ID

27935

Description

Blood Sample Form Department of Neurology UKM (Begleitschein Blutentnahme für die zelluläre Biobank (Neuroinflammation)) Klinik für Allgemeine Neurologie, Liquor und Labordiagnostik, Neurologische Biobank, Albert-Schweitzer-Campus 1, 48149 Münster. Provided by Dr. Antje Echterhoff

Keywords

Versions (1)
  1. 12/6/17 12/6/17 -
Copyright Holder

Department of Neurology UKM

Uploaded on

December 6, 2017

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Blood Sample Form Neuroinflammatory Biobank Department of Neurology UKM

German English

Blood Sample Form Neuroinflammatory Biobank Department of Neurology UKM

1 forms  
Patientendaten
Description

Patientendaten

Name
Description

Patient name

Data type

text

Alias
UMLS CUI [1]
C1299487
Vorname
Description

First Name

Data type

text

Alias
UMLS CUI [1]
C1443235
Geburtsdatum
Description

Date of birth

Data type

date

Alias
UMLS CUI [1]
C0421451
Geschlecht
Description

Gender

Data type

text

Alias
UMLS CUI [1]
C0079399
Durchführende Person
Description

Durchführende Person

Alias
UMLS CUI-1
C1550483
Name
Description

Name

Data type

text

Alias
UMLS CUI [1]
C0027365
Tel.
Description

telephone number

Data type

integer

Alias
UMLS CUI [1]
C1515258
Station
Description

Ward

Data type

text

Alias
UMLS CUI [1]
C1305702
Blutabnahme
Description

Blutabnahme

Alias
UMLS CUI-1
C0005834
Datum
Description

blood sample date

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0005834
Uhrzeit
Description

blood sample time

Data type

time

Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C0005834
Diagnose
Description

Diagnosis

Data type

integer

Alias
UMLS CUI [1]
C0011900
Andere Diagnosen:
Description

Other diagnosis

Data type

text

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C0011302
Diagnose gesichert?
Description

reliable diagnosis

Data type

boolean

Alias
UMLS CUI [1,1]
C0011900
UMLS CUI [1,2]
C3858758
wenn ja, seit
Description

reliable diagnosis date

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0011900
UMLS CUI [1,3]
C3858758
AIE Typ
Description

AIE type

Data type

text

Alias
UMLS CUI [1]
C4316639
Aktuelle Therapie
Description

Current Therapy

Data type

integer

Alias
UMLS CUI [1]
C2827774
Andere Therapie
Description

Other therapy

Data type

text

Alias
UMLS CUI [1,1]
C2827774
UMLS CUI [1,2]
C0205394
Therapie naiv?
Description

Therapy naive

Data type

text

Alias
UMLS CUI [1]
C0919936
Beginn der aktuellen Therapie
Description

(Monat/Jahr)

Data type

date

Alias
UMLS CUI [1,1]
C3173309
UMLS CUI [1,2]
C2827774
Studie
Description

Studie

Alias
UMLS CUI-1
C0008976
Falls bekannt, bitte die Studie angeben:
Description

Study Name

Data type

text

Alias
UMLS CUI [1]
C2348560
Back to the top of the page

Similar models

Blood Sample Form Neuroinflammatory Biobank Department of Neurology UKM

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Patientendaten
Patient name
Item
Name
text
C1299487 (UMLS CUI [1])
First Name
Item
Vorname
text
C1443235 (UMLS CUI [1])
Date of birth
Item
Geburtsdatum
date
C0421451 (UMLS CUI [1])
Gender
Item
Geschlecht
text
C0079399 (UMLS CUI [1])
Item Group
Durchführende Person
C1550483 (UMLS CUI-1)
Name
Item
Name
text
C0027365 (UMLS CUI [1])
telephone number
Item
Tel.
integer
C1515258 (UMLS CUI [1])
Ward
Item
Station
text
C1305702 (UMLS CUI [1])
Item Group
Blutabnahme
C0005834 (UMLS CUI-1)
blood sample date
Item
Datum
date
C0011008 (UMLS CUI [1,1])
C0005834 (UMLS CUI [1,2])
blood sample time
Item
Uhrzeit
time
C0040223 (UMLS CUI [1,1])
C0005834 (UMLS CUI [1,2])
Item
Diagnose
integer
C0011900 (UMLS CUI [1])
Diagnosis
Code List
Diagnose
CL Item
AIE Typ: ________________________ (1)
C4316639 (UMLS CUI-1)
(Comment:de)
CL Item
andere (AOD) (2)
C0434543 (UMLS CUI-1)
(Comment:de)
CL Item
CIS (3)
C2921627 (UMLS CUI-1)
(Comment:de)
CL Item
V. a. entzündliche ZNS Erkrankung (4)
C0683396 (UMLS CUI-1)
(Comment:de)
CL Item
NMO (5)
C0027873 (UMLS CUI-1)
(Comment:de)
CL Item
PML (6)
C0023524 (UMLS CUI-1)
(Comment:de)
CL Item
PPMS (7)
C0751964 (UMLS CUI-1)
(Comment:de)
CL Item
RRMS (8)
C0751967 (UMLS CUI-1)
(Comment:de)
CL Item
Susac (9)
C2717757 (UMLS CUI-1)
(Comment:de)
Other diagnosis
Item
Andere Diagnosen:
text
C0205394 (UMLS CUI [1,1])
C0011302 (UMLS CUI [1,2])
reliable diagnosis
Item
Diagnose gesichert?
boolean
C0011900 (UMLS CUI [1,1])
C3858758 (UMLS CUI [1,2])
reliable diagnosis date
Item
wenn ja, seit
date
C0011008 (UMLS CUI [1,1])
C0011900 (UMLS CUI [1,2])
C3858758 (UMLS CUI [1,3])
AIE type
Item
AIE Typ
text
C4316639 (UMLS CUI [1])
Item
Aktuelle Therapie
integer
C2827774 (UMLS CUI [1])
Current Therapy
Code List
Aktuelle Therapie
CL Item
Alemtuzumab / Lemtrada (1)
C0383429 (UMLS CUI-1)
(Comment:de)
CL Item
BG12 (2)
C0058218 (UMLS CUI-1)
(Comment:de)
CL Item
Daclizumab (3)
C0663182 (UMLS CUI-1)
(Comment:de)
CL Item
FTY (4)
C1699926 (UMLS CUI-1)
(Comment:de)
CL Item
Interferon (GA) (5)
C0907160 (UMLS CUI-2)
(Comment:de)
CL Item
Mitoxantron (6)
C0026259 (UMLS CUI-1)
(Comment:de)
CL Item
Natalizumab (7)
C1172734 (UMLS CUI-1)
(Comment:de)
CL Item
Teriflunomid (8)
C1718383 (UMLS CUI-1)
(Comment:de)
CL Item
Rituximab (9)
C0393022 (UMLS CUI-1)
(Comment:de)
Other therapy
Item
Andere Therapie
text
C2827774 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Therapy naive
Item
Therapie naiv?
text
C0919936 (UMLS CUI [1])
Start Date Current Therapy
Item
Beginn der aktuellen Therapie
date
C3173309 (UMLS CUI [1,1])
C2827774 (UMLS CUI [1,2])
Item Group
Studie
C0008976 (UMLS CUI-1)
Study Name
Item
Falls bekannt, bitte die Studie angeben:
text
C2348560 (UMLS CUI [1])
Back to the top of the page 

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

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