ID

41360

Description

ICHOM Overall Adult Health data collection Version 1.0.0 Date (downloaded on 1st April 2020) International Consortium for Health Outcomes Measurement (ICHOM) Source: http://www.ichom.org/ Notice: This work was conducted using resources from ICHOM, the International Consortium for Health Outcomes Measurement (www.ICHOM.org). The content is solely the responsibility of the authors and does not necessarily represent the official views of ICHOM. For Overall Adult Health, the following conditions and treatment approaches (or interventions) are covered by our Standard Set. Population: An adult (≥ 18 years) who is healthy, has well-controlled disease, or has poorly-controlled disease Excluded populations: Pediatrics (< 18 years) This document contains the Baseline and Annual Patient form. Collecting Patient-Reported Outcome Measures: WHO (Five) Wellbeing Index (WHO5). The WHO-5 is free of charge and does not require permission to use. The scoring guide is only available upon a license agreement being made. PROMIS Scale V1.2 Global Health: As there is an official distribution site, this questionnaire will not be included in this version of the standard set. For more information see: http://www.healthmeasures.net/exploremeasurement-systems/promis/obtain-administer-measures WHO Disability Assessment Schedule 2.0 (WHO-DAS 12): As there is a license needed for use of this questionnaire, only the total score will be included in this version of the standard set. For more information see: https://www.who.int/classifications/icf/whodasii/en/ ICHOM was supported for this standard set by NSW Agency for Clinical Innovation, HCF Research Foundation, Providence St. Joseph Health and NHS Wales. For this version of the standard set, semantic annotation with UMLS CUIs has been added.

Link

http://www.ichom.org/

Keywords

Versions (2)
  1. 9/9/20 9/9/20 -
  2. 12/4/20 12/4/20 - Sarah Riepenhausen
Copyright Holder

ICHOM

Uploaded on

September 9, 2020

DOI

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License

Creative Commons BY-NC 4.0
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ICHOM Overall Adult Health Data Collection

English

Baseline and Annual Patient form

1 forms  
Administrative documentation
Description

Administrative documentation

Alias
UMLS CUI-1
C1320722
Patient ID
Description

Patient ID

Data type

text

Alias
UMLS CUI [1]
C2348585
Time Relative to Baseline (e.g. Baseline, 6 months follow-up, 1 year follow-up, ...)
Description

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_BASE (baseline); VARIABLEID_6MO (6 month follow-up); VARIABLEID_1YR (1 year follow-up), etc.

Data type

text

Alias
UMLS CUI [1,1]
C0439564
UMLS CUI [1,2]
C1442488
Demographic factors
Description

Demographic factors

Alias
UMLS CUI-1
C1704791
Indicate the patient’s age
Description

Recorded as year of birth Inclusion: All patients Timing: Baseline Reporting Source: Patient-reported Type: Date by YYYY

Data type

integer

Measurement units
  • Year
Alias
UMLS CUI [1]
C0001779
UMLS CUI [2]
C2826771
Year
Indicate the patient’s sex at birth
Description

Inclusion: All patients Timing: Baseline Reporting Source: Patient-reported Type: Single Answer

Data type

integer

Alias
UMLS CUI [1,1]
C0079399
UMLS CUI [1,2]
C2599577
Highest attained education
Description

Supporting Definition: Level of schooling defined in each country according to the International Standard Classification of Education Inclusion: All patients Timing: Health individuals: Baseline/Annually (6 months, 1y, 18months, 2 years etc.) Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting Source: Patient-reported Type: Single Answer Response Option: 0 = None, 1 = Early Childhood Education, 2 = Primary Education, 3 = Lower Secondary Education, 4 = Upper Secondary Education, 5 = Short Cycle Tertiary Education, 6 = Bachelor’s or Equivalent Level, 7 = Master’s or Equivalent Level, 8 = Doctoral or Equivalent Level The original OID of this item was complemented by a numbering.

Data type

integer

Alias
UMLS CUI [1]
C2030935
What is your marital status
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually (6 months, 1y, 18months, 2 years etc.) Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting Source: Patient-reported Type: Single Answer The original OID of this item was complemented by a numbering.

Data type

integer

Alias
UMLS CUI [1]
C0024819
What is your work status?
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually (6 months, 1y, 18months, 2 years etc.) Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting Source: Patient-reported Type: Single Answer The original OID of this item was complemented by a numbering.

Data type

integer

Alias
UMLS CUI [1]
C0242271
What are your current living arrangements?
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually (6 months, 1y, 18months, 2 years etc.) Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting Source: Patient-reported Type: Single Answer The original OID of this item was complemented by a numbering.

Data type

integer

Alias
UMLS CUI [1,1]
C0521116
UMLS CUI [1,2]
C3475493
Clinical Factors
Description

Clinical Factors

Alias
UMLS CUI-1
C0449440
Modified Self-Administered Comorbidity Questionnaire (SCQ)
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting Source: Patient-reported

Data type

text

Alias
UMLS CUI [1,1]
C0009488
UMLS CUI [1,2]
C0034394
UMLS CUI [1,3]
C1274040
Lifestyle Factors
Description

Lifestyle Factors

Alias
UMLS CUI-1
C0023676
UMLS CUI-2
C1521761
Indicate the patient’s category
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually (6 months, 1y, 18months, 2 years etc.) Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting Source: Patient-reported Type: Single Answer

Data type

integer

Alias
UMLS CUI [1]
C1519386
How often do you drink alcohol? When you do drink alcohol, how many standard drinks do you consume on average?
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually (6 months, 1y, 18months, 2 years etc.) Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting Source: Patient-reported Type: Single Answer

Data type

integer

Alias
UMLS CUI [1]
C0001948
In a typical week, how much time do you spend doing physical activity?
Description

Supporting Definition: Physical activity is any activity that makes you breath hard, feel warm and feel your heart beat faster Inclusion: All patients Timing: Health individuals: Baseline/Annually (6 months, 1y, 18months, 2 years etc.) Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting Source: Patient-reported Type: Single Answer

Data type

integer

Alias
UMLS CUI [1,1]
C0026606
UMLS CUI [1,2]
C0556976
Seeing
Description

Seeing

Alias
UMLS CUI-1
C0042789
At the present time, would you say your eyesight, with glasses or contact lenses if you wear them is…
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually (6 months, 1y, 18months, 2 years etc.) Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0042789
Hearing
Description

Hearing

Alias
UMLS CUI-1
C0018767
Would you say your hearing is…
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually (6 months, 1y, 18months, 2 years etc.) Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting Source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C0018767
Patient-Reported Outcome Measures
Description

Patient-Reported Outcome Measures

Alias
UMLS CUI-1
C4277735
PROMIS Global Health - Total score
Description

As license is needed for use of this questionnaire, the actual 10 questions of the PROMIS Scale v1.2- Global Health are not included in this version of the standard set. The ICHOM ID's are PROMIS-10_Q01 to PROMIS-10_Q010 Inclusion: All patients Timing: Health individuals: Baseline/Annually Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C3836333
UMLS CUI [1,2]
C2964552
WHODAS 2.0 (12 item) - Total score
Description

As license is needed for use of this questionnaire, the actual 12 questions of the WHODAS 2.0 questionnaire are not included in this version of the standard set. The ICHOM ID's are WHODAS_Q01 to WHODAS_Q12 Inclusion: All patients Timing: Health individuals: Baseline/Annually Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1,1]
C4321496
UMLS CUI [1,2]
C2964552
I have felt cheerful and in good spirits
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C3261637
I have felt calm and relaxed
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C3261651
I have felt active and vigorous
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C3842459
I woke up feeling fresh and rested
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C2984071
My daily life has been filled with things that interest me
Description

Inclusion: All patients Timing: Health individuals: Baseline/Annually Patients with comorbid conditions: Align timepoints with timepoints in condition Standard set Reporting source: Patient-reported Type: Single answer

Data type

integer

Alias
UMLS CUI [1]
C3829819
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Similar models

Baseline and Annual Patient form

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative documentation
C1320722 (UMLS CUI-1)
Patient ID
Item
Patient ID
text
C2348585 (UMLS CUI [1])
Time Relative to Baseline
Item
Time Relative to Baseline (e.g. Baseline, 6 months follow-up, 1 year follow-up, ...)
text
C0439564 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
Item Group
Demographic factors
C1704791 (UMLS CUI-1)
Age
Item
Indicate the patient’s age
integer
C0001779 (UMLS CUI [1])
C2826771 (UMLS CUI [2])
Item
Indicate the patient’s sex at birth
integer
C0079399 (UMLS CUI [1,1])
C2599577 (UMLS CUI [1,2])
Sex at birth
Code List
Indicate the patient’s sex at birth
CL Item
Male (1)
C0086582 (UMLS CUI-1)
(Comment:en)
CL Item
Female (2)
C0086287 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C1271088 (UMLS CUI-1)
(Comment:en)
Item
Highest attained education
integer
C2030935 (UMLS CUI [1])
Education level
Code List
Highest attained education
CL Item
None (0)
C0557286 (UMLS CUI-1)
(Comment:en)
CL Item
Primary (1)
C0013658 (UMLS CUI-1)
C0033145 (UMLS CUI-2)
(Comment:en)
CL Item
Secondary (2)
C0557289 (UMLS CUI-1)
(Comment:en)
CL Item
Tertiary (3)
C0557291 (UMLS CUI-1)
(Comment:en)
Item
What is your marital status
integer
C0024819 (UMLS CUI [1])
Marital Status
Code List
What is your marital status
CL Item
Never married (1)
C0027952 (UMLS CUI-1)
(Comment:en)
CL Item
Widowed (2)
C0206275 (UMLS CUI-1)
(Comment:en)
CL Item
Divorced (3)
C0086170 (UMLS CUI-1)
(Comment:en)
CL Item
Separated (4)
C4721417 (UMLS CUI-1)
(Comment:en)
CL Item
Married (registered and de facto) (5)
C0555047 (UMLS CUI-1)
(Comment:en)
CL Item
Not stated/inadequately described (6)
C1706613 (UMLS CUI-1)
C0205412 (UMLS CUI-2)
C1552738 (UMLS CUI-3)
(Comment:en)
Item
What is your work status?
integer
C0242271 (UMLS CUI [1])
Marital Status
Code List
What is your work status?
CL Item
Employed full time (1)
C0682295 (UMLS CUI-1)
(Comment:en)
CL Item
Employed part time (2)
C0682294 (UMLS CUI-1)
(Comment:en)
CL Item
Non-working (student, retired, caregiver, homemaker) (3)
C0043227 (UMLS CUI-1)
C0332197 (UMLS CUI-2)
C0038492 (UMLS CUI-4)
C0035345 (UMLS CUI-6)
C0555052 (UMLS CUI-8)
C0085537 (UMLS CUI-10)
(Comment:en)
CL Item
Unemployed (4)
C0041674 (UMLS CUI-1)
(Comment:en)
CL Item
Other (5)
C0205394 (UMLS CUI-1)
C0242271 (UMLS CUI-2)
(Comment:en)
Item
What are your current living arrangements?
integer
C0521116 (UMLS CUI [1,1])
C3475493 (UMLS CUI [1,2])
Housing Status
Code List
What are your current living arrangements?
CL Item
I live with partner/spouse/family/friends (1)
C1443355 (UMLS CUI-1)
C2184147 (UMLS CUI-2)
C0557130 (UMLS CUI-3)
C0557128 (UMLS CUI-4)
(Comment:en)
CL Item
I live alone (2)
C0439044 (UMLS CUI-1)
(Comment:en)
CL Item
I live in a nursing home, hospital or other long term care home (3)
C0425205 (UMLS CUI-1)
C0557218 (UMLS CUI-2)
C3640869 (UMLS CUI-3)
(Comment:en)
CL Item
Other (888)
C0205394 (UMLS CUI-1)
C2184149 (UMLS CUI-2)
(Comment:en)
Item Group
Clinical Factors
C0449440 (UMLS CUI-1)
Comorbidities
Item
Modified Self-Administered Comorbidity Questionnaire (SCQ)
text
C0009488 (UMLS CUI [1,1])
C0034394 (UMLS CUI [1,2])
C1274040 (UMLS CUI [1,3])
Item Group
Lifestyle Factors
C0023676 (UMLS CUI-1)
C1521761 (UMLS CUI-2)
Item
Indicate the patient’s category
integer
C1519386 (UMLS CUI [1])
Smoking status
Code List
Indicate the patient’s category
CL Item
None (0)
C0549184 (UMLS CUI-1)
(Comment:en)
CL Item
1-6 (1)
C0205447 (UMLS CUI-1)
C0547043 (UMLS CUI-2)
C0205452 (UMLS CUI-3)
(Comment:en)
CL Item
7-14 (2)
C0205453 (UMLS CUI-1)
C0547043 (UMLS CUI-2)
C3715152 (UMLS CUI-3)
(Comment:en)
CL Item
>14 (3)
C0205172 (UMLS CUI-1)
C3715152 (UMLS CUI-2)
(Comment:en)
CL Item
No (4)
C1298908 (UMLS CUI-1)
(Comment:en)
CL Item
Yes (5)
C1705108 (UMLS CUI-1)
(Comment:en)
CL Item
Unknown (999)
C0439673 (UMLS CUI-1)
(Comment:en)
Item
How often do you drink alcohol? When you do drink alcohol, how many standard drinks do you consume on average?
integer
C0001948 (UMLS CUI [1])
Alcohol Intake - AUFTEILEN
Code List
How often do you drink alcohol? When you do drink alcohol, how many standard drinks do you consume on average?
CL Item
Everyday/7 days per week (1)
C0332173 (UMLS CUI-1)
(Comment:en)
CL Item
5 or 6 days per week (2)
C3844180 (UMLS CUI-1)
(Comment:en)
CL Item
3 or 4 days per week (3)
C3844181 (UMLS CUI-1)
(Comment:en)
CL Item
1 to 2 days per week  (4)
C3844183 (UMLS CUI-1)
(Comment:en)
CL Item
2 to 3 days per month (5)
C3844154 (UMLS CUI-1)
(Comment:en)
CL Item
once per month (6)
C3845349 (UMLS CUI-1)
(Comment:en)
CL Item
7 to 11 days in the past year (7)
C5142836 (UMLS CUI-1)
(Comment:en)
CL Item
4 to 6 days in the past year (8)
C3843788 (UMLS CUI-1)
C0556972 (UMLS CUI-2)
(Comment:en)
CL Item
2 to 3 days in the past year  (9)
C3843066 (UMLS CUI-1)
C4086728 (UMLS CUI-2)
(Comment:en)
CL Item
once in the past year  (10)
C4036229 (UMLS CUI-1)
C4086728 (UMLS CUI-2)
(Comment:en)
CL Item
Never drank any alcoholic beverage in the past year  (11)
CL Item
Never in my life (12)
Item
In a typical week, how much time do you spend doing physical activity?
integer
C0026606 (UMLS CUI [1,1])
C0556976 (UMLS CUI [1,2])
Physical Activity/Exercise
Code List
In a typical week, how much time do you spend doing physical activity?
CL Item
None (1)
C0549184 (UMLS CUI-1)
(Comment:en)
CL Item
About 30 mins (2)
C1442458 (UMLS CUI-1)
(Comment:en)
CL Item
About 1 hour (3)
C1442450 (UMLS CUI-1)
(Comment:en)
CL Item
About 2 hours (4)
C1292425 (UMLS CUI-1)
(Comment:en)
CL Item
More than 2 hours (5)
C0439093 (UMLS CUI-1)
C1292425 (UMLS CUI-2)
(Comment:en)
Item Group
Seeing
C0042789 (UMLS CUI-1)
Item
At the present time, would you say your eyesight, with glasses or contact lenses if you wear them is…
integer
C0042789 (UMLS CUI [1])
Seeing
Code List
At the present time, would you say your eyesight, with glasses or contact lenses if you wear them is…
CL Item
Excellent (5)
C1961136 (UMLS CUI-1)
(Comment:en)
CL Item
Very good (4)
C3641222 (UMLS CUI-1)
(Comment:en)
CL Item
Good (3)
C0205170 (UMLS CUI-1)
(Comment:en)
CL Item
Fair (2)
C2911689 (UMLS CUI-1)
(Comment:en)
CL Item
Poor (1)
C2700379 (UMLS CUI-1)
(Comment:en)
Item Group
Hearing
C0018767 (UMLS CUI-1)
Item
Would you say your hearing is…
integer
C0018767 (UMLS CUI [1])
Hearing
Code List
Would you say your hearing is…
CL Item
Excellent (1)
C1961136 (UMLS CUI-1)
(Comment:en)
CL Item
Good (2)
C0205170 (UMLS CUI-1)
(Comment:en)
CL Item
A little trouble (3)
C2984078 (UMLS CUI-1)
C3829759 (UMLS CUI-2)
(Comment:en)
CL Item
Moderate hearing trouble (4)
C3829759 (UMLS CUI-1)
C0205081 (UMLS CUI-2)
(Comment:en)
CL Item
A lot of trouble (5)
C2984081 (UMLS CUI-1)
C3829759 (UMLS CUI-2)
(Comment:en)
CL Item
Deaf (6)
C0011053 (UMLS CUI-1)
(Comment:en)
Item Group
Patient-Reported Outcome Measures
C4277735 (UMLS CUI-1)
PROMIS Global Health
Item
PROMIS Global Health - Total score
integer
C3836333 (UMLS CUI [1,1])
C2964552 (UMLS CUI [1,2])
WHODAS 2.0
Item
WHODAS 2.0 (12 item) - Total score
integer
C4321496 (UMLS CUI [1,1])
C2964552 (UMLS CUI [1,2])
Item
I have felt cheerful and in good spirits
integer
C3261637 (UMLS CUI [1])
WHO DAS 5 (5 item) - Question 1
Code List
I have felt cheerful and in good spirits
CL Item
All of the time (5)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (4)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
More than half of the time (3)
C3828960 (UMLS CUI-1)
(Comment:en)
CL Item
Less than half of the time (2)
C3843158 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (1)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
At no time (0)
C2003901 (UMLS CUI-1)
(Comment:en)
Item
I have felt calm and relaxed
integer
C3261651 (UMLS CUI [1])
WHO DAS 5 (5 item) - Question 1
Code List
I have felt calm and relaxed
CL Item
All of the time (5)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (4)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
More than half of the time (3)
C3828960 (UMLS CUI-1)
(Comment:en)
CL Item
Less than half of the time (2)
C3843158 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (1)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
At no time (0)
C2003901 (UMLS CUI-1)
(Comment:en)
Item
I have felt active and vigorous
integer
C3842459 (UMLS CUI [1])
WHO DAS 5 (5 item) - Question 1
Code List
I have felt active and vigorous
CL Item
All of the time (5)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (4)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
More than half of the time (3)
C3828960 (UMLS CUI-1)
(Comment:en)
CL Item
Less than half of the time (2)
C3843158 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (1)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
At no time (0)
C2003901 (UMLS CUI-1)
(Comment:en)
Item
I woke up feeling fresh and rested
integer
C2984071 (UMLS CUI [1])
WHO DAS 5 (5 item) - Question 1
Code List
I woke up feeling fresh and rested
CL Item
All of the time (5)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (4)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
More than half of the time (3)
C3828960 (UMLS CUI-1)
(Comment:en)
CL Item
Less than half of the time (2)
C3843158 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (1)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
At no time (0)
C2003901 (UMLS CUI-1)
(Comment:en)
Item
My daily life has been filled with things that interest me
integer
C3829819 (UMLS CUI [1])
WHO DAS 5 (5 item) - Question 1
Code List
My daily life has been filled with things that interest me
CL Item
All of the time (5)
C3812891 (UMLS CUI-1)
(Comment:en)
CL Item
Most of the time (4)
C3828954 (UMLS CUI-1)
(Comment:en)
CL Item
More than half of the time (3)
C3828960 (UMLS CUI-1)
(Comment:en)
CL Item
Less than half of the time (2)
C3843158 (UMLS CUI-1)
(Comment:en)
CL Item
Some of the time (1)
C3827992 (UMLS CUI-1)
(Comment:en)
CL Item
At no time (0)
C2003901 (UMLS CUI-1)
(Comment:en)
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