Englisch

Ongoing, End of pediatric or planned care - Parent-reported Form

1 Formulare  
Administrative Data
Beschreibung

Administrative Data

Alias
UMLS CUI-1
C1320722
Indicate the patient's medical record number
Beschreibung

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: Administrative or clinical RESPONSE OPTIONS: According to institution

Datentyp

text

Alias
UMLS CUI [1]
C1269815
Time Relative to Baseline
Beschreibung

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.

Datentyp

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C1442488
Type of document
Beschreibung

This item does not exist in the original version of the standard set. As this form includes several documents this item has to be fill in to mark the different time points.

Datentyp

integer

Alias
UMLS CUI [1]
C1547673
Patient Demographic Factors
Beschreibung

Patient Demographic Factors

Alias
UMLS CUI-1
C1704791
Indicate the age at each clinical evaluation
Beschreibung

Inclusion Criteria: All patients Timing: On all forms Data Source: Clinical, parent-reported, or patient-reported Type: Single answer Response Options: Years and fractions

Datentyp

text

Maßeinheiten
  • years
Alias
UMLS CUI [1]
C0001779
years
Indicate the patient’s sex at birth
Beschreibung

Inclusion Criteria: All patients Inclusion Criteria: All patients Timing: Baseline Data Source: Clinical, parent-reported, or patient-reported Type: Single answer

Datentyp

integer

Alias
UMLS CUI [1]
C0079399
Indicate the patient’s insurance status
Beschreibung

Inclusion Criteria: All patients Timing: On all forms Data Source: Administrative data Type: Single answer

Datentyp

integer

Alias
UMLS CUI [1]
C1548070
Degree of Health
Beschreibung

Degree of Health

Alias
UMLS CUI-1
C0018759
Food falls out my child's mouth when they eat, more than I would expect for their age
Beschreibung

Inclusion Criteria: Age <8y Timing: Baseline, Pre-Intervention,Post-Intervention, 5 and 11 years of age Follow-up, End of pediatric or planned care Data Source: Parent-reported Type: Single answer

Datentyp

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0332307
UMLS CUI [2,1]
C0008059
UMLS CUI [2,2]
C4062836
UMLS CUI [2,3]
C0439093
UMLS CUI [2,4]
C0679138
Liquid falls out of my child's mouth when they drink, more than I would expect for their age
Beschreibung

Inclusion Criteria: Age <8y Timing: Baseline, Pre-Intervention,Post-Intervention, 5 and 11 years of age Follow-up, End of pediatric or planned care Data Source: Parent-reported Type: Single answer

Datentyp

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0332307
UMLS CUI [2,1]
C0008059
UMLS CUI [2,2]
C4062836
UMLS CUI [2,3]
C0302908
UMLS CUI [2,4]
C0439093
UMLS CUI [2,5]
C0679138
My child is has trouble chewing food
Beschreibung

Inclusion Criteria: Age <8y Timing: Baseline, Pre-Intervention,Post-Intervention, 5 and 11 years of age Follow-up, End of pediatric or planned care Data Source: Parent-reported Type: Single answer

Datentyp

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0332307
UMLS CUI [2,1]
C0008059
UMLS CUI [2,2]
C1299586
UMLS CUI [2,3]
C0518499
My child bites their cheeks a lot
Beschreibung

Inclusion Criteria: Age <8y Timing: Baseline, Pre-Intervention,Post-Intervention, 5 and 11 years of age Follow-up, End of pediatric or planned care Data Source: Parent-reported Type: Single answer

Datentyp

integer

Alias
UMLS CUI [1,1]
C1457887
UMLS CUI [1,2]
C0332307
UMLS CUI [2,1]
C0008059
UMLS CUI [2,2]
C0233625
UMLS CUI [2,3]
C0332183
PROMIS Paediatric Global Health
Beschreibung

As there is an official distribution site, the actual 7 questions of this questionnaire are not included in this version of the standard set. ICHOM's OIDs are: PROMIS-PPGH7_Q01 to PROMIS-PPGH7_Q07 Inclusion Criteria: Age 4-7 (if the patient is unable to respond to PROMIS CPGH7) Timing: Baseline, Pre-Intervention, Post-Intervention, 5 and 11 years of age Follow-up, End of pediatric or planned care Data Source: Parent-reported Type: Single answer

Datentyp

integer

Alias
UMLS CUI [1,1]
C3836333
UMLS CUI [1,2]
C0030755
UMLS CUI [1,3]
C2964552
Zum Seitenanfang zurückkehren

Ähnliche Modelle

Ongoing, End of pediatric or planned care - Parent-reported Form

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Patient ID
Item
Indicate the patient's medical record number
text
C1269815 (UMLS CUI [1])
Time Relative to Baseline
Item
Time Relative to Baseline
text
C0439564 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
Item
Type of document
integer
C1547673 (UMLS CUI [1])
Type of document
Code List
Type of document
CL Item
Pre-Intervention (1)
C0332152 (UMLS CUI-1)
C0087111 (UMLS CUI-2)
(Comment:en)
CL Item
Post-Intervention (2)
C0087111 (UMLS CUI-1)
C0231290 (UMLS CUI-2)
(Comment:en)
CL Item
5 and 11 ages Follow-up  (3)
C0205451 (UMLS CUI-1)
C0205457 (UMLS CUI-2)
C0001779 (UMLS CUI-3)
C1522577 (UMLS CUI-4)
(Comment:en)
CL Item
End of study (4)
C0444496 (UMLS CUI-1)
(Comment:en)
Item Group
Patient Demographic Factors
C1704791 (UMLS CUI-1)
Age
Item
Indicate the age at each clinical evaluation
text
C0001779 (UMLS CUI [1])
Item
Indicate the patient’s sex at birth
integer
C0079399 (UMLS CUI [1])
Sex at birth
Code List
Indicate the patient’s sex at birth
CL Item
Male (1)
C1706180 (UMLS CUI-1)
(Comment:en)
CL Item
Female (2)
C0086287 (UMLS CUI-1)
(Comment:en)
CL Item
Undisclosed (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Item
Indicate the patient’s insurance status
integer
C1548070 (UMLS CUI [1])
Insurance status
Code List
Indicate the patient’s insurance status
CL Item
Uninsured (0)
C0087134 (UMLS CUI-1)
(Comment:en)
CL Item
Private insurance (1)
C3845555 (UMLS CUI-1)
(Comment:en)
CL Item
Governmental insurance (2)
C0021682 (UMLS CUI-1)
(Comment:en)
Item Group
Degree of Health
C0018759 (UMLS CUI-1)
Item
Food falls out my child's mouth when they eat, more than I would expect for their age
integer
C1457887 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C0008059 (UMLS CUI [2,1])
C4062836 (UMLS CUI [2,2])
C0439093 (UMLS CUI [2,3])
C0679138 (UMLS CUI [2,4])
Oral symptoms question 1
Code List
Food falls out my child's mouth when they eat, more than I would expect for their age
CL Item
No (0)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
Item
Liquid falls out of my child's mouth when they drink, more than I would expect for their age
integer
C1457887 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C0008059 (UMLS CUI [2,1])
C4062836 (UMLS CUI [2,2])
C0302908 (UMLS CUI [2,3])
C0439093 (UMLS CUI [2,4])
C0679138 (UMLS CUI [2,5])
Oral symptoms question 1
Code List
Liquid falls out of my child's mouth when they drink, more than I would expect for their age
CL Item
No (0)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
Item
My child is has trouble chewing food
integer
C1457887 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C0008059 (UMLS CUI [2,1])
C1299586 (UMLS CUI [2,2])
C0518499 (UMLS CUI [2,3])
Oral symptoms question 1
Code List
My child is has trouble chewing food
CL Item
No (0)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
Item
My child bites their cheeks a lot
integer
C1457887 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C0008059 (UMLS CUI [2,1])
C0233625 (UMLS CUI [2,2])
C0332183 (UMLS CUI [2,3])
Oral symptoms question 1
Code List
My child bites their cheeks a lot
CL Item
No (0)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (1)
C1705108 (UMLS CUI-1)
(Comment:en)
PROMIS Paediatric Global Health
Item
PROMIS Paediatric Global Health
integer
C3836333 (UMLS CUI [1,1])
C0030755 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
Zum Seitenanfang zurückkehren