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ID

42849

Beschrijving

https://www.hope-clara.de/ The HOPE Hospice and Palliative Care Recording standard documentation is used for documentation of palliative care and as an instrument for quality assurance in pallatiave wards, hospices and oncological wards as well as in ambulatory services and palliative teams. This questionnaire is designed to record tumor-specific therapies.

Link

https://www.hope-clara.de/

Trefwoorden

Versies (2)
  1. 10-08-16 10-08-16 -
  2. 17-09-21 17-09-21 -
Geüploaded op

17 september 2021

DOI

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Licentie

Creative Commons BY-NC 3.0
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    Palliative and Hospice Care Tumor-specific Therapies in Palliative Care

    Duits Engels

    Palliative and Hospice Care Tumor-specific Therapies in Palliative Care

    1 Formulieren  
    Date
    Beschrijving

    Date

    Date
    Beschrijving

    date of interview

    Datatype

    date

    Alias
    UMLS CUI [1]
    C0011008
    Date
    Beschrijving

    date first metastasis

    Datatype

    date

    Alias
    UMLS CUI [1,1]
    C0027627
    UMLS CUI [1,2]
    C0011008
    TT1. Type of therapy
    Beschrijving

    TT1. Type of therapy

    Intravenous, cyclic or ccontinuous cytotoxic chemotherapy
    Beschrijving

    cytotoxic chemotherapy

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0677881
    UMLS CUI [1,2]
    C0348016
    Oral, cyclic or ccontinuous cytotoxic chemotherapy
    Beschrijving

    oral cytotoxic chemotherapy

    Datatype

    text

    Alias
    UMLS CUI [1]
    C4040137
    Tumor-specific antibody
    Beschrijving

    tumor-specific antibody

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0041361
    Hormone therapy
    Beschrijving

    hormone therapy

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0279025
    Oral tyrosine-kinase inhibitor or other targeted therapy
    Beschrijving

    TKI or other targeted therapy

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0879484
    UMLS CUI [1,2]
    C0001563
    UMLS CUI [2]
    C3854476
    Radiotherapy
    Beschrijving

    radiotherapy

    Datatype

    text

    Alias
    UMLS CUI [1]
    C1522449
    Endoscopic intervention
    Beschrijving

    endoscopic intervention

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0014245
    Nuclear medicine therapy
    Beschrijving

    nuclear medicine therapy

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0203485
    Operative intervention
    Beschrijving

    operative intervention

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0543467
    Other procedure (please specify:)
    Beschrijving

    other procedures

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0393107
    Other procedure (please specify:)
    Beschrijving

    other procedure specification

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0393107
    TT2. Number of previous treatments
    Beschrijving

    TT2. Number of previous treatments

    Chemotherapy
    Beschrijving

    no. of previous treatments

    Datatype

    integer

    Alias
    UMLS CUI [1,1]
    C0392920
    UMLS CUI [1,2]
    C0750480
    Hormone therapy
    Beschrijving

    no. of previous treatments

    Datatype

    integer

    Alias
    UMLS CUI [1,1]
    C0279025
    UMLS CUI [1,2]
    C0750480
    TT3. Indications
    Beschrijving

    TT3. Indications

    Reduction of tumor size to prevent symptoms and/or for prolongation of survival time
    Beschrijving

    reduction of tumor size

    Datatype

    boolean

    Alias
    UMLS CUI [1]
    C0475440
    Mainly to control symptoms
    Beschrijving

    control symptoms

    Datatype

    boolean

    Alias
    UMLS CUI [1,1]
    C1457887
    UMLS CUI [1,2]
    C0243148
    Neurological compression + brain pressure
    Beschrijving

    neurological compression

    Datatype

    boolean

    Alias
    UMLS CUI [1,1]
    C0849479
    UMLS CUI [1,2]
    C1395826
    Pain
    Beschrijving

    pain

    Datatype

    boolean

    Alias
    UMLS CUI [1]
    C0030193
    Shortness of breath
    Beschrijving

    shortness of breath

    Datatype

    boolean

    Alias
    UMLS CUI [1]
    C0013404
    Gastrointestinal compression
    Beschrijving

    gastrointestinal compression

    Datatype

    boolean

    Alias
    UMLS CUI [1,1]
    C0565514
    UMLS CUI [1,2]
    C0521362
    Other:
    Beschrijving

    other indication

    Datatype

    boolean

    Alias
    UMLS CUI [1,1]
    C3146298
    UMLS CUI [1,2]
    C0205394
    Other:
    Beschrijving

    other indication specification

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C3146298
    UMLS CUI [1,2]
    C0205394
    TT4. Agents/Regime/Modus
    Beschrijving

    TT4. Agents/Regime/Modus

    Agents/Regime/Modus
    Beschrijving

    agents regime and modus

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0003392
    UMLS CUI [2]
    C1273869
    UMLS CUI [3]
    C0184661
    TT5. Medical indication assessed by
    Beschrijving

    TT5. Medical indication assessed by

    Medical indication assessed by
    Beschrijving

    medical indication assessed by

    Datatype

    text

    Alias
    UMLS CUI [1]
    C1444284
    Pre-treating clinic:
    Beschrijving

    pre-treating clinic

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0442592
    UMLS CUI [1,2]
    C2709094
    TT6. Palliative prognostic index PPI in pre-treatment/ starting the new indicated tumor treatment
    Beschrijving

    TT6. Palliative prognostic index PPI in pre-treatment/ starting the new indicated tumor treatment

    Palliative performance score
    Beschrijving

    palliative performance score

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0449820
    UMLS CUI [1,2]
    C1518965
    UMLS CUI [1,3]
    C1285530
    Oral intake
    Beschrijving

    oral intake

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0518037
    Edema
    Beschrijving

    edema

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0013604
    Dyspnoea at rest
    Beschrijving

    dyspnoea at rest

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0743330
    Delirium
    Beschrijving

    delirium

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0011206
    PPI Score
    Beschrijving

    PPI score

    Datatype

    float

    Alias
    UMLS CUI [1,1]
    C0449821
    UMLS CUI [1,2]
    C1285530
    TT7. Was proceding/start of tumor therapy based on consensus in the palliative team?
    Beschrijving

    TT7. Was proceding/start of tumor therapy based on consensus in the palliative team?

    Was proceding/start of tumor therapy based on consensus in the palliative team?
    Beschrijving

    consensus making decision

    Datatype

    integer

    Alias
    UMLS CUI [1,1]
    C0376298
    UMLS CUI [1,2]
    C4042877
    Reasons:
    Beschrijving

    reasons for medical decision

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0920425
    UMLS CUI [1,2]
    C0392360
    TT8. What was the subjective success of the tumor therapy?
    Beschrijving

    TT8. What was the subjective success of the tumor therapy?

    What was the subjective success of the tumor therapy?
    Beschrijving

    success of tumor therapy

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0679864
    UMLS CUI [1,2]
    C0439655
    TT9. Was the tumor therapy determined early?
    Beschrijving

    TT9. Was the tumor therapy determined early?

    Was the tumor therapy determined early?
    Beschrijving

    early determination of tumor therapy

    Datatype

    boolean

    Alias
    UMLS CUI [1,1]
    C0920425
    UMLS CUI [1,2]
    C0457454
    TT10. If yes, what were the reasons for the discontinuation of tumor therapy?
    Beschrijving

    TT10. If yes, what were the reasons for the discontinuation of tumor therapy?

    If yes, what were the reasons for the discontinuation of tumor therapy?
    Beschrijving

    reasons for the discontinuation

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0920425
    UMLS CUI [1,2]
    C0457454
    UMLS CUI [1,3]
    C0392360
    Type of toxicity/ side effects
    Beschrijving

    toxicity

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0600688
    UMLS CUI [2]
    C0879626
    TT11. Was discontinuation of tumor therapy based on consensus in the palliative team?
    Beschrijving

    TT11. Was discontinuation of tumor therapy based on consensus in the palliative team?

    Was discontinuation of tumor therapy based on consensus in the palliative team?
    Beschrijving

    discontinuation decision

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0920425
    UMLS CUI [1,2]
    C0457454
    UMLS CUI [1,3]
    C0376298
    UMLS CUI [1,4]
    C4042877
    Reasons:
    Beschrijving

    discontinuation decision reason

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0920425
    UMLS CUI [1,2]
    C0457454
    UMLS CUI [1,3]
    C0392360
    TT12. Who completes this questionnaire?
    Beschrijving

    TT12. Who completes this questionnaire?

    TT12. Who completes this questionnaire?
    Beschrijving

    person documenting

    Datatype

    text

    Alias
    UMLS CUI [1]
    C3258039
    Medical field
    Beschrijving

    medical field documenting person

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0037778
    UMLS CUI [1,2]
    C3258039
    Other:
    Beschrijving

    other medical field

    Datatype

    text

    Alias
    UMLS CUI [1,1]
    C0037778
    UMLS CUI [1,2]
    C0205394
    Terug naar het begin van de pagina

    Similar models

    Palliative and Hospice Care Tumor-specific Therapies in Palliative Care

    1 Formulieren
    Name
    Type
    Description | Question | Decode (Coded Value)
    Datatype
    Alias
    Item Group
    Date
    date of interview
    Item
    Date
    date
    C0011008 (UMLS CUI [1])
    date first metastasis
    Item
    Date
    date
    C0027627 (UMLS CUI [1,1])
    C0011008 (UMLS CUI [1,2])
    Item Group
    TT1. Type of therapy
    Item
    Intravenous, cyclic or ccontinuous cytotoxic chemotherapy
    text
    C0677881 (UMLS CUI [1,1])
    C0348016 (UMLS CUI [1,2])
    cytotoxic chemotherapy
    Code List
    Intravenous, cyclic or ccontinuous cytotoxic chemotherapy
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    Item
    Oral, cyclic or ccontinuous cytotoxic chemotherapy
    text
    C4040137 (UMLS CUI [1])
    cytotoxic chemotherapy
    Code List
    Oral, cyclic or ccontinuous cytotoxic chemotherapy
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    Item
    Tumor-specific antibody
    text
    C0041361 (UMLS CUI [1])
    cytotoxic chemotherapy
    Code List
    Tumor-specific antibody
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    Item
    Hormone therapy
    text
    C0279025 (UMLS CUI [1])
    cytotoxic chemotherapy
    Code List
    Hormone therapy
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    Item
    Oral tyrosine-kinase inhibitor or other targeted therapy
    text
    C0879484 (UMLS CUI [1,1])
    C0001563 (UMLS CUI [1,2])
    C3854476 (UMLS CUI [2])
    cytotoxic chemotherapy
    Code List
    Oral tyrosine-kinase inhibitor or other targeted therapy
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    Item
    Radiotherapy
    text
    C1522449 (UMLS CUI [1])
    cytotoxic chemotherapy
    Code List
    Radiotherapy
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    Item
    Endoscopic intervention
    text
    C0014245 (UMLS CUI [1])
    cytotoxic chemotherapy
    Code List
    Endoscopic intervention
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    Item
    Nuclear medicine therapy
    text
    C0203485 (UMLS CUI [1])
    cytotoxic chemotherapy
    Code List
    Nuclear medicine therapy
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    Item
    Operative intervention
    text
    C0543467 (UMLS CUI [1])
    cytotoxic chemotherapy
    Code List
    Operative intervention
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    Item
    Other procedure (please specify:)
    text
    C0393107 (UMLS CUI [1])
    cytotoxic chemotherapy
    Code List
    Other procedure (please specify:)
    CL Item
     (fortgesetzt)
    CL Item
     (neu)
    other procedure specification
    Item
    Other procedure (please specify:)
    text
    C0393107 (UMLS CUI [1])
    Item Group
    TT2. Number of previous treatments
    chemotherapy number
    Item
    Chemotherapy
    integer
    C0392920 (UMLS CUI [1,1])
    C0750480 (UMLS CUI [1,2])
    hormone therapy number
    Item
    Hormone therapy
    integer
    C0279025 (UMLS CUI [1,1])
    C0750480 (UMLS CUI [1,2])
    Item Group
    TT3. Indications
    reduction of tumor size
    Item
    Reduction of tumor size to prevent symptoms and/or for prolongation of survival time
    boolean
    C0475440 (UMLS CUI [1])
    control symptoms
    Item
    Mainly to control symptoms
    boolean
    C1457887 (UMLS CUI [1,1])
    C0243148 (UMLS CUI [1,2])
    neurological compression
    Item
    Neurological compression + brain pressure
    boolean
    C0849479 (UMLS CUI [1,1])
    C1395826 (UMLS CUI [1,2])
    pain
    Item
    Pain
    boolean
    C0030193 (UMLS CUI [1])
    shortness of breath
    Item
    Shortness of breath
    boolean
    C0013404 (UMLS CUI [1])
    gastrointestinal compression
    Item
    Gastrointestinal compression
    boolean
    C0565514 (UMLS CUI [1,1])
    C0521362 (UMLS CUI [1,2])
    other indication
    Item
    Other:
    boolean
    C3146298 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    other indication specification
    Item
    Other:
    text
    C3146298 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    Item Group
    TT4. Agents/Regime/Modus
    agents regime and modus
    Item
    Agents/Regime/Modus
    text
    C0003392 (UMLS CUI [1])
    C1273869 (UMLS CUI [2])
    C0184661 (UMLS CUI [3])
    Item Group
    TT5. Medical indication assessed by
    Item
    Medical indication assessed by
    text
    C1444284 (UMLS CUI [1])
    medical indication assessed by
    Code List
    Medical indication assessed by
    CL Item
     (Vorbehandelnde Abteilungen (bitte spezifizieren): )
    CL Item
     (Eigene Indikationsstellung nach Rücksprache mit anderen Fachdisziplinen)
    CL Item
     (Eigene Indikationsstellung)
    pre-treating clinic
    Item
    Pre-treating clinic:
    text
    C0442592 (UMLS CUI [1,1])
    C2709094 (UMLS CUI [1,2])
    Item Group
    TT6. Palliative prognostic index PPI in pre-treatment/ starting the new indicated tumor treatment
    Item
    Palliative performance score
    text
    C0449820 (UMLS CUI [1,1])
    C1518965 (UMLS CUI [1,2])
    C1285530 (UMLS CUI [1,3])
    palliative performance score
    Code List
    Palliative performance score
    CL Item
    4.0P (1PPS 0-20) (4.0P (1PPS 0-20))
    CL Item
    2.5P (PPS 20-50) (2.5P (PPS 20-50))
    CL Item
    0P (PPS>60) (0P (PPS>60))
    Item
    Oral intake
    text
    C0518037 (UMLS CUI [1])
    oral intake
    Code List
    Oral intake
    CL Item
    0P (normal) (0P (normal))
    CL Item
     (2.5P (stark reduziert))
    CL Item
     (1.0P (moderat reduziert))
    Item
    Edema
    text
    C0013604 (UMLS CUI [1])
    edema
    Code List
    Edema
    CL Item
     (1.0P (ja))
    CL Item
     (0P (nein))
    Item
    Dyspnoea at rest
    text
    C0743330 (UMLS CUI [1])
    dyspnoea at rest
    Code List
    Dyspnoea at rest
    CL Item
     (3.5P (ja))
    CL Item
     (0P (nein))
    Item
    Delirium
    text
    C0011206 (UMLS CUI [1])
    delirium
    Code List
    Delirium
    CL Item
     (4.0P (ja))
    CL Item
     (0P (nein))
    PPI score
    Item
    PPI Score
    float
    C0449821 (UMLS CUI [1,1])
    C1285530 (UMLS CUI [1,2])
    Item Group
    TT7. Was proceding/start of tumor therapy based on consensus in the palliative team?
    Item
    Was proceding/start of tumor therapy based on consensus in the palliative team?
    integer
    C0376298 (UMLS CUI [1,1])
    C4042877 (UMLS CUI [1,2])
    consensus making decision
    Code List
    Was proceding/start of tumor therapy based on consensus in the palliative team?
    CL Item
    Clear divergence of opinion, difficult decision making (1)
    CL Item
    Rather consensus, but also votes against (2)
    CL Item
    Clear consensus (3)
    reasons for medical decision
    Item
    Reasons:
    text
    C0920425 (UMLS CUI [1,1])
    C0392360 (UMLS CUI [1,2])
    Item Group
    TT8. What was the subjective success of the tumor therapy?
    Item
    What was the subjective success of the tumor therapy?
    text
    C0679864 (UMLS CUI [1,1])
    C0439655 (UMLS CUI [1,2])
    success of tumor therapy
    Code List
    What was the subjective success of the tumor therapy?
    CL Item
     (sehr schlecht)
    CL Item
     (schlecht)
    CL Item
     (zufriedenstellend)
    CL Item
     (gut)
    CL Item
     (sehr gut)
    Item Group
    TT9. Was the tumor therapy determined early?
    early determination of tumor therapy
    Item
    Was the tumor therapy determined early?
    boolean
    C0920425 (UMLS CUI [1,1])
    C0457454 (UMLS CUI [1,2])
    Item Group
    TT10. If yes, what were the reasons for the discontinuation of tumor therapy?
    Item
    If yes, what were the reasons for the discontinuation of tumor therapy?
    text
    C0920425 (UMLS CUI [1,1])
    C0457454 (UMLS CUI [1,2])
    C0392360 (UMLS CUI [1,3])
    reasons for the discontinuation
    Code List
    If yes, what were the reasons for the discontinuation of tumor therapy?
    CL Item
     (Toxizitäten)
    CL Item
     (Ineffizienz der Therapie)
    CL Item
     (Verschlechterung des Allgemeinzustandes )
    CL Item
     (Wunsch des Patienten)
    toxicity
    Item
    Type of toxicity/ side effects
    text
    C0600688 (UMLS CUI [1])
    C0879626 (UMLS CUI [2])
    Item Group
    TT11. Was discontinuation of tumor therapy based on consensus in the palliative team?
    Item
    Was discontinuation of tumor therapy based on consensus in the palliative team?
    text
    C0920425 (UMLS CUI [1,1])
    C0457454 (UMLS CUI [1,2])
    C0376298 (UMLS CUI [1,3])
    C4042877 (UMLS CUI [1,4])
    consensus making decision
    Code List
    Was discontinuation of tumor therapy based on consensus in the palliative team?
    CL Item
    Clear divergence of opinion, difficult decision making (1)
    CL Item
    Rather consensus, but also votes against (2)
    CL Item
    Clear consensus (3)
    discontinuation decision reason
    Item
    Reasons:
    text
    C0920425 (UMLS CUI [1,1])
    C0457454 (UMLS CUI [1,2])
    C0392360 (UMLS CUI [1,3])
    Item Group
    TT12. Who completes this questionnaire?
    Item
    TT12. Who completes this questionnaire?
    text
    C3258039 (UMLS CUI [1])
    person documenting
    Code List
    TT12. Who completes this questionnaire?
    CL Item
     (Arzt/Ärztin)
    CL Item
     (Pflegende)
    CL Item
     (Andere Mitarbeiter)
    Item
    Medical field
    text
    C0037778 (UMLS CUI [1,1])
    C3258039 (UMLS CUI [1,2])
    medical field documenting person
    Code List
    Medical field
    CL Item
     (Innere Medizin)
    CL Item
     (Hämatologie/Onkologie)
    CL Item
     (Anästhesie)
    CL Item
     (Sonstige)
    other medical field
    Item
    Other:
    text
    C0037778 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
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