ID

162

Beschrijving

Form from HIS OpenVistA

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Versies (2)
  1. 09-02-12 09-02-12 -
  2. 04-06-17 04-06-17 - Martin Dugas
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9 februari 2012

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HIS Family Hx

Duits Engels

HIS

1 Formulieren  
  1. StudyEvent: HIS
    1. HIS
Maternal Family History
Beschrijving

Maternal Family History

Mutter lebt
Beschrijving

Mother living

Datatype

boolean

Hypertonie
Beschrijving

Hypertension

Datatype

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
Beschrijving

Diabetes mellitus

Datatype

boolean

Alias
UMLS CUI
C0011849
SNOMED CT 2010_0731
191044006
Schlaganfall
Beschrijving

Stroke

Datatype

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
Herzinfarkt
Beschrijving

Myocardial Infarction (MI)

Datatype

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
Beschrijving

Early Coronary Vascular Disease

Datatype

boolean

Brustkrebs
Beschrijving

Breast Cancer

Datatype

boolean

Alias
UMLS CUI
C0678222
SNOMED CT 2010_0731
254838004
MedDRA 13.1
10006204
Darmkrebs
Beschrijving

Colon Cancer

Datatype

boolean

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

Other

Datatype

text

FH: Age at death
Beschrijving

Mother's age of death

Datatype

integer

Alias
UMLS CUI
C1720406
Todesursache (Mutter)
Beschrijving

Mother's cause of death

Datatype

text

Alias
UMLS CUI
C0007465
SNOMED CT 2010_0731
184305005
LOINC Version 232
MTHU010441
Kommentar
Beschrijving

comment

Datatype

text

Paternal Family History
Beschrijving

Paternal Family History

Vater lebt
Beschrijving

Father living

Datatype

boolean

Hypertonie
Beschrijving

Hypertension

Datatype

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
Beschrijving

Diabetes mellitus

Datatype

boolean

Alias
UMLS CUI
C0011849
SNOMED CT 2010_0731
191044006
Schlaganfall
Beschrijving

Stroke

Datatype

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
Herzinfarkt
Beschrijving

Myocardial Infarction (MI)

Datatype

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
Beschrijving

Early Coronary Vascular Disease

Datatype

boolean

Prostatakrebs
Beschrijving

Prostate Cancer

Datatype

boolean

Alias
UMLS CUI
C0600139
SNOMED CT 2010_0731
254900004
MedDRA 13.1
10036921
Darmkrebs
Beschrijving

Colon Cancer

Datatype

boolean

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

Other

Datatype

text

FH: Age at death
Beschrijving

Father's age of death

Datatype

integer

Alias
UMLS CUI
C1720406
Todesursache (Vater)
Beschrijving

Father's cause of death

Datatype

text

Alias
UMLS CUI
C0007465
SNOMED CT 2010_0731
184305005
LOINC Version 232
MTHU010441
Kommentar
Beschrijving

comment

Datatype

text

Siblings Family History
Beschrijving

Siblings Family History

Geschwister ohne signifikante Erkrankung
Beschrijving

Siblings without significant disease

Datatype

text

Geschwister mit signifikanter Erkrankung
Beschrijving

Siblings with significant disease

Datatype

boolean

Hypertonie
Beschrijving

Hypertension

Datatype

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
Schlaganfall
Beschrijving

Stroke

Datatype

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
Herzinfarkt
Beschrijving

Myocardial Infarction (MI)

Datatype

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
Beschrijving

Diabetes mellitus

Datatype

boolean

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

Early Coronary Vascular Disease

Datatype

boolean

Darmkrebs
Beschrijving

Colon Cancer

Datatype

boolean

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

Other

Datatype

text

Terug naar het begin van de pagina

Similar models

HIS

1 Formulieren
  1. StudyEvent: HIS
    1. HIS
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Mother living
Item
Mutter lebt
boolean
Hypertension
Item
Hypertonie
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
Schlaganfall
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
Herzinfarkt
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
Breast Cancer
Item
Brustkrebs
boolean
C0678222 (UMLS CUI)
254838004 (SNOMED CT 2010_0731)
10006204 (MedDRA 13.1)
Colon Cancer
Item
Darmkrebs
boolean
C0699790 (UMLS CUI)
269533000 (SNOMED CT 2010_0731)
10009957 (MedDRA 13.1)
Other
Item
Other
text
Mother's age of death
Item
FH: Age at death
integer
C1720406 (UMLS CUI)
Mother's cause of death
Item
Todesursache (Mutter)
text
C0007465 (UMLS CUI)
184305005 (SNOMED CT 2010_0731)
MTHU010441 (LOINC Version 232)
comment
Item
Kommentar
text
Father living
Item
Vater lebt
boolean
Hypertension
Item
Hypertonie
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
Schlaganfall
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
Herzinfarkt
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
Prostate Cancer
Item
Prostatakrebs
boolean
C0600139 (UMLS CUI)
254900004 (SNOMED CT 2010_0731)
10036921 (MedDRA 13.1)
Colon Cancer
Item
Darmkrebs
boolean
C0699790 (UMLS CUI)
269533000 (SNOMED CT 2010_0731)
10009957 (MedDRA 13.1)
Other
Item
Other
text
Father's age of death
Item
FH: Age at death
integer
C1720406 (UMLS CUI)
Father's cause of death
Item
Todesursache (Vater)
text
C0007465 (UMLS CUI)
184305005 (SNOMED CT 2010_0731)
MTHU010441 (LOINC Version 232)
comment
Item
Kommentar
text
Siblings without significant disease
Item
Geschwister ohne signifikante Erkrankung
text
Siblings with significant disease
Item
Geschwister mit signifikanter Erkrankung
boolean
Hypertension
Item
Hypertonie
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
Schlaganfall
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
Herzinfarkt
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
Colon Cancer
Item
Darmkrebs
boolean
C0699790 (UMLS CUI)
269533000 (SNOMED CT 2010_0731)
10009957 (MedDRA 13.1)
Other
Item
Other
text
Terug naar het begin van de pagina 

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