-2 weeks (1-2 weeks)
clinical prognosis score
Item
Score
float
C0449820 (UMLS CUI [1,1])
C0033325 (UMLS CUI [1,2])
C2919552 (UMLS CUI [1,3])
Item Group
PR4. Hemogram
Item
Leucocytes
text
C0023508 (UMLS CUI [1])
WBC
Code List
Leucocytes
CL Item
4800-8500 (4800-8500)
CL Item
8500-11000 (8500-11000)
CL Item
>11000 (>11000)
WBC score
Item
Score
float
C0449820 (UMLS CUI [1,1])
C0023508 (UMLS CUI [1,2])
Item
Lymphocytes
text
C0024264 (UMLS CUI [1])
lymphocytes
Code List
Lymphocytes
CL Item
20-40%  (20-40% )
CL Item
12-19,9% (12-19,9%)
CL Item
<11,9% (<11,9%)
lymphocytes score
Item
Score
float
C0024264 (UMLS CUI [1,1])
C0024264 (UMLS CUI [1,2])
Item Group
PaP Score (maximal 17.5 Points)
PaP score
Item
PaP Score
float
Item Group
PR5. Palliative Performance Scale
PPS60-100
Item
PPS 60%-100% Score 0
boolean
PPS50-30
Item
PPS 30%-50% Score 2,5
boolean
PPS20-10
Item
PPS 10%-20% Score 4
boolean
PPS0
Item
PPS 0%
boolean
life expectancy
Item
Life expectancy of 6 months 10% in case of < 50% PPS
boolean
C3845482 (UMLS CUI [1])
total score PPS
Item
Total Score PPS
float
C2964552 (UMLS CUI [1])
Item Group
PR6. Oral Intake
normal oral intake
Item
Oral intake: Normal Score: 0
boolean
C0518037 (UMLS CUI [1,1])
C0205307 (UMLS CUI [1,2])
slightly reduced oral intake
Item
Oral intake: Sligthly reduced (> entire mouth) Score: 1
boolean
C0518037 (UMLS CUI [1,1])
C0392756 (UMLS CUI [1,2])
C0750482 (UMLS CUI [1,3])
clearly reduced oral intake
Item
Oral intake: Clearly reduced (<= entire mouth) Score: 2,5
boolean
C0518037 (UMLS CUI [1,1])
C0392756 (UMLS CUI [1,2])
total score oral intake
Item
Total Score:
float
C0518037 (UMLS CUI [1,1])
C2964552 (UMLS CUI [1,2])
Item Group
PR7. Symptoms
edema
Item
Edema
boolean
C0013604 (UMLS CUI [1])
shortness of breath
Item
Shortness of breath at rest
boolean
C0748649 (UMLS CUI [1])
delir
Item
Delir
boolean
C0011206 (UMLS CUI [1])
Item Group
Palliative Prognostic Index
score PPI
Item
Palliative Prognostic Index (maximal 15 Points)
float
Terug naar het begin van de pagina 

Contact

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial