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ID

31456

Description

LOW BACK PAIN DATA COLLECTION Version 2.0.3 Revised August 24th, 2017 www.ichom.org ICHOM received an endorsement of Arthritis Research UK for the development of this standard set. Conditions: Lumbar Disc Herniation | Lumbar Stenosis | Lumbar Spondylolisthesis | Degenerative Scoliosis | Adult Idiopathic Scoliosis | Degenerative Disc Disorder | Other Degenerative Lumbar Disorders | Mechanical, Acute, and Chronic Lumbar Back Pain and Back-Related Leg Pain Conditions Not Covered: Individuals < 18 Years of Age | Spinal Infection | Spinal Tumor | Spinal Fractures | Traumatic Dislocation | Congenital Scoliosis Documented as >20 Degrees, Moderate, Large, or Severe Treatment Approaches: Conservative Therapy (e.g. physical therapy, chiropractic, drug therapy, injections, etc.) | Surgical Therapy (e.g. spinal fusion, decompression, or discectomy) This ODM-file contains a clinical follow-up form to document disease recurrence, to be reported when occurs. Use of the following Scores: ODI - Oswestry Disability Index Version 2.1a: The ODI is free for all health care organizations, but a license is needed for use (therefore not included in this version of the standard set). Please visit eprovide: https://eprovide.mapi-trust.org/ NPRS - Numerical Pain Rating Scale: The NPRS is free for all health care organizations, and a license is not needed. EQ-5D-3L - EuroQol‐5D descriptive system (EQ-­5D‐3L) and visual analogue scale (EQ-­VAS): The EQ-5D-3L is free for non-profits and academic research, but a license is needed for use (therefore not included in this version of the standard set). https://euroqol.org/support/how-to-obtain-eq-5d/

Link

www.ichom.org

Keywords

Versions (3)
  1. 23.08.18 23.08.18 - Sarah Riepenhausen
  2. 31.08.18 31.08.18 - Sarah Riepenhausen
  3. 30.04.20 30.04.20 - Sarah Riepenhausen
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ICHOM

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23. August 2018

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Creative Commons BY-NC 3.0
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    ICHOM Low Back Pain

    English

    Clinical Follow-up Form (Disease recurrence)

    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
    Acute Complications of Treatment
    Description

    Acute Complications of Treatment

    Alias
    UMLS CUI-1
    C0087111
    UMLS CUI-2
    C0009566
    Indicate if the current surgery is a reoperation at the same level because the prior surgery at the same level did not reach its technical or clinical goals
    Description

    INCLUSION CRITERIA: Surgically treated patients TIMING: when occurs REPORTING SOURCE: Clinical TYPE: Single Answer

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0558347
    UMLS CUI [1,2]
    C0741419
    UMLS CUI [1,3]
    C0037949
    UMLS CUI [1,4]
    C2946261
    UMLS CUI [1,5]
    C0445247
    Indicate the type of reoperation
    Description

    Hardware removal: removal of implants (For example, screws, rods) Non-union: failure of bony consolidation of bridge/union at minimum 12 months after surgery Neuro-compression: compression of neural structures with or without neurological deficits (select recurrent disc herniation or other neuro- compression) Post-op infection: superficial or deep (subfascial) wound/tissue infection after surgery Implant malposition: incorrect position of the implant Implant failure: problem due to an implant (For example, loosening, breakage) Wrong level: procedure mistakenly performed at wrong vertebral level Sagittal imbalance: sagittal malalignment of the spine (select lumbar flatback deformity or junctional kyphosis) Cerebrospinal fluid leakage: includes CSF fistula, seudomeningocele, etc. Epidural hematoma: collection of blood adjacent to dura, potentially creating compression INCLUSION CRITERIA: Surgically treated patients, If answered 'yes' to having a reoperation (REOP) TIMING: when occurs REPORTING SOURCE: clinical TYPE: Single Answer

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0558347
    UMLS CUI [1,2]
    C0741419
    UMLS CUI [1,3]
    C0332307
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    Similar models

    Clinical Follow-up Form (Disease recurrence)

    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
    Acute Complications of Treatment
    C0087111 (UMLS CUI-1)
    C0009566 (UMLS CUI-2)
    Item
    Indicate if the current surgery is a reoperation at the same level because the prior surgery at the same level did not reach its technical or clinical goals
    integer
    C0558347 (UMLS CUI [1,1])
    C0741419 (UMLS CUI [1,2])
    C0037949 (UMLS CUI [1,3])
    C2946261 (UMLS CUI [1,4])
    C0445247 (UMLS CUI [1,5])
    Current procedure a reoperation at same level?
    Code List
    Indicate if the current surgery is a reoperation at the same level because the prior surgery at the same level did not reach its technical or clinical goals
    CL Item
    No (0)
    C1298908 (UMLS CUI-1)
    (Comment:en)
    CL Item
    Yes (1)
    C1705108 (UMLS CUI-1)
    (Comment:en)
    Item
    Indicate the type of reoperation
    integer
    C0558347 (UMLS CUI [1,1])
    C0741419 (UMLS CUI [1,2])
    C0332307 (UMLS CUI [1,3])
    Type of reoperation (if applicable)
    Code List
    Indicate the type of reoperation
    CL Item
    Hardware removal (1)
    C1096445 (UMLS CUI-1)
    (Comment:en)
    CL Item
    Non-union (2)
    C0037935 (UMLS CUI-1)
    C1272705 (UMLS CUI-2)
    (Comment:en)
    CL Item
    Neuro-compression (3)
    C0576717 (UMLS CUI-1)
    (Comment:en)
    CL Item
    Post-op infection (4)
    C0038941 (UMLS CUI-1)
    (Comment:en)
    CL Item
    Implant malposition (5)
    C0333042 (UMLS CUI-1)
    C0021102 (UMLS CUI-2)
    (Comment:en)
    CL Item
    Implant failure (6)
    C0854676 (UMLS CUI-1)
    (Comment:en)
    CL Item
    Wrong level (7)
    C2224801 (UMLS CUI-1)
    C3845811 (UMLS CUI-2)
    (Comment:en)
    CL Item
    Sagittal imbalance (8)
    C1397014 (UMLS CUI-1)
    C0205129 (UMLS CUI-2)
    (Comment:en)
    CL Item
    Cerebrospinal fluid leakage (9)
    C0023182 (UMLS CUI-1)
    (Comment:en)
    CL Item
    Epidural hematoma (10)
    C0877172 (UMLS CUI-1)
    (Comment:en)
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