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Targeted Medical History and Baseline Conditions Screening

1 Formulaires  
TARGETED MEDICAL HISTORY AND BASELINE CONDITIONS (SCREENING)
Description

TARGETED MEDICAL HISTORY AND BASELINE CONDITIONS (SCREENING)

Alias
UMLS CUI-1
C0262926
Subject Number:
Description

Subject Number

Type de données

text

Alias
UMLS CUI [1]
C2348585
Subject Initials:
Description

Subject Initials

Type de données

text

Alias
UMLS CUI [1,1]
C1997894
UMLS CUI [1,2]
C2986440
Visit Date:
Description

Visit Date

Type de données

date

Alias
UMLS CUI [1]
C1320303
Diagnosis
Description

Diagnosis

Type de données

text

Alias
UMLS CUI [1]
C0011900
Open Angle Glaucoma
Description

Open Angle Glaucoma

Type de données

text

Alias
UMLS CUI [1]
C0017612
No Known History
Description

Medical history

Type de données

boolean

Alias
UMLS CUI [1]
C0262926
Condition Currently Active?
Description

Medical condition ongoing

Type de données

boolean

Alias
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C0549178
Onset Date / Procedure Date
Description

Onset Date

Type de données

date

Alias
UMLS CUI [1]
C0574845
Date Unknown
Description

Date unknown

Type de données

boolean

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0439673
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Similar models

Targeted Medical History and Baseline Conditions Screening

1 Formulaires
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
TARGETED MEDICAL HISTORY AND BASELINE CONDITIONS (SCREENING)
C0262926 (UMLS CUI-1)
Subject Number
Item
Subject Number:
text
C2348585 (UMLS CUI [1])
Subject Initials
Item
Subject Initials:
text
C1997894 (UMLS CUI [1,1])
C2986440 (UMLS CUI [1,2])
Visit Date
Item
Visit Date:
date
C1320303 (UMLS CUI [1])
Item
Diagnosis
text
C0011900 (UMLS CUI [1])
Organ system code
Code List
Diagnosis
CL Item
Open Angle Glaucoma (1)
C0017612 (UMLS CUI-1)
(Comment:en)
CL Item
Hypertension (2)
C0020538 (UMLS CUI-1)
(Comment:en)
CL Item
Angina (3)
C0002962 (UMLS CUI-1)
(Comment:en)
CL Item
Myocardial Infarction (4)
C0027051 (UMLS CUI-1)
(Comment:en)
CL Item
Congestive Heart Failure (5)
C0018802 (UMLS CUI-1)
(Comment:en)
CL Item
Transient Ischemic Attack (6)
C0007787 (UMLS CUI-1)
(Comment:en)
CL Item
CVA - Ischemic (7)
C0948008 (UMLS CUI-1)
(Comment:en)
CL Item
CVA - Hemorrhagic (8)
C0553692 (UMLS CUI-1)
(Comment:en)
CL Item
Prior Non-Ocular Hemorrhage (9)
C0019080 (UMLS CUI-1)
(Comment:en)
CL Item
Deep Vein Thrombosis (10)
C0149871 (UMLS CUI-1)
(Comment:en)
CL Item
Endarterectomy (11)
C0014098 (UMLS CUI-1)
(Comment:en)
CL Item
Diabetes Mellitus (12)
C0011849 (UMLS CUI-1)
(Comment:en)
CL Item
Behcet’s Disease (13)
C0004943 (UMLS CUI-1)
(Comment:en)
CL Item
Sarcoidosis (14)
C0036202 (UMLS CUI-1)
(Comment:en)
CL Item
Syphilis (15)
C0039128 (UMLS CUI-1)
(Comment:en)
CL Item
Lyme Disease (16)
C0024198 (UMLS CUI-1)
(Comment:en)
CL Item
Polycythemia (17)
C0032461 (UMLS CUI-1)
(Comment:en)
CL Item
Leukemia (18)
C0023418 (UMLS CUI-1)
(Comment:en)
CL Item
Lymphoma (19)
C0024299 (UMLS CUI-1)
(Comment:en)
CL Item
Multiple Myeloma (20)
C0026764 (UMLS CUI-1)
(Comment:en)
CL Item
Waldenstrom’s Macroglobulinemia (21)
C0024419 (UMLS CUI-1)
(Comment:en)
CL Item
Cryoglobulinemia (22)
C0010403 (UMLS CUI-1)
(Comment:en)
Item
Open Angle Glaucoma
text
C0017612 (UMLS CUI [1])
Open Angle Glaucoma
Code List
Open Angle Glaucoma
CL Item
OD (OD)
C0229089 (UMLS CUI-1)
(Comment:en)
CL Item
OS (OS)
C0229090 (UMLS CUI-1)
(Comment:en)
CL Item
OU (OU)
C0229118 (UMLS CUI-1)
(Comment:en)
Medical history
Item
No Known History
boolean
C0262926 (UMLS CUI [1])
Medical condition ongoing
Item
Condition Currently Active?
boolean
C0012634 (UMLS CUI [1,1])
C0549178 (UMLS CUI [1,2])
Onset Date
Item
Onset Date / Procedure Date
date
C0574845 (UMLS CUI [1])
Date unknown
Item
Date Unknown
boolean
C0011008 (UMLS CUI [1,1])
C0439673 (UMLS CUI [1,2])
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