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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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