ID

39140

Beskrivning

A Representational Intervention to Promote Preparation for End-of-life Decision Making; ODM derived from: https://clinicaltrials.gov/show/NCT01259011

Länk

https://clinicaltrials.gov/show/NCT01259011

Nyckelord

Versioner (1)
  1. 2019-12-05 2019-12-05 -
Rättsinnehavare

See clinicaltrials.gov

Uppladdad den

5 december 2019

DOI

För en begäran logga in.

Licens

Creative Commons BY 4.0
Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Tillbaka till modellkommentarer
Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

Eligibility End Stage Renal Disease NCT01259011

Engelsk

Eligibility End Stage Renal Disease NCT01259011

1 Formulär  
Inclusion Criteria
Beskrivning

Inclusion Criteria

Alias
UMLS CUI
C1512693
for patients,
Beskrivning

Patients

Datatyp

boolean

Alias
UMLS CUI [1]
C0030705
self-identified caucasian or african american;
Beskrivning

Caucasians | African American

Datatyp

boolean

Alias
UMLS CUI [1]
C0043157
UMLS CUI [2]
C0085756
receiving either center-hemodialysis or home-peritoneal dialysis for at least 6 months prior to enrollment;
Beskrivning

In center hemodialysis | Peritoneal Dialysis At home

Datatyp

boolean

Alias
UMLS CUI [1]
C3841812
UMLS CUI [2,1]
C0031139
UMLS CUI [2,2]
C4534363
availability of an individual chosen by the patient who can be present during the intervention as a surrogate decision maker;
Beskrivning

The patient has designated a decision-maker

Datatyp

boolean

Alias
UMLS CUI [1]
C3845103
age 18 years or older;
Beskrivning

Age

Datatyp

boolean

Alias
UMLS CUI [1]
C0001779
ability to participate in health care decisions as evidenced by less than 3 errors on the short portable mental status questionnaire (spmsq), suggesting normal mental functioning;
Beskrivning

Ability Participation Decision Making | Mental status questionnaire

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0085732
UMLS CUI [1,2]
C0679823
UMLS CUI [1,3]
C0011109
UMLS CUI [2]
C0451291
ability to read, write, and speak english.
Beskrivning

Able to read English Language | Able to write English Language | Able to speak English Language

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0586740
UMLS CUI [1,2]
C0376245
UMLS CUI [2,1]
C0584993
UMLS CUI [2,2]
C0376245
UMLS CUI [3,1]
C0564215
UMLS CUI [3,2]
C0376245
a cci score of ≥6;
Beskrivning

Charlson Comorbidity Index

Datatyp

boolean

Alias
UMLS CUI [1]
C4546361
hospitalization in the last 6 months, a cci score of 5, including congestive heart failure (chf).
Beskrivning

Hospitalization Recent | Charlson Comorbidity Index | Congestive heart failure

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0019993
UMLS CUI [1,2]
C0332185
UMLS CUI [2]
C4546361
UMLS CUI [3]
C0018802
for surrogates,
Beskrivning

Patient Surrogate

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0030705
UMLS CUI [1,2]
C4053457
age 18 years or older (to serve as a surrogate decision maker, the individual must be an adult);
Beskrivning

Age

Datatyp

boolean

Alias
UMLS CUI [1]
C0001779
willingness to serve as the surrogate decision maker and participate in the intervention with the patient;
Beskrivning

Surrogate Decision Making Willing | Participation Intervention Willing

Datatyp

boolean

Alias
UMLS CUI [1,1]
C4053457
UMLS CUI [1,2]
C0011109
UMLS CUI [1,3]
C0600109
UMLS CUI [2,1]
C0679823
UMLS CUI [2,2]
C0184661
UMLS CUI [2,3]
C0600109
ability to read, write, and speak english.
Beskrivning

Able to read English Language | Able to write English Language | Able to speak English Language

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0586740
UMLS CUI [1,2]
C0376245
UMLS CUI [2,1]
C0584993
UMLS CUI [2,2]
C0376245
UMLS CUI [3,1]
C0564215
UMLS CUI [3,2]
C0376245
Exclusion Criteria
Beskrivning

Exclusion Criteria

Alias
UMLS CUI
C0680251
patients who are too sick to participate in an hour-long interview, who require special care and assistance, who would not be able to care for their needs will be excluded.
Beskrivning

Participation Patient interview Unable | Requirement Special care | Requirement Assistance | Self-care Unable

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0679823
UMLS CUI [1,2]
C0683518
UMLS CUI [1,3]
C1299582
UMLS CUI [2,1]
C1514873
UMLS CUI [2,2]
C1718344
UMLS CUI [3,1]
C1514873
UMLS CUI [3,2]
C1269765
UMLS CUI [4,1]
C3872897
UMLS CUI [4,2]
C1299582
Tillbaka till toppen

Similar models

Eligibility End Stage Renal Disease NCT01259011

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
C1512693 (UMLS CUI)
Patients
Item
for patients,
boolean
C0030705 (UMLS CUI [1])
Caucasians | African American
Item
self-identified caucasian or african american;
boolean
C0043157 (UMLS CUI [1])
C0085756 (UMLS CUI [2])
In center hemodialysis | Peritoneal Dialysis At home
Item
receiving either center-hemodialysis or home-peritoneal dialysis for at least 6 months prior to enrollment;
boolean
C3841812 (UMLS CUI [1])
C0031139 (UMLS CUI [2,1])
C4534363 (UMLS CUI [2,2])
The patient has designated a decision-maker
Item
availability of an individual chosen by the patient who can be present during the intervention as a surrogate decision maker;
boolean
C3845103 (UMLS CUI [1])
Age
Item
age 18 years or older;
boolean
C0001779 (UMLS CUI [1])
Ability Participation Decision Making | Mental status questionnaire
Item
ability to participate in health care decisions as evidenced by less than 3 errors on the short portable mental status questionnaire (spmsq), suggesting normal mental functioning;
boolean
C0085732 (UMLS CUI [1,1])
C0679823 (UMLS CUI [1,2])
C0011109 (UMLS CUI [1,3])
C0451291 (UMLS CUI [2])
Able to read English Language | Able to write English Language | Able to speak English Language
Item
ability to read, write, and speak english.
boolean
C0586740 (UMLS CUI [1,1])
C0376245 (UMLS CUI [1,2])
C0584993 (UMLS CUI [2,1])
C0376245 (UMLS CUI [2,2])
C0564215 (UMLS CUI [3,1])
C0376245 (UMLS CUI [3,2])
Charlson Comorbidity Index
Item
a cci score of ≥6;
boolean
C4546361 (UMLS CUI [1])
Hospitalization Recent | Charlson Comorbidity Index | Congestive heart failure
Item
hospitalization in the last 6 months, a cci score of 5, including congestive heart failure (chf).
boolean
C0019993 (UMLS CUI [1,1])
C0332185 (UMLS CUI [1,2])
C4546361 (UMLS CUI [2])
C0018802 (UMLS CUI [3])
Patient Surrogate
Item
for surrogates,
boolean
C0030705 (UMLS CUI [1,1])
C4053457 (UMLS CUI [1,2])
Age
Item
age 18 years or older (to serve as a surrogate decision maker, the individual must be an adult);
boolean
C0001779 (UMLS CUI [1])
Surrogate Decision Making Willing | Participation Intervention Willing
Item
willingness to serve as the surrogate decision maker and participate in the intervention with the patient;
boolean
C4053457 (UMLS CUI [1,1])
C0011109 (UMLS CUI [1,2])
C0600109 (UMLS CUI [1,3])
C0679823 (UMLS CUI [2,1])
C0184661 (UMLS CUI [2,2])
C0600109 (UMLS CUI [2,3])
Able to read English Language | Able to write English Language | Able to speak English Language
Item
ability to read, write, and speak english.
boolean
C0586740 (UMLS CUI [1,1])
C0376245 (UMLS CUI [1,2])
C0584993 (UMLS CUI [2,1])
C0376245 (UMLS CUI [2,2])
C0564215 (UMLS CUI [3,1])
C0376245 (UMLS CUI [3,2])
Item Group
C0680251 (UMLS CUI)
Participation Patient interview Unable | Requirement Special care | Requirement Assistance | Self-care Unable
Item
patients who are too sick to participate in an hour-long interview, who require special care and assistance, who would not be able to care for their needs will be excluded.
boolean
C0679823 (UMLS CUI [1,1])
C0683518 (UMLS CUI [1,2])
C1299582 (UMLS CUI [1,3])
C1514873 (UMLS CUI [2,1])
C1718344 (UMLS CUI [2,2])
C1514873 (UMLS CUI [3,1])
C1269765 (UMLS CUI [3,2])
C3872897 (UMLS CUI [4,1])
C1299582 (UMLS CUI [4,2])
Tillbaka till toppen 

Kontakt

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Hjälp

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial