ID

21219

Beskrivning

Hospital Routine Documentation Subform at the University Hospital Cologne Original Form name: Allgemeine Anforderung_CIO_Thorax

Nyckelord

  1. 2017-04-13 2017-04-13 -
  2. 2017-04-25 2017-04-25 -
Uppladdad den

13 april 2017

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.

General request form, Oncology Tumor Board, University Hospital Cologne

General request form, Oncology Tumor Board, University Hospital Cologne

CIO Thorax Tumor Board Request
Beskrivning

CIO Thorax Tumor Board Request

Alias
UMLS CUI-1
C0805438
UMLS CUI-2
C1272683
Patient name
Beskrivning

Patient name

Datatyp

text

Alias
UMLS CUI [1]
C1299487
Diagnosis ICD Code
Beskrivning

Diagnosis ICD Code

Datatyp

text

Alias
UMLS CUI [1]
C2598420
Diagnosis (free text)
Beskrivning

Diagnosis (free text)

Datatyp

text

Alias
UMLS CUI [1]
C0011900
Date of diagnosis
Beskrivning

Date of diagnosis

Datatyp

date

Måttenheter
  • mm/yyyy
Alias
UMLS CUI [1]
C2316983
mm/yyyy
ECOG Performance Status
Beskrivning

ECOG Performance Status

Datatyp

integer

Alias
UMLS CUI [1]
C1520224
Clinical course
Beskrivning

Clinical course

Datatyp

text

Alias
UMLS CUI [1]
C0449259
Age
Beskrivning

Age

Datatyp

integer

Måttenheter
  • yy
Alias
UMLS CUI [1]
C0001779
yy
Body height
Beskrivning

Body height

Datatyp

float

Måttenheter
  • m
Alias
UMLS CUI [1]
C0005890
m
Body weight
Beskrivning

Body weight

Datatyp

float

Måttenheter
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Tobacco use
Beskrivning

Tobacco use

Datatyp

integer

Alias
UMLS CUI [1]
C0543414
Treatment plan
Beskrivning

Treatment plan

Datatyp

integer

Alias
UMLS CUI [1]
C0599880
Prior therapy
Beskrivning

Prior therapy

Datatyp

integer

Alias
UMLS CUI [1]
C1514463
Question
Beskrivning

Question

Datatyp

text

Alias
UMLS CUI [1,1]
C1522634
UMLS CUI [1,2]
C0805438
Contact person
Beskrivning

Contact person

Datatyp

text

Måttenheter
  • Name
Alias
UMLS CUI [1]
C0337611
Name
Requested service
Beskrivning

Requested service

Alias
UMLS CUI-1
C1272683
UMLS CUI-2
C0557854
Type of request
Beskrivning

Type of request

Datatyp

text

Alias
UMLS CUI [1,1]
C1272683
UMLS CUI [1,2]
C2348235
Service
Beskrivning

Service

Datatyp

text

Alias
UMLS CUI [1]
C0199168
Quantity of requested services
Beskrivning

Quantity of requested services

Datatyp

integer

Alias
UMLS CUI [1,1]
C1265611
UMLS CUI [1,2]
C1272683
UMLS CUI [1,3]
C0557854
Request data
Beskrivning

Request data

Alias
UMLS CUI-1
C1272683
UMLS CUI-2
C1511726
Request identification number
Beskrivning

Request identification number

Datatyp

integer

Alias
UMLS CUI [1,1]
C1300638
UMLS CUI [1,2]
C1272683
Order status
Beskrivning

Order status

Datatyp

text

Alias
UMLS CUI [1]
C1550341
Urgency
Beskrivning

Urgency

Datatyp

text

Alias
UMLS CUI [1]
C4049774
Date of order
Beskrivning

Date of order

Datatyp

date

Måttenheter
  • dd.mm.yyyy
Alias
UMLS CUI [1,1]
C1549499
UMLS CUI [1,2]
C0011008
dd.mm.yyyy
Time of order
Beskrivning

Time of order

Datatyp

time

Måttenheter
  • hh:mm
Alias
UMLS CUI [1,1]
C1549499
UMLS CUI [1,2]
C0040223
hh:mm
Department performing service
Beskrivning

Department performing service

Alias
UMLS CUI-1
C0557854
UMLS CUI-2
C1550369
UMLS CUI-3
C0019961
Department performing service
Beskrivning

Department performing service

Datatyp

text

Alias
UMLS CUI [1]
C0019961
Department requesting service
Beskrivning

Department requesting service

Alias
UMLS CUI-1
C1272683
UMLS CUI-2
C1550369
UMLS CUI-3
C0019961
Department
Beskrivning

Department

Datatyp

text

Alias
UMLS CUI [1]
C0019961
Name of requesting physician
Beskrivning

Name of requesting physician

Datatyp

text

Måttenheter
  • Name
Alias
UMLS CUI [1]
C0686901
Name
Further information
Beskrivning

Further information

Alias
UMLS CUI-1
C1533716
Wanted date of appointment
Beskrivning

Wanted date of appointment

Datatyp

date

Måttenheter
  • dd.mm.yyyy
Alias
UMLS CUI [1,1]
C1444647
UMLS CUI [1,2]
C0011008
dd.mm.yyyy
Wanted time of appointment
Beskrivning

Wanted time of appointment

Datatyp

time

Måttenheter
  • hh:mm
Alias
UMLS CUI [1,1]
C1444647
UMLS CUI [1,2]
C0040223
hh:mm
Comment
Beskrivning

Comment

Datatyp

text

Alias
UMLS CUI [1]
C0947611
Mobility
Beskrivning

Mobility

Datatyp

text

Alias
UMLS CUI [1]
C0449580
Previous finding
Beskrivning

Previous finding

Datatyp

text

Alias
UMLS CUI [1,1]
C0243095
UMLS CUI [1,2]
C0205156
Diagnostic imaging
Beskrivning

Diagnostic imaging

Datatyp

text

Alias
UMLS CUI [1]
C0011923
Pulmonary function tests
Beskrivning

Pulmonary function tests

Alias
UMLS CUI-1
C0024119
Exercise load
Beskrivning

Exercise load

Datatyp

integer

Måttenheter
  • W/kg
Alias
UMLS CUI [1,1]
C0015259
UMLS CUI [1,2]
C2020707
W/kg
VO2 max
Beskrivning

VO2 max

Datatyp

float

Måttenheter
  • ml/(kg * min)
Alias
UMLS CUI [1]
C1305742
ml/(kg * min)
Lung functional tests requested
Beskrivning

Lung functional tests requested

Datatyp

boolean

Alias
UMLS CUI [1,1]
C1272683
UMLS CUI [1,2]
C0024119
BGA at rest
Beskrivning

BGA at rest

Alias
UMLS CUI-1
C0005800
UMLS CUI-2
C0035253
Blood oxygen partial pressure
Beskrivning

Blood oxygen partial pressure

Datatyp

float

Måttenheter
  • mmHg
Alias
UMLS CUI [1]
C1291013
mmHg
Blood carbon dioxide partial pressure
Beskrivning

Blood carbon dioxide partial pressure

Datatyp

float

Måttenheter
  • mmHg
Alias
UMLS CUI [1]
C0201931
mmHg
pH
Beskrivning

pH

Datatyp

float

Alias
UMLS CUI [1]
C0202165
BGA during exercise
Beskrivning

BGA during exercise

Alias
UMLS CUI-1
C0005800
UMLS CUI-2
C0015259
Blood oxygen partial pressure
Beskrivning

Blood oxygen partial pressure

Datatyp

float

Måttenheter
  • mmHg
Alias
UMLS CUI [1]
C1291013
mmHg
Blood carbon dioxide partial pressure
Beskrivning

Blood carbon dioxide partial pressure

Datatyp

float

Måttenheter
  • mmHg
Alias
UMLS CUI [1]
C0201930
mmHg
pH
Beskrivning

pH

Datatyp

float

Alias
UMLS CUI [1]
C0202165

Similar models

General request form, Oncology Tumor Board, University Hospital Cologne

Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
C0805438 (UMLS CUI-1)
C1272683 (UMLS CUI-2)
Patient name
Item
text
C1299487 (UMLS CUI [1])
Diagnosis ICD Code
Item
text
C2598420 (UMLS CUI [1])
Diagnosis (free text)
Item
text
C0011900 (UMLS CUI [1])
Date of diagnosis
Item
date
C2316983 (UMLS CUI [1])
ECOG Performance Status
Item
integer
C1520224 (UMLS CUI [1])
Clinical course
Item
text
C0449259 (UMLS CUI [1])
Age
Item
integer
C0001779 (UMLS CUI [1])
Body height
Item
float
C0005890 (UMLS CUI [1])
Body weight
Item
float
C0005910 (UMLS CUI [1])
Item
integer
C0543414 (UMLS CUI [1])
Code List
Tobacco use
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
Item
integer
C0599880 (UMLS CUI [1])
Code List
Treatment plan
CL Item
 (1)
CL Item
 (2)
Item
integer
C1514463 (UMLS CUI [1])
Code List
Prior therapy
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
Question
Item
text
C1522634 (UMLS CUI [1,1])
C0805438 (UMLS CUI [1,2])
Contact person
Item
text
C0337611 (UMLS CUI [1])
Item Group
C1272683 (UMLS CUI-1)
C0557854 (UMLS CUI-2)
Type of request
Item
text
C1272683 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Service
Item
text
C0199168 (UMLS CUI [1])
Quantity of requested services
Item
integer
C1265611 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
C0557854 (UMLS CUI [1,3])
Item Group
C1272683 (UMLS CUI-1)
C1511726 (UMLS CUI-2)
Request identification number
Item
integer
C1300638 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
Order status
Item
text
C1550341 (UMLS CUI [1])
Urgency
Item
text
C4049774 (UMLS CUI [1])
Date of order
Item
date
C1549499 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Time of order
Item
time
C1549499 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Item Group
C0557854 (UMLS CUI-1)
C1550369 (UMLS CUI-2)
C0019961 (UMLS CUI-3)
Department performing service
Item
text
C0019961 (UMLS CUI [1])
Item Group
C1272683 (UMLS CUI-1)
C1550369 (UMLS CUI-2)
C0019961 (UMLS CUI-3)
Department
Item
text
C0019961 (UMLS CUI [1])
Name of requesting physician
Item
text
C0686901 (UMLS CUI [1])
Item Group
C1533716 (UMLS CUI-1)
Wanted date of appointment
Item
date
C1444647 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Wanted time of appointment
Item
time
C1444647 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Comment
Item
text
C0947611 (UMLS CUI [1])
Mobility
Item
text
C0449580 (UMLS CUI [1])
Previous finding
Item
text
C0243095 (UMLS CUI [1,1])
C0205156 (UMLS CUI [1,2])
Diagnostic imaging
Item
text
C0011923 (UMLS CUI [1])
Item Group
C0024119 (UMLS CUI-1)
Exercise load
Item
integer
C0015259 (UMLS CUI [1,1])
C2020707 (UMLS CUI [1,2])
VO2 max
Item
float
C1305742 (UMLS CUI [1])
Lung functional tests requested
Item
boolean
C1272683 (UMLS CUI [1,1])
C0024119 (UMLS CUI [1,2])
Item Group
C0005800 (UMLS CUI-1)
C0035253 (UMLS CUI-2)
Blood oxygen partial pressure
Item
float
C1291013 (UMLS CUI [1])
Blood carbon dioxide partial pressure
Item
float
C0201931 (UMLS CUI [1])
pH
Item
float
C0202165 (UMLS CUI [1])
Item Group
C0005800 (UMLS CUI-1)
C0015259 (UMLS CUI-2)
Blood oxygen partial pressure
Item
float
C1291013 (UMLS CUI [1])
Blood carbon dioxide partial pressure
Item
float
C0201930 (UMLS CUI [1])
pH
Item
float
C0202165 (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