Informatie:
Fout:
ID
46189
Beschrijving
Nephrologie SPZ Anamnese
Trefwoorden
Versies (1)
- 07-05-25 07-05-25 - Dr. med. Anke Doyon
Houder van rechten
Anke Doyon
Geüploaded op
7 mei 2025
DOI
Voor een aanvraag inloggen.
Licentie
Creative Commons BY-NC 4.0
Model Commentaren :
Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.
Itemgroep Commentaren voor :
Item Commentaren voor :
U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.
Anamnesebogen Nephrologie SPZ
F.niere_spz_form
- StudyEvent: SE.neph_spz
Similar models
F.niere_spz_form
- StudyEvent: SE.neph_spz
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
CL Item
(1)
CL Item
(2)
CL Item
(3)
I.spz_responsible_other
Item
text
I.spz_date_quest
Item
date
I.spz_birth_patient
Item
date
I.spz_phone
Item
text
I.spz_mail
Item
text
I.spz_pediatrician_name
Item
text
I.spz_pediatrician_address
Item
text
I.spz_pediatrician_phone
Item
text
I.spz_reason_visit
Item
text
I.spz_father_age
Item
integer
I.spz_mother_age
Item
integer
I.spz_father_job
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
I.spz_mother_job
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
I.spz_custody_other
Item
text
I.spz_sibling_surname
Item
text
I.spz_sibling_forename
Item
text
I.spz_sibling_birthdate
Item
date
CL Item
(1)
CL Item
(2)
I.spz_sibling_kidney_specify
Item
text
CL Item
(1)
CL Item
(2)
I.spz_sibling_percent_kidney_function
Item
integer
CL Item
(1)
CL Item
(2)
I.spz_sibling_dial_start
Item
date
CL Item
(1)
CL Item
(2)
I.spz_sibling_transplant_date
Item
date
CL Item
(1)
CL Item
(2)
I.spz_sibling_multiple_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_sibling_disease_specify
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
I.spz_kidney_disease_mother
Item
text
I.spz_mother_gfr
Item
integer
CL Item
(1)
CL Item
(2)
I.spz_dialysis_mother_start
Item
date
CL Item
(1)
CL Item
(2)
I.spz_mother_tx_year
Item
integer
CL Item
(1)
CL Item
(2)
I.spz_father_kidney_disease
Item
text
I.spz_father_gfr
Item
integer
CL Item
(1)
CL Item
(2)
I.spz_father_dialysis_start
Item
date
CL Item
(1)
CL Item
(2)
I.spz_father_tx_year
Item
integer
CL Item
(1)
CL Item
(2)
I.spz_family_kidney_gmm_spec
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
I.spz_family_kidney_gfm_spec
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
I.spz_family_kidney_gmf_spec
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
I.spz_family_kidney_gff_spec
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
I.spz_family_kidney_other_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_family_kidney_specify_text
Item
text
CL Item
(1)
CL Item
(2)
I.spz_family_eye_person_specify_text
Item
text
CL Item
(1)
CL Item
(2)
I.spz_family_hear_specify_txt
Item
text
CL Item
(1)
CL Item
(2)
I.spz_parents_relation_specify
Item
text
CL Item
(1)
CL Item
(2)
I.spz_family_epilepsy_specify
Item
text
CL Item
(1)
CL Item
(2)
I.spz_family_neuro_spec
Item
text
CL Item
(1)
CL Item
(2)
I.30
Item
text
CL Item
(1)
CL Item
(2)
I.spz_family_drugs_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_family_others_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_pregnancy_comp_infections_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_pregnancy_bleeding_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_pregnancy_comp_other_specify
Item
text
CL Item
(1)
CL Item
(2)
I.spz_pregnancy_fluid_specify
Item
text
CL Item
(1)
CL Item
(2)
I.spz_pregnancy_chorion_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_pregnancy_ultrasound_specify
Item
text
CL Item
(1)
CL Item
(2)
I.spz_pregnancy_med_specify
Item
text
CL Item
(1)
CL Item
(2)
I.spz_pregnancy_nicotin_spec
Item
integer
CL Item
(1)
CL Item
(2)
I.48
Item
text
CL Item
(1)
CL Item
(2)
I.spz_pregnancy_fail_year
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
I.spz_birth_time_early
Item
integer
I.spz_birth_time_late
Item
integer
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
I.spz_birth_weight
Item
integer
I.spz_birth_length
Item
integer
I.spz_birth_headcirc
Item
integer
I.spz_birth_apgar1
Item
integer
I.spz_birth_apgar5
Item
integer
I.spz_birth_apgar10
Item
integer
I.spz_birth_ph
Item
double
I.spz_birth_abnormalities
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
I.spz_newborn_problems_specify
Item
text
CL Item
(1)
CL Item
(2)
I.spz_dev_abnorm_spec
Item
text
I.spz_devel_walk
Item
integer
CL Item
(1)
CL Item
(2)
I.spz_devel_motor_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_devel_fine_motor_spec
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
CL Item
(5)
I.spz_devel_eyesears_exam_result_abnorm_spec
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
CL Item
(3)
I.spz_eye_abnorm_spec
Item
text
I.spz_speech_word
Item
integer
I.spz_speech_sentence
Item
integer
CL Item
(1)
CL Item
(2)
I.spz_speech_problems_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_social_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_eat_spec
Item
text
I.spz_diaper
Item
integer
CL Item
(1)
CL Item
(2)
I.spz_heart_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_lung_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_visceral_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_neuro_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_muscles_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_more_problems_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_med_name
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
CL Item
(5)
I.spz_dose_med_morning
Item
float
I.spz_med_dose_lunch
Item
float
I.spz_dose_med_evening
Item
float
I.spz_med_dose_night
Item
float
CL Item
(1)
I.spz_med_dose_other_spec
Item
text
CL Item
(1)
CL Item
(2)
I.spz_doctors_name
Item
text
I.spz_doctors_reason
Item
text
I.spz_doctors_specialization
Item
text
I.spz_doctors_tel
Item
text
CL Item
(1)
CL Item
(2)
I.spz_hospital_date
Item
date
I.spz_hospital_date1
Item
date
I.spz_hospital_reason
Item
text
CL Item
(1)
CL Item
(2)
I.spz_surgery_date
Item
date
I.spz_surgery_specify_intervention
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(1)
CL Item
(2)
I.spz_physio_person
Item
text
I.spz_physio_start
Item
date
I.spz_physio_stop
Item
date
CL Item
(1)
CL Item
(2)
I.spz_ergo_person
Item
text
I.spz_ergo_start
Item
date
I.spz_ergo_stop
Item
date
CL Item
(1)
CL Item
(2)
I.spz_logo_person
Item
text
I.spz_logo_start
Item
date
I.spz_logo_stop
Item
date
CL Item
(1)
CL Item
(2)
I.spz_therapy_other_specify
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
CL Item
(5)
CL Item
(6)
CL Item
(7)
CL Item
(8)
CL Item
(9)
CL Item
(10)
CL Item
(11)
CL Item
(12)
I.spz_school_other
Item
text
CL Item
(1)
CL Item
(2)
I.spz_school_special_specify
Item
text
I.spz_school_class_spec
Item
integer
CL Item
(1)
CL Item
(2)
I.spz_social_device_specify
Item
text
CL Item
(1)
CL Item
(2)
CL Item
(3)
CL Item
(4)
CL Item
(1)
CL Item
(2)
I.spz_disable_percent
Item
integer
I.spz_disable_kind
Item
text