ID

44574

Beschrijving

Personal Health Record السجل الصحي الشخ ي ص

Trefwoorden

Versies (3)
  1. 06-11-17 06-11-17 -
  2. 21-11-17 21-11-17 -
  3. 27-09-21 27-09-21 -
Houder van rechten

European Union

Geüploaded op

27 september 2021

DOI

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Licentie

Creative Commons BY-NC 3.0
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Personal Health Record

Arabic Engels

Personal Health Record

1 Formulieren  
  1. StudyEvent: ODM
    1. Personal Health Record
General Information
Beschrijving

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.
Beschrijving

General Information

Datatype

text

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

SECTION A. PATIENT REGISTRATION

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

Patient Family Name

Datatype

text

Alias
UMLS CUI [1]
C1301584
Patient First Name
Beschrijving

Patient First Name

Datatype

text

Alias
UMLS CUI [1]
C1443235
Date of birth
Beschrijving

Date of birth

Datatype

date

Alias
UMLS CUI [1]
C0421451
Sex/Gender
Beschrijving

Sex/Gender

Datatype

text

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

Country of birth/countries lived in/transited

Datatype

text

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

Telephone or mobile number

Datatype

text

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

Email address

Datatype

text

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

Marital status

Datatype

text

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

Number of family members travelling

Datatype

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
Beschrijving

Number of family members travelling young

Datatype

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
Beschrijving

SECTION B. SERVICE PROVIDER INFORMATION

Alias
UMLS CUI-1
C0679886
Physician Family Name
Beschrijving

Physician Family Name

Datatype

text

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

Physician First Name

Datatype

text

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

Physician Telephone or mobile number

Datatype

text

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

Physician Email address

Datatype

text

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

Name of medical affiliation

Datatype

text

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

City, Country

Datatype

text

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

Interpretation/mediation used

Datatype

boolean

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

Interpretation/mediation comment

Datatype

text

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

SECTION C. MEDICAL HISTORY

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

Illness or injury requiring hospitalization

Datatype

boolean

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

Illness or injury requiring hospitalization comment

Datatype

text

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

Surgical interventions

Datatype

boolean

Alias
UMLS CUI [1]
C0184661
Surgical interventions
Beschrijving

Surgical interventions comment

Datatype

text

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

Heart disease or high blood pressure

Datatype

boolean

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

Heart disease or high blood pressure comment

Datatype

text

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

Neurologic disease, incl. stroke or seizures

Datatype

boolean

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

Neurologic disease, incl. stroke or seizures comment

Datatype

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
Beschrijving

Mental illness/problems

Datatype

boolean

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

Mental illness/problems comment

Datatype

text

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

Stomach or bowel disease (incl. recent diarrhea)

Datatype

boolean

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

Stomach or bowel disease (incl. recent diarrhea) comment

Datatype

text

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

Liver or kidney disease

Datatype

boolean

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

Liver or kidney disease comment

Datatype

text

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

Diabetes or other endocrine disorder

Datatype

boolean

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

Diabetes or other endocrine disorder comment

Datatype

text

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

Urogenital problems/conditions

Datatype

boolean

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

Urogenital problems/conditions comment

Datatype

boolean

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

Hematologic disease

Datatype

boolean

Alias
UMLS CUI [1]
C0018939
Hematologic disease
Beschrijving

Hematologic disease comment

Datatype

text

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

Muscle, bone and joint problems

Datatype

boolean

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

Muscle, bone and joint problems comment

Datatype

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
Beschrijving

Problems with eyes or ears

Datatype

boolean

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

Problems with eyes or ears comment

Datatype

text

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

History of cancer or tumors

Datatype

boolean

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

History of cancer or tumors comment

Datatype

text

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

Tuberculosis, pneumonia or other lung disease

Datatype

boolean

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

Tuberculosis, pneumonia or other lung disease comment

Datatype

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)
Beschrijving

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

Datatype

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)
Beschrijving

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

Datatype

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)
Beschrijving

Recurrent fever (in the past 6 months)

Datatype

boolean

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

Recurrent fever (in the past 6 months) comment

Datatype

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
Beschrijving

Coughing

Datatype

boolean

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

Coughing comment

Datatype

text

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

Significant weight loss

Datatype

boolean

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

Significant weight loss comment

Datatype

text

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

Sexually transmitted infections

Datatype

boolean

Alias
UMLS CUI [1]
C0036916
Sexually transmitted infections
Beschrijving

Sexually transmitted infections comment

Datatype

text

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

Skin conditions

Datatype

boolean

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

Skin conditions comment

Datatype

text

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

Tattoos, body piercings

Datatype

boolean

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

Tattoos, body piercings comment

Datatype

text

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

History of blood transfusion

Datatype

boolean

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

History of blood transfusion comment

Datatype

text

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

History of torture, violence

Datatype

boolean

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

History of torture, violence comment

Datatype

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)
Beschrijving

Displaced from home

Datatype

text

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

Current medications

Datatype

text

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

Allergies, including to drugs

Datatype

boolean

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

Allergies, including to drugs comment

Datatype

text

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

Smoking or history of smoking

Datatype

boolean

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

Smoking or history of smoking comment

Datatype

text

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

Alcohol or history of alcohol

Datatype

boolean

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

Alcohol or history of alcohol comment

Datatype

text

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

Pregnancies

Datatype

boolean

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

Pregnancies comment

Datatype

text

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

Deliveries

Datatype

text

Alias
UMLS CUI [1]
C0559563
Last menstrual period
Beschrijving

Last menstrual period

Datatype

date

Alias
UMLS CUI [1]
C0425932
Current pregnancy
Beschrijving

Current pregnancy

Datatype

boolean

Alias
UMLS CUI [1]
C0549206
Current pregnancy
Beschrijving

Current pregnancy comment

Datatype

text

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

Gestational week

Datatype

text

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

SECTION D. PATIENT’S IMMUNIZATION RECORD

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

Immunization record

Datatype

boolean

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

Immunization record comment

Datatype

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
Beschrijving

Immunization status

Datatype

boolean

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

Pediatric diphtheria and tetanus

Datatype

boolean

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

Pediatric diphtheria and tetanus

Datatype

text

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

Pediatric diphtheria and tetanus comment

Datatype

text

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

Diphtheria, tetanus, pertussis (DTP)

Datatype

boolean

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

Diphtheria, tetanus, pertussis (DTP)

Datatype

text

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

Diphtheria, tetanus, pertussis (DTP) comment

Datatype

text

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

Pediatric diphtheria, tetanus and acellular pertussis (DTaP)

Datatype

boolean

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

Pediatric diphtheria, tetanus and acellular pertussis (DTaP)

Datatype

text

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

Pediatric diphtheria, tetanus and acellular pertussis (DTaP) comment

Datatype

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)
Beschrijving

Older children and adults tetanus and diphtheria vaccine (Td)

Datatype

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)
Beschrijving

Older children and adults tetanus and diphtheria vaccine (Td)

Datatype

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)
Beschrijving

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

Datatype

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)
Beschrijving

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

Datatype

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)
Beschrijving

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

Datatype

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)
Beschrijving

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

Datatype

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)
Beschrijving

Oral Polio vaccine (OPV)

Datatype

boolean

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

Oral Polio vaccine (OPV)

Datatype

text

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

Oral Polio vaccine (OPV) comment

Datatype

text

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

Inactivated Polio vaccine (IPV)

Datatype

boolean

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

Inactivated Polio vaccine (IPV)

Datatype

text

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

Inactivated Polio vaccine (IPV) comment

Datatype

text

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

Measles, mumps, rubella (MMR)

Datatype

boolean

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

Measles, mumps, rubella (MMR)

Datatype

text

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

Measles, mumps, rubella (MMR) comment

Datatype

text

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

Rubella

Datatype

boolean

Alias
UMLS CUI [1]
C0042206
Rubella
Beschrijving

Rubella

Datatype

text

Alias
UMLS CUI [1]
C0042206
Rubella
Beschrijving

Rubella comment

Datatype

text

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

Measles

Datatype

boolean

Alias
UMLS CUI [1]
C0042201
Measles
Beschrijving

Measles

Datatype

text

Alias
UMLS CUI [1]
C0042201
Measles
Beschrijving

Measles comment

Datatype

text

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

Measles-Rubella

Datatype

boolean

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

Measles-Rubella

Datatype

text

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

Measles-Rubella comment

Datatype

text

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

Mumps

Datatype

boolean

Alias
UMLS CUI [1]
C0042202
Mumps
Beschrijving

Mumps

Datatype

text

Alias
UMLS CUI [1]
C0042202
Mumps
Beschrijving

Mumps comment

Datatype

text

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

Mumps-Rubella

Datatype

boolean

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

Mumps-Rubella

Datatype

text

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

Mumps-Rubella comment

Datatype

text

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

Haemophilus influenzae type B (Hib)

Datatype

boolean

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

Haemophilus influenzae type B (Hib)

Datatype

text

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

Haemophilus influenzae type B (Hib) comment

Datatype

text

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

Hepatitis A

Datatype

boolean

Alias
UMLS CUI [1]
C0419735
Hepatitis A
Beschrijving

Hepatitis A

Datatype

text

Alias
UMLS CUI [1]
C0419735
Hepatitis A
Beschrijving

Hepatitis A comment

Datatype

text

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

Hepatitis B

Datatype

boolean

Alias
UMLS CUI [1]
C0474232
Hepatitis B
Beschrijving

Hepatitis B

Datatype

text

Alias
UMLS CUI [1]
C0474232
Hepatitis B
Beschrijving

Hepatitis B comment

Datatype

text

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

Meningococcal

Datatype

boolean

Alias
UMLS CUI [1]
C0700144
Meningococcal
Beschrijving

Meningococcal

Datatype

text

Alias
UMLS CUI [1]
C0700144
Meningococcal
Beschrijving

Meningococcal comment

Datatype

text

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

Human papillomavirus (HPV)

Datatype

boolean

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

Human papillomavirus (HPV)

Datatype

text

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

Human papillomavirus (HPV) comment

Datatype

text

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

Varicella (chicken pox)

Datatype

boolean

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

Varicella (chicken pox)

Datatype

text

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

Varicella (chicken pox) comment

Datatype

text

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

Herpes zoster (shingles)

Datatype

boolean

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

Herpes zoster (shingles)

Datatype

text

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

Herpes zoster (shingles) comment

Datatype

text

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

Pneumococcal

Datatype

boolean

Alias
UMLS CUI [1]
C0419707
Pneumococcal
Beschrijving

Pneumococcal

Datatype

text

Alias
UMLS CUI [1]
C0419707
Pneumococcal
Beschrijving

Pneumococcal comment

Datatype

text

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

Influenza

Datatype

boolean

Alias
UMLS CUI [1]
C0021403
Influenza
Beschrijving

Influenza

Datatype

text

Alias
UMLS CUI [1]
C0021403
Influenza
Beschrijving

Influenza comment

Datatype

text

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

SECTION E. CLINICAL MEASUREMENTS

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

Height

Datatype

integer

Maateenheden
  • سم
Alias
UMLS CUI [1]
C0489786
سم
Weight
Beschrijving

Weight

Datatype

integer

Maateenheden
  • كجم
Alias
UMLS CUI [1]
C0005910
كجم
BMI
Beschrijving

BMI

Datatype

integer

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

Head circumference

Datatype

integer

Maateenheden
  • سم
Alias
UMLS CUI [1]
C0262499
سم
Blood pressure initial: Systolic
Beschrijving

Blood pressure initial: Systolic

Datatype

integer

Maateenheden
  • مم زئبق
Alias
UMLS CUI [1,1]
C0871470
UMLS CUI [1,2]
C0205265
مم زئبق
Blood pressure initial: Dyastolic
Beschrijving

Blood pressure initial: Dyastolic

Datatype

integer

Maateenheden
  • مم زئبق
Alias
UMLS CUI [1,1]
C0428883
UMLS CUI [1,2]
C0205265
مم زئبق
Blood pressure repeated: Systolic
Beschrijving

Blood pressure repeated: Systolic

Datatype

integer

Maateenheden
  • مم زئبق
Alias
UMLS CUI [1,1]
C0871470
UMLS CUI [1,2]
C0205341
مم زئبق
Blood pressure repeated: Dyastolic
Beschrijving

Blood pressure repeated: Dyastolic

Datatype

integer

Maateenheden
  • مم زئبق
Alias
UMLS CUI [1,1]
C0428883
UMLS CUI [1,2]
C0205341
مم زئبق
Pulse initial
Beschrijving

Pulse initial

Datatype

integer

Maateenheden
  • /دقيقة
Alias
UMLS CUI [1,1]
C0232117
UMLS CUI [1,2]
C0205265
/دقيقة
Respiratory Rate
Beschrijving

Respiratory Rate

Datatype

integer

Maateenheden
  • / دقيقة
Alias
UMLS CUI [1]
C0231832
/ دقيقة
Pulse repeated
Beschrijving

Pulse repeated

Datatype

integer

Maateenheden
  • / دقيقة
Alias
UMLS CUI [1,1]
C0232117
UMLS CUI [1,2]
C0205341
/ دقيقة
Visual Acuity Left uncorrected
Beschrijving

Visual Acuity Left uncorrected

Datatype

text

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

Visual Acuity Right uncorrected

Datatype

text

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

Visual Acuity Left corrected

Datatype

text

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

Visual Acuity Right corrected

Datatype

text

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

SECTION F. EXAM FINDINGS

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

General appearance and nutritional status

Datatype

integer

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

Hearing and ears

Datatype

integer

Alias
UMLS CUI [1]
C0455216
Eyes
Beschrijving

Eyes

Datatype

integer

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

Nose, mouth and throat

Datatype

integer

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

Heart

Datatype

integer

Alias
UMLS CUI [1]
C0562319
Breast
Beschrijving

Breast

Datatype

integer

Alias
UMLS CUI [1]
C0199850
Lungs
Beschrijving

Lungs

Datatype

integer

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

Abdomen

Datatype

integer

Alias
UMLS CUI [1]
C0562238
Genitalia
Beschrijving

Genitalia

Datatype

integer

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

Inguinal region

Datatype

integer

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

Extremities

Datatype

integer

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

Musculoskeletal system

Datatype

integer

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

Skin

Datatype

integer

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

Lymph nodes

Datatype

integer

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

Nervous system

Datatype

integer

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

Mental status

Datatype

integer

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

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
Beschrijving

Urinalysis: dipstick

Datatype

text

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

Malaria rapid test

Datatype

text

Alias
UMLS CUI [1]
C2368143
Pregnancy
Beschrijving

Pregnancy

Datatype

text

Alias
UMLS CUI [1]
C0032976
Electrocardiogram
Beschrijving

Electrocardiogram

Datatype

text

Alias
UMLS CUI [1]
C0013798
Mantoux
Beschrijving

Mantoux

Datatype

text

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

SECTION H. DIAGNOSTICS

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

Imaging: chest X-ray

Datatype

text

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

Imaging: other X-ray

Datatype

text

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

Imaging: other imaging examination

Datatype

text

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

Electrocardiogram

Datatype

text

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

Laboratory: full blood count

Datatype

text

Alias
UMLS CUI [1]
C0005771
Laboratory: creatinine
Beschrijving

Laboratory: creatinine

Datatype

text

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

Laboratory: hep B surface antigen

Datatype

text

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

Laboratory: hep C serology

Datatype

text

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

Laboratory: HIV

Datatype

text

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

Laboratory: syphilis

Datatype

text

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

Laboratory: liver function tests

Datatype

text

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

Laboratory: tuberculosis (sputum smear)

Datatype

text

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

Instrument: mini-mental state

Datatype

text

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

Instrument: assessment of activities of daily living

Datatype

text

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

Instrument: chart of early childhood development

Datatype

text

Alias
UMLS CUI [1]
C0870455
Other referrals
Beschrijving

Other referrals

Datatype

text

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

SECTION I. SUMMARY FINDINGS

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

Significant medical condition

Datatype

text

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

ICD A15-A19

Datatype

text

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

ICD A15-A19

Datatype

text

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

ICD A50-A64

Datatype

text

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

ICD B20-B24

Datatype

text

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

Physical impairment/disability

Datatype

text

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

Significant mental health condition

Datatype

text

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

Addiction

Datatype

text

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

Other significant condition

Datatype

text

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

SECTION J. TREATMENT RECOMMENDATION

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

Treatment required?

Datatype

text

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

Treatment required For ICD A50-A64?

Datatype

text

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

Treatment required for malaria?

Datatype

text

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

Treatment required for gastrointestinal parasites?

Datatype

text

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

Treatment required for acute condition?

Datatype

text

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

Treatment required for chronic condition?

Datatype

text

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

Hospitalisation required (immediate)

Datatype

text

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

Hospitalisation required (within several days)

Datatype

text

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

Hospitalisation required (within several months)

Datatype

text

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

Immunisation required?

Datatype

text

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

Adjusted/appropriate accommodation required?

Datatype

text

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

SECTION K. TRAVEL RECOMMENDATION

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

Fit for further travel?

Datatype

text

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

Special medical attention during the travel?

Datatype

text

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

If pregnant, not to travel before ……?

Datatype

text

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

If pregnant, to travel before …?

Datatype

text

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

TRQ: ambulance

Datatype

text

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

TRQ: WCH

Datatype

text

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

TRQ: stretcher

Datatype

text

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

TRQ: oxygen

Datatype

text

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

TRQ: bowel preparation

Datatype

text

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

TRQ: diapers

Datatype

text

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

TRQ: urinary catheter

Datatype

text

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

TRQ: other

Datatype

text

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

TRQ: medical escort

Datatype

text

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

TRQ: family escort

Datatype

text

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

TRQ: operational escort

Datatype

text

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

SECTION L. POST-ARRIVAL RECOMMENDATION

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

PTR: special schooling needs

Datatype

text

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

PTR: consequences on daily living activities (assistance required)

Datatype

text

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

PTR: special housing requirements

Datatype

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)
Beschrijving

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

Datatype

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)
Beschrijving

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

Datatype

text

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

SECTION M. TREATMENT ADMINISTRATION

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

Tx administered for ICD A50-A64

Datatype

text

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

Tx administered for malaria

Datatype

text

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

Tx administered for gastrointestinal parasites

Datatype

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)
Beschrijving

Tx administered for other conditions

Datatype

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)
Beschrijving

Tx — other treatment applied (specify)

Datatype

text

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

SECTION N. VACCINE ADMINISTRATION

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

Vaccine administered

Datatype

text

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

Vaccine: DT

Datatype

text

Alias
UMLS CUI [1]
C0058773
Vaccine: DTP
Beschrijving

Vaccine: DTP

Datatype

text

Alias
UMLS CUI [1]
C0012559
Vaccine: DTaP
Beschrijving

Vaccine: DTaP

Datatype

text

Alias
UMLS CUI [1]
C3526553
Vaccine: Td
Beschrijving

Vaccine: Td

Datatype

text

Alias
UMLS CUI [1]
C0058773
Vaccine: Tdap
Beschrijving

Vaccine: Tdap

Datatype

text

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

Vaccine: polio — OPV

Datatype

text

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

Vaccine: polio — IPV

Datatype

text

Alias
UMLS CUI [1]
C0718003
Vaccine: MMR
Beschrijving

Vaccine: MMR

Datatype

text

Alias
UMLS CUI [1]
C0065828
Vaccine: rubella
Beschrijving

Vaccine: rubella

Datatype

text

Alias
UMLS CUI [1]
C0035923
Vaccine: measles
Beschrijving

Vaccine: measles

Datatype

text

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

Vaccine: measles-rubella

Datatype

text

Alias
UMLS CUI [1]
C0361142
Vaccine: mumps
Beschrijving

Vaccine: mumps

Datatype

text

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

Vaccine: mumps-rubella

Datatype

text

Alias
UMLS CUI [1]
C0694750
Vaccine: Hib
Beschrijving

Vaccine: Hib

Datatype

text

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

Vaccine: hep A

Datatype

text

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

Vaccine: hep B

Datatype

text

Alias
UMLS CUI [1]
C2240392
Vaccine: meningococcal
Beschrijving

Vaccine: meningococcal

Datatype

text

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

Vaccine: human papillomavirus

Datatype

text

Alias
UMLS CUI [1]
C1512511
Vaccine: varicella
Beschrijving

Vaccine: varicella

Datatype

text

Alias
UMLS CUI [1]
C0078048
Vaccine: pneumococcal
Beschrijving

Vaccine: pneumococcal

Datatype

text

Alias
UMLS CUI [1]
C0358314
Vaccine: influenza
Beschrijving

Vaccine: influenza

Datatype

text

Alias
UMLS CUI [1]
C0021403
Vaccine: others
Beschrijving

Vaccine: others

Datatype

text

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C0042210
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Similar models

Personal Health Record

1 Formulieren
  1. StudyEvent: ODM
    1. Personal Health Record
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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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