ID

16888

Beskrivning

Nyckelord

  1. 2016-07-28 2016-07-28 -
  2. 2016-08-12 2016-08-12 -
Uppladdad den

12 augusti 2016

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0

Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

Durchgangsarztbericht

Durchgangsarztbericht

  1. StudyEvent: ODM
    1. Durchgangsarztbericht
Patient Information
Beskrivning

Patient Information

Alias
UMLS CUI-1
C1955348
Accident insurer
Beskrivning

Accident insurer

Datatyp

text

Alias
UMLS CUI [1,1]
C0021680
UMLS CUI [1,2]
C0021675
Name of insured person
Beskrivning

Name of insured person

Datatyp

text

Alias
UMLS CUI [1,1]
C1548651
UMLS CUI [1,2]
C0027365
Surname of insured person
Beskrivning

Surname of insured person

Datatyp

text

Alias
UMLS CUI [1,1]
C1548651
UMLS CUI [1,2]
C0421448
Birth date of insured person
Beskrivning

Birth date of insured person

Datatyp

date

Alias
UMLS CUI [1,1]
C1548651
UMLS CUI [1,2]
C0421451
Employment
Beskrivning

Employment

Datatyp

text

Alias
UMLS CUI [1]
C0014003
Employment date
Beskrivning

Employment date

Datatyp

date

Alias
UMLS CUI [1,1]
C0014003
UMLS CUI [1,2]
C0011008
Company where accident happened
Beskrivning

Company where accident happened

Datatyp

text

Alias
UMLS CUI [1,1]
C0683757
UMLS CUI [1,2]
C0000924
Address of insured person
Beskrivning

Address of insured person

Datatyp

text

Alias
UMLS CUI [1,1]
C1548651
UMLS CUI [1,2]
C1442065
Report Information
Beskrivning

Report Information

Alias
UMLS CUI-1
C0684224
Arrival
Beskrivning

Arrival

Datatyp

date

Alias
UMLS CUI [1]
C1706079
Arrival time
Beskrivning

Arrival time

Datatyp

time

Alias
UMLS CUI [1,1]
C1706079
UMLS CUI [1,2]
C0040223
Health insurance
Beskrivning

Health insurance

Datatyp

text

Nursing care insurance
Beskrivning

Nursing care insurance

Datatyp

text

Alias
UMLS CUI [1]
C0021690
Phone Number of Insured Person
Beskrivning

Phone Number of Insured Person

Datatyp

text

Alias
UMLS CUI [1,1]
C1548651
UMLS CUI [1,2]
C1515258
Nationality
Beskrivning

Nationality

Datatyp

text

Alias
UMLS CUI [1]
C0027473
Gender
Beskrivning

Gender

Datatyp

text

Alias
UMLS CUI [1]
C0079399
Accident
Beskrivning

Accident

Alias
UMLS CUI-1
C0000924
Date of accident
Beskrivning

Date of accident

Datatyp

date

Alias
UMLS CUI [1,1]
C0000924
UMLS CUI [1,2]
C0011008
Time of Accident
Beskrivning

Time of Accident

Datatyp

time

Alias
UMLS CUI [1,1]
C0000924
UMLS CUI [1,2]
C0040223
Working time: Start Time
Beskrivning

Working time: Start Time

Datatyp

time

Alias
UMLS CUI [1,1]
C2135639
UMLS CUI [1,2]
C1301880
Working time: End Time
Beskrivning

Working time: End Time

Datatyp

time

Alias
UMLS CUI [1,1]
C2135639
UMLS CUI [1,2]
C1522314
Accident scene
Beskrivning

Accident scene

Datatyp

text

Alias
UMLS CUI [1]
C0337069
Course of accident
Beskrivning

Course of accident

Datatyp

text

Alias
UMLS CUI [1,1]
C0750729
UMLS CUI [1,2]
C0000924
Activity while accident
Beskrivning

Activity while accident

Datatyp

text

Alias
UMLS CUI [1,1]
C0336911
UMLS CUI [1,2]
C0000924
Behaviour after accident
Beskrivning

Behaviour after accident

Datatyp

text

Alias
UMLS CUI [1,1]
C0004927
UMLS CUI [1,2]
C0000924
Treatment and findings
Beskrivning

Treatment and findings

Alias
UMLS CUI-1
C0087111
UMLS CUI-2
C0243095
Medical care specification
Beskrivning

Medical care specification

Datatyp

text

Alias
UMLS CUI [1,1]
C0496675
UMLS CUI [1,2]
C2348235
First Treatment: Date
Beskrivning

First Treatment: Date

Datatyp

date

Alias
UMLS CUI [1,1]
C0805838
UMLS CUI [1,2]
C0087111
First Treatment: Physician
Beskrivning

First Treatment: Physician

Datatyp

text

Alias
UMLS CUI [1,1]
C0805838
UMLS CUI [1,2]
C0087111
UMLS CUI [1,3]
C0031831
Substance Use Disorder
Beskrivning

Substance Use Disorder

Datatyp

boolean

Alias
UMLS CUI [1]
C0038586
Substance Use Disorder: Specification
Beskrivning

Substance Use Disorder: Specification

Datatyp

text

Alias
UMLS CUI [1,1]
C0038586
UMLS CUI [1,2]
C2348235
Blood sample
Beskrivning

Blood sample

Datatyp

boolean

Alias
UMLS CUI [1]
C0005834
X-ray: finding
Beskrivning

X-ray: finding

Datatyp

text

Alias
UMLS CUI [1,1]
C0034571
UMLS CUI [1,2]
C0243095
Initial diagnosis
Beskrivning

Initial diagnosis

Datatyp

text

Alias
UMLS CUI [1]
C4071762
Medical care by accident insurance consultance
Beskrivning

Medical care by accident insurance consultance

Datatyp

text

Alias
UMLS CUI [1,1]
C0496675
UMLS CUI [1,2]
C0021680
UMLS CUI [1,3]
C0031831
Comorbidity
Beskrivning

Comorbidity

Datatyp

text

Alias
UMLS CUI [1]
C0009488
Contradiction to accident
Beskrivning

Contradiction to accident

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0442809
UMLS CUI [1,2]
C0000924
Contradiction to accident: specification
Beskrivning

Contradiction to accident: specification

Datatyp

text

Alias
UMLS CUI [1,1]
C0442809
UMLS CUI [1,2]
C0000924
UMLS CUI [1,3]
C2348235
Accident insurance: consultation
Beskrivning

Accident insurance: consultation

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0009818
UMLS CUI [1,2]
C0021680
Accident insurance: consultation specification
Beskrivning

Accident insurance: consultation specification

Datatyp

text

Alias
UMLS CUI [1,1]
C0009818
UMLS CUI [1,2]
C0021680
UMLS CUI [1,3]
C2348235
Treatment
Beskrivning

Treatment

Datatyp

text

Alias
UMLS CUI [1]
C0087111
Work ability
Beskrivning

Work ability

Datatyp

text

Alias
UMLS CUI [1]
C2960301
Work inability: Date
Beskrivning

Work inability: Date

Datatyp

date

Alias
UMLS CUI [1,1]
C2960301
UMLS CUI [1,2]
C0011008
Work ability: Date
Beskrivning

Work ability: Date

Datatyp

date

Alias
UMLS CUI [1,1]
C2960301
UMLS CUI [1,2]
C0011008
Consultant physician
Beskrivning

Consultant physician

Datatyp

boolean

Alias
UMLS CUI [1]
C0401971
Consultant physician: Specification
Beskrivning

Consultant physician: Specification

Datatyp

text

Alias
UMLS CUI [1,1]
C0401971
UMLS CUI [1,2]
C2348235
Follow up date
Beskrivning

Follow up date

Datatyp

date

Alias
UMLS CUI [1]
C3694716
Hospital's or Physician's Address
Beskrivning

Hospital's or Physician's Address

Datatyp

text

Alias
UMLS CUI [1]
C2986046
UMLS CUI [2]
C3669301
Identification and Signature
Beskrivning

Identification and Signature

Alias
UMLS CUI-1
C0205396
UMLS CUI-2
C1519316
Date of report
Beskrivning

Date of report

Datatyp

date

Alias
UMLS CUI [1]
C1302584
Physician's signature
Beskrivning

Physician's signature

Datatyp

text

Alias
UMLS CUI [1]
C1519316
Invoice
Beskrivning

Invoice

Alias
UMLS CUI-1
C2981733
Report Fee
Beskrivning

Report Fee

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C0015754
UMLS CUI [1,2]
C0684224
EUR
Complementary report
Beskrivning

Complementary report

Datatyp

float

Alias
UMLS CUI [1,1]
C1524062
UMLS CUI [1,2]
C0684224
Complementary report: Payment
Beskrivning

Complementary report: Payment

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C1524062
UMLS CUI [1,2]
C0684224
UMLS CUI [1,3]
C0220808
EUR
Medical Service
Beskrivning

Medical Service

Datatyp

float

Alias
UMLS CUI [1]
C0199168
Medical Service: Payment
Beskrivning

Medical Service: Payment

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C0199168
UMLS CUI [1,2]
C0220808
EUR
Medical Service: Payment Specifciation
Beskrivning

Medical Service: Payment Specifciation

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C0199168
UMLS CUI [1,2]
C0220808
EUR
Tetanus Vaccine: Payment
Beskrivning

Tetanus Vaccine: Payment

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C0305062
UMLS CUI [1,2]
C0220808
EUR
Tetanus Vaccine: Payment Specification
Beskrivning

Tetanus Vaccine: Payment Specification

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C0305062
UMLS CUI [1,2]
C0220808
UMLS CUI [1,3]
C2348235
EUR
Active Tetanus Vaccine: Payment
Beskrivning

Active Tetanus Vaccine: Payment

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C0305062
UMLS CUI [1,2]
C0205991
UMLS CUI [1,3]
C0220808
EUR
Active Tetanus Vaccine: Payment Specification
Beskrivning

Active Tetanus Vaccine: Payment Specification

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C0305062
UMLS CUI [1,2]
C0205991
UMLS CUI [1,3]
C0220808
UMLS CUI [1,4]
C2348235
EUR
Sum: Special costs
Beskrivning

Sum: Special costs

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C1515051
UMLS CUI [1,2]
C0220808
UMLS CUI [1,3]
C2348235
EUR
Postage: Payment
Beskrivning

Postage: Payment

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C0032755
UMLS CUI [1,2]
C0220808
EUR
Sum: Payment
Beskrivning

Sum: Payment

Datatyp

float

Måttenheter
  • EUR
Alias
UMLS CUI [1,1]
C1515051
UMLS CUI [1,2]
C0220808
EUR
Invoice number
Beskrivning

Invoice number

Datatyp

text

Alias
UMLS CUI [1,1]
C2981733
UMLS CUI [1,2]
C0237753
Institution label
Beskrivning

Institution label

Datatyp

text

Alias
UMLS CUI [1,1]
C2607850
UMLS CUI [1,2]
C2983610
Bank account
Beskrivning

Bank account

Datatyp

text

Alias
UMLS CUI [1]
C1549682

Similar models

Durchgangsarztbericht

  1. StudyEvent: ODM
    1. Durchgangsarztbericht
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Patient Information
C1955348 (UMLS CUI-1)
Accident insurer
Item
text
C0021680 (UMLS CUI [1,1])
C0021675 (UMLS CUI [1,2])
Name of insured person
Item
text
C1548651 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
Surname of insured person
Item
text
C1548651 (UMLS CUI [1,1])
C0421448 (UMLS CUI [1,2])
Birth date of insured person
Item
date
C1548651 (UMLS CUI [1,1])
C0421451 (UMLS CUI [1,2])
Employment
Item
text
C0014003 (UMLS CUI [1])
Employment date
Item
date
C0014003 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Company where accident happened
Item
text
C0683757 (UMLS CUI [1,1])
C0000924 (UMLS CUI [1,2])
Address of insured person
Item
text
C1548651 (UMLS CUI [1,1])
C1442065 (UMLS CUI [1,2])
Item Group
C0684224 (UMLS CUI-1)
Arrival
Item
date
C1706079 (UMLS CUI [1])
Arrival time
Item
time
C1706079 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Health insurance
Item
text
Nursing care insurance
Item
text
C0021690 (UMLS CUI [1])
Phone Number of Insured Person
Item
text
C1548651 (UMLS CUI [1,1])
C1515258 (UMLS CUI [1,2])
Nationality
Item
text
C0027473 (UMLS CUI [1])
Gender
Item
text
C0079399 (UMLS CUI [1])
Item Group
C0000924 (UMLS CUI-1)
Date of accident
Item
date
C0000924 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Time of Accident
Item
time
C0000924 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Working time: Start Time
Item
time
C2135639 (UMLS CUI [1,1])
C1301880 (UMLS CUI [1,2])
Working time: End Time
Item
time
C2135639 (UMLS CUI [1,1])
C1522314 (UMLS CUI [1,2])
Accident scene
Item
text
C0337069 (UMLS CUI [1])
Course of accident
Item
text
C0750729 (UMLS CUI [1,1])
C0000924 (UMLS CUI [1,2])
Activity while accident
Item
text
C0336911 (UMLS CUI [1,1])
C0000924 (UMLS CUI [1,2])
Behaviour after accident
Item
text
C0004927 (UMLS CUI [1,1])
C0000924 (UMLS CUI [1,2])
Item Group
C0087111 (UMLS CUI-1)
C0243095 (UMLS CUI-2)
Medical care specification
Item
text
C0496675 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
First Treatment: Date
Item
date
C0805838 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
First Treatment: Physician
Item
text
C0805838 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0031831 (UMLS CUI [1,3])
Substance Use Disorder
Item
boolean
C0038586 (UMLS CUI [1])
Substance Use Disorder: Specification
Item
text
C0038586 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Blood sample
Item
boolean
C0005834 (UMLS CUI [1])
X-ray: finding
Item
text
C0034571 (UMLS CUI [1,1])
C0243095 (UMLS CUI [1,2])
Initial diagnosis
Item
text
C4071762 (UMLS CUI [1])
Medical care by accident insurance consultance
Item
text
C0496675 (UMLS CUI [1,1])
C0021680 (UMLS CUI [1,2])
C0031831 (UMLS CUI [1,3])
Comorbidity
Item
text
C0009488 (UMLS CUI [1])
Contradiction to accident
Item
boolean
C0442809 (UMLS CUI [1,1])
C0000924 (UMLS CUI [1,2])
Contradiction to accident: specification
Item
text
C0442809 (UMLS CUI [1,1])
C0000924 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Accident insurance: consultation
Item
boolean
C0009818 (UMLS CUI [1,1])
C0021680 (UMLS CUI [1,2])
Accident insurance: consultation specification
Item
text
C0009818 (UMLS CUI [1,1])
C0021680 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Item
text
C0087111 (UMLS CUI [1])
Code List
Treatment
CL Item
 (Allgemeine Heilbehandlung durch anderen Arzt)
CL Item
 (Allgemeine Heilbehandlung durch mich)
CL Item
 (Besondere Heilbehandlung: ambulant)
CL Item
 (Besondere Heilbehandlung: stationär)
CL Item
 (Liegt eine Verletzung nach dem Verletzungs-/ Schwerstverletzungsartenverzeichnis vor? Nein)
CL Item
 (Liegt eine Verletzung nach dem Verletzungs-/ Schwerstverletzungsartenverzeichnis vor? Ja)
CL Item
 (Es wird keine Heilbehandlung zu Lasten der UV durchgeführt)
Item
text
C2960301 (UMLS CUI [1])
Code List
Work ability
CL Item
 (arbeitsfähig)
CL Item
 (voraussichtlich länger als 6 Monate arbeitsunfähig)
CL Item
 (voraussichtlich wieder arbeitsunfähig)
Work inability: Date
Item
date
C2960301 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Work ability: Date
Item
date
C2960301 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Consultant physician
Item
boolean
C0401971 (UMLS CUI [1])
Consultant physician: Specification
Item
text
C0401971 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Follow up date
Item
date
C3694716 (UMLS CUI [1])
Hospital's or Physician's Address
Item
text
C2986046 (UMLS CUI [1])
C3669301 (UMLS CUI [2])
Item Group
C0205396 (UMLS CUI-1)
C1519316 (UMLS CUI-2)
Date of report
Item
date
C1302584 (UMLS CUI [1])
Physician's signature
Item
text
C1519316 (UMLS CUI [1])
Item Group
C2981733 (UMLS CUI-1)
Report Fee
Item
float
C0015754 (UMLS CUI [1,1])
C0684224 (UMLS CUI [1,2])
Complementary report
Item
float
C1524062 (UMLS CUI [1,1])
C0684224 (UMLS CUI [1,2])
Complementary report: Payment
Item
float
C1524062 (UMLS CUI [1,1])
C0684224 (UMLS CUI [1,2])
C0220808 (UMLS CUI [1,3])
Medical Service
Item
float
C0199168 (UMLS CUI [1])
Medical Service: Payment
Item
float
C0199168 (UMLS CUI [1,1])
C0220808 (UMLS CUI [1,2])
Medical Service: Payment Specifciation
Item
float
C0199168 (UMLS CUI [1,1])
C0220808 (UMLS CUI [1,2])
Tetanus Vaccine: Payment
Item
float
C0305062 (UMLS CUI [1,1])
C0220808 (UMLS CUI [1,2])
Tetanus Vaccine: Payment Specification
Item
float
C0305062 (UMLS CUI [1,1])
C0220808 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Active Tetanus Vaccine: Payment
Item
float
C0305062 (UMLS CUI [1,1])
C0205991 (UMLS CUI [1,2])
C0220808 (UMLS CUI [1,3])
Active Tetanus Vaccine: Payment Specification
Item
float
C0305062 (UMLS CUI [1,1])
C0205991 (UMLS CUI [1,2])
C0220808 (UMLS CUI [1,3])
C2348235 (UMLS CUI [1,4])
Sum: Special costs
Item
float
C1515051 (UMLS CUI [1,1])
C0220808 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Postage: Payment
Item
float
C0032755 (UMLS CUI [1,1])
C0220808 (UMLS CUI [1,2])
Sum: Payment
Item
float
C1515051 (UMLS CUI [1,1])
C0220808 (UMLS CUI [1,2])
Invoice number
Item
text
C2981733 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Institution label
Item
text
C2607850 (UMLS CUI [1,1])
C2983610 (UMLS CUI [1,2])
Bank account
Item
text
C1549682 (UMLS CUI [1])

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

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