ID
36725
Beschreibung
ICHOM Dementia data collection Version 1.0.1 Revised: April 3rd, 2017 International Consortium for Health Outcomes Measurement (ICHOM), Source: http://www.ichom.org/ For Dementia, the following conditions are covered by the Standard Set. Condition: Alzheimer’s disease | Vascular dementia | Dementia in other diseases classified elsewhere (e.g. dementia with Lewy bodies and fronto-temporal dementia) Stages: Early | Middle | Late This document contains the Annual - Clinical Form. It has to be filled in annually (from baseline). Collecting Clinician and Patient-Reported Outcome Measures: Neuropsychiatric Inventory (NPI). Copyrighted, fees only for industry-sponsored research. No republishing without permission of the originator (JL Cummings, 1994). Therefore (for now) only the total score will be included in this version of the standard set. Bristol Activity Daily Living Scale (BADLS). As redistribution possibility is not yet cleared, for now only the total score will be included in this version of the standard set. Quality of Life-AD (QOL-AD). Use of the scale in clinical practice or by academic users is free as long as no funding is received from commercial users, however a license is required. Therefore only the total score score will be included in this version of the standard set. Logsdon RG, Gibbons LE, McCurry SM, Teri L. Quality of Life in Alzheimer’s disease: Patient and Caregiver Reports. Journal of Mental Health and Aging. 1999;5(1):21-32 Quality of Wellbeing Scale-Self Administered (QWB-SA). The QWB-SA may be used free of charge by non-profit organizations that provide evidence of their non-profit status and agree to provide a copy of relevant, non-identifiable project data with UCSD; Scoring instructions are provided free of charge after a signed copyright agreement is received. As https://hoap.ucsd.edu/qwb-info/NotforProfit-Copyright.pdf is the official permission site, only the total score score will be included in this version of the standard set. EuroQol-5D (EQ-5D). As a license is required for use this questionaire, only the total score will be included in this version of the standard set. Veterans RAND 12 (VR-12). As this questionaire is copyrighted and needs an user agreement for use, only the total score score will be included in this version of the standard set. Clinical Dementia Rating (CDR). This questionaire is Copyrighted.The Washington University The Charles F. and Joanne Knight Alzheimer’s Disease Research Center (Knight ADRC) holds the United States Copyright for the Clinical Dementia Rating (CDR). Therefore only the total score score will be included in this version of the standard set. Montreal Cognitive Assessment (MoCA copyrighted). For clinical and educational use, MoCA© may be used, reproduced, and distributed without permission. This Standard set was supported by the Scottish Government.
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Stichworte
Versionen (5)
- 04.06.19 04.06.19 -
- 04.06.19 04.06.19 - Sarah Riepenhausen
- 04.06.19 04.06.19 -
- 04.06.19 04.06.19 -
- 30.04.20 30.04.20 - Sarah Riepenhausen
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ICHOM
Hochgeladen am
4. Juni 2019
DOI
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Creative Commons BY-NC 3.0
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ICHOM Dementia
Annual - Clinical Form
- StudyEvent: ODM
Beschreibung
Demographic factors
Alias
- UMLS CUI-1
- C1704791
Beschreibung
Supporting Definition: Height and weight are used to calculate BMI Inclusion Criteria: All patients Timing: Baseline Annually Data Source: Clinical Type: Numerical value Response Options: Numerical value of body mass index in kg/m2
Datentyp
float
Maßeinheiten
- kg/m^2
Alias
- UMLS CUI [1]
- C1305855
Beschreibung
Associated clinical history
Alias
- UMLS CUI-1
- C0262926
- UMLS CUI-2
- C0332281
Beschreibung
Supporting Definition: Has the patient had a cardiovascular death, non‐fatal myocardial infarction, sustained ventricular arrhythmia, any coronary intervention, hospitalization for congestive heart failure, angina requiring hospital admission, peripheral vascular or cerebrovascular event in the last year Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-reported, clinical or administrative Type: Single answer
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C1320716
- UMLS CUI [1,2]
- C0021149
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C1298908
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0018799
- UMLS CUI [3]
- C0018801
- UMLS CUI [4]
- C0002962
- UMLS CUI [5]
- C0027051
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0020538
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0024115
- UMLS CUI [3]
- C0004096
- UMLS CUI [4]
- C0008677
- UMLS CUI [5]
- C0034067
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C1306889
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0011854
- UMLS CUI [3]
- C0011860
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0022658
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0027765
- UMLS CUI [3]
- C0030567
- UMLS CUI [4]
- C0026769
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0023895
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0006826
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2,1]
- C0011581
- UMLS CUI [2,2]
- C0332152
- UMLS CUI [2,3]
- C0497327
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0020443
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2,1]
- C0038454
- UMLS CUI [2,2]
- C0678227
- UMLS CUI [2,3]
- C1546466
Beschreibung
Supporting Definition: Based upon the Self-administered Comorbidity Questionnaire (Sanga et al, 2003) Item is phrased as a patient reported measure. However, if the patient is unable to answer, this information can be abstracted from the medical records. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Patient/caregiver-‐reported, clinical or administrative Type: Multiple answers
Datentyp
boolean
Alias
- UMLS CUI [1]
- C0009488
- UMLS CUI [2]
- C0038586
Beschreibung
Medication variables
Alias
- UMLS CUI-1
- C0013227
Beschreibung
Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical or administrative data Type: Numerical value
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C0750480
- UMLS CUI [1,2]
- C3166216
- UMLS CUI [2,1]
- C0332300
- UMLS CUI [2,2]
- C1522168
Beschreibung
Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical or administrative data Type: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0001046
Beschreibung
Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical or administrative data Type: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C2916808
Beschreibung
Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical or administrative data Type: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0040615
Beschreibung
Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical or administrative data Type: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0003289
Beschreibung
Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical or administrative data Type: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0003286
Beschreibung
Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical or administrative data Type: Single answer
Datentyp
integer
Alias
- UMLS CUI [1]
- C0020591
Beschreibung
Outcome
Alias
- UMLS CUI-1
- C1547647
Beschreibung
Neuropsychiatric
Alias
- UMLS CUI-1
- C3203509
Beschreibung
As permission for use is required, the 9 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are NPI_C_D, NPI_C_D1 to NPI_C_D8. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Options: Delusions (0‐24)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C3539727
- UMLS CUI [1,2]
- C0011253
- UMLS CUI [1,3]
- C2964552
Beschreibung
As permission for use is required, the 8 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are NPI_C_H, NPI_C_H1 to NPI_C_H7. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Option: Hallucinations (0-21)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C3539727
- UMLS CUI [1,2]
- C0018524
- UMLS CUI [1,3]
- C2964552
Beschreibung
As permission for use is required, the 14 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are NPI_C_AGI, NPI_C_AGI1 to NPI_C_AGI13. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Option: Agitation (0-39)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C3539727
- UMLS CUI [1,2]
- C0085631
- UMLS CUI [1,3]
- C2964552
Beschreibung
As permission for use is required, the 9 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are NPI_C_AGG, NPI_C_AGG1 to NPI_C_AGG8. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Option: Aggression (0-24)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C3539727
- UMLS CUI [1,2]
- C1457883
- UMLS CUI [1,3]
- C2964552
Beschreibung
As permission for use is required, the 14 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are NPI_C_DYS, NPI_C_DYS1 to NPI_C_DYS13. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Option: Dysphoria (0-39)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C3539727
- UMLS CUI [1,2]
- C3176492
- UMLS CUI [1,3]
- C2964552
Beschreibung
As permission for use is required, the 15 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are NPI_C_ANX, NPI_C_ANX1 to NPI_C_ANX14. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Option: Anxiety (0-42)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C3539727
- UMLS CUI [1,2]
- C0003467
- UMLS CUI [1,3]
- C2964552
Beschreibung
As permission for use is required, the 13 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are NPI_C_APA_IND, NPI_C_APA_IND1 to NPI_C_APA_IND12. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Option: Apathy (0-36)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C3539727
- UMLS CUI [1,2]
- C3828762
Beschreibung
As permission for use is required, the 9 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are NPI_C_SLEEPDIS, NPI_C_SLEEPDIS1 to NPI_C_SLEEPDIS8. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Option: Sleep (0-24)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C3539727
- UMLS CUI [1,2]
- C0851578
- UMLS CUI [1,3]
- C2964552
Beschreibung
As permission for use is required, the 10 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are NPI_C_APP_ EAT_DIS, NPI_C_APP_ EAT_DIS1 to NPI_C_APP_ EAT_DIS9. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Option: Appetite (0-27)
Datentyp
integer
Alias
- UMLS CUI [1,1]
- C3539727
- UMLS CUI [1,2]
- C0003621
- UMLS CUI [1,3]
- C0013473
- UMLS CUI [1,4]
- C2964552
Beschreibung
Clinical Dementia Rating
Alias
- UMLS CUI-1
- C0451074
Beschreibung
As this questionaire is copyrighted, the 16 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are CDR_INFOR_MEM1 to CDR_INFOR_MEM15. Additionnaly the MEN1 question has a subquestion: CDR_INFOR_MEM1A Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Caregiver or Clinical Impression Type: Single answer
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0451074
- UMLS CUI [1,2]
- C0025260
- UMLS CUI [1,3]
- C1550484
- UMLS CUI [1,4]
- C2964552
Beschreibung
As this questionaire is copyrighted, the 8 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are CDR_INFOR_ORIENT1 to CDR_INFOR_ORIENT8. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Caregiver or Clinical Impression Type: Single answer
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0451074
- UMLS CUI [1,2]
- C0029266
- UMLS CUI [1,3]
- C1550484
- UMLS CUI [1,4]
- C2964552
Beschreibung
As this questionaire is copyrighted, the 6 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are CDR_INFOR_JUDGE_PROB1 to CDR_INFOR_JUDGE_PROB6. Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Caregiver or Clinical Impression Type: Single answer
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0451074
- UMLS CUI [1,2]
- C0022423
- UMLS CUI [1,3]
- C0033211
- UMLS CUI [1,4]
- C1550484
- UMLS CUI [1,5]
- C2964552
Beschreibung
As this questionaire is copyrighted, the 27 actual questions are not included in this version of the standard set. ICHOM ID of the single questions are CDR_INFOR_COMMAFF, CDR_INFOR_COMMAFF1 to CDR_INFOR_COMMAFF10. Additionnaly some questions have subquestions: CDR_INFOR_COMMAFF4A, CDR_INFOR_COMMAFF4B, CDR_INFOR_COMMAFF8A, CDR_INFOR_COMMAFF10_1A, CDR_INFOR_COMMAFF10_1B, CDR_INFOR_COMMAFF10_2A, CDR_INFOR_COMMAFF10_2B, CDR_INFOR_COMMAFF10_3, CDR_INFOR_COMMAFF10_4, CDR_INFOR_COMMAFF10_4A, CDR_INFOR_COMMAFF10_5, CDR_INFOR_COMMAFF10_6, CDR_INFOR_COMMAFF10_6A to CDR_INFOR_COMMAFF10_6D Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Caregiver or Clinical Impression Type: Single answer
Datentyp
text
Alias
- UMLS CUI [1,1]
- C0451074
- UMLS CUI [1,2]
- C3640458
- UMLS CUI [1,3]
- C1550484
- UMLS CUI [1,4]
- C2964552
Beschreibung
Daily Living
Alias
- UMLS CUI-1
- C4552744
Beschreibung
Inclusion Criteria: All patients Timing: Baseline, Annually Data Source: Clinical Type: Numerical Response Options: 0-60
Datentyp
integer
Alias
- UMLS CUI [1]
- C2959408
Beschreibung
Cognitive
Alias
- UMLS CUI-1
- C0392335
Ähnliche Modelle
Annual - Clinical Form
- StudyEvent: ODM
C0332281 (UMLS CUI-2)
C0021149 (UMLS CUI [1,2])
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C1298908 (UMLS CUI [2])
C0018799 (UMLS CUI [2])
C0018801 (UMLS CUI [3])
C0002962 (UMLS CUI [4])
C0027051 (UMLS CUI [5])
C0020538 (UMLS CUI [2])
C0024115 (UMLS CUI [2])
C0004096 (UMLS CUI [3])
C0008677 (UMLS CUI [4])
C0034067 (UMLS CUI [5])
C1306889 (UMLS CUI [2])
C0011854 (UMLS CUI [2])
C0011860 (UMLS CUI [3])
C0022658 (UMLS CUI [2])
C0027765 (UMLS CUI [2])
C0030567 (UMLS CUI [3])
C0026769 (UMLS CUI [4])
C0023895 (UMLS CUI [2])
C0006826 (UMLS CUI [2])
C0011581 (UMLS CUI [2,1])
C0332152 (UMLS CUI [2,2])
C0497327 (UMLS CUI [2,3])
C0020443 (UMLS CUI [2])
C0038454 (UMLS CUI [2,1])
C0678227 (UMLS CUI [2,2])
C1546466 (UMLS CUI [2,3])
C0038586 (UMLS CUI [2])
C3166216 (UMLS CUI [1,2])
C0332300 (UMLS CUI [2,1])
C1522168 (UMLS CUI [2,2])
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C4718742 (UMLS CUI [2])
C0451074 (UMLS CUI [3])
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C0011253 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C0018524 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C0085631 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C1457883 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C3176492 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C0003467 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C3828762 (UMLS CUI [1,2])
C0851578 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C0003621 (UMLS CUI [1,2])
C0013473 (UMLS CUI [1,3])
C2964552 (UMLS CUI [1,4])
C0025260 (UMLS CUI [1,2])
C1550484 (UMLS CUI [1,3])
C2964552 (UMLS CUI [1,4])
C0029266 (UMLS CUI [1,2])
C1550484 (UMLS CUI [1,3])
C2964552 (UMLS CUI [1,4])
C0022423 (UMLS CUI [1,2])
C0033211 (UMLS CUI [1,3])
C1550484 (UMLS CUI [1,4])
C2964552 (UMLS CUI [1,5])
C3640458 (UMLS CUI [1,2])
C1550484 (UMLS CUI [1,3])
C2964552 (UMLS CUI [1,4])