ID

44574

Description

Personal Health Record السجل الصحي الشخ ي ص

Mots-clés

Versions (3)
  1. 06/11/2017 06/11/2017 -
  2. 21/11/2017 21/11/2017 -
  3. 27/09/2021 27/09/2021 -
Détendeur de droits

European Union

Téléchargé le

27 septembre 2021

DOI

Pour une demande vous connecter.

Licence

Creative Commons BY-NC 3.0
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    Personal Health Record

    Arabe Anglais

    Personal Health Record

    1 Formulaires  
    1. StudyEvent: ODM
      1. Personal Health Record
    General Information
    Description

    General Information

    Alias
    UMLS CUI-1
    C1508263
    The ‘Personal Health Record’ was developed by the Migration Health Division of the International Organization for Migration with the support from the European Commission and the contribution from the European Centre for Disease Prevention and Control. This is a personal document. It includes in one single document the health data and information that will help the health professionals get a comprehensive view of your health status and needs. You will keep this document with you to help you in further contact with health professionals. The medical check is voluntary and the content of this document is confidential. It is covered by European and national regulations on data protection.
    Description

    General Information

    Type de données

    text

    Alias
    UMLS CUI [1]
    C1508263
    SECTION A. PATIENT REGISTRATION
    Description

    SECTION A. PATIENT REGISTRATION

    Alias
    UMLS CUI-1
    C0011008
    UMLS CUI-2
    C0030705
    UMLS CUI-3
    C1514821
    Patient Family Name
    Description

    Patient Family Name

    Type de données

    text

    Alias
    UMLS CUI [1]
    C1301584
    Patient First Name
    Description

    Patient First Name

    Type de données

    text

    Alias
    UMLS CUI [1]
    C1443235
    Date of birth
    Description

    Date of birth

    Type de données

    date

    Alias
    UMLS CUI [1]
    C0421451
    Sex/Gender
    Description

    Sex/Gender

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0079399
    Country of birth/countries lived in/transited
    Description

    Country of birth/countries lived in/transited

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1300001
    UMLS CUI [1,2]
    C1562954
    UMLS CUI [1,3]
    C0687759
    Telephone or mobile number
    Description

    Telephone or mobile number

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0421455
    UMLS CUI [1,2]
    C3273868
    Email address
    Description

    Email address

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1705961
    UMLS CUI [1,2]
    C0030705
    Marital status (married/separated/single)
    Description

    Marital status

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0024819
    Number of family members travelling
    Description

    Number of family members travelling

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C0449788
    Number of family members traveling under the age of 10
    Description

    Number of family members travelling young

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C0449788
    UMLS CUI [1,4]
    C0001779
    SECTION B. SERVICE PROVIDER INFORMATION
    Description

    SECTION B. SERVICE PROVIDER INFORMATION

    Alias
    UMLS CUI-1
    C0679886
    Physician Family Name
    Description

    Physician Family Name

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C2361125
    UMLS CUI [1,2]
    C1301584
    Physician First Name
    Description

    Physician First Name

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C2361125
    UMLS CUI [1,2]
    C1443235
    Telephone or mobile number
    Description

    Physician Telephone or mobile number

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1515258
    UMLS CUI [1,2]
    C1710470
    Email address
    Description

    Physician Email address

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1705961
    UMLS CUI [1,2]
    C1710470
    Name of medical affiliation (e.g. clinic, hospital)
    Description

    Name of medical affiliation

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0029239
    UMLS CUI [1,2]
    C1510825
    UMLS CUI [1,3]
    C2371809
    City, Country
    Description

    City, Country

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0019994
    UMLS CUI [1,2]
    C0008848
    Interpretation/mediation used
    Description

    Interpretation/mediation used

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0459471
    UMLS CUI [1,2]
    C0262765
    Interpretation/mediation used
    Description

    Interpretation/mediation comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0459471
    UMLS CUI [1,2]
    C0262765
    UMLS CUI [1,3]
    C0947611
    SECTION C. MEDICAL HISTORY
    Description

    SECTION C. MEDICAL HISTORY

    Alias
    UMLS CUI-1
    C0262926
    Illness or injury requiring hospitalization
    Description

    Illness or injury requiring hospitalization

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C1836348
    UMLS CUI [1,2]
    C1514873
    UMLS CUI [1,3]
    C0019993
    Illness or injury requiring hospitalization
    Description

    Illness or injury requiring hospitalization comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1836348
    UMLS CUI [1,2]
    C1514873
    UMLS CUI [1,3]
    C0019993
    UMLS CUI [1,4]
    C0947611
    Surgical interventions
    Description

    Surgical interventions

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0184661
    Surgical interventions
    Description

    Surgical interventions comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0184661
    UMLS CUI [1,2]
    C0947611
    Heart disease or high blood pressure
    Description

    Heart disease or high blood pressure

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0020538
    UMLS CUI [1,2]
    C0018799
    Heart disease or high blood pressure
    Description

    Heart disease or high blood pressure comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0020538
    UMLS CUI [1,2]
    C0018799
    UMLS CUI [1,3]
    C0947611
    Neurologic disease, incl. stroke or seizures
    Description

    Neurologic disease, incl. stroke or seizures

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0027765
    UMLS CUI [1,2]
    C0036572
    UMLS CUI [1,3]
    C0038454
    Neurologic disease, incl. stroke or seizures
    Description

    Neurologic disease, incl. stroke or seizures comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0027765
    UMLS CUI [1,2]
    C0036572
    UMLS CUI [1,3]
    C0038454
    UMLS CUI [1,4]
    C0947611
    Mental illness/problems
    Description

    Mental illness/problems

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0004936
    Mental illness/problems
    Description

    Mental illness/problems comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0004936
    UMLS CUI [1,2]
    C0947611
    Stomach or bowel disease (incl. recent diarrhea)
    Description

    Stomach or bowel disease (incl. recent diarrhea)

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0017178
    UMLS CUI [1,2]
    C0038354
    Stomach or bowel disease (incl. recent diarrhea)
    Description

    Stomach or bowel disease (incl. recent diarrhea) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0017178
    UMLS CUI [1,2]
    C0038354
    UMLS CUI [1,3]
    C0947611
    Liver or kidney disease
    Description

    Liver or kidney disease

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0023895
    UMLS CUI [1,2]
    C0022658
    Liver or kidney disease
    Description

    Liver or kidney disease comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0023895
    UMLS CUI [1,2]
    C0022658
    UMLS CUI [1,3]
    C0947611
    Diabetes or other endocrine disorder
    Description

    Diabetes or other endocrine disorder

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0014130
    UMLS CUI [1,2]
    C0011849
    Diabetes or other endocrine disorder
    Description

    Diabetes or other endocrine disorder comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0014130
    UMLS CUI [1,2]
    C0011849
    UMLS CUI [1,3]
    C0947611
    Urogenital problems/conditions
    Description

    Urogenital problems/conditions

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0080276
    Urogenital problems/conditions
    Description

    Urogenital problems/conditions comment

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0080276
    UMLS CUI [1,2]
    C0947611
    Hematologic disease
    Description

    Hematologic disease

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0018939
    Hematologic disease
    Description

    Hematologic disease comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0018939
    UMLS CUI [1,2]
    C0947611
    Muscle, bone and joint problems
    Description

    Muscle, bone and joint problems

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0575078
    UMLS CUI [1,2]
    C0003862
    UMLS CUI [1,3]
    C0575044
    Muscle, bone and joint problems
    Description

    Muscle, bone and joint problems comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0575078
    UMLS CUI [1,2]
    C0003862
    UMLS CUI [1,3]
    C0575044
    UMLS CUI [1,4]
    C0947611
    Problems with eyes or ears
    Description

    Problems with eyes or ears

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0262477
    UMLS CUI [1,2]
    C0260662
    Problems with eyes or ears
    Description

    Problems with eyes or ears comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0262477
    UMLS CUI [1,2]
    C0260662
    UMLS CUI [1,3]
    C0947611
    History of cancer or tumors
    Description

    History of cancer or tumors

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C2735088
    History of cancer or tumors
    Description

    History of cancer or tumors comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C2735088
    UMLS CUI [1,2]
    C0947611
    Tuberculosis, pneumonia or other lung disease
    Description

    Tuberculosis, pneumonia or other lung disease

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0024115
    UMLS CUI [1,2]
    C0032285
    UMLS CUI [1,3]
    C0041296
    Tuberculosis, pneumonia or other lung disease
    Description

    Tuberculosis, pneumonia or other lung disease comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0024115
    UMLS CUI [1,2]
    C0032285
    UMLS CUI [1,3]
    C0041296
    UMLS CUI [1,4]
    C0947611
    Family member or close contact with an infectious disease (or TB contact in general)
    Description

    Family member or close contact with an infectious disease (or TB contact in general)

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0332158
    UMLS CUI [1,2]
    C0086282
    UMLS CUI [1,3]
    C0009450
    Family member or close contact with an infectious disease (or TB contact in general)
    Description

    Family member or close contact with an infectious disease (or TB contact in general) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0332158
    UMLS CUI [1,2]
    C0086282
    UMLS CUI [1,3]
    C0009450
    UMLS CUI [1,4]
    C0947611
    Recurrent fever (in the past 6 months)
    Description

    Recurrent fever (in the past 6 months)

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0013806
    UMLS CUI [1,2]
    C2945760
    Recurrent fever (in the past 6 months)
    Description

    Recurrent fever (in the past 6 months) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0013806
    UMLS CUI [1,2]
    C2945760
    UMLS CUI [1,3]
    C0947611
    Coughing. Specify if protracted coughing over two weeks, combined with other symptoms
    Description

    Coughing

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0010200
    Coughing. Specify if protracted coughing over two weeks, combined with other symptoms
    Description

    Coughing comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0010200
    UMLS CUI [1,2]
    C0947611
    Significant weight loss (in the past 6 months)
    Description

    Significant weight loss

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C1262477
    Significant weight loss (in the past 6 months)
    Description

    Significant weight loss comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1262477
    UMLS CUI [1,2]
    C0947611
    Sexually transmitted infections
    Description

    Sexually transmitted infections

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0036916
    Sexually transmitted infections
    Description

    Sexually transmitted infections comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0036916
    UMLS CUI [1,2]
    C0947611
    Skin conditions (e.g. rash)
    Description

    Skin conditions

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0037274
    Skin conditions (e.g. rash)
    Description

    Skin conditions comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0037274
    UMLS CUI [1,2]
    C0947611
    Tattoos, body piercings
    Description

    Tattoos, body piercings

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0191391
    UMLS CUI [1,2]
    C1446587
    Tattoos, body piercings
    Description

    Tattoos, body piercings comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0191391
    UMLS CUI [1,2]
    C1446587
    UMLS CUI [1,3]
    C0947611
    History of blood transfusion
    Description

    History of blood transfusion

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C1519604
    History of blood transfusion
    Description

    History of blood transfusion comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1519604
    UMLS CUI [1,2]
    C0947611
    History of torture, violence
    Description

    History of torture, violence

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0262926
    UMLS CUI [1,2]
    C0042693
    UMLS CUI [1,3]
    C4061703
    History of torture, violence
    Description

    History of torture, violence comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0262926
    UMLS CUI [1,2]
    C0042693
    UMLS CUI [1,3]
    C4061703
    UMLS CUI [1,4]
    C0947611
    Displaced from home (specify duration)
    Description

    Displaced from home

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C2699029
    UMLS CUI [1,2]
    C2046927
    Current medications (specify)
    Description

    Current medications

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0746467
    Allergies, including to drugs
    Description

    Allergies, including to drugs

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0020517
    UMLS CUI [1,2]
    C0013227
    Allergies, including to drugs
    Description

    Allergies, including to drugs comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0020517
    UMLS CUI [1,2]
    C0013227
    UMLS CUI [1,3]
    C0947611
    Smoking or history of smoking
    Description

    Smoking or history of smoking

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C1519384
    UMLS CUI [1,2]
    C0543414
    Smoking or history of smoking
    Description

    Smoking or history of smoking comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1519384
    UMLS CUI [1,2]
    C0543414
    UMLS CUI [1,3]
    C0947611
    Alcohol or history of alcohol
    Description

    Alcohol or history of alcohol

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0221628
    UMLS CUI [1,2]
    C0085762
    Alcohol or history of alcohol
    Description

    Alcohol or history of alcohol comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0221628
    UMLS CUI [1,2]
    C0085762
    UMLS CUI [1,3]
    C0947611
    Pregnancies (number)
    Description

    Pregnancies

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C3812254
    Pregnancies (number)
    Description

    Pregnancies comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C3812254
    UMLS CUI [1,2]
    C0947611
    Deliveries (number)
    Description

    Deliveries

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0559563
    Last menstrual period
    Description

    Last menstrual period

    Type de données

    date

    Alias
    UMLS CUI [1]
    C0425932
    Current pregnancy
    Description

    Current pregnancy

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0549206
    Current pregnancy
    Description

    Current pregnancy comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0549206
    UMLS CUI [1,2]
    C0947611
    Gestational week
    Description

    Gestational week

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0017504
    SECTION D. PATIENT’S IMMUNIZATION RECORD
    Description

    SECTION D. PATIENT’S IMMUNIZATION RECORD

    Alias
    UMLS CUI-1
    C0552506
    Immunization record presented/available
    Description

    Immunization record

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0552506
    UMLS CUI [1,2]
    C0684224
    Immunization record presented/available
    Description

    Immunization record comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0552506
    UMLS CUI [1,2]
    C0684224
    UMLS CUI [1,3]
    C0947611
    Immunization status meets age specific requirements based on national requirement of the country of stay. If yes, proceed with points 3-24 and indicate date or age at vaccination
    Description

    Immunization status

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0552506
    UMLS CUI [1,2]
    C0020405
    UMLS CUI [1,3]
    C1514873
    Pediatric diphtheria and tetanus (DT)
    Description

    Pediatric diphtheria and tetanus

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0058773
    UMLS CUI [1,2]
    C1521725
    Pediatric diphtheria and tetanus (DT)
    Description

    Pediatric diphtheria and tetanus

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0058773
    UMLS CUI [1,2]
    C1521725
    Pediatric diphtheria and tetanus (DT)
    Description

    Pediatric diphtheria and tetanus comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0058773
    UMLS CUI [1,2]
    C1521725
    UMLS CUI [1,3]
    C0947611
    Diphtheria, tetanus, pertussis (DTP)
    Description

    Diphtheria, tetanus, pertussis (DTP)

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0012559
    Diphtheria, tetanus, pertussis (DTP)
    Description

    Diphtheria, tetanus, pertussis (DTP)

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0012559
    Diphtheria, tetanus, pertussis (DTP)
    Description

    Diphtheria, tetanus, pertussis (DTP) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0012559
    UMLS CUI [1,2]
    C0947611
    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)
    Description

    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0012559
    UMLS CUI [1,2]
    C1521725
    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)
    Description

    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0012559
    UMLS CUI [1,2]
    C1521725
    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)
    Description

    Pediatric diphtheria, tetanus and acellular pertussis (DTaP) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0012559
    UMLS CUI [1,2]
    C1521725
    UMLS CUI [1,3]
    C0947611
    Older children and adults tetanus and diphtheria vaccine (Td)
    Description

    Older children and adults tetanus and diphtheria vaccine (Td)

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0058773
    UMLS CUI [1,2]
    C0001675
    UMLS CUI [1,3]
    C0008059
    Older children and adults tetanus and diphtheria vaccine (Td)
    Description

    Older children and adults tetanus and diphtheria vaccine (Td)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0058773
    UMLS CUI [1,2]
    C0001675
    UMLS CUI [1,3]
    C0008059
    Older children and adults tetanus and diphtheria vaccine (Td)
    Description

    Older children and adults tetanus and diphtheria vaccine (Td) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0058773
    UMLS CUI [1,2]
    C0001675
    UMLS CUI [1,3]
    C0008059
    UMLS CUI [1,4]
    C0947611
    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)
    Description

    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0012559
    UMLS CUI [1,2]
    C0001675
    UMLS CUI [1,3]
    C0008059
    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)
    Description

    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0012559
    UMLS CUI [1,2]
    C0001675
    UMLS CUI [1,3]
    C0008059
    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)
    Description

    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0012559
    UMLS CUI [1,2]
    C0001675
    UMLS CUI [1,3]
    C0008059
    UMLS CUI [1,4]
    C0947611
    Oral Polio vaccine (OPV)
    Description

    Oral Polio vaccine (OPV)

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0032375
    Oral Polio vaccine (OPV)
    Description

    Oral Polio vaccine (OPV)

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0032375
    Oral Polio vaccine (OPV)
    Description

    Oral Polio vaccine (OPV) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0032375
    UMLS CUI [1,2]
    C0947611
    Inactivated Polio vaccine (IPV)
    Description

    Inactivated Polio vaccine (IPV)

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0718003
    Inactivated Polio vaccine (IPV)
    Description

    Inactivated Polio vaccine (IPV)

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0718003
    Inactivated Polio vaccine (IPV)
    Description

    Inactivated Polio vaccine (IPV) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0718003
    UMLS CUI [1,2]
    C0947611
    Measles, mumps, rubella (MMR)
    Description

    Measles, mumps, rubella (MMR)

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0065828
    Measles, mumps, rubella (MMR)
    Description

    Measles, mumps, rubella (MMR)

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0065828
    Measles, mumps, rubella (MMR)
    Description

    Measles, mumps, rubella (MMR) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0065828
    UMLS CUI [1,2]
    C0947611
    Rubella
    Description

    Rubella

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0042206
    Rubella
    Description

    Rubella

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0042206
    Rubella
    Description

    Rubella comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042206
    UMLS CUI [1,2]
    C0947611
    Measles
    Description

    Measles

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0042201
    Measles
    Description

    Measles

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0042201
    Measles
    Description

    Measles comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042201
    UMLS CUI [1,2]
    C0947611
    Measles-Rubella
    Description

    Measles-Rubella

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0042201
    UMLS CUI [1,2]
    C0042206
    Measles-Rubella
    Description

    Measles-Rubella

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042201
    UMLS CUI [1,2]
    C0042206
    Measles-Rubella
    Description

    Measles-Rubella comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042201
    UMLS CUI [1,2]
    C0042206
    UMLS CUI [1,3]
    C0947611
    Mumps
    Description

    Mumps

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0042202
    Mumps
    Description

    Mumps

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0042202
    Mumps
    Description

    Mumps comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042202
    UMLS CUI [1,2]
    C0947611
    Mumps-Rubella
    Description

    Mumps-Rubella

    Type de données

    boolean

    Alias
    UMLS CUI [1,1]
    C0042202
    UMLS CUI [1,2]
    C0042206
    Mumps-Rubella
    Description

    Mumps-Rubella

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042202
    UMLS CUI [1,2]
    C0042206
    Mumps-Rubella
    Description

    Mumps-Rubella comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042202
    UMLS CUI [1,2]
    C0042206
    UMLS CUI [1,3]
    C0947611
    Haemophilus influenzae type B (Hib)
    Description

    Haemophilus influenzae type B (Hib)

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0199818
    Haemophilus influenzae type B (Hib)
    Description

    Haemophilus influenzae type B (Hib)

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0199818
    Haemophilus influenzae type B (Hib)
    Description

    Haemophilus influenzae type B (Hib) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0199818
    UMLS CUI [1,2]
    C0947611
    Hepatitis A
    Description

    Hepatitis A

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0419735
    Hepatitis A
    Description

    Hepatitis A

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0419735
    Hepatitis A
    Description

    Hepatitis A comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0419735
    UMLS CUI [1,2]
    C0947611
    Hepatitis B
    Description

    Hepatitis B

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0474232
    Hepatitis B
    Description

    Hepatitis B

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0474232
    Hepatitis B
    Description

    Hepatitis B comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0474232
    UMLS CUI [1,2]
    C0947611
    Meningococcal
    Description

    Meningococcal

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0700144
    Meningococcal
    Description

    Meningococcal

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0700144
    Meningococcal
    Description

    Meningococcal comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0700144
    UMLS CUI [1,2]
    C0947611
    Human papillomavirus (HPV)
    Description

    Human papillomavirus (HPV)

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C1512511
    Human papillomavirus (HPV)
    Description

    Human papillomavirus (HPV)

    Type de données

    text

    Alias
    UMLS CUI [1]
    C1512511
    Human papillomavirus (HPV)
    Description

    Human papillomavirus (HPV) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1512511
    UMLS CUI [1,2]
    C0947611
    Varicella (chicken pox)
    Description

    Varicella (chicken pox)

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0078048
    Varicella (chicken pox)
    Description

    Varicella (chicken pox)

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0078048
    Varicella (chicken pox)
    Description

    Varicella (chicken pox) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0078048
    UMLS CUI [1,2]
    C0947611
    Herpes zoster (shingles)
    Description

    Herpes zoster (shingles)

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C1720918
    Herpes zoster (shingles)
    Description

    Herpes zoster (shingles)

    Type de données

    text

    Alias
    UMLS CUI [1]
    C1720918
    Herpes zoster (shingles)
    Description

    Herpes zoster (shingles) comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1720918
    UMLS CUI [1,2]
    C0947611
    Pneumococcal
    Description

    Pneumococcal

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0419707
    Pneumococcal
    Description

    Pneumococcal

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0419707
    Pneumococcal
    Description

    Pneumococcal comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0419707
    UMLS CUI [1,2]
    C0947611
    Influenza
    Description

    Influenza

    Type de données

    boolean

    Alias
    UMLS CUI [1]
    C0021403
    Influenza
    Description

    Influenza

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0021403
    Influenza
    Description

    Influenza comment

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0021403
    UMLS CUI [1,2]
    C0947611
    SECTION E. CLINICAL MEASUREMENTS
    Description

    SECTION E. CLINICAL MEASUREMENTS

    Alias
    UMLS CUI-1
    C0205485
    UMLS CUI-2
    C0242485
    Height
    Description

    Height

    Type de données

    integer

    Unités de mesure
    • سم
    Alias
    UMLS CUI [1]
    C0489786
    سم
    Weight
    Description

    Weight

    Type de données

    integer

    Unités de mesure
    • كجم
    Alias
    UMLS CUI [1]
    C0005910
    كجم
    BMI
    Description

    BMI

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C1305855
    Head circumference if <18months
    Description

    Head circumference

    Type de données

    integer

    Unités de mesure
    • سم
    Alias
    UMLS CUI [1]
    C0262499
    سم
    Blood pressure initial: Systolic
    Description

    Blood pressure initial: Systolic

    Type de données

    integer

    Unités de mesure
    • مم زئبق
    Alias
    UMLS CUI [1,1]
    C0871470
    UMLS CUI [1,2]
    C0205265
    مم زئبق
    Blood pressure initial: Dyastolic
    Description

    Blood pressure initial: Dyastolic

    Type de données

    integer

    Unités de mesure
    • مم زئبق
    Alias
    UMLS CUI [1,1]
    C0428883
    UMLS CUI [1,2]
    C0205265
    مم زئبق
    Blood pressure repeated: Systolic
    Description

    Blood pressure repeated: Systolic

    Type de données

    integer

    Unités de mesure
    • مم زئبق
    Alias
    UMLS CUI [1,1]
    C0871470
    UMLS CUI [1,2]
    C0205341
    مم زئبق
    Blood pressure repeated: Dyastolic
    Description

    Blood pressure repeated: Dyastolic

    Type de données

    integer

    Unités de mesure
    • مم زئبق
    Alias
    UMLS CUI [1,1]
    C0428883
    UMLS CUI [1,2]
    C0205341
    مم زئبق
    Pulse initial
    Description

    Pulse initial

    Type de données

    integer

    Unités de mesure
    • /دقيقة
    Alias
    UMLS CUI [1,1]
    C0232117
    UMLS CUI [1,2]
    C0205265
    /دقيقة
    Respiratory Rate
    Description

    Respiratory Rate

    Type de données

    integer

    Unités de mesure
    • / دقيقة
    Alias
    UMLS CUI [1]
    C0231832
    / دقيقة
    Pulse repeated
    Description

    Pulse repeated

    Type de données

    integer

    Unités de mesure
    • / دقيقة
    Alias
    UMLS CUI [1,1]
    C0232117
    UMLS CUI [1,2]
    C0205341
    / دقيقة
    Visual Acuity Left uncorrected
    Description

    Visual Acuity Left uncorrected

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042812
    UMLS CUI [1,2]
    C0205091
    Visual Acuity Right uncorrected
    Description

    Visual Acuity Right uncorrected

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042812
    UMLS CUI [1,2]
    C0205090
    Visual Acuity Left corrected
    Description

    Visual Acuity Left corrected

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1690532
    UMLS CUI [1,2]
    C0229090
    Visual Acuity Right corrected
    Description

    Visual Acuity Right corrected

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1690532
    UMLS CUI [1,2]
    C0229089
    SECTION F. EXAM FINDINGS
    Description

    SECTION F. EXAM FINDINGS

    Alias
    UMLS CUI-1
    C0031809
    General appearance and nutritional status
    Description

    General appearance and nutritional status

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C1148438
    UMLS CUI [1,2]
    C0392209
    Hearing and ears
    Description

    Hearing and ears

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0455216
    Eyes
    Description

    Eyes

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0015392
    UMLS CUI [1,2]
    C0031809
    Nose, mouth and throat (include dental)
    Description

    Nose, mouth and throat

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0553490
    UMLS CUI [1,2]
    C0031809
    Heart (S1, S2, murmur, rub)
    Description

    Heart

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0562319
    Breast
    Description

    Breast

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0199850
    Lungs
    Description

    Lungs

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C2228454
    Abdomen (including liver, spleen)
    Description

    Abdomen

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0562238
    Genitalia
    Description

    Genitalia

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0031809
    UMLS CUI [1,2]
    C0017420
    Inguinal region (including adenopathy)
    Description

    Inguinal region

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0031809
    UMLS CUI [1,2]
    C0018246
    Extremities (including pulses, edema)
    Description

    Extremities

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C0436150
    Musculoskeletal system (including gait)
    Description

    Musculoskeletal system

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0031809
    UMLS CUI [1,2]
    C0026860
    Skin (including findings consistent with self-inflicted injury or injections)
    Description

    Skin

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0582103
    UMLS CUI [1,2]
    C1123023
    Lymph nodes
    Description

    Lymph nodes

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0031809
    UMLS CUI [1,2]
    C0024204
    Nervous system
    Description

    Nervous system

    Type de données

    integer

    Alias
    UMLS CUI [1,1]
    C0027763
    UMLS CUI [1,2]
    C0031809
    Mental status (including mood, intelligence, perception, thought processes, behaviour during examination…)
    Description

    Mental status

    Type de données

    integer

    Alias
    UMLS CUI [1]
    C3260990
    SECTION G. LABORATORY/OTHER TESTS
    Description

    SECTION G. LABORATORY/OTHER TESTS

    Alias
    UMLS CUI-1
    C0022885
    UMLS CUI-2
    C0582103
    UMLS CUI-3
    C0205394
    Urinalysis: dipstick for albumin or protein, sugar and blood
    Description

    Urinalysis: dipstick

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0042014
    UMLS CUI [1,2]
    C0430370
    UMLS CUI [1,3]
    C0022885
    Malaria rapid test (pan malaria)
    Description

    Malaria rapid test

    Type de données

    text

    Alias
    UMLS CUI [1]
    C2368143
    Pregnancy
    Description

    Pregnancy

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0032976
    Electrocardiogram
    Description

    Electrocardiogram

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0013798
    Mantoux
    Description

    Mantoux

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0041290
    SECTION H. DIAGNOSTICS
    Description

    SECTION H. DIAGNOSTICS

    Alias
    UMLS CUI-1
    C0430022
    Imaging: chest X-ray
    Description

    Imaging: chest X-ray

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0039985
    Imaging: other X-ray
    Description

    Imaging: other X-ray

    Type de données

    text

    Alias
    UMLS CUI [1]
    C1306645
    Imaging: other imaging examination (e.g. ultrasound, etc.)
    Description

    Imaging: other imaging examination

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0011923
    UMLS CUI [1,2]
    C0079595
    UMLS CUI [1,3]
    C0205394
    Electrocardiogram (if not performed at hotspot)
    Description

    Electrocardiogram

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0013798
    Laboratory: full blood count
    Description

    Laboratory: full blood count

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0005771
    Laboratory: creatinine
    Description

    Laboratory: creatinine

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0201975
    Laboratory: hep B surface antigen (HBsAg)
    Description

    Laboratory: hep B surface antigen

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0201477
    Laboratory: hep C serology
    Description

    Laboratory: hep C serology

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0459958
    UMLS CUI [1,2]
    C0019196
    Laboratory: HIV
    Description

    Laboratory: HIV

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0022877
    UMLS CUI [1,2]
    C0019682
    Laboratory: syphilis
    Description

    Laboratory: syphilis

    Type de données

    text

    Alias
    UMLS CUI [1]
    C3516463
    Laboratory: liver function tests
    Description

    Laboratory: liver function tests

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0023901
    Laboratory: tuberculosis (sputum smear)
    Description

    Laboratory: tuberculosis (sputum smear)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0041296
    UMLS CUI [1,2]
    C0444186
    Instrument: mini-mental state dementia screening form
    Description

    Instrument: mini-mental state

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0451306
    Instrument: assessment of activities of daily living
    Description

    Instrument: assessment of activities of daily living

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0001288
    UMLS CUI [1,2]
    C1518965
    Instrument: chart of early childhood development
    Description

    Instrument: chart of early childhood development

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0870455
    Other referrals
    Description

    Other referrals

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0022877
    SECTION I. SUMMARY FINDINGS
    Description

    SECTION I. SUMMARY FINDINGS

    Alias
    UMLS CUI-1
    C0242482
    Significant medical condition has been identified?
    Description

    Significant medical condition

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C3843040
    UMLS CUI [1,2]
    C0750502
    ICD A15-A19
    Description

    ICD A15-A19

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0041296
    ICD A15-A19
    Description

    ICD A15-A19

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0041296
    ICD A50-A64
    Description

    ICD A50-A64

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0036916
    ICD B20-B24
    Description

    ICD B20-B24

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0019682
    Physical impairment/disability
    Description

    Physical impairment/disability

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0231171
    Significant mental health condition
    Description

    Significant mental health condition

    Type de données

    text

    Alias
    UMLS CUI [1]
    C3840291
    Addiction (abuse) of specific substances
    Description

    Addiction

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0038586
    Other significant condition (specify):
    Description

    Other significant condition

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C3843040
    UMLS CUI [1,2]
    C0750502
    SECTION J. TREATMENT RECOMMENDATION
    Description

    SECTION J. TREATMENT RECOMMENDATION

    Alias
    UMLS CUI-1
    C0039798
    UMLS CUI-2
    C0034866
    Treatment required?
    Description

    Treatment required?

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0332121
    Treatment required For ICD A50-A64?
    Description

    Treatment required For ICD A50-A64?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0332121
    UMLS CUI [1,2]
    C0036916
    Treatment required for malaria?
    Description

    Treatment required for malaria?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0332121
    UMLS CUI [1,2]
    C0024530
    Treatment required for gastrointestinal parasites? (e.g. presumptive treatment)
    Description

    Treatment required for gastrointestinal parasites?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0332121
    UMLS CUI [1,2]
    C0017178
    UMLS CUI [1,3]
    C0030498
    Treatment required for acute condition?
    Description

    Treatment required for acute condition?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0332121
    UMLS CUI [1,2]
    C1699700
    UMLS CUI [1,3]
    C0205178
    Treatment required for chronic condition?
    Description

    Treatment required for chronic condition?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0332121
    UMLS CUI [1,2]
    C0008679
    Hospitalisation required (immediate)
    Description

    Hospitalisation required (immediate)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0019993
    UMLS CUI [1,2]
    C0205253
    Hospitalisation required (within several days)
    Description

    Hospitalisation required (within several days)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0019993
    UMLS CUI [1,2]
    C3844034
    Hospitalisation required (within several months)
    Description

    Hospitalisation required (within several months)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0019993
    UMLS CUI [1,2]
    C0439231
    Immunisation required?
    Description

    Immunisation required?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0020971
    UMLS CUI [1,2]
    C1514873
    Adjusted/appropriate accommodation required?
    Description

    Adjusted/appropriate accommodation required?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0595920
    UMLS CUI [1,2]
    C1514873
    SECTION K. TRAVEL RECOMMENDATION
    Description

    SECTION K. TRAVEL RECOMMENDATION

    Alias
    UMLS CUI-1
    C0034866
    UMLS CUI-2
    C0040802
    Fit for further travel? (Yes / conditionally / no)
    Description

    Fit for further travel?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0040802
    UMLS CUI [1,2]
    C0424576
    Special medical attention during the travel?
    Description

    Special medical attention during the travel?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0040802
    UMLS CUI [1,2]
    C0004268
    UMLS CUI [1,3]
    C1830593
    If pregnant, not to travel before ……?
    Description

    If pregnant, not to travel before ……?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0549206
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C0040223
    If pregnant, to travel before …?
    Description

    If pregnant, to travel before …?

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0549206
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C0040223
    TRQ: ambulance
    Description

    TRQ: ambulance

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0002422
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C1514873
    TRQ: WCH
    Description

    TRQ: WCH

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0043143
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C1514873
    TRQ: stretcher
    Description

    TRQ: stretcher

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0972406
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C1514873
    TRQ: oxygen
    Description

    TRQ: oxygen

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0184633
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C1514873
    TRQ: bowel preparation
    Description

    TRQ: bowel preparation

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0455052
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C1514873
    TRQ: diapers
    Description

    TRQ: diapers

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1875617
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C1514873
    TRQ: urinary catheter
    Description

    TRQ: urinary catheter

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0179802
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C1514873
    TRQ: other
    Description

    TRQ: other

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0040802
    UMLS CUI [1,3]
    C1514873
    TRQ: medical escort
    Description

    TRQ: medical escort

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1547632
    UMLS CUI [1,2]
    C0040802
    TRQ: family escort
    Description

    TRQ: family escort

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1547632
    UMLS CUI [1,2]
    C0015576
    TRQ: operational escort
    Description

    TRQ: operational escort

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1547632
    UMLS CUI [1,2]
    C0040802
    SECTION L. POST-ARRIVAL RECOMMENDATION
    Description

    SECTION L. POST-ARRIVAL RECOMMENDATION

    Alias
    UMLS CUI-1
    C0034866
    UMLS CUI-2
    C1706079
    PTR: special schooling needs
    Description

    PTR: special schooling needs

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0871403
    UMLS CUI [1,2]
    C0455002
    PTR: consequences on daily living activities (assistance required)
    Description

    PTR: consequences on daily living activities (assistance required)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0001288
    UMLS CUI [1,2]
    C3840284
    PTR: special housing requirements
    Description

    PTR: special housing requirements

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0871403
    UMLS CUI [1,2]
    C0020056
    UMLS CUI [1,3]
    C1514873
    PTR: follow-up examination needed by GP (within 1 w/1 m/6 m)
    Description

    PTR: follow-up examination needed by GP (within 1 w/1 m/6 m)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C3694716
    UMLS CUI [1,2]
    C0017319
    PTR: Follow-up examination needed by specialist (within 1 w/1 m/6 m)
    Description

    PTR: Follow-up examination needed by specialist (within 1 w/1 m/6 m)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C3694716
    UMLS CUI [1,2]
    C1611835
    SECTION M. TREATMENT ADMINISTRATION
    Description

    SECTION M. TREATMENT ADMINISTRATION

    Alias
    UMLS CUI-1
    C1533734
    Tx administered for ICD A50-A64
    Description

    Tx administered for ICD A50-A64

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1533734
    UMLS CUI [1,2]
    C0036916
    Tx administered for malaria
    Description

    Tx administered for malaria

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1533734
    UMLS CUI [1,2]
    C0024530
    Tx administered for gastrointestinal parasites
    Description

    Tx administered for gastrointestinal parasites

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1533734
    UMLS CUI [1,2]
    C0030498
    UMLS CUI [1,3]
    C0017178
    Tx administered for other conditions (specify medication and dosage)
    Description

    Tx administered for other conditions

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1533734
    UMLS CUI [1,2]
    C3843040
    UMLS CUI [1,3]
    C0013227
    UMLS CUI [1,4]
    C0178602
    Tx — other treatment applied (specify)
    Description

    Tx — other treatment applied (specify)

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C1533734
    UMLS CUI [1,2]
    C0205394
    SECTION N. VACCINE ADMINISTRATION
    Description

    SECTION N. VACCINE ADMINISTRATION

    Alias
    UMLS CUI-1
    C2368628
    Vaccine administered (date/dose and application/batch #)
    Description

    Vaccine administered

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C2368628
    UMLS CUI [1,2]
    C1115436
    UMLS CUI [1,3]
    C0178602
    Vaccine: DT
    Description

    Vaccine: DT

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0058773
    Vaccine: DTP
    Description

    Vaccine: DTP

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0012559
    Vaccine: DTaP
    Description

    Vaccine: DTaP

    Type de données

    text

    Alias
    UMLS CUI [1]
    C3526553
    Vaccine: Td
    Description

    Vaccine: Td

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0058773
    Vaccine: Tdap
    Description

    Vaccine: Tdap

    Type de données

    text

    Alias
    UMLS CUI [1]
    C3526553
    Vaccine: polio — OPV
    Description

    Vaccine: polio — OPV

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0032375
    Vaccine: polio — IPV
    Description

    Vaccine: polio — IPV

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0718003
    Vaccine: MMR
    Description

    Vaccine: MMR

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0065828
    Vaccine: rubella
    Description

    Vaccine: rubella

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0035923
    Vaccine: measles
    Description

    Vaccine: measles

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0025010
    Vaccine: measles-rubella
    Description

    Vaccine: measles-rubella

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0361142
    Vaccine: mumps
    Description

    Vaccine: mumps

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0026782
    Vaccine: mumps-rubella
    Description

    Vaccine: mumps-rubella

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0694750
    Vaccine: Hib
    Description

    Vaccine: Hib

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0062086
    Vaccine: hep A
    Description

    Vaccine: hep A

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0795623
    Vaccine: hep B
    Description

    Vaccine: hep B

    Type de données

    text

    Alias
    UMLS CUI [1]
    C2240392
    Vaccine: meningococcal
    Description

    Vaccine: meningococcal

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0700144
    Vaccine: human papillomavirus
    Description

    Vaccine: human papillomavirus

    Type de données

    text

    Alias
    UMLS CUI [1]
    C1512511
    Vaccine: varicella
    Description

    Vaccine: varicella

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0078048
    Vaccine: pneumococcal
    Description

    Vaccine: pneumococcal

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0358314
    Vaccine: influenza
    Description

    Vaccine: influenza

    Type de données

    text

    Alias
    UMLS CUI [1]
    C0021403
    Vaccine: others
    Description

    Vaccine: others

    Type de données

    text

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0042210
    Retour au début de la page

    Similar models

    Personal Health Record

    1 Formulaires
    1. StudyEvent: ODM
      1. Personal Health Record
    Name
    Type
    Description | Question | Decode (Coded Value)
    Type de données
    Alias
    Item Group
    General Information
    C1508263 (UMLS CUI-1)
    General Information
    Item
    The ‘Personal Health Record’ was developed by the Migration Health Division of the International Organization for Migration with the support from the European Commission and the contribution from the European Centre for Disease Prevention and Control. This is a personal document. It includes in one single document the health data and information that will help the health professionals get a comprehensive view of your health status and needs. You will keep this document with you to help you in further contact with health professionals. The medical check is voluntary and the content of this document is confidential. It is covered by European and national regulations on data protection.
    text
    C1508263 (UMLS CUI [1])
    Item Group
    SECTION A. PATIENT REGISTRATION
    C0011008 (UMLS CUI-1)
    C0030705 (UMLS CUI-2)
    C1514821 (UMLS CUI-3)
    Patient Family Name
    Item
    Patient Family Name
    text
    C1301584 (UMLS CUI [1])
    Patient First Name
    Item
    Patient First Name
    text
    C1443235 (UMLS CUI [1])
    Date of birth
    Item
    Date of birth
    date
    C0421451 (UMLS CUI [1])
    Sex/Gender
    Item
    Sex/Gender
    text
    C0079399 (UMLS CUI [1])
    Country of birth/countries lived in/transited
    Item
    Country of birth/countries lived in/transited
    text
    C1300001 (UMLS CUI [1,1])
    C1562954 (UMLS CUI [1,2])
    C0687759 (UMLS CUI [1,3])
    Telephone or mobile number
    Item
    Telephone or mobile number
    text
    C0421455 (UMLS CUI [1,1])
    C3273868 (UMLS CUI [1,2])
    Email address
    Item
    Email address
    text
    C1705961 (UMLS CUI [1,1])
    C0030705 (UMLS CUI [1,2])
    Marital status
    Item
    Marital status (married/separated/single)
    text
    C0024819 (UMLS CUI [1])
    Number of family members travelling
    Item
    Number of family members travelling
    text
    C0086282 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C0449788 (UMLS CUI [1,3])
    Number of family members travelling young
    Item
    Number of family members traveling under the age of 10
    text
    C0086282 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C0449788 (UMLS CUI [1,3])
    C0001779 (UMLS CUI [1,4])
    Item Group
    SECTION B. SERVICE PROVIDER INFORMATION
    C0679886 (UMLS CUI-1)
    Physician Family Name
    Item
    Physician Family Name
    text
    C2361125 (UMLS CUI [1,1])
    C1301584 (UMLS CUI [1,2])
    Physician First Name
    Item
    Physician First Name
    text
    C2361125 (UMLS CUI [1,1])
    C1443235 (UMLS CUI [1,2])
    Physician Telephone or mobile number
    Item
    Telephone or mobile number
    text
    C1515258 (UMLS CUI [1,1])
    C1710470 (UMLS CUI [1,2])
    Physician Email address
    Item
    Email address
    text
    C1705961 (UMLS CUI [1,1])
    C1710470 (UMLS CUI [1,2])
    Name of medical affiliation
    Item
    Name of medical affiliation (e.g. clinic, hospital)
    text
    C0029239 (UMLS CUI [1,1])
    C1510825 (UMLS CUI [1,2])
    C2371809 (UMLS CUI [1,3])
    City, Country
    Item
    City, Country
    text
    C0019994 (UMLS CUI [1,1])
    C0008848 (UMLS CUI [1,2])
    Interpretation/mediation used
    Item
    Interpretation/mediation used
    boolean
    C0459471 (UMLS CUI [1,1])
    C0262765 (UMLS CUI [1,2])
    Interpretation/mediation comment
    Item
    Interpretation/mediation used
    text
    C0459471 (UMLS CUI [1,1])
    C0262765 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Item Group
    SECTION C. MEDICAL HISTORY
    C0262926 (UMLS CUI-1)
    Illness or injury requiring hospitalization
    Item
    Illness or injury requiring hospitalization
    boolean
    C1836348 (UMLS CUI [1,1])
    C1514873 (UMLS CUI [1,2])
    C0019993 (UMLS CUI [1,3])
    Illness or injury requiring hospitalization comment
    Item
    Illness or injury requiring hospitalization
    text
    C1836348 (UMLS CUI [1,1])
    C1514873 (UMLS CUI [1,2])
    C0019993 (UMLS CUI [1,3])
    C0947611 (UMLS CUI [1,4])
    Surgical interventions
    Item
    Surgical interventions
    boolean
    C0184661 (UMLS CUI [1])
    Surgical interventions comment
    Item
    Surgical interventions
    text
    C0184661 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Heart disease or high blood pressure
    Item
    Heart disease or high blood pressure
    boolean
    C0020538 (UMLS CUI [1,1])
    C0018799 (UMLS CUI [1,2])
    Heart disease or high blood pressure comment
    Item
    Heart disease or high blood pressure
    text
    C0020538 (UMLS CUI [1,1])
    C0018799 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Neurologic disease, incl. stroke or seizures
    Item
    Neurologic disease, incl. stroke or seizures
    boolean
    C0027765 (UMLS CUI [1,1])
    C0036572 (UMLS CUI [1,2])
    C0038454 (UMLS CUI [1,3])
    Neurologic disease, incl. stroke or seizures comment
    Item
    Neurologic disease, incl. stroke or seizures
    text
    C0027765 (UMLS CUI [1,1])
    C0036572 (UMLS CUI [1,2])
    C0038454 (UMLS CUI [1,3])
    C0947611 (UMLS CUI [1,4])
    Mental illness/problems
    Item
    Mental illness/problems
    boolean
    C0004936 (UMLS CUI [1])
    Mental illness/problems comment
    Item
    Mental illness/problems
    text
    C0004936 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Stomach or bowel disease (incl. recent diarrhea)
    Item
    Stomach or bowel disease (incl. recent diarrhea)
    boolean
    C0017178 (UMLS CUI [1,1])
    C0038354 (UMLS CUI [1,2])
    Stomach or bowel disease (incl. recent diarrhea) comment
    Item
    Stomach or bowel disease (incl. recent diarrhea)
    text
    C0017178 (UMLS CUI [1,1])
    C0038354 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Liver or kidney disease
    Item
    Liver or kidney disease
    boolean
    C0023895 (UMLS CUI [1,1])
    C0022658 (UMLS CUI [1,2])
    Liver or kidney disease comment
    Item
    Liver or kidney disease
    text
    C0023895 (UMLS CUI [1,1])
    C0022658 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Diabetes or other endocrine disorder
    Item
    Diabetes or other endocrine disorder
    boolean
    C0014130 (UMLS CUI [1,1])
    C0011849 (UMLS CUI [1,2])
    Diabetes or other endocrine disorder comment
    Item
    Diabetes or other endocrine disorder
    text
    C0014130 (UMLS CUI [1,1])
    C0011849 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Urogenital problems/conditions
    Item
    Urogenital problems/conditions
    boolean
    C0080276 (UMLS CUI [1])
    Urogenital problems/conditions comment
    Item
    Urogenital problems/conditions
    boolean
    C0080276 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Hematologic disease
    Item
    Hematologic disease
    boolean
    C0018939 (UMLS CUI [1])
    Hematologic disease comment
    Item
    Hematologic disease
    text
    C0018939 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Muscle, bone and joint problems
    Item
    Muscle, bone and joint problems
    boolean
    C0575078 (UMLS CUI [1,1])
    C0003862 (UMLS CUI [1,2])
    C0575044 (UMLS CUI [1,3])
    Muscle, bone and joint problems comment
    Item
    Muscle, bone and joint problems
    text
    C0575078 (UMLS CUI [1,1])
    C0003862 (UMLS CUI [1,2])
    C0575044 (UMLS CUI [1,3])
    C0947611 (UMLS CUI [1,4])
    Problems with eyes or ears
    Item
    Problems with eyes or ears
    boolean
    C0262477 (UMLS CUI [1,1])
    C0260662 (UMLS CUI [1,2])
    Problems with eyes or ears comment
    Item
    Problems with eyes or ears
    text
    C0262477 (UMLS CUI [1,1])
    C0260662 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    History of cancer or tumors
    Item
    History of cancer or tumors
    boolean
    C2735088 (UMLS CUI [1])
    History of cancer or tumors comment
    Item
    History of cancer or tumors
    text
    C2735088 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Tuberculosis, pneumonia or other lung disease
    Item
    Tuberculosis, pneumonia or other lung disease
    boolean
    C0024115 (UMLS CUI [1,1])
    C0032285 (UMLS CUI [1,2])
    C0041296 (UMLS CUI [1,3])
    Tuberculosis, pneumonia or other lung disease comment
    Item
    Tuberculosis, pneumonia or other lung disease
    text
    C0024115 (UMLS CUI [1,1])
    C0032285 (UMLS CUI [1,2])
    C0041296 (UMLS CUI [1,3])
    C0947611 (UMLS CUI [1,4])
    Family member or close contact with an infectious disease (or TB contact in general)
    Item
    Family member or close contact with an infectious disease (or TB contact in general)
    boolean
    C0332158 (UMLS CUI [1,1])
    C0086282 (UMLS CUI [1,2])
    C0009450 (UMLS CUI [1,3])
    Family member or close contact with an infectious disease (or TB contact in general) comment
    Item
    Family member or close contact with an infectious disease (or TB contact in general)
    text
    C0332158 (UMLS CUI [1,1])
    C0086282 (UMLS CUI [1,2])
    C0009450 (UMLS CUI [1,3])
    C0947611 (UMLS CUI [1,4])
    Recurrent fever (in the past 6 months)
    Item
    Recurrent fever (in the past 6 months)
    boolean
    C0013806 (UMLS CUI [1,1])
    C2945760 (UMLS CUI [1,2])
    Recurrent fever (in the past 6 months) comment
    Item
    Recurrent fever (in the past 6 months)
    text
    C0013806 (UMLS CUI [1,1])
    C2945760 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Coughing
    Item
    Coughing. Specify if protracted coughing over two weeks, combined with other symptoms
    boolean
    C0010200 (UMLS CUI [1])
    Coughing comment
    Item
    Coughing. Specify if protracted coughing over two weeks, combined with other symptoms
    text
    C0010200 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Significant weight loss
    Item
    Significant weight loss (in the past 6 months)
    boolean
    C1262477 (UMLS CUI [1])
    Significant weight loss comment
    Item
    Significant weight loss (in the past 6 months)
    text
    C1262477 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Sexually transmitted infections
    Item
    Sexually transmitted infections
    boolean
    C0036916 (UMLS CUI [1])
    Sexually transmitted infections comment
    Item
    Sexually transmitted infections
    text
    C0036916 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Skin conditions
    Item
    Skin conditions (e.g. rash)
    boolean
    C0037274 (UMLS CUI [1])
    Skin conditions comment
    Item
    Skin conditions (e.g. rash)
    text
    C0037274 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Tattoos, body piercings
    Item
    Tattoos, body piercings
    boolean
    C0191391 (UMLS CUI [1,1])
    C1446587 (UMLS CUI [1,2])
    Tattoos, body piercings comment
    Item
    Tattoos, body piercings
    text
    C0191391 (UMLS CUI [1,1])
    C1446587 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    History of blood transfusion
    Item
    History of blood transfusion
    boolean
    C1519604 (UMLS CUI [1])
    History of blood transfusion comment
    Item
    History of blood transfusion
    text
    C1519604 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    History of torture, violence
    Item
    History of torture, violence
    boolean
    C0262926 (UMLS CUI [1,1])
    C0042693 (UMLS CUI [1,2])
    C4061703 (UMLS CUI [1,3])
    History of torture, violence comment
    Item
    History of torture, violence
    text
    C0262926 (UMLS CUI [1,1])
    C0042693 (UMLS CUI [1,2])
    C4061703 (UMLS CUI [1,3])
    C0947611 (UMLS CUI [1,4])
    Displaced from home
    Item
    Displaced from home (specify duration)
    text
    C2699029 (UMLS CUI [1,1])
    C2046927 (UMLS CUI [1,2])
    Current medications
    Item
    Current medications (specify)
    text
    C0746467 (UMLS CUI [1])
    Allergies, including to drugs
    Item
    Allergies, including to drugs
    boolean
    C0020517 (UMLS CUI [1,1])
    C0013227 (UMLS CUI [1,2])
    Allergies, including to drugs comment
    Item
    Allergies, including to drugs
    text
    C0020517 (UMLS CUI [1,1])
    C0013227 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Smoking or history of smoking
    Item
    Smoking or history of smoking
    boolean
    C1519384 (UMLS CUI [1,1])
    C0543414 (UMLS CUI [1,2])
    Smoking or history of smoking comment
    Item
    Smoking or history of smoking
    text
    C1519384 (UMLS CUI [1,1])
    C0543414 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Alcohol or history of alcohol
    Item
    Alcohol or history of alcohol
    boolean
    C0221628 (UMLS CUI [1,1])
    C0085762 (UMLS CUI [1,2])
    Alcohol or history of alcohol comment
    Item
    Alcohol or history of alcohol
    text
    C0221628 (UMLS CUI [1,1])
    C0085762 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Pregnancies
    Item
    Pregnancies (number)
    boolean
    C3812254 (UMLS CUI [1])
    Pregnancies comment
    Item
    Pregnancies (number)
    text
    C3812254 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Deliveries
    Item
    Deliveries (number)
    text
    C0559563 (UMLS CUI [1])
    Last menstrual period
    Item
    Last menstrual period
    date
    C0425932 (UMLS CUI [1])
    Current pregnancy
    Item
    Current pregnancy
    boolean
    C0549206 (UMLS CUI [1])
    Current pregnancy comment
    Item
    Current pregnancy
    text
    C0549206 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Gestational week
    Item
    Gestational week
    text
    C0017504 (UMLS CUI [1])
    Item Group
    SECTION D. PATIENT’S IMMUNIZATION RECORD
    C0552506 (UMLS CUI-1)
    Immunization record
    Item
    Immunization record presented/available
    boolean
    C0552506 (UMLS CUI [1,1])
    C0684224 (UMLS CUI [1,2])
    Immunization record comment
    Item
    Immunization record presented/available
    text
    C0552506 (UMLS CUI [1,1])
    C0684224 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Immunization status
    Item
    Immunization status meets age specific requirements based on national requirement of the country of stay. If yes, proceed with points 3-24 and indicate date or age at vaccination
    boolean
    C0552506 (UMLS CUI [1,1])
    C0020405 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    Pediatric diphtheria and tetanus
    Item
    Pediatric diphtheria and tetanus (DT)
    boolean
    C0058773 (UMLS CUI [1,1])
    C1521725 (UMLS CUI [1,2])
    Item
    Pediatric diphtheria and tetanus (DT)
    text
    C0058773 (UMLS CUI [1,1])
    C1521725 (UMLS CUI [1,2])
    Pediatric diphtheria and tetanus
    Code List
    Pediatric diphtheria and tetanus (DT)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Pediatric diphtheria and tetanus comment
    Item
    Pediatric diphtheria and tetanus (DT)
    text
    C0058773 (UMLS CUI [1,1])
    C1521725 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Diphtheria, tetanus, pertussis (DTP)
    Item
    Diphtheria, tetanus, pertussis (DTP)
    boolean
    C0012559 (UMLS CUI [1])
    Item
    Diphtheria, tetanus, pertussis (DTP)
    text
    C0012559 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Diphtheria, tetanus, pertussis (DTP)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Diphtheria, tetanus, pertussis (DTP) comment
    Item
    Diphtheria, tetanus, pertussis (DTP)
    text
    C0012559 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)
    Item
    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)
    boolean
    C0012559 (UMLS CUI [1,1])
    C1521725 (UMLS CUI [1,2])
    Item
    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)
    text
    C0012559 (UMLS CUI [1,1])
    C1521725 (UMLS CUI [1,2])
    Pediatric diphtheria and tetanus
    Code List
    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Pediatric diphtheria, tetanus and acellular pertussis (DTaP) comment
    Item
    Pediatric diphtheria, tetanus and acellular pertussis (DTaP)
    text
    C0012559 (UMLS CUI [1,1])
    C1521725 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Older children and adults tetanus and diphtheria vaccine (Td)
    Item
    Older children and adults tetanus and diphtheria vaccine (Td)
    boolean
    C0058773 (UMLS CUI [1,1])
    C0001675 (UMLS CUI [1,2])
    C0008059 (UMLS CUI [1,3])
    Item
    Older children and adults tetanus and diphtheria vaccine (Td)
    text
    C0058773 (UMLS CUI [1,1])
    C0001675 (UMLS CUI [1,2])
    C0008059 (UMLS CUI [1,3])
    Pediatric diphtheria and tetanus
    Code List
    Older children and adults tetanus and diphtheria vaccine (Td)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Older children and adults tetanus and diphtheria vaccine (Td) comment
    Item
    Older children and adults tetanus and diphtheria vaccine (Td)
    text
    C0058773 (UMLS CUI [1,1])
    C0001675 (UMLS CUI [1,2])
    C0008059 (UMLS CUI [1,3])
    C0947611 (UMLS CUI [1,4])
    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)
    Item
    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)
    boolean
    C0012559 (UMLS CUI [1,1])
    C0001675 (UMLS CUI [1,2])
    C0008059 (UMLS CUI [1,3])
    Item
    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)
    text
    C0012559 (UMLS CUI [1,1])
    C0001675 (UMLS CUI [1,2])
    C0008059 (UMLS CUI [1,3])
    Pediatric diphtheria and tetanus
    Code List
    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap) comment
    Item
    Older children and adults tetanus, diphtheria and acellular pertussis (Tdap)
    text
    C0012559 (UMLS CUI [1,1])
    C0001675 (UMLS CUI [1,2])
    C0008059 (UMLS CUI [1,3])
    C0947611 (UMLS CUI [1,4])
    Oral Polio vaccine (OPV)
    Item
    Oral Polio vaccine (OPV)
    boolean
    C0032375 (UMLS CUI [1])
    Item
    Oral Polio vaccine (OPV)
    text
    C0032375 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Oral Polio vaccine (OPV)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Oral Polio vaccine (OPV) comment
    Item
    Oral Polio vaccine (OPV)
    text
    C0032375 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Inactivated Polio vaccine (IPV)
    Item
    Inactivated Polio vaccine (IPV)
    boolean
    C0718003 (UMLS CUI [1])
    Item
    Inactivated Polio vaccine (IPV)
    text
    C0718003 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Inactivated Polio vaccine (IPV)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Inactivated Polio vaccine (IPV) comment
    Item
    Inactivated Polio vaccine (IPV)
    text
    C0718003 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Measles, mumps, rubella (MMR)
    Item
    Measles, mumps, rubella (MMR)
    boolean
    C0065828 (UMLS CUI [1])
    Item
    Measles, mumps, rubella (MMR)
    text
    C0065828 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Measles, mumps, rubella (MMR)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Measles, mumps, rubella (MMR) comment
    Item
    Measles, mumps, rubella (MMR)
    text
    C0065828 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Rubella
    Item
    Rubella
    boolean
    C0042206 (UMLS CUI [1])
    Item
    Rubella
    text
    C0042206 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Rubella
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Rubella comment
    Item
    Rubella
    text
    C0042206 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Measles
    Item
    Measles
    boolean
    C0042201 (UMLS CUI [1])
    Item
    Measles
    text
    C0042201 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Measles
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Measles comment
    Item
    Measles
    text
    C0042201 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Measles-Rubella
    Item
    Measles-Rubella
    boolean
    C0042201 (UMLS CUI [1,1])
    C0042206 (UMLS CUI [1,2])
    Item
    Measles-Rubella
    text
    C0042201 (UMLS CUI [1,1])
    C0042206 (UMLS CUI [1,2])
    Pediatric diphtheria and tetanus
    Code List
    Measles-Rubella
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Measles-Rubella comment
    Item
    Measles-Rubella
    text
    C0042201 (UMLS CUI [1,1])
    C0042206 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Mumps
    Item
    Mumps
    boolean
    C0042202 (UMLS CUI [1])
    Item
    Mumps
    text
    C0042202 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Mumps
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Mumps comment
    Item
    Mumps
    text
    C0042202 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Mumps-Rubella
    Item
    Mumps-Rubella
    boolean
    C0042202 (UMLS CUI [1,1])
    C0042206 (UMLS CUI [1,2])
    Item
    Mumps-Rubella
    text
    C0042202 (UMLS CUI [1,1])
    C0042206 (UMLS CUI [1,2])
    Pediatric diphtheria and tetanus
    Code List
    Mumps-Rubella
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Mumps-Rubella comment
    Item
    Mumps-Rubella
    text
    C0042202 (UMLS CUI [1,1])
    C0042206 (UMLS CUI [1,2])
    C0947611 (UMLS CUI [1,3])
    Haemophilus influenzae type B (Hib)
    Item
    Haemophilus influenzae type B (Hib)
    boolean
    C0199818 (UMLS CUI [1])
    Item
    Haemophilus influenzae type B (Hib)
    text
    C0199818 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Haemophilus influenzae type B (Hib)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Haemophilus influenzae type B (Hib) comment
    Item
    Haemophilus influenzae type B (Hib)
    text
    C0199818 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Hepatitis A
    Item
    Hepatitis A
    boolean
    C0419735 (UMLS CUI [1])
    Item
    Hepatitis A
    text
    C0419735 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Hepatitis A
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Hepatitis A comment
    Item
    Hepatitis A
    text
    C0419735 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Hepatitis B
    Item
    Hepatitis B
    boolean
    C0474232 (UMLS CUI [1])
    Item
    Hepatitis B
    text
    C0474232 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Hepatitis B
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Hepatitis B comment
    Item
    Hepatitis B
    text
    C0474232 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Meningococcal
    Item
    Meningococcal
    boolean
    C0700144 (UMLS CUI [1])
    Item
    Meningococcal
    text
    C0700144 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Meningococcal
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Meningococcal comment
    Item
    Meningococcal
    text
    C0700144 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Human papillomavirus (HPV)
    Item
    Human papillomavirus (HPV)
    boolean
    C1512511 (UMLS CUI [1])
    Item
    Human papillomavirus (HPV)
    text
    C1512511 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Human papillomavirus (HPV)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Human papillomavirus (HPV) comment
    Item
    Human papillomavirus (HPV)
    text
    C1512511 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Varicella (chicken pox)
    Item
    Varicella (chicken pox)
    boolean
    C0078048 (UMLS CUI [1])
    Item
    Varicella (chicken pox)
    text
    C0078048 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Varicella (chicken pox)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Varicella (chicken pox) comment
    Item
    Varicella (chicken pox)
    text
    C0078048 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Herpes zoster (shingles)
    Item
    Herpes zoster (shingles)
    boolean
    C1720918 (UMLS CUI [1])
    Item
    Herpes zoster (shingles)
    text
    C1720918 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Herpes zoster (shingles)
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Herpes zoster (shingles) comment
    Item
    Herpes zoster (shingles)
    text
    C1720918 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Pneumococcal
    Item
    Pneumococcal
    boolean
    C0419707 (UMLS CUI [1])
    Item
    Pneumococcal
    text
    C0419707 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Pneumococcal
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Pneumococcal comment
    Item
    Pneumococcal
    text
    C0419707 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Influenza
    Item
    Influenza
    boolean
    C0021403 (UMLS CUI [1])
    Item
    Influenza
    text
    C0021403 (UMLS CUI [1])
    Pediatric diphtheria and tetanus
    Code List
    Influenza
    CL Item
    Completed series (C)
    CL Item
    Not age appropriate (A)
    CL Item
    Insufficient time interval (T)
    CL Item
    Contraindicated (F)
    CL Item
    Not routinely available (R)
    CL Item
    Not appropriate season for vaccination (S)
    Influenza comment
    Item
    Influenza
    text
    C0021403 (UMLS CUI [1,1])
    C0947611 (UMLS CUI [1,2])
    Item Group
    SECTION E. CLINICAL MEASUREMENTS
    C0205485 (UMLS CUI-1)
    C0242485 (UMLS CUI-2)
    Height
    Item
    Height
    integer
    C0489786 (UMLS CUI [1])
    Weight
    Item
    Weight
    integer
    C0005910 (UMLS CUI [1])
    BMI
    Item
    BMI
    integer
    C1305855 (UMLS CUI [1])
    Head circumference
    Item
    Head circumference if <18months
    integer
    C0262499 (UMLS CUI [1])
    Blood pressure initial: Systolic
    Item
    Blood pressure initial: Systolic
    integer
    C0871470 (UMLS CUI [1,1])
    C0205265 (UMLS CUI [1,2])
    Blood pressure initial: Dyastolic
    Item
    Blood pressure initial: Dyastolic
    integer
    C0428883 (UMLS CUI [1,1])
    C0205265 (UMLS CUI [1,2])
    Blood pressure repeated: Systolic
    Item
    Blood pressure repeated: Systolic
    integer
    C0871470 (UMLS CUI [1,1])
    C0205341 (UMLS CUI [1,2])
    Blood pressure repeated: Dyastolic
    Item
    Blood pressure repeated: Dyastolic
    integer
    C0428883 (UMLS CUI [1,1])
    C0205341 (UMLS CUI [1,2])
    Pulse initial
    Item
    Pulse initial
    integer
    C0232117 (UMLS CUI [1,1])
    C0205265 (UMLS CUI [1,2])
    Respiratory Rate
    Item
    Respiratory Rate
    integer
    C0231832 (UMLS CUI [1])
    Pulse repeated
    Item
    Pulse repeated
    integer
    C0232117 (UMLS CUI [1,1])
    C0205341 (UMLS CUI [1,2])
    Visual Acuity Left uncorrected
    Item
    Visual Acuity Left uncorrected
    text
    C0042812 (UMLS CUI [1,1])
    C0205091 (UMLS CUI [1,2])
    Visual Acuity Right uncorrected
    Item
    Visual Acuity Right uncorrected
    text
    C0042812 (UMLS CUI [1,1])
    C0205090 (UMLS CUI [1,2])
    Visual Acuity Left corrected
    Item
    Visual Acuity Left corrected
    text
    C1690532 (UMLS CUI [1,1])
    C0229090 (UMLS CUI [1,2])
    Visual Acuity Right corrected
    Item
    Visual Acuity Right corrected
    text
    C1690532 (UMLS CUI [1,1])
    C0229089 (UMLS CUI [1,2])
    Item Group
    SECTION F. EXAM FINDINGS
    C0031809 (UMLS CUI-1)
    Item
    General appearance and nutritional status
    integer
    C1148438 (UMLS CUI [1,1])
    C0392209 (UMLS CUI [1,2])
    General appearance and nutritional status
    Code List
    General appearance and nutritional status
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Hearing and ears
    integer
    C0455216 (UMLS CUI [1])
    General appearance and nutritional status
    Code List
    Hearing and ears
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Eyes
    integer
    C0015392 (UMLS CUI [1,1])
    C0031809 (UMLS CUI [1,2])
    General appearance and nutritional status
    Code List
    Eyes
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Nose, mouth and throat (include dental)
    integer
    C0553490 (UMLS CUI [1,1])
    C0031809 (UMLS CUI [1,2])
    General appearance and nutritional status
    Code List
    Nose, mouth and throat (include dental)
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Heart (S1, S2, murmur, rub)
    integer
    C0562319 (UMLS CUI [1])
    General appearance and nutritional status
    Code List
    Heart (S1, S2, murmur, rub)
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Breast
    integer
    C0199850 (UMLS CUI [1])
    General appearance and nutritional status
    Code List
    Breast
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Lungs
    integer
    C2228454 (UMLS CUI [1])
    General appearance and nutritional status
    Code List
    Lungs
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Abdomen (including liver, spleen)
    integer
    C0562238 (UMLS CUI [1])
    General appearance and nutritional status
    Code List
    Abdomen (including liver, spleen)
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Genitalia
    integer
    C0031809 (UMLS CUI [1,1])
    C0017420 (UMLS CUI [1,2])
    General appearance and nutritional status
    Code List
    Genitalia
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Inguinal region (including adenopathy)
    integer
    C0031809 (UMLS CUI [1,1])
    C0018246 (UMLS CUI [1,2])
    General appearance and nutritional status
    Code List
    Inguinal region (including adenopathy)
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Extremities (including pulses, edema)
    integer
    C0436150 (UMLS CUI [1])
    General appearance and nutritional status
    Code List
    Extremities (including pulses, edema)
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Musculoskeletal system (including gait)
    integer
    C0031809 (UMLS CUI [1,1])
    C0026860 (UMLS CUI [1,2])
    General appearance and nutritional status
    Code List
    Musculoskeletal system (including gait)
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Skin (including findings consistent with self-inflicted injury or injections)
    integer
    C0582103 (UMLS CUI [1,1])
    C1123023 (UMLS CUI [1,2])
    General appearance and nutritional status
    Code List
    Skin (including findings consistent with self-inflicted injury or injections)
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Lymph nodes
    integer
    C0031809 (UMLS CUI [1,1])
    C0024204 (UMLS CUI [1,2])
    General appearance and nutritional status
    Code List
    Lymph nodes
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Nervous system
    integer
    C0027763 (UMLS CUI [1,1])
    C0031809 (UMLS CUI [1,2])
    General appearance and nutritional status
    Code List
    Nervous system
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item
    Mental status (including mood, intelligence, perception, thought processes, behaviour during examination…)
    integer
    C3260990 (UMLS CUI [1])
    General appearance and nutritional status
    Code List
    Mental status (including mood, intelligence, perception, thought processes, behaviour during examination…)
    CL Item
    Normal (1)
    CL Item
    Abnormal (2)
    CL Item
    Not assessed (3)
    Item Group
    SECTION G. LABORATORY/OTHER TESTS
    C0022885 (UMLS CUI-1)
    C0582103 (UMLS CUI-2)
    C0205394 (UMLS CUI-3)
    Urinalysis: dipstick
    Item
    Urinalysis: dipstick for albumin or protein, sugar and blood
    text
    C0042014 (UMLS CUI [1,1])
    C0430370 (UMLS CUI [1,2])
    C0022885 (UMLS CUI [1,3])
    Malaria rapid test
    Item
    Malaria rapid test (pan malaria)
    text
    C2368143 (UMLS CUI [1])
    Pregnancy
    Item
    Pregnancy
    text
    C0032976 (UMLS CUI [1])
    Electrocardiogram
    Item
    Electrocardiogram
    text
    C0013798 (UMLS CUI [1])
    Mantoux
    Item
    Mantoux
    text
    C0041290 (UMLS CUI [1])
    Item Group
    SECTION H. DIAGNOSTICS
    C0430022 (UMLS CUI-1)
    Imaging: chest X-ray
    Item
    Imaging: chest X-ray
    text
    C0039985 (UMLS CUI [1])
    Imaging: other X-ray
    Item
    Imaging: other X-ray
    text
    C1306645 (UMLS CUI [1])
    Imaging: other imaging examination
    Item
    Imaging: other imaging examination (e.g. ultrasound, etc.)
    text
    C0011923 (UMLS CUI [1,1])
    C0079595 (UMLS CUI [1,2])
    C0205394 (UMLS CUI [1,3])
    Electrocardiogram
    Item
    Electrocardiogram (if not performed at hotspot)
    text
    C0013798 (UMLS CUI [1])
    Laboratory: full blood count
    Item
    Laboratory: full blood count
    text
    C0005771 (UMLS CUI [1])
    Laboratory: creatinine
    Item
    Laboratory: creatinine
    text
    C0201975 (UMLS CUI [1])
    Laboratory: hep B surface antigen
    Item
    Laboratory: hep B surface antigen (HBsAg)
    text
    C0201477 (UMLS CUI [1])
    Laboratory: hep C serology
    Item
    Laboratory: hep C serology
    text
    C0459958 (UMLS CUI [1,1])
    C0019196 (UMLS CUI [1,2])
    Laboratory: HIV
    Item
    Laboratory: HIV
    text
    C0022877 (UMLS CUI [1,1])
    C0019682 (UMLS CUI [1,2])
    Laboratory: syphilis
    Item
    Laboratory: syphilis
    text
    C3516463 (UMLS CUI [1])
    Laboratory: liver function tests
    Item
    Laboratory: liver function tests
    text
    C0023901 (UMLS CUI [1])
    Laboratory: tuberculosis (sputum smear)
    Item
    Laboratory: tuberculosis (sputum smear)
    text
    C0041296 (UMLS CUI [1,1])
    C0444186 (UMLS CUI [1,2])
    Instrument: mini-mental state
    Item
    Instrument: mini-mental state dementia screening form
    text
    C0451306 (UMLS CUI [1])
    Instrument: assessment of activities of daily living
    Item
    Instrument: assessment of activities of daily living
    text
    C0001288 (UMLS CUI [1,1])
    C1518965 (UMLS CUI [1,2])
    Instrument: chart of early childhood development
    Item
    Instrument: chart of early childhood development
    text
    C0870455 (UMLS CUI [1])
    Other referrals
    Item
    Other referrals
    text
    C0205394 (UMLS CUI [1,1])
    C0022877 (UMLS CUI [1,2])
    Item Group
    SECTION I. SUMMARY FINDINGS
    C0242482 (UMLS CUI-1)
    Significant medical condition
    Item
    Significant medical condition has been identified?
    text
    C3843040 (UMLS CUI [1,1])
    C0750502 (UMLS CUI [1,2])
    ICD A15-A19
    Item
    ICD A15-A19
    text
    C0041296 (UMLS CUI [1])
    ICD A15-A19
    Item
    ICD A15-A19
    text
    C0041296 (UMLS CUI [1])
    ICD A50-A64
    Item
    ICD A50-A64
    text
    C0036916 (UMLS CUI [1])
    ICD B20-B24
    Item
    ICD B20-B24
    text
    C0019682 (UMLS CUI [1])
    Physical impairment/disability
    Item
    Physical impairment/disability
    text
    C0231171 (UMLS CUI [1])
    Significant mental health condition
    Item
    Significant mental health condition
    text
    C3840291 (UMLS CUI [1])
    Addiction
    Item
    Addiction (abuse) of specific substances
    text
    C0038586 (UMLS CUI [1])
    Other significant condition
    Item
    Other significant condition (specify):
    text
    C3843040 (UMLS CUI [1,1])
    C0750502 (UMLS CUI [1,2])
    Item Group
    SECTION J. TREATMENT RECOMMENDATION
    C0039798 (UMLS CUI-1)
    C0034866 (UMLS CUI-2)
    Treatment required?
    Item
    Treatment required?
    text
    C0332121 (UMLS CUI [1])
    Treatment required For ICD A50-A64?
    Item
    Treatment required For ICD A50-A64?
    text
    C0332121 (UMLS CUI [1,1])
    C0036916 (UMLS CUI [1,2])
    Treatment required for malaria?
    Item
    Treatment required for malaria?
    text
    C0332121 (UMLS CUI [1,1])
    C0024530 (UMLS CUI [1,2])
    Treatment required for gastrointestinal parasites?
    Item
    Treatment required for gastrointestinal parasites? (e.g. presumptive treatment)
    text
    C0332121 (UMLS CUI [1,1])
    C0017178 (UMLS CUI [1,2])
    C0030498 (UMLS CUI [1,3])
    Treatment required for acute condition?
    Item
    Treatment required for acute condition?
    text
    C0332121 (UMLS CUI [1,1])
    C1699700 (UMLS CUI [1,2])
    C0205178 (UMLS CUI [1,3])
    Treatment required for chronic condition?
    Item
    Treatment required for chronic condition?
    text
    C0332121 (UMLS CUI [1,1])
    C0008679 (UMLS CUI [1,2])
    Hospitalisation required (immediate)
    Item
    Hospitalisation required (immediate)
    text
    C0019993 (UMLS CUI [1,1])
    C0205253 (UMLS CUI [1,2])
    Hospitalisation required (within several days)
    Item
    Hospitalisation required (within several days)
    text
    C0019993 (UMLS CUI [1,1])
    C3844034 (UMLS CUI [1,2])
    Hospitalisation required (within several months)
    Item
    Hospitalisation required (within several months)
    text
    C0019993 (UMLS CUI [1,1])
    C0439231 (UMLS CUI [1,2])
    Immunisation required?
    Item
    Immunisation required?
    text
    C0020971 (UMLS CUI [1,1])
    C1514873 (UMLS CUI [1,2])
    Adjusted/appropriate accommodation required?
    Item
    Adjusted/appropriate accommodation required?
    text
    C0595920 (UMLS CUI [1,1])
    C1514873 (UMLS CUI [1,2])
    Item Group
    SECTION K. TRAVEL RECOMMENDATION
    C0034866 (UMLS CUI-1)
    C0040802 (UMLS CUI-2)
    Fit for further travel?
    Item
    Fit for further travel? (Yes / conditionally / no)
    text
    C0040802 (UMLS CUI [1,1])
    C0424576 (UMLS CUI [1,2])
    Special medical attention during the travel?
    Item
    Special medical attention during the travel?
    text
    C0040802 (UMLS CUI [1,1])
    C0004268 (UMLS CUI [1,2])
    C1830593 (UMLS CUI [1,3])
    If pregnant, not to travel before ……?
    Item
    If pregnant, not to travel before ……?
    text
    C0549206 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C0040223 (UMLS CUI [1,3])
    If pregnant, to travel before …?
    Item
    If pregnant, to travel before …?
    text
    C0549206 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C0040223 (UMLS CUI [1,3])
    TRQ: ambulance
    Item
    TRQ: ambulance
    text
    C0002422 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    TRQ: WCH
    Item
    TRQ: WCH
    text
    C0043143 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    TRQ: stretcher
    Item
    TRQ: stretcher
    text
    C0972406 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    TRQ: oxygen
    Item
    TRQ: oxygen
    text
    C0184633 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    TRQ: bowel preparation
    Item
    TRQ: bowel preparation
    text
    C0455052 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    TRQ: diapers
    Item
    TRQ: diapers
    text
    C1875617 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    TRQ: urinary catheter
    Item
    TRQ: urinary catheter
    text
    C0179802 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    TRQ: other
    Item
    TRQ: other
    text
    C0205394 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    TRQ: medical escort
    Item
    TRQ: medical escort
    text
    C1547632 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    TRQ: family escort
    Item
    TRQ: family escort
    text
    C1547632 (UMLS CUI [1,1])
    C0015576 (UMLS CUI [1,2])
    TRQ: operational escort
    Item
    TRQ: operational escort
    text
    C1547632 (UMLS CUI [1,1])
    C0040802 (UMLS CUI [1,2])
    Item Group
    SECTION L. POST-ARRIVAL RECOMMENDATION
    C0034866 (UMLS CUI-1)
    C1706079 (UMLS CUI-2)
    PTR: special schooling needs
    Item
    PTR: special schooling needs
    text
    C0871403 (UMLS CUI [1,1])
    C0455002 (UMLS CUI [1,2])
    PTR: consequences on daily living activities (assistance required)
    Item
    PTR: consequences on daily living activities (assistance required)
    text
    C0001288 (UMLS CUI [1,1])
    C3840284 (UMLS CUI [1,2])
    PTR: special housing requirements
    Item
    PTR: special housing requirements
    text
    C0871403 (UMLS CUI [1,1])
    C0020056 (UMLS CUI [1,2])
    C1514873 (UMLS CUI [1,3])
    PTR: follow-up examination needed by GP (within 1 w/1 m/6 m)
    Item
    PTR: follow-up examination needed by GP (within 1 w/1 m/6 m)
    text
    C3694716 (UMLS CUI [1,1])
    C0017319 (UMLS CUI [1,2])
    PTR: Follow-up examination needed by specialist (within 1 w/1 m/6 m)
    Item
    PTR: Follow-up examination needed by specialist (within 1 w/1 m/6 m)
    text
    C3694716 (UMLS CUI [1,1])
    C1611835 (UMLS CUI [1,2])
    Item Group
    SECTION M. TREATMENT ADMINISTRATION
    C1533734 (UMLS CUI-1)
    Tx administered for ICD A50-A64
    Item
    Tx administered for ICD A50-A64
    text
    C1533734 (UMLS CUI [1,1])
    C0036916 (UMLS CUI [1,2])
    Tx administered for malaria
    Item
    Tx administered for malaria
    text
    C1533734 (UMLS CUI [1,1])
    C0024530 (UMLS CUI [1,2])
    Tx administered for gastrointestinal parasites
    Item
    Tx administered for gastrointestinal parasites
    text
    C1533734 (UMLS CUI [1,1])
    C0030498 (UMLS CUI [1,2])
    C0017178 (UMLS CUI [1,3])
    Tx administered for other conditions
    Item
    Tx administered for other conditions (specify medication and dosage)
    text
    C1533734 (UMLS CUI [1,1])
    C3843040 (UMLS CUI [1,2])
    C0013227 (UMLS CUI [1,3])
    C0178602 (UMLS CUI [1,4])
    Tx — other treatment applied (specify)
    Item
    Tx — other treatment applied (specify)
    text
    C1533734 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    Item Group
    SECTION N. VACCINE ADMINISTRATION
    C2368628 (UMLS CUI-1)
    Vaccine administered
    Item
    Vaccine administered (date/dose and application/batch #)
    text
    C2368628 (UMLS CUI [1,1])
    C1115436 (UMLS CUI [1,2])
    C0178602 (UMLS CUI [1,3])
    Vaccine: DT
    Item
    Vaccine: DT
    text
    C0058773 (UMLS CUI [1])
    Vaccine: DTP
    Item
    Vaccine: DTP
    text
    C0012559 (UMLS CUI [1])
    Vaccine: DTaP
    Item
    Vaccine: DTaP
    text
    C3526553 (UMLS CUI [1])
    Vaccine: Td
    Item
    Vaccine: Td
    text
    C0058773 (UMLS CUI [1])
    Vaccine: Tdap
    Item
    Vaccine: Tdap
    text
    C3526553 (UMLS CUI [1])
    Vaccine: polio — OPV
    Item
    Vaccine: polio — OPV
    text
    C0032375 (UMLS CUI [1])
    Vaccine: polio — IPV
    Item
    Vaccine: polio — IPV
    text
    C0718003 (UMLS CUI [1])
    Vaccine: MMR
    Item
    Vaccine: MMR
    text
    C0065828 (UMLS CUI [1])
    Vaccine: rubella
    Item
    Vaccine: rubella
    text
    C0035923 (UMLS CUI [1])
    Vaccine: measles
    Item
    Vaccine: measles
    text
    C0025010 (UMLS CUI [1])
    Vaccine: measles-rubella
    Item
    Vaccine: measles-rubella
    text
    C0361142 (UMLS CUI [1])
    Vaccine: mumps
    Item
    Vaccine: mumps
    text
    C0026782 (UMLS CUI [1])
    Vaccine: mumps-rubella
    Item
    Vaccine: mumps-rubella
    text
    C0694750 (UMLS CUI [1])
    Vaccine: Hib
    Item
    Vaccine: Hib
    text
    C0062086 (UMLS CUI [1])
    Vaccine: hep A
    Item
    Vaccine: hep A
    text
    C0795623 (UMLS CUI [1])
    Vaccine: hep B
    Item
    Vaccine: hep B
    text
    C2240392 (UMLS CUI [1])
    Vaccine: meningococcal
    Item
    Vaccine: meningococcal
    text
    C0700144 (UMLS CUI [1])
    Vaccine: human papillomavirus
    Item
    Vaccine: human papillomavirus
    text
    C1512511 (UMLS CUI [1])
    Vaccine: varicella
    Item
    Vaccine: varicella
    text
    C0078048 (UMLS CUI [1])
    Vaccine: pneumococcal
    Item
    Vaccine: pneumococcal
    text
    C0358314 (UMLS CUI [1])
    Vaccine: influenza
    Item
    Vaccine: influenza
    text
    C0021403 (UMLS CUI [1])
    Vaccine: others
    Item
    Vaccine: others
    text
    C0205394 (UMLS CUI [1,1])
    C0042210 (UMLS CUI [1,2])
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