ID

31224

Description

CHRONIC KIDNEY DISEASE DATA COLLECTION REFERENCE GUIDE Version 1.0.0 Revised October 25th, 2017 www.ichom.org Conditions: Chronic Kidney Disease Stage G3a/A3 | Chronic Kidney Disease StageG 3b/A2/A3 | Chronic Kidney Disease Stage G4 | Chronic Kidney Disease Stage G5 (KDIGO 2012 Stages) Treatment Approaches: Pre-RRT = Pre-Renal Replacement Therapy | HD = Haemodialysis | PD = Peritoneal Dialysis | Tx = Renal Transplantation | CC = Conservative Care This ODM-file contains Patient reported Forms for Demographics and Smoking Status. To be collected at Baseline Visit. Surveys used: The OptumTM SF-36v2® Health Survey: The SF-36v2 Health Survey requires a license agreement prior to the use or reprodution of the tool. Information on how to obtain a license can be found here: bit.ly/SF36LIC . The scoring guide for the SF36v2 is only available upon a license agreement being made. Due to the requirement of a license the Score cannot be found in this version of the standard set. PROMIS-Global Health and PROMIS-29: Free for use in clinical practice and a license is not required. Information http://www.nihpromis.org/measures/translations . The scoring guides for the two PROMIS Scores can be found at bit.ly/PROMISGLOBALSCORE and bit.ly/PROMIS29SCORE . RAND-36: Free for use in clinical practice and a license is not required. The RAND-36 is available in English and Arabic. https://www.rand.org/health/surveys_tools/mos/36-item-short-form.html . The Scoring guide can be found at bit.ly/RAND36Score .

Link

www.ichom.org

Keywords

Versions (2)
  1. 7/30/18 7/30/18 - Sarah Riepenhausen
  2. 4/30/20 4/30/20 - Sarah Riepenhausen
Copyright Holder

ICHOM

Uploaded on

July 30, 2018

DOI

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License

Creative Commons BY-NC 3.0
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ICHOM Chronic Kidney Disease

English

Demographics, Smoking Status (Patient reported)

1 forms  
Patient ID
Description

Patient ID

Alias
UMLS CUI-1
C1269815
Indicate the patient's medical record number.
Description

This number will not be shared with ICHOM. In the case patient-level data is submitted to ICHOM for benchmarking or research purposes, a separate ICHOM Patient Identifier will be created and cross-linking between the ICHOM Patient Identifier and the medical record number will only be known at the treating institution. INCLUSION CRITERIA: All patients TIMING: On all forms REPORTING SOURCE: Administrative or clinical RESPONSE OPTIONS: According to institution

Data type

integer

Alias
UMLS CUI [1]
C1269815
Demographic Factors
Description

Demographic Factors

Alias
UMLS CUI-1
C1704791
Indicate the patient's age
Description

Recorded as year of birth INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Date by YYYY

Data type

partialDate

Measurement units
  • YYYY
Alias
UMLS CUI [1]
C0001779
UMLS CUI [2]
C2826771
YYYY
Indicate the patient’s sex at birth
Description

INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient-reported TYPE: Single Answer

Data type

integer

Alias
UMLS CUI [1]
C0079399
Highest attained education
Description

Level of schooling defined in each country according to the International Standard Classification of Education INCLUSION CRITERIA: All patients TIMING: Baseline and ongoing REPORTING SOURCE: Patient-reported TYPE: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0013658
Baseline Characteristics (Patient reported)
Description

Baseline Characteristics (Patient reported)

Alias
UMLS CUI-1
C1442488
UMLS CUI-2
C0815172
Indicate the patient’s category
Description

INCLUSION CRITERIA: All patients TIMING: Baseline REPORTING SOURCE: Patient reported TYPE: Single Answer

Data type

integer

Alias
UMLS CUI [1]
C1519386
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Similar models

Demographics, Smoking Status (Patient reported)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Patient ID
C1269815 (UMLS CUI-1)
Patient ID
Item
Indicate the patient's medical record number.
integer
C1269815 (UMLS CUI [1])
Item Group
Demographic Factors
C1704791 (UMLS CUI-1)
AGE
Item
Indicate the patient's age
partialDate
C0001779 (UMLS CUI [1])
C2826771 (UMLS CUI [2])
Item
Indicate the patient’s sex at birth
integer
C0079399 (UMLS CUI [1])
Sex
Code List
Indicate the patient’s sex at birth
CL Item
Male (1)
CL Item
Female (2)
CL Item
Unknown (999)
Item
Highest attained education
integer
C0013658 (UMLS CUI [1])
Educational level
Code List
Highest attained education
CL Item
None (0)
CL Item
Primary (1)
CL Item
Secondary  (2)
CL Item
Tertiary (3)
Item Group
Baseline Characteristics (Patient reported)
C1442488 (UMLS CUI-1)
C0815172 (UMLS CUI-2)
Item
Indicate the patient’s category
integer
C1519386 (UMLS CUI [1])
Smoking status
Code List
Indicate the patient’s category
CL Item
Never  (0)
CL Item
Former (1)
CL Item
Current (2)
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