ID
37729
Descrição
ICHOM Paediatric Facial Palsy data collection Version 1.0.0 Revised: August 31st, 2018 International Consortium for Health Outcomes Measurement (ICHOM), Source: http://www.ichom.org/ For Paediatric Facial Palsy, the following conditions and treatment approaches (or interventions) are covered by ICHOM‘s Standard Set. Conditions: Congenital/Syndromic | Acquired Unilateral (single- and multi-territory) | Bilateral (single- and multi-territory) Treatment approaches: Medical treatment | Surgery | Eye care Physiotherapy/Occupational therapy | Botulinum toxin | Psychological support This document contains the 5 and 11 ages follow-up - Clinical Form. This document is intended to represent the developmental stages of the patient. It has to be filled in at the ages of 5 and 11 years. Collecting Patient-Reported Outcome Measure: eFACE – Clinician. For more information see: Banks CA, Bhama PK, Park J, Hadlock CR, Hadlock TA. Clinician-Graded Electronic Facial Paralysis Assessment: The eFACE, August 2015. doi: 10.1097/PRS.0000000000001447 FACE-Q Kids. As there is a license for use of this questionnaire, the questions will not be included in this version of the standard set, only subscores. Snellen Chart – Clinician. PROMIS Paediatric Global Health 7 and PROMIS Pediatric Peer Relationships SF 8a. As there is an official distribution site, only the total score of these questionnaires will be included in this version of the standard set. For more information see: http://www. healthmeasures.net/explore-measurement-systems/promis/ obtain-administer-measures Reference: Butler DP, De la Torre A, Borschel GH, et al. An International Collaborative Standardizing Patient-Centered Outcome Measures in Pediatric Facial Palsy. JAMA Facial Plast Surg. Published online May 09, 2019. doi:10.1001/jamafacial.2019.0224 The Standard set of ICHOM was supported by the royal free charity and the Dianne and Michael Bienes Charitable Foundation Inc.
Link
Palavras-chave
Versões (3)
- 20/08/2019 20/08/2019 -
- 28/08/2019 28/08/2019 -
- 30/04/2020 30/04/2020 - Sarah Riepenhausen
Titular dos direitos
ICHOM
Transferido a
20 de agosto de 2019
DOI
Para um pedido faça login.
Licença
Creative Commons BY-NC 3.0
Comentários do modelo :
Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.
Comentários do grupo de itens para :
Comentários do item para :
Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.
ICHOM Paediatric Facial Palsy
5 and 11 ages follow-up - Clinical Form
- StudyEvent: ODM
Descrição
Patient Demographic Factors
Alias
- UMLS CUI-1
- C1704791
Descrição
Inclusion Criteria: All patients Timing: On all forms Data Source: Clinical, parent-reported, or patient-reported Type: Single answer Response Options: Years and fractions
Tipo de dados
integer
Alias
- UMLS CUI [1]
- C0001779
Descrição
Inclusion Criteria: All patients Timing: On all forms Data Source: Administrative data Type: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1]
- C1548070
Descrição
Clinical Status
Alias
- UMLS CUI-1
- C0449440
Descrição
Inclusion Criteria: All patients Timing: On all forms Data Source: Clinician Type: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1]
- C0009488
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C1298908
- UMLS CUI [2,2]
- C2359476
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2]
- C3277906
- UMLS CUI [3,1]
- C0232164
- UMLS CUI [3,2]
- C1704258
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C0042066
- UMLS CUI [2,2]
- C1704258
- UMLS CUI [3,1]
- C0042066
- UMLS CUI [3,2]
- C3887504
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2]
- C0424605
- UMLS CUI [3]
- C0851265
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2]
- C0004936
- UMLS CUI [3]
- C0004930
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2]
- C0009450
- UMLS CUI [3,1]
- C0040549
- UMLS CUI [3,2]
- C0012634
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C0521362
- UMLS CUI [2,2]
- C1704258
- UMLS CUI [3,1]
- C0521362
- UMLS CUI [3,2]
- C3887504
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C0026860
- UMLS CUI [2,2]
- C3887504
- UMLS CUI [3,1]
- C0026860
- UMLS CUI [3,2]
- C1704258
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C0205394
- UMLS CUI [2,2]
- C0037303
- UMLS CUI [2,3]
- C0024947
- UMLS CUI [2,4]
- C1704258
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C2709248
- UMLS CUI [2,2]
- C1704258
- UMLS CUI [3]
- C1709770
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C0279810
- UMLS CUI [2,2]
- C1704258
- UMLS CUI [3,1]
- C0279810
- UMLS CUI [3,2]
- C3887504
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C0205470
- UMLS CUI [2,2]
- C1704258
- UMLS CUI [3,1]
- C0205470
- UMLS CUI [3,2]
- C3887504
Descrição
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Tipo de dados
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C0027853
- UMLS CUI [2,2]
- C1704258
- UMLS CUI [3,1]
- C0027853
- UMLS CUI [3,2]
- C3887504
Descrição
Other
Alias
- UMLS CUI-1
- C0205394
Descrição
Inclusion Criteria: All patients Timing: Pre-Intervention, 5 and 11 ages follow-up Data Source: Clinician Type: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C1302313
- UMLS CUI [1,2]
- C1518988
Descrição
Degree of Health
Alias
- UMLS CUI-1
- C0018759
Descrição
Supporting Definition: PROMs refer to patient-, parent- or proxy-reported tools Inclusion Criteria: All patients Timing: On all forms Data Source: Administrative Type: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1]
- C4038447
Descrição
Supporting Definition: Use Snellen Chart to measure visual acuity Inclusion Criteria: Age >6y Timing: Baseline, 5 and 11 ages Follow-up, End of study Data Source: Clinician Type: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0183370
- UMLS CUI [1,3]
- C0442747
- UMLS CUI [1,4]
- C4072785
- UMLS CUI [1,5]
- C0229089
Descrição
Supporting Definition: Use Snellen Chart to measure visual acuity Inclusion Criteria: Age >6y Timing: Baseline, 5 and 11 ages Follow-up, End of study Data Source: Clinician Type: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0183370
- UMLS CUI [1,3]
- C0442747
- UMLS CUI [1,4]
- C1690532
- UMLS CUI [1,5]
- C0229089
Descrição
Supporting Definition: Use Snellen Chart to measure visual acuity Inclusion Criteria: Age >6y Timing: Baseline, 5 and 11 ages Follow-up, End of study Data Source: Clinician Type: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0183370
- UMLS CUI [1,3]
- C0442747
- UMLS CUI [1,4]
- C4072785
- UMLS CUI [1,5]
- C0229090
Descrição
Supporting Definition: Use Snellen Chart to measure visual acuity Inclusion Criteria: Age >6y Timing: Baseline, 5 and 11 ages Follow-up, End of study Data Source: Clinician Type: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0183370
- UMLS CUI [1,3]
- C0442747
- UMLS CUI [1,4]
- C1690532
- UMLS CUI [1,5]
- C0229090
Descrição
Inclusion Criteria: All patients Timing: Baseline, 5 and 11 ages Follow-up Data Source: Clinician Type: Single answer
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C0002418
- UMLS CUI [1,2]
- C2911685
Descrição
Supporting Definition: Based on eFACE Inclusion Criteria: Age >3y Timing: On all forms Data Source: Clinician/Administrative data Type: Numerical value Response Options: Numerical
Tipo de dados
integer
Alias
- UMLS CUI [1,1]
- C3846158
- UMLS CUI [1,2]
- C0449820
- UMLS CUI [1,3]
- C0439793
- UMLS CUI [1,4]
- C0015469
- UMLS CUI [2]
- C0517048
Similar models
5 and 11 ages follow-up - Clinical Form
- StudyEvent: ODM
C1442488 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C0009488 (UMLS CUI [1,2])
C1298908 (UMLS CUI [2,1])
C2359476 (UMLS CUI [2,2])
C0009488 (UMLS CUI [1,2])
C3277906 (UMLS CUI [2])
C0232164 (UMLS CUI [3,1])
C1704258 (UMLS CUI [3,2])
C0009488 (UMLS CUI [1,2])
C0042066 (UMLS CUI [2,1])
C1704258 (UMLS CUI [2,2])
C0042066 (UMLS CUI [3,1])
C3887504 (UMLS CUI [3,2])
C0009488 (UMLS CUI [1,2])
C0424605 (UMLS CUI [2])
C0851265 (UMLS CUI [3])
C0009488 (UMLS CUI [1,2])
C0004936 (UMLS CUI [2])
C0004930 (UMLS CUI [3])
C0009488 (UMLS CUI [1,2])
C0009450 (UMLS CUI [2])
C0040549 (UMLS CUI [3,1])
C0012634 (UMLS CUI [3,2])
C0009488 (UMLS CUI [1,2])
C0521362 (UMLS CUI [2,1])
C1704258 (UMLS CUI [2,2])
C0521362 (UMLS CUI [3,1])
C3887504 (UMLS CUI [3,2])
C0009488 (UMLS CUI [1,2])
C0026860 (UMLS CUI [2,1])
C3887504 (UMLS CUI [2,2])
C0026860 (UMLS CUI [3,1])
C1704258 (UMLS CUI [3,2])
C0009488 (UMLS CUI [1,2])
C0205394 (UMLS CUI [2,1])
C0037303 (UMLS CUI [2,2])
C0024947 (UMLS CUI [2,3])
C1704258 (UMLS CUI [2,4])
C0009488 (UMLS CUI [1,2])
C2709248 (UMLS CUI [2,1])
C1704258 (UMLS CUI [2,2])
C1709770 (UMLS CUI [3])
C0009488 (UMLS CUI [1,2])
C0279810 (UMLS CUI [2,1])
C1704258 (UMLS CUI [2,2])
C0279810 (UMLS CUI [3,1])
C3887504 (UMLS CUI [3,2])
C0009488 (UMLS CUI [1,2])
C0205470 (UMLS CUI [2,1])
C1704258 (UMLS CUI [2,2])
C0205470 (UMLS CUI [3,1])
C3887504 (UMLS CUI [3,2])
C0009488 (UMLS CUI [1,2])
C0027853 (UMLS CUI [2,1])
C1704258 (UMLS CUI [2,2])
C0027853 (UMLS CUI [3,1])
C3887504 (UMLS CUI [3,2])
C1518988 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
(Comment:en)
(Comment:en)
C0600420 (UMLS CUI-2)
(Comment:en)
C0183370 (UMLS CUI [1,2])
C0442747 (UMLS CUI [1,3])
C4072785 (UMLS CUI [1,4])
C0229089 (UMLS CUI [1,5])
C0183370 (UMLS CUI [1,2])
C0442747 (UMLS CUI [1,3])
C1690532 (UMLS CUI [1,4])
C0229089 (UMLS CUI [1,5])
C0183370 (UMLS CUI [1,2])
C0442747 (UMLS CUI [1,3])
C4072785 (UMLS CUI [1,4])
C0229090 (UMLS CUI [1,5])
C0183370 (UMLS CUI [1,2])
C0442747 (UMLS CUI [1,3])
C1690532 (UMLS CUI [1,4])
C0229090 (UMLS CUI [1,5])
C2911685 (UMLS CUI [1,2])
(Comment:en)
(Comment:en)
(Comment:en)
C0449820 (UMLS CUI [1,2])
C0439793 (UMLS CUI [1,3])
C0015469 (UMLS CUI [1,4])
C0517048 (UMLS CUI [2])