ID

27935

Descripción

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

Palabras clave

Versiones (1)
  1. 6/12/17 6/12/17 -
Titular de derechos de autor

Department of Neurology UKM

Subido en

6 de diciembre de 2017

DOI

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Licencia

Creative Commons BY-NC 3.0
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Blood Sample Form Neuroinflammatory Biobank Department of Neurology UKM

Alemán Inglés

Blood Sample Form Neuroinflammatory Biobank Department of Neurology UKM

1 formularios  
Patientendaten
Descripción

Patientendaten

Name
Descripción

Patient name

Tipo de datos

text

Alias
UMLS CUI [1]
C1299487
Vorname
Descripción

First Name

Tipo de datos

text

Alias
UMLS CUI [1]
C1443235
Geburtsdatum
Descripción

Date of birth

Tipo de datos

date

Alias
UMLS CUI [1]
C0421451
Geschlecht
Descripción

Gender

Tipo de datos

text

Alias
UMLS CUI [1]
C0079399
Durchführende Person
Descripción

Durchführende Person

Alias
UMLS CUI-1
C1550483
Name
Descripción

Name

Tipo de datos

text

Alias
UMLS CUI [1]
C0027365
Tel.
Descripción

telephone number

Tipo de datos

integer

Alias
UMLS CUI [1]
C1515258
Station
Descripción

Ward

Tipo de datos

text

Alias
UMLS CUI [1]
C1305702
Blutabnahme
Descripción

Blutabnahme

Alias
UMLS CUI-1
C0005834
Datum
Descripción

blood sample date

Tipo de datos

date

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

blood sample time

Tipo de datos

time

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

Diagnosis

Tipo de datos

integer

Alias
UMLS CUI [1]
C0011900
Andere Diagnosen:
Descripción

Other diagnosis

Tipo de datos

text

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

reliable diagnosis

Tipo de datos

boolean

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

reliable diagnosis date

Tipo de datos

date

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

AIE type

Tipo de datos

text

Alias
UMLS CUI [1]
C4316639
Aktuelle Therapie
Descripción

Current Therapy

Tipo de datos

integer

Alias
UMLS CUI [1]
C2827774
Andere Therapie
Descripción

Other therapy

Tipo de datos

text

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

Therapy naive

Tipo de datos

text

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

(Monat/Jahr)

Tipo de datos

date

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

Studie

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

Study Name

Tipo de datos

text

Alias
UMLS CUI [1]
C2348560
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Similar models

Blood Sample Form Neuroinflammatory Biobank Department of Neurology UKM

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
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])
Volver a la parte superior de la página 

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