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31606

Description

COLORECTAL CANCER DATA COLLECTION Version 1.1.2 Revised: November 6th, 2017 http://www.ichom.org/ Conditions: All patients with newly pathologically diagnosed invasive colorectal cancer (stage I-IV) Excluded Conditions: Non-adenocarcinoma, non-primary colorectal tumors and patients with recurrent disease at baseline will be excluded. Treatment Approaches: Surgery | Radiotherapy | Chemotherapy | Targeted Therapy Forms: Baseline Patient-reported Form Baseline Clinical Form 6 Month post treatment administered Clinical Form 1 year post treatment, then annually up to 10 years administered Clinical Form Baseline, 6 months, annually up to 10 years administered patient-reported form ICHOM was supported by Alliance of Dedicated Cancer Centers (CZ, DICA, Bowel Cancer Australia) for this standard set.

Lien

http://www.ichom.org/

Mots-clés

Versions (2)
  1. 11/09/2018 11/09/2018 - Sarah Riepenhausen
  2. 30/04/2020 30/04/2020 - Sarah Riepenhausen
Détendeur de droits

ICHOM

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11 septembre 2018

DOI

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Creative Commons BY-NC 3.0
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    ICHOM Colorectal Cancer

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    Annual Clinical Form

    1 Formulaires  
    1. StudyEvent: SE
      1. Annual Clinical Form
    Administrative Data
    Description

    Administrative Data

    Alias
    UMLS CUI-1
    C1320722
    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

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C1269815
    Patient's last name:
    Description

    The patients' name will not be shared with ICHOM.  INCLUSION CRITERIA: All patients TIMING: On all forms REPORTING SOURCE: Administrative or clinical

    Type de données

    text

    Alias
    UMLS CUI [1]
    C1299487
    Time Relative to Baseline (e.g. Baseline, 6 months follow-up, 1 year follow-up, ...)
    Description

    This Item does not exist in the original standard set. In other standard sets with multiple timepoints the following is requested to do: Please timestamp all variables. Some Standard Set variables are collected at multiple timepoints, and we will ask you to submit these variables in a concatenated VARIABLEID_TIMESTAMP form for future analyses. For example, VARIABLEID_BASE (baseline); VARIABLEID_6MO (6 month follow-up); VARIABLEID_1YR (1 year follow-up), etc.

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0439564
    UMLS CUI [1,2]
    C1442488
    Survival and disease control
    Description

    Survival and disease control

    Alias
    UMLS CUI-1
    C1148433
    UMLS CUI-2
    C4304384
    Indicate whether there is evidence of local, regional or distant recurrence.
    Description

    INCLUSION CRITERIA: Only if the patient is treated with curative intent.  TIMING: 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0034897
    Provide method of confirmation:
    Description

    INCLUSION CRITERIA: Only if answered "yes" on recurrence [RECUR] TIMING: 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0034897
    UMLS CUI [1,2]
    C0332307
    Provide the date of the recurrence:
    Description

    INCLUSION CRITERIA: Only if answered "yes" on recurrence [RECUR] TIMING: 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1]
    C0807712
    DD/MM/YYYY
    Indicate whether there is evidence of disease progression:
    Description

    INCLUSION CRITERIA: Only if the patient has advanced disease. TIMING: 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0242656
    Provide method of confirmation:
    Description

    INCLUSION CRITERIA: Only if answered "yes" on progression [PROGRESS] TIMING: 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0242656
    UMLS CUI [1,2]
    C0430022
    Provide the date of the progression:
    Description

    INCLUSION CRITERIA: Only if answered "yes" on progression [PROGRESS] TIMING: 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1,1]
    C0242656
    UMLS CUI [1,2]
    C0011008
    DD/MM/YYYY
    Indicate whether the patient has died
    Description

    INCLUSION CRITERIA: All patients TIMING: 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Administrative TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0011065
    Provide the date of the death:
    Description

    INCLUSION CRITERIA: If answered "yes" on patient died [DEATH] TIMING: 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Administrative TYPE: Date, Please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1]
    C1148348
    DD/MM/YYYY
    Indicate if death is attributable to colorectal cancer:
    Description

    INCLUSION CRITERIA: If answered "yes" on patient died [DEATH] TIMING: 1 year post treatment, tracked annually up to 10 years REPORTING SOURCE: Administrative TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0007465
    Treatment Variables
    Description

    Treatment Variables

    Alias
    UMLS CUI-1
    C0087111
    Indicate whether the patient received one of the following treatment during the last year: (select all that apply)
    Description

    INCLUSION CRITERIA: All patients TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0087111
    Indicate whether the patient received surgery during the last year:
    Description

    INCLUSION CRITERIA: If answered "surgery" on treatment [TREATMENT] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0543467
    Indicate the method of the surgical procedure:
    Description

    INCLUSION CRITERIA: If yes answered "yes" on surgery [SURGERY] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0683312
    UMLS CUI [1,2]
    C0543467
    Provide the date of surgery:
    Description

    INCLUSION CRITERIA: If yes answered "yes" on surgery [SURGERY] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1]
    C1628561
    DD/MM/YYYY
    Indicate whether the patient received radiotherapy during the last year
    Description

    INCLUSION CRITERIA: If answered "radiotherapy" on treatment [TREATMENT] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C1522449
    Indicate what type of radiotherapy:
    Description

    INCLUSION CRITERIA: If answered "yes" on radiotherapy [RADIOTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Multiple answer

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C1522449
    UMLS CUI [1,2]
    C1521902
    Provide the start date of radiotherapy:
    Description

    INCLUSION CRITERIA: If answered "yes" on radiotherapy [RADIOTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1]
    C0436382
    DD/MM/YYYY
    Provide the stop date of radiotherapy:
    Description

    INCLUSION CRITERIA: If answered "yes" on radiotherapy [RADIOTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1]
    C0436385
    DD/MM/YYYY
    Indicate whether the patient received chemotherapy during the last year:
    Description

    INCLUSION CRITERIA: If answered "chemotherapy" on treatment [TREATMENT] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0392920
    Indicate what type of chemotherapy:
    Description

    INCLUSION CRITERIA: If answered "chemotherapy" on treatment TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0392920
    UMLS CUI [1,2]
    C0332307
    Provide the start date of chemotherapy:
    Description

    INCLUSION CRITERIA: If answered "chemotherapy" on treatment TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1,1]
    C1302181
    UMLS CUI [1,2]
    C3173309
    DD/MM/YYYY
    Provide the stop date of chemotherapy, if applicable:
    Description

    INCLUSION CRITERIA: If answered "chemotherapy" on treatment TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1,1]
    C1302181
    UMLS CUI [1,2]
    C0806020
    DD/MM/YYYY
    Indicate whether the patient received targeted therapy during the last year:
    Description

    INCLUSION CRITERIA: If answered "targeted therapy" on treatment [TREATMENT] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Single Answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C2985566
    Provide the start date of targeted therapy:
    Description

    INCLUSION CRITERIA: If answered "yes on targeted therapy [TARGETTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1,1]
    C2985566
    UMLS CUI [1,2]
    C3173309
    DD/MM/YYYY
    Provide the stop date of targeted therapy, if applicable:
    Description

    INCLUSION CRITERIA: If answered "yes on targeted therapy [TARGETTX] TIMING: 6 months, update at least annually up to 10 years REPORTING SOURCE: Clinical TYPE: Date, please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1,1]
    C2985566
    UMLS CUI [1,2]
    C1531784
    DD/MM/YYYY
    Quality of death
    Description

    Quality of death

    Indicate where patient died as indicated on certificate of death: 
    Description

    INCLUSION CRITERIA: If answered "yes" on patient died [DEATH] TIMING: 1 year post treatment, tracked annually REPORTING SOURCE: Administrative TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0421611
    Indicate whether patient was cared for by hospice at time of death:
    Description

    INCLUSION CRITERIA: If answered "yes" on patient died [DEATH] TIMING: 1 year post treatment, tracked annually REPORTING SOURCE: Administrative or clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0085555
    Indicate whether the preference for place of death was documented (the most recent documented place of death):
    Description

    INCLUSION CRITERIA: If answered "yes" on patient died [DEATH] TIMING: 1 year post treatment, tracked annually REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0421611
    UMLS CUI [1,2]
    C0558295
    Provide the date of documentation:
    Description

    INCLUSION CRITERIA: If answered "yes" on patient died [DEATH] TIMING: 1 year post treatment, tracked annually REPORTING SOURCE: Clinical TYPE: Date, Please enter "999" if date is unknown

    Type de données

    date

    Unités de mesure
    • DD/MM/YYYY
    Alias
    UMLS CUI [1,1]
    C0011008
    UMLS CUI [1,2]
    C0920316
    DD/MM/YYYY
    Indicate whether the patient was admitted to the hospital > 1 time in the last 30 days of life:
    Description

    Emergency visits should not be included. INCLUSION CRITERIA: If answered "yes" on patient died [DEATH] TIMING: 1 year post treatment, tracked annually REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0184666
    Indicate whether the patient was admitted to the hospital > 1 time in the last 30 days of life:
    Description

    Emergency visits should not be included. INCLUSION CRITERIA: If answered "yes" on patient died [DEATH] TIMING: 1 year post treatment, tracked annually REPORTING SOURCE: Clinical TYPE: Single answer

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0184666
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    Similar models

    Annual Clinical Form

    1 Formulaires
    1. StudyEvent: SE
      1. Annual Clinical Form
    Name
    Type
    Description | Question | Decode (Coded Value)
    Type de données
    Alias
    Item Group
    Administrative Data
    C1320722 (UMLS CUI-1)
    Patient ID
    Item
    Indicate the patient's medical record number
    integer
    C1269815 (UMLS CUI [1])
    Patient's last name
    Item
    Patient's last name:
    text
    C1299487 (UMLS CUI [1])
    Time Relative to Baseline
    Item
    Time Relative to Baseline (e.g. Baseline, 6 months follow-up, 1 year follow-up, ...)
    text
    C0439564 (UMLS CUI [1,1])
    C1442488 (UMLS CUI [1,2])
    Item Group
    Survival and disease control
    C1148433 (UMLS CUI-1)
    C4304384 (UMLS CUI-2)
    Item
    Indicate whether there is evidence of local, regional or distant recurrence.
    integer
    C0034897 (UMLS CUI [1])
    Residual invasive cancer
    Code List
    Indicate whether there is evidence of local, regional or distant recurrence.
    CL Item
    No (0)
    CL Item
    Local recurrence (1)
    CL Item
    Unknown (999)
    CL Item
    Regional recurrence (2)
    CL Item
    Distant recurrence (3)
    Item
    Provide method of confirmation:
    integer
    C0034897 (UMLS CUI [1,1])
    C0332307 (UMLS CUI [1,2])
    Residual invasive cancer
    Code List
    Provide method of confirmation:
    CL Item
    Radiological diagnosis (0)
    CL Item
    Histological diagnosis (1)
    CL Item
    Unknown (999)
    CL Item
    Radiological and histological diagnosis (2)
    Recurrence date
    Item
    Provide the date of the recurrence:
    date
    C0807712 (UMLS CUI [1])
    Item
    Indicate whether there is evidence of disease progression:
    integer
    C0242656 (UMLS CUI [1])
    Disease progression
    Code List
    Indicate whether there is evidence of disease progression:
    CL Item
    No (0)
    CL Item
    Yes (1)
    CL Item
    Unknown (999)
    Item
    Provide method of confirmation:
    integer
    C0242656 (UMLS CUI [1,1])
    C0430022 (UMLS CUI [1,2])
    Disease progression
    Code List
    Provide method of confirmation:
    CL Item
    Laboratory diagnosis (0)
    CL Item
    Clinical diagnosis (1)
    CL Item
    Unknown (999)
    CL Item
    Radiological diagnosis (2)
    CL Item
    Histological diagnosis (3)
    CL Item
    Radiological and histological diagnosis (4)
    Progression date
    Item
    Provide the date of the progression:
    date
    C0242656 (UMLS CUI [1,1])
    C0011008 (UMLS CUI [1,2])
    Item
    Indicate whether the patient has died
    integer
    C0011065 (UMLS CUI [1])
    Death
    Code List
    Indicate whether the patient has died
    CL Item
    No (0)
    CL Item
    Yes (1)
    CL Item
    Unknown (999)
    Date of death
    Item
    Provide the date of the death:
    date
    C1148348 (UMLS CUI [1])
    Item
    Indicate if death is attributable to colorectal cancer:
    integer
    C0007465 (UMLS CUI [1])
    Weight units
    Code List
    Indicate if death is attributable to colorectal cancer:
    CL Item
    Yes  (1)
    CL Item
    No  (0)
    CL Item
    Unknown (999)
    Item Group
    Treatment Variables
    C0087111 (UMLS CUI-1)
    Item
    Indicate whether the patient received one of the following treatment during the last year: (select all that apply)
    integer
    C0087111 (UMLS CUI [1])
    Treatment
    Code List
    Indicate whether the patient received one of the following treatment during the last year: (select all that apply)
    CL Item
    No treatment (0)
    CL Item
    Surgery (1)
    CL Item
    Radiotherapy (2)
    CL Item
    Chemotherapy (3)
    CL Item
    Targeted therapy (4)
    CL Item
    Best supportive care (5)
    CL Item
    Unknown (999)
    Item
    Indicate whether the patient received surgery during the last year:
    integer
    C0543467 (UMLS CUI [1])
    Treatment
    Code List
    Indicate whether the patient received surgery during the last year:
    CL Item
    Hemicolectomy right (1)
    CL Item
    Extended colectomy right (2)
    CL Item
    Transverse resection (3)
    CL Item
    Hemicolectomy left (4)
    CL Item
    Subtotal colectomy (5)
    CL Item
    Unknown (999)
    CL Item
    Total colectomy (6)
    CL Item
    Sigmoid resection (7)
    CL Item
    Anterior resection (8)
    CL Item
    Low anterior resection (LAR) (9)
    CL Item
    Abdomino-perineal resection (APR) (10)
    CL Item
    Proctectomy with coloanal (11)
    CL Item
    Other (12)
    Item
    Indicate the method of the surgical procedure:
    integer
    C0683312 (UMLS CUI [1,1])
    C0543467 (UMLS CUI [1,2])
    Treatment
    Code List
    Indicate the method of the surgical procedure:
    CL Item
    Endoscopic (for colon tumors) (1)
    CL Item
    Transabdominal open (2)
    CL Item
    Transabdominal minimally invasive (laparoscopic/robotic) (3)
    CL Item
    Transanal open (4)
    CL Item
    Transanal endoscopic (TEMS/SPTS)/minimally invasive (TAMIS) (5)
    CL Item
    Unknown (999)
    CL Item
    Other (6)
    Surgery date
    Item
    Provide the date of surgery:
    date
    C1628561 (UMLS CUI [1])
    Item
    Indicate whether the patient received radiotherapy during the last year
    integer
    C1522449 (UMLS CUI [1])
    Radiotherapy
    Code List
    Indicate whether the patient received radiotherapy during the last year
    CL Item
    Neoadjuvant  (1)
    CL Item
    Adjuvant  (2)
    CL Item
    Definitive (3)
    CL Item
    Unknown (999)
    Item
    Indicate what type of radiotherapy:
    integer
    C1522449 (UMLS CUI [1,1])
    C1521902 (UMLS CUI [1,2])
    Radiotherapy
    Code List
    Indicate what type of radiotherapy:
    CL Item
    Long course without chemotherapy  (1)
    CL Item
    Long course chemoradiation  (2)
    CL Item
    Brachytherapy  (3)
    CL Item
    Unknown (999)
    CL Item
    Short course  (0)
    CL Item
    Intraoperative radiation therapy (ORT)  (4)
    CL Item
    Other  (5)
    Start of radiotherapy
    Item
    Provide the start date of radiotherapy:
    date
    C0436382 (UMLS CUI [1])
    End of radiotherapy
    Item
    Provide the stop date of radiotherapy:
    date
    C0436385 (UMLS CUI [1])
    Item
    Indicate whether the patient received chemotherapy during the last year:
    integer
    C0392920 (UMLS CUI [1])
    Chemotherapy
    Code List
    Indicate whether the patient received chemotherapy during the last year:
    CL Item
    Neoadjuvant (1)
    CL Item
    Adjuvant (2)
    CL Item
    Definitive (3)
    CL Item
    Unknown (999)
    Item
    Indicate what type of chemotherapy:
    integer
    C0392920 (UMLS CUI [1,1])
    C0332307 (UMLS CUI [1,2])
    Chemotherapy
    Code List
    Indicate what type of chemotherapy:
    CL Item
    Capecitabine/oxaliplatin (1)
    CL Item
    Capecitabine (2)
    CL Item
    5-FU/leucovorin (3)
    CL Item
    Unknown (999)
    CL Item
    FOLFOX regimen (0)
    CL Item
    5-FU (4)
    CL Item
    Irinotecan (5)
    CL Item
    FOLFIRI (6)
    CL Item
    FOLFOXIRI (7)
    CL Item
    Uracil-tegafur (UFT)/leucovorin (8)
    CL Item
    Lonsurf (trifluridine and tipiracil) (9)
    CL Item
    Other (10)
    Start of chemotherapy
    Item
    Provide the start date of chemotherapy:
    date
    C1302181 (UMLS CUI [1,1])
    C3173309 (UMLS CUI [1,2])
    End of chemotherapy
    Item
    Provide the stop date of chemotherapy, if applicable:
    date
    C1302181 (UMLS CUI [1,1])
    C0806020 (UMLS CUI [1,2])
    Item
    Indicate whether the patient received targeted therapy during the last year:
    integer
    C2985566 (UMLS CUI [1])
    Targeted therapy
    Code List
    Indicate whether the patient received targeted therapy during the last year:
    CL Item
    Cetuximab (1)
    CL Item
    Bevacizumab (2)
    CL Item
    Panitumumab (3)
    CL Item
    Ramicurimab (4)
    CL Item
    Aflibercept (5)
    CL Item
    Regorafenib (6)
    CL Item
    Other (7)
    CL Item
    Unknown (999)
    Start of targeted therapy
    Item
    Provide the start date of targeted therapy:
    date
    C2985566 (UMLS CUI [1,1])
    C3173309 (UMLS CUI [1,2])
    End of targeted therapy
    Item
    Provide the stop date of targeted therapy, if applicable:
    date
    C2985566 (UMLS CUI [1,1])
    C1531784 (UMLS CUI [1,2])
    Item Group
    Quality of death
    Item
    Indicate where patient died as indicated on certificate of death: 
    integer
    C0421611 (UMLS CUI [1])
    Place of death
    Code List
    Indicate where patient died as indicated on certificate of death: 
    CL Item
    Home (1)
    CL Item
    Hospital (2)
    CL Item
    Nursing home/care home (including assisted living facilities) (3)
    CL Item
    other (4)
    CL Item
    Unknown (999)
    Item
    Indicate whether patient was cared for by hospice at time of death:
    integer
    C0085555 (UMLS CUI [1])
    Weight units
    Code List
    Indicate whether patient was cared for by hospice at time of death:
    CL Item
    Yes  (1)
    CL Item
    No  (0)
    CL Item
    Unknown (999)
    Item
    Indicate whether the preference for place of death was documented (the most recent documented place of death):
    integer
    C0421611 (UMLS CUI [1,1])
    C0558295 (UMLS CUI [1,2])
    Preference of place of death
    Code List
    Indicate whether the preference for place of death was documented (the most recent documented place of death):
    CL Item
    No (0)
    CL Item
    Home (1)
    CL Item
    Hospital (2)
    CL Item
    Nursing home/care home (including assisted living facilities) (3)
    CL Item
    other (4)
    CL Item
    Unknown (999)
    Date of documentation
    Item
    Provide the date of documentation:
    date
    C0011008 (UMLS CUI [1,1])
    C0920316 (UMLS CUI [1,2])
    Item
    Indicate whether the patient was admitted to the hospital > 1 time in the last 30 days of life:
    integer
    C0184666 (UMLS CUI [1])
    Hospital admissions
    Code List
    Indicate whether the patient was admitted to the hospital > 1 time in the last 30 days of life:
    CL Item
    No (0)
    CL Item
    Yes (1)
    CL Item
    Unknown (999)
    Item
    Indicate whether the patient was admitted to the hospital > 1 time in the last 30 days of life:
    integer
    C0184666 (UMLS CUI [1])
    Hospital admissions
    Code List
    Indicate whether the patient was admitted to the hospital > 1 time in the last 30 days of life:
    CL Item
    No (0)
    CL Item
    Yes (1)
    CL Item
    Unknown (999)
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