ID

36716

Description

ICHOM Hypertension in low- and middle-income countries data collection Version 1.0.0 Revised: November 3rd, 2017 International Consortium for Health Outcomes Measurement (ICHOM), Source: http://www.ichom.org/ The following condition and treatment approaches (or interventions) are covered by our Standard Set. Condition: Hypertension (ICD-10: I10) Treatment Approaches: Pharmacological and Non-Pharmacological Collecting Patient-Reported Outcome Measures: Survey Used: EuroQol-5D-3L (EQ-5D-3L). As a licence is needed for use of EQ-5D-3L questionnaires, the actual questions are not part of this version of the standard set. For licensing information see: https://euroqol.org/support/how-to-obtain-eq-5d/ This document contains the Annually - Clinical Form. It has to be filled in one year after patient's entry into set and annually for life. PROMIS Single Question on erectile Dysfunction. Free for use in clinical practice. As http://www.nihpromis.org/ is the official distribution site for PROMIS questionnaires and translations, only the total score will be included in this version of the standard set. Beliefs about Medication Questionnaire (BMQ)-Specific: Copyrighted, permission to use the scale can be obtained from Professor Rob Horne’s research team. The scoring guide can be found in the original validation article: Horne et al. (1999) The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychology & Health, 14:1. Hill-Bone Compliance to High Blood Pressure Therapy Scale - South Africa Version: Permission to use the scale can be obtained from Estelle V. Lambert’s research team, The scoring guide can be found in the original validation article: Lambert, E.V. et al. (2006) Cross-Cultural Validation of the Hill-Bone Compliance To High Blood Pressure Therapy Scale in a South African, Primary Healthcare Setting. Ethnicity and Disease, 16. WHO STEPS Instrument. Free for use in clinical practice and a license is not required. http://www.who.int/chp/steps/instrument/en/ International Physical Activity Questionnaire(IPAQ)-Short Form: Publically available, open access, and no permissions are required to use it. https://sites.google.com/site/theipaq/ Alternative Quality of Life Surveys: PROMIS Global-10 Free for use in clinical practice. As http://www.nihpromis.org/ is the official distribution site for PROMIS questionnaires and translations, only the total score will be included in this version of the standard set. Veteran’s Rand 12-Item Health Survey (VR-12). Free for all health care organizations, license required and can be requested at: http://bit.ly/2ir84sG. As a license is needed, the actual questions are not part of this version of the standard set. 12-Item Short Form Survey (SF-12). As a license is needed for use of SF-12 questionaires, the actual questions are not part of this version of the standard set. For more information see: http://bit.ly/2AcNLrme This Standard set was supported by the Novartis Foundation.

Link

http://www.ichom.org/

Keywords

Versions (3)
  1. 6/4/19 6/4/19 -
  2. 6/4/19 6/4/19 -
  3. 4/30/20 4/30/20 - Sarah Riepenhausen
Copyright Holder

ICHOM

Uploaded on

June 4, 2019

DOI

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License

Creative Commons BY-NC 3.0
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ICHOM Hypertension in low- and middle-income countries

English

Time of/Review after clinical incident - Clinical Form

1 forms  
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Patient ID
Description

Supporting Definition: 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: Administratively-­‐reported or clinician-­‐reported Type: Numerical Response Options: According to institution

Data type

integer

Alias
UMLS CUI [1]
C2348585
Time relative to baseline
Description

This Item does not exist in the original standard set, instead it is asked to do the following: 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_AT (After treatment); VARIABLEID_AS (After surgery); VARIABLEID_UPDATE (Update at least annually), etc.

Data type

text

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

Survival, disease control and cardiovascular complications

Alias
UMLS CUI-1
C1148433
UMLS CUI-2
C0012634
UMLS CUI-3
C0243148
UMLS CUI-4
C0007226
UMLS CUI-5
C0009566
Patient systolic blood pressure reading in mmHg
Description

Inclusion Criteria: All patients Timing: Minimum annually Reporting Source: Clinician‐reported Type: Numerical Response Options: Numerical value

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0871470
mmHg
Patient diastolic blood pressure reading in mmHg
Description

Inclusion Criteria: All patients Timing: Minimum annually Reporting Source: Clinician‐reported Type: Numerical Response Options: Numerical value

Data type

integer

Measurement units
  • mmHg
Alias
UMLS CUI [1]
C0428883
mmHg
Has the patient died, regardless of cause?
Description

Inclusion Criteria: All patients Timing: At time of death Reporting Source: Clinician-­reported/administratively‐reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0011065
If yes, indicate date of death
Description

Inclusion Criteria: If answered 'yes' to overall survival (OVERALLSURV) Timing: At time of death Reporting Source: Clinician-­reported/administratively‐reported Type: Date by DD/MM/YYYY or by MM/YYYY (in case exact day is unknown) Response Options: DD/MM/YYYY or MM/YYYY

Data type

date

Alias
UMLS CUI [1]
C1148348
If yes, indicate cause of death, if known
Description

Inclusion Criteria: If answered 'yes' to overall survival (OVERALLSURV) Timing: At time of death Reporting Source: Clinician-­reported/administratively‐reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0007465
Has the patient experienced any adverse events or unwanted side effects of medication?
Description

Inclusion Criteria: All patients Timing: Annually and 4-­‐6 weeks after initiation or change of treatment Reporting Source: Clinician‐reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0392325
UMLS CUI [2]
C0877248
If yes, please specify by selecting all that apply. 1 = Falls
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C0085639
If yes, please specify by selecting all that apply. 2 = Acute kidney injury
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C2609414
If yes, please specify by selecting all that apply. 3 = Peripheral oedema
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C0085649
If yes, please specify by selecting all that apply. 4 = Fatigue or unusual tiredness
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C0015672
UMLS CUI [3,1]
C2700116
UMLS CUI [3,2]
C0848717
If yes, please specify by selecting all that apply. 5 = Electrolyte abnormalities
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C0151613
If yes, please specify by selecting all that apply. 6 = Hypokalaemia
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C0020621
If yes, please specify by selecting all that apply. 7 = Cough
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C0010200
If yes, please specify by selecting all that apply. 8 = Erectile dysfunction
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C0242350
If yes, please specify by selecting all that apply. 9 = Urinary frequency
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C0042023
If yes, please specify by selecting all that apply. 10 = Other
Description

Supporting Definition: Hypotension and clinical manifestations of hypotension Inclusion Criteria: If answered 'yes' to medication side effects ('MEDEFFECTS') Timing: Annually and 4-­6 weeks after initiation or change of treatment Reporting Source: Clinician-­reported Type: Multiple answer

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0392325
UMLS CUI [2]
C0205394
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Similar models

Time of/Review after clinical incident - Clinical Form

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Patient ID
Item
Patient ID
integer
C2348585 (UMLS CUI [1])
Time relative to baseline
Item
Time relative to baseline
text
C0439564 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
Item Group
Survival, disease control and cardiovascular complications
C1148433 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
C0243148 (UMLS CUI-3)
C0007226 (UMLS CUI-4)
C0009566 (UMLS CUI-5)
Systolic blood pressure
Item
Patient systolic blood pressure reading in mmHg
integer
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
Patient diastolic blood pressure reading in mmHg
integer
C0428883 (UMLS CUI [1])
Item
Has the patient died, regardless of cause?
integer
C0011065 (UMLS CUI [1])
Has the patient died?
Code List
Has the patient died, regardless of cause?
CL Item
No (0)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Date of death
Item
If yes, indicate date of death
date
C1148348 (UMLS CUI [1])
Item
If yes, indicate cause of death, if known
integer
C0007465 (UMLS CUI [1])
Cause of death
Code List
If yes, indicate cause of death, if known
CL Item
Acute myocardial infarction (1)
C0155626 (UMLS CUI-1)
(Comment:en)
CL Item
Sudden cardiac death (2)
C0085298 (UMLS CUI-1)
(Comment:en)
CL Item
Heart failure (3)
C0018801 (UMLS CUI-1)
(Comment:en)
CL Item
Stroke (4)
C0038454 (UMLS CUI-1)
(Comment:en)
CL Item
Cardiovascular procedures (5)
C0007222 (UMLS CUI-1)
C0430022 (UMLS CUI-2)
(Comment:en)
CL Item
Cardiovascular haemorrhage (6)
C0007222 (UMLS CUI-1)
C0019080 (UMLS CUI-2)
(Comment:en)
CL Item
Other cardiovascular causes (7)
C0205394 (UMLS CUI-1)
C0007222 (UMLS CUI-2)
(Comment:en)
CL Item
Non‐cardiovascular causes (8)
C0007222 (UMLS CUI-1)
C1298908 (UMLS CUI-2)
C0007465 (UMLS CUI-3)
(Comment:en)
CL Item
Cause unknown (9)
C0439673 (UMLS CUI-1)
(Comment:en)
Item
Has the patient experienced any adverse events or unwanted side effects of medication?
integer
C0392325 (UMLS CUI [1])
C0877248 (UMLS CUI [2])
Medication side effects and adverse events
Code List
Has the patient experienced any adverse events or unwanted side effects of medication?
CL Item
No (0)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Type of medication side effects: Falls
Item
If yes, please specify by selecting all that apply. 1 = Falls
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C0085639 (UMLS CUI [2])
Type of medication side effects: Acute kidney injury
Item
If yes, please specify by selecting all that apply. 2 = Acute kidney injury
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C2609414 (UMLS CUI [2])
Type of medication side effects: Peripheral oedema
Item
If yes, please specify by selecting all that apply. 3 = Peripheral oedema
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C0085649 (UMLS CUI [2])
Type of medication side effects: Fatigue or unusual tiredness
Item
If yes, please specify by selecting all that apply. 4 = Fatigue or unusual tiredness
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C0015672 (UMLS CUI [2])
C2700116 (UMLS CUI [3,1])
C0848717 (UMLS CUI [3,2])
Type of medication side effects: Electrolyte abnormalities
Item
If yes, please specify by selecting all that apply. 5 = Electrolyte abnormalities
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C0151613 (UMLS CUI [2])
Type of medication side effects: Hypokalaemia
Item
If yes, please specify by selecting all that apply. 6 = Hypokalaemia
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C0020621 (UMLS CUI [2])
Type of medication side effects: Cough
Item
If yes, please specify by selecting all that apply. 7 = Cough
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C0010200 (UMLS CUI [2])
Type of medication side effects: Erectile dysfunction
Item
If yes, please specify by selecting all that apply. 8 = Erectile dysfunction
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C0242350 (UMLS CUI [2])
Type of medication side effects: Urinary frequency
Item
If yes, please specify by selecting all that apply. 9 = Urinary frequency
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C0042023 (UMLS CUI [2])
Type of medication side effects: Other
Item
If yes, please specify by selecting all that apply. 10 = Other
boolean
C0332307 (UMLS CUI [1,1])
C0392325 (UMLS CUI [1,2])
C0205394 (UMLS CUI [2])
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