ID
37870
Beschrijving
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 years of age 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.
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Trefwoorden
Versies (3)
- 20-08-19 20-08-19 -
- 28-08-19 28-08-19 -
- 30-04-20 30-04-20 - Sarah Riepenhausen
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ICHOM
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Creative Commons BY-NC 3.0
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ICHOM Paediatric Facial Palsy
5 and 11 years of age follow-up - Clinical Form
- StudyEvent: ODM
Beschrijving
Patient Demographic Factors
Alias
- UMLS CUI-1
- C1704791
Beschrijving
Inclusion Criteria: All patients Timing: On all forms Data Source: Clinical, parent-reported, or patient-reported Type: Single answer Response Options: Years and fractions
Datatype
text
Maateenheden
- years
Alias
- UMLS CUI [1]
- C0001779
Beschrijving
Inclusion Criteria: All patients Timing: On all forms Data Source: Administrative data Type: Single answer
Datatype
integer
Alias
- UMLS CUI [1]
- C1548070
Beschrijving
Clinical Status
Alias
- UMLS CUI-1
- C0449440
Beschrijving
Inclusion Criteria: All patients Timing: On all forms Data Source: Clinician Type: Single answer
Datatype
integer
Alias
- UMLS CUI [1]
- C0009488
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2,1]
- C1298908
- UMLS CUI [2,2]
- C2359476
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2]
- C3277906
- UMLS CUI [3,1]
- C0018787
- UMLS CUI [3,2]
- C1704258
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
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
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2]
- C0424605
- UMLS CUI [3]
- C0851265
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
boolean
Alias
- UMLS CUI [1,1]
- C1521725
- UMLS CUI [1,2]
- C0009488
- UMLS CUI [2]
- C0004936
- UMLS CUI [3]
- C0004930
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
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
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
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
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
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
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
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
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
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
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
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
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
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
Beschrijving
Inclusion Criteria: If "1 = Yes" to COMORB Timing: On all forms Data Source: Clinician Type: Multiple answer Separate multiple entries with ";"
Datatype
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
Beschrijving
Other
Alias
- UMLS CUI-1
- C0205394
Beschrijving
Inclusion Criteria: All patients Timing: Pre-Intervention, 5 and 11 years of age Follow-up Data Source: Clinician Type: Single answer
Datatype
integer
Alias
- UMLS CUI [1,1]
- C1302313
- UMLS CUI [1,2]
- C1518988
Beschrijving
Degree of Health
Alias
- UMLS CUI-1
- C0018759
Beschrijving
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
Datatype
integer
Alias
- UMLS CUI [1,1]
- C4038447
- UMLS CUI [1,2]
- C4277735
Beschrijving
Supporting Definition: Use Snellen Chart to measure visual acuity Inclusion Criteria: Age >6y Timing: Baseline, 5 and 11 years of age Follow-up , End of pediatric or planned care Data Source: Clinician Type: Single answer
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0183370
- UMLS CUI [1,2]
- C0429537
- UMLS CUI [1,3]
- C4072785
- UMLS CUI [1,4]
- C0229089
Beschrijving
Supporting Definition: Use Snellen Chart to measure visual acuity Inclusion Criteria: Age >6y Timing: Baseline, 5 and 11 years of age Follow-up , End of pediatric or planned care Data Source: Clinician Type: Single answer
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0183370
- UMLS CUI [1,2]
- C0429537
- UMLS CUI [1,3]
- C1690532
- UMLS CUI [1,4]
- C0229089
Beschrijving
Supporting Definition: Use Snellen Chart to measure visual acuity Inclusion Criteria: Age >6y Timing: Baseline, 5 and 11 years of age Follow-up , End of pediatric or planned care Data Source: Clinician Type: Single answer
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0183370
- UMLS CUI [1,2]
- C0429537
- UMLS CUI [1,3]
- C4072785
- UMLS CUI [1,4]
- C0229090
Beschrijving
Supporting Definition: Use Snellen Chart to measure visual acuity Inclusion Criteria: Age >6y Timing: Baseline, 5 and 11 years of age Follow-up , End of pediatric or planned care Data Source: Clinician Type: Single answer
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0183370
- UMLS CUI [1,2]
- C0429537
- UMLS CUI [1,3]
- C1690532
- UMLS CUI [1,4]
- C0229090
Beschrijving
Inclusion Criteria: All patients Timing: Baseline, 5 and 11 years of age Follow-up Data Source: Clinician Type: Single answer
Datatype
integer
Alias
- UMLS CUI [1,1]
- C0002418
- UMLS CUI [1,2]
- C0220825
Beschrijving
Supporting Definition: Based on eFACE Inclusion Criteria: Age >3y Timing: On all forms Data Source: Clinician/Administrative data Type: Numerical value Response Options: Numerical
Datatype
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
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- StudyEvent: ODM
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