ID

22443

Description

Form from HIS OpenVistA

Keywords

Versions (2)
  1. 2/9/12 2/9/12 -
  2. 6/4/17 6/4/17 - Martin Dugas
Uploaded on

June 4, 2017

DOI

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License

Creative Commons BY-NC 3.0
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Family history

German English

HIS

1 forms  
  1. StudyEvent: HIS
    1. HIS
Maternal Family History
Description

Maternal Family History

Alias
UMLS CUI-1
C0424914
Mother living
Description

Mother alive

Data type

boolean

Alias
UMLS CUI [1]
C2321272
Hypertensive disease
Description

Hypertension

Data type

boolean

Alias
UMLS CUI
C0020538
SNOMED CT 2010_0731
38341003
MedDRA 13.1
10020772
LOINC Version 232
MTHU020789
ICD-10-CM Version 2010
I10
ICD-9-CM Version 2011
997.91
CTCAE Version 4.03
E13785
Diabetes mellitus
Description

Diabetes mellitus

Data type

boolean

Alias
UMLS CUI
C0011849
SNOMED CT 2010_0731
191044006
Stroke
Description

Stroke

Data type

boolean

Alias
UMLS CUI
C0038454
SNOMED CT 2010_0731
230690007
MedDRA 13.1
10042244
ICD-10-CM Version 2010
I63.9
CTCAE Version 4.03
E12826
Heart infarction
Description

Myocardial Infarction (MI)

Data type

boolean

Alias
UMLS CUI
C0027051
SNOMED CT 2010_0731
22298006
MedDRA 13.1
10028596
LOINC Version 232
MTHU035551
ICD-10-CM Version 2010
I21-I22
ICD-9-CM Version 2011
410
CTCAE Version 4.03
E10152
Early Coronary Vascular Disease
Description

Premature coronary artery disease

Data type

boolean

Alias
UMLS CUI [1]
C1867743
Breast Carcinoma
Description

Breast Cancer

Data type

boolean

Alias
UMLS CUI
C0678222
SNOMED CT 2010_0731
254838004
MedDRA 13.1
10006204
Colon Carcinoma
Description

Colon Cancer

Data type

boolean

Alias
UMLS CUI
C0699790
SNOMED CT 2010_0731
269533000
MedDRA 13.1
10009957
Other
Description

Other

Data type

text

Mother's age at death
Description

age of death mother

Data type

integer

Alias
UMLS CUI [1,1]
C1720406
UMLS CUI [1,2]
C0026591
Mother's Cause of Death
Description

cause of death mother

Data type

text

Alias
SNOMED CT 2010_0731
184305005
LOINC Version 232
MTHU010441
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0026591
comment
Description

comment

Data type

text

Alias
UMLS CUI [1]
C0947611
Paternal Family History
Description

Paternal Family History

Alias
UMLS CUI-1
C0424909
Father living
Description

Father living

Data type

boolean

Hypertensive disease
Description

Hypertension

Data type

boolean

Alias
UMLS CUI
C0020538
SNOMED CT 2010_0731
38341003
MedDRA 13.1
10020772
LOINC Version 232
MTHU020789
ICD-10-CM Version 2010
I10
ICD-9-CM Version 2011
997.91
CTCAE Version 4.03
E13785
Diabetes mellitus
Description

Diabetes mellitus

Data type

boolean

Alias
UMLS CUI
C0011849
SNOMED CT 2010_0731
191044006
Stroke
Description

Stroke

Data type

boolean

Alias
UMLS CUI
C0038454
SNOMED CT 2010_0731
230690007
MedDRA 13.1
10042244
ICD-10-CM Version 2010
I63.9
CTCAE Version 4.03
E12826
Heart infarction
Description

Myocardial Infarction (MI)

Data type

boolean

Alias
UMLS CUI
C0027051
SNOMED CT 2010_0731
22298006
MedDRA 13.1
10028596
LOINC Version 232
MTHU035551
ICD-10-CM Version 2010
I21-I22
ICD-9-CM Version 2011
410
CTCAE Version 4.03
E10152
Early Coronary Vascular Disease
Description

Early Coronary Vascular Disease

Data type

boolean

Alias
UMLS CUI [1]
C1867743
Prostate carcinoma
Description

Prostate Cancer

Data type

boolean

Alias
UMLS CUI
C0600139
SNOMED CT 2010_0731
254900004
MedDRA 13.1
10036921
Colon Carcinoma
Description

Colon Cancer

Data type

boolean

Alias
UMLS CUI
C0699790
SNOMED CT 2010_0731
269533000
MedDRA 13.1
10009957
Other
Description

Other

Data type

text

Father's age at death
Description

age of death father

Data type

integer

Alias
UMLS CUI [1,1]
C1720406
UMLS CUI [1,2]
C0015671
Father's cause of death
Description

cause of death father

Data type

text

Alias
SNOMED CT 2010_0731
184305005
LOINC Version 232
MTHU010441
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0015671
comment
Description

comment

Data type

text

Alias
UMLS CUI [1]
C0947611
Siblings Family History
Description

Siblings Family History

Alias
UMLS CUI-1
C0241889
UMLS CUI-2
C0037047
Siblings without significant disease
Description

Siblings without significant disease

Data type

text

Alias
UMLS CUI [1,1]
C0037047
UMLS CUI [1,2]
C0497153
Siblings with significant disease
Description

Siblings with significant disease

Data type

boolean

Alias
UMLS CUI [1,1]
C0037047
UMLS CUI [1,2]
C0012634
Hypertensive disease
Description

Hypertension

Data type

boolean

Alias
UMLS CUI
C0020538
SNOMED CT 2010_0731
38341003
MedDRA 13.1
10020772
LOINC Version 232
MTHU020789
ICD-10-CM Version 2010
I10
ICD-9-CM Version 2011
997.91
CTCAE Version 4.03
E13785
Stroke
Description

Stroke

Data type

boolean

Alias
UMLS CUI
C0038454
SNOMED CT 2010_0731
230690007
MedDRA 13.1
10042244
ICD-10-CM Version 2010
I63.9
CTCAE Version 4.03
E12826
Heart infarction
Description

Myocardial Infarction (MI)

Data type

boolean

Alias
UMLS CUI
C0027051
SNOMED CT 2010_0731
22298006
MedDRA 13.1
10028596
LOINC Version 232
MTHU035551
ICD-10-CM Version 2010
I21-I22
ICD-9-CM Version 2011
410
CTCAE Version 4.03
E10152
Diabetes mellitus
Description

Diabetes mellitus

Data type

boolean

Alias
UMLS CUI
C0011849
SNOMED CT 2010_0731
191044006
Early Coronary Vascular Disease
Description

Early Coronary Vascular Disease

Data type

boolean

Alias
UMLS CUI [1]
C1867743
Colon Carcinoma
Description

Colon Cancer

Data type

boolean

Alias
UMLS CUI
C0699790
SNOMED CT 2010_0731
269533000
MedDRA 13.1
10009957
Other
Description

Other

Data type

text

Alias
UMLS CUI [1]
C0205394
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Similar models

HIS

1 forms
  1. StudyEvent: HIS
    1. HIS
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Maternal Family History
C0424914 (UMLS CUI-1)
Mother alive
Item
Mother living
boolean
C2321272 (UMLS CUI [1])
Hypertension
Item
Hypertensive disease
boolean
C0020538 (UMLS CUI)
38341003 (SNOMED CT 2010_0731)
10020772 (MedDRA 13.1)
MTHU020789 (LOINC Version 232)
I10 (ICD-10-CM Version 2010)
997.91 (ICD-9-CM Version 2011)
E13785 (CTCAE Version 4.03)
Diabetes mellitus
Item
Diabetes mellitus
boolean
C0011849 (UMLS CUI)
191044006 (SNOMED CT 2010_0731)
Stroke
Item
Stroke
boolean
C0038454 (UMLS CUI)
230690007 (SNOMED CT 2010_0731)
10042244 (MedDRA 13.1)
I63.9 (ICD-10-CM Version 2010)
E12826 (CTCAE Version 4.03)
Myocardial Infarction (MI)
Item
Heart infarction
boolean
C0027051 (UMLS CUI)
22298006 (SNOMED CT 2010_0731)
10028596 (MedDRA 13.1)
MTHU035551 (LOINC Version 232)
I21-I22 (ICD-10-CM Version 2010)
410 (ICD-9-CM Version 2011)
E10152 (CTCAE Version 4.03)
Premature coronary artery disease
Item
Early Coronary Vascular Disease
boolean
C1867743 (UMLS CUI [1])
Breast Cancer
Item
Breast Carcinoma
boolean
C0678222 (UMLS CUI)
254838004 (SNOMED CT 2010_0731)
10006204 (MedDRA 13.1)
Colon Cancer
Item
Colon Carcinoma
boolean
C0699790 (UMLS CUI)
269533000 (SNOMED CT 2010_0731)
10009957 (MedDRA 13.1)
Other
Item
Other
text
age of death mother
Item
Mother's age at death
integer
C1720406 (UMLS CUI [1,1])
C0026591 (UMLS CUI [1,2])
cause of death mother
Item
Mother's Cause of Death
text
184305005 (SNOMED CT 2010_0731)
MTHU010441 (LOINC Version 232)
C0007465 (UMLS CUI [1,1])
C0026591 (UMLS CUI [1,2])
comment
Item
comment
text
C0947611 (UMLS CUI [1])
Item Group
Paternal Family History
C0424909 (UMLS CUI-1)
Father living
Item
Father living
boolean
Hypertension
Item
Hypertensive disease
boolean
C0020538 (UMLS CUI)
38341003 (SNOMED CT 2010_0731)
10020772 (MedDRA 13.1)
MTHU020789 (LOINC Version 232)
I10 (ICD-10-CM Version 2010)
997.91 (ICD-9-CM Version 2011)
E13785 (CTCAE Version 4.03)
Diabetes mellitus
Item
Diabetes mellitus
boolean
C0011849 (UMLS CUI)
191044006 (SNOMED CT 2010_0731)
Stroke
Item
Stroke
boolean
C0038454 (UMLS CUI)
230690007 (SNOMED CT 2010_0731)
10042244 (MedDRA 13.1)
I63.9 (ICD-10-CM Version 2010)
E12826 (CTCAE Version 4.03)
Myocardial Infarction (MI)
Item
Heart infarction
boolean
C0027051 (UMLS CUI)
22298006 (SNOMED CT 2010_0731)
10028596 (MedDRA 13.1)
MTHU035551 (LOINC Version 232)
I21-I22 (ICD-10-CM Version 2010)
410 (ICD-9-CM Version 2011)
E10152 (CTCAE Version 4.03)
Early Coronary Vascular Disease
Item
Early Coronary Vascular Disease
boolean
C1867743 (UMLS CUI [1])
Prostate Cancer
Item
Prostate carcinoma
boolean
C0600139 (UMLS CUI)
254900004 (SNOMED CT 2010_0731)
10036921 (MedDRA 13.1)
Colon Cancer
Item
Colon Carcinoma
boolean
C0699790 (UMLS CUI)
269533000 (SNOMED CT 2010_0731)
10009957 (MedDRA 13.1)
Other
Item
Other
text
age of death father
Item
Father's age at death
integer
C1720406 (UMLS CUI [1,1])
C0015671 (UMLS CUI [1,2])
cause of death father
Item
Father's cause of death
text
184305005 (SNOMED CT 2010_0731)
MTHU010441 (LOINC Version 232)
C0007465 (UMLS CUI [1,1])
C0015671 (UMLS CUI [1,2])
comment
Item
comment
text
C0947611 (UMLS CUI [1])
Item Group
Siblings Family History
C0241889 (UMLS CUI-1)
C0037047 (UMLS CUI-2)
Siblings without significant disease
Item
Siblings without significant disease
text
C0037047 (UMLS CUI [1,1])
C0497153 (UMLS CUI [1,2])
Siblings with significant disease
Item
Siblings with significant disease
boolean
C0037047 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
Hypertension
Item
Hypertensive disease
boolean
C0020538 (UMLS CUI)
38341003 (SNOMED CT 2010_0731)
10020772 (MedDRA 13.1)
MTHU020789 (LOINC Version 232)
I10 (ICD-10-CM Version 2010)
997.91 (ICD-9-CM Version 2011)
E13785 (CTCAE Version 4.03)
Stroke
Item
Stroke
boolean
C0038454 (UMLS CUI)
230690007 (SNOMED CT 2010_0731)
10042244 (MedDRA 13.1)
I63.9 (ICD-10-CM Version 2010)
E12826 (CTCAE Version 4.03)
Myocardial Infarction (MI)
Item
Heart infarction
boolean
C0027051 (UMLS CUI)
22298006 (SNOMED CT 2010_0731)
10028596 (MedDRA 13.1)
MTHU035551 (LOINC Version 232)
I21-I22 (ICD-10-CM Version 2010)
410 (ICD-9-CM Version 2011)
E10152 (CTCAE Version 4.03)
Diabetes mellitus
Item
Diabetes mellitus
boolean
C0011849 (UMLS CUI)
191044006 (SNOMED CT 2010_0731)
Early Coronary Vascular Disease
Item
Early Coronary Vascular Disease
boolean
C1867743 (UMLS CUI [1])
Colon Cancer
Item
Colon Carcinoma
boolean
C0699790 (UMLS CUI)
269533000 (SNOMED CT 2010_0731)
10009957 (MedDRA 13.1)
Other
Item
Other
text
C0205394 (UMLS CUI [1])
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