ID

9816

Beschrijving

Documentation form for quality assurance in German Health Care by the Institute for Applied Quality Improvement and Research in Health Care (Aqua), https://www.aqua-institut.de/en/home. Internal Aqua form version: HTXFU Specification 2015 V02

Link

https://www.aqua-institut.de/en/home

Trefwoorden

Versies (5)
  1. 22/12/2014 22/12/2014 - Julian Varghese
  2. 11/01/2015 11/01/2015 - Sarah Schulze Sünninghausen
  3. 19/01/2015 19/01/2015 - Julian Varghese
  4. 31/01/2015 31/01/2015 - Julian Varghese
  5. 13/04/2021 13/04/2021 - Ahmed Rafee, MD
Geüploaded op

31 janvier 2015

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0 Legacy
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.

Terug naar het model Commentaren
Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Quality assurance Follow-up Heart Transplant (AQUA)

Duits Engels

Quality assurance Follow-up Heart Transplant (AQUA)

1 Formulieren  
Follow-up(to be filled out after 1, 2 and 3 years)
Beschrijving

Follow-up(to be filled out after 1, 2 and 3 years)

Health Insurance Identifier
Beschrijving

Institutionskennzeichen

Datatype

integer

Alias
UMLS CUI-1
C1548070
Zip Code of Discharge
Beschrijving

Entlassender Standort

Datatype

string

Alias
UMLS CUI-1
C1521842
Facility's Section Identifier
Beschrijving

Betriebsstätten-Nummer

Datatype

string

Alias
UMLS CUI-1
C1547540
Medical specialty
Beschrijving

Fachabteilung

Datatype

integer

Alias
UMLS CUI-1
C0037778
Recipient ID (ET-Number)
Beschrijving

Empfänger ID

Datatype

string

Alias
UMLS CUI-1
m
Date of Birth (DD.MM.YYYY)
Beschrijving

Geburtsdatum

Datatype

date

Alias
UMLS CUI-1
C0421451
Gender
Beschrijving

Geschlecht

Datatype

integer

Alias
UMLS CUI-1
C0079399
Date of last transplant (dd.mm.yyyy)
Beschrijving

Datum der letzten Transplantation

Datatype

date

Alias
UMLS CUI-1
C3262243
Date of Follow-up examination (dd.mm.yyyy)
Beschrijving

Datum der Follow-up-Erhebung

Datatype

date

Alias
UMLS CUI-1
C3694716
Type of follow-up inquiry
Beschrijving

Art der Follow-up-Erhebung

Datatype

integer

Alias
UMLS CUI-1
C1710508
Follow-up: Year(s) after transplant ((1, 2, 3))
Beschrijving

Follow-up: Jahr(e) nach Transplantation

Datatype

string

treated graft reactions since last follow-up year
Beschrijving

behandelte Abstoßungsreaktionen seit dem letzten Jahres-Follow-up

Datatype

integer

Alias
UMLS CUI-1
C0018129
Number of treated rejection episodes since last follow-up year
Beschrijving

Anzahl der behandelten Abstoßungsepisoden seit dem letzten Jahres-Follow-up

Datatype

string

Alias
UMLS CUI-1-1
C1265611
UMLS CUI-1-2
C1522326
UMLS CUI-1-3
C0877542
Survival status of recipient
Beschrijving

Survival status of recipient

Deceased patient
Beschrijving

Patient verstorben

Datatype

integer

Alias
UMLS CUI-1
C1306577
Date of death (dd.mm.yyyy)
Beschrijving

Todesdatum

Datatype

date

Alias
UMLS CUI-1
C1148348
Causes of death in the course
Beschrijving

Todesursache(n) im Verlauf

Datatype

integer

Alias
UMLS CUI-1
C0007465
Current immunosuppression
Beschrijving

Current immunosuppression

Cyclosporine
Beschrijving

Cyclosporin

Datatype

integer

Alias
UMLS CUI-1
C0010592
Tacrolimus
Beschrijving

Tacrolimus

Datatype

integer

Alias
UMLS CUI-1
C0085149
Azathioprine
Beschrijving

Azathioprin

Datatype

integer

Alias
UMLS CUI-1
C0004482
Mycophenolat
Beschrijving

Mycophenolat

Datatype

integer

Alias
UMLS CUI-1
C0209368
Steroids
Beschrijving

Steroide

Datatype

integer

Alias
UMLS CUI-1
C0038317
m-ToR-Inhibitor
Beschrijving

m-ToR-Inhibitor

Datatype

integer

Alias
UMLS CUI-1
C2746052
other
Beschrijving

andere

Datatype

integer

Terug naar het begin van de pagina

Similar models

Quality assurance Follow-up Heart Transplant (AQUA)

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Follow-up(to be filled out after 1, 2 and 3 years)
Institutionskennzeichen
Item
Health Insurance Identifier
integer
C1548070 (UMLS CUI-1)
Entlassender Standort
Item
Zip Code of Discharge
string
C1521842 (UMLS CUI-1)
Betriebsstätten-Nummer
Item
Facility's Section Identifier
string
C1547540 (UMLS CUI-1)
Item
Medical specialty
integer
C0037778 (UMLS CUI-1)
Fachabteilung
Code List
Medical specialty
CL Item
internal medicine (0100)
CL Item
internal medicine: geriatrics (0102)
CL Item
internal medicine: cardiology (0103)
CL Item
internal medicine: nephrology (0104)
CL Item
internal medicine: hematology and internal oncology  (0105)
CL Item
internal medicine: endocrinology (0106)
CL Item
internal medicine: gastroenterology  (0107)
CL Item
internal medicine: pneumonology (0108)
CL Item
internal medicine: rheumatology (0109)
CL Item
internal medicine: pulmonology (0114)
CL Item
internal medicine: tumor research (0150)
CL Item
internal medicine: coloproctology (0151)
CL Item
internal medicine: infectiology (0152)
CL Item
internal medicine: diabetes (0153)
CL Item
internal medicine: naturopathy (0154)
CL Item
internal medicine: stroke unit (0156)
CL Item
internal medicine (0190)
CL Item
geriatry (0200)
CL Item
geriatry: gynecology  (0224)
CL Item
geriatry: day unit (for semi-residential care)  (0260)
CL Item
geriaty: night unit (for semi-residential care) (0261)
CL Item
geriatry (0290)
CL Item
cardiology (0300)
CL Item
nephrology (0400)
CL Item
nephrology: pediatrics (0410)
CL Item
nephrology: intensive care (0436)
CL Item
nephrology (0490)
CL Item
hematology and internal oncology  (0500)
CL Item
hematology and internal oncology: pediatrics (0510)
CL Item
hematology and internal oncology: gynacology (0524)
CL Item
hematology and internal oncology: radiation therapy (0533)
CL Item
hematology and internal oncology  (0590)
CL Item
endocrinology (0600)
CL Item
endicrinology: gastroenterology (0607)
CL Item
endocrinology: pediatrics (0610)
CL Item
endocrinology (0690)
CL Item
gastroenterology (0700)
CL Item
gastroenterology: endocrinology (0706)
CL Item
gastroenterology: pediatrics (0710)
CL Item
gastroenterology (0790)
CL Item
pneumology (0800)
CL Item
rheumatology (0900)
CL Item
rheumatology: pediatrics (0910)
CL Item
rheumatology (0990)
CL Item
pediatrics (1000)
CL Item
pediatrics: nephrology (1004)
CL Item
pediatrics: hematology and internal oncology  (1005)
CL Item
pediatrics: endocrinology (1006)
CL Item
pediatrics: gastroenterology (1007)
CL Item
pediatrics: rheumatology (1009)
CL Item
pediatrics: pediatric cardiology (1011)
CL Item
pediatrics: nephrology (1012)
CL Item
pediatrics: pulmonology (1014)
CL Item
pediatrics: pediatric neurology (1028)
CL Item
pediatrics: perinatal medicine (1050)
CL Item
continuing care for children (1051)
CL Item
pediatrics (1090)
CL Item
pediatric cardiology (1100)
CL Item
pediatric cardiology: intensive care (1136)
CL Item
pediatric cardiology (1190)
CL Item
neonatology (1200)
CL Item
pediatric surgery (1300)
CL Item
pulmonology (1400)
CL Item
pulmonology: pediatrics (1410)
CL Item
pulmonology (1490)
CL Item
general surgery (1500)
CL Item
general surgery: pediatric surgery (1513)
CL Item
general surgery: trauma surgery (1516)
CL Item
general surgery: vascular surgery (1518)
CL Item
general surgery: plastic surgery (1519)
CL Item
general surgery: thoracic surgery (1520)
CL Item
general surgery: orthopedics (1523)
CL Item
general surgery: intensive care (1536)
CL Item
general surgery: abdominal- and vascular surgery (1550)
CL Item
Allgemeine Chirurgie: hand surgery (1551)
CL Item
general surgery (1590)
CL Item
trauma surgery (1600)
CL Item
neurosurgery (1700)
CL Item
vascular surgery (1800)
CL Item
plastic surgery (1900)
CL Item
thoracic surgery (2000)
CL Item
thoracic surgery: cardiac surgery (2021)
CL Item
thoracic surgery: intensive care (2036)
CL Item
thoracic surgery: cardiac surgery intensive care (2050)
CL Item
thoracic surgery (2090)
CL Item
cardiac surgery (2100)
CL Item
cardiac surgery: vascular surgery (2118)
CL Item
cardiac surgery: thoracic surgery (2120)
CL Item
cardiac surgery: intensive care (2136)
CL Item
cardiac surgery: thoracic surgery and intensive care (2150)
CL Item
cardiac surgery (2190)
CL Item
urology (2200)
CL Item
orthopedics (2300)
CL Item
orthopedics: rheumatology (2309)
CL Item
orthopedics: surgery (2315)
CL Item
orthopedics and trauma surgery (2316)
CL Item
orthopedics (2390)
CL Item
gynecology and obstetrics (2400)
CL Item
gynecology: geriatry (2402)
CL Item
gynecology: hematology and internal oncology  (2405)
CL Item
gynecology: endocrinology (2406)
CL Item
gynecology (2425)
CL Item
gynecology and obstetrics (2490)
CL Item
obstetrics (2500)
CL Item
otolaryngology (2600)
CL Item
ophthalmology (2700)
CL Item
neurology: (2800)
CL Item
neurology: pediatrics (2810)
CL Item
neurology: stroke units (2856)
CL Item
neurology (2890)
CL Item
general psychiatry: (2900)
CL Item
general psychiatry: neurology (2928)
CL Item
general psychiatry: child and adolescent psychiatry (2930)
CL Item
general psychiatry: psychosomatics and psychotherapy (2931)
CL Item
general psychiatry: addiction treatment (2950)
CL Item
general psychiatry: geropsychiatry (2951)
CL Item
general psychiatry: forensic treatment (2952)
CL Item
general psychiatry: addiction treatment (day unit) (2953)
CL Item
general psychiatry: addiction treatment (night unit) (2954)
CL Item
general psychiatry: geropsychiatry (day unit) (2955)
CL Item
general psychiatry: geropsychiatry (night unit) (2956)
CL Item
general psychiatry: day unit (for semi-residential care) (2960)
CL Item
general psychiatry: night unit (for semi-residential care) (2961)
CL Item
general psychiatry (2990)
CL Item
child and adolescent psychiatry (3000)
CL Item
child and adolescent psychiatry: day unit (for semi-residential care) (3060)
CL Item
child and adolescent psychiatry: night unit (for semi-residential care) (3061)
CL Item
child and adolescent psychiatry (3090)
CL Item
psychosomatic/psychotherapy (3100)
CL Item
psychosomatic/psychotherapy: child and adolescent psychiatry (3110)
CL Item
psychosomatic/psychotherapy: day unit (for semi-residential care) (3160)
CL Item
psychosomatic/psychotherapy: night unit (for semi-residential care) (3161)
CL Item
psychosomatic/psychotherapy (3190)
CL Item
nuclear medicine (3200)
CL Item
nuclear medicine: radiation therapy (3233)
CL Item
nuclear medicine (3290)
CL Item
radiation therapy (3300)
CL Item
radiation therapy: hematology and internal oncology  (3305)
CL Item
radiation therapy: radiology (3350)
CL Item
radiation therapy (3390)
CL Item
dermatology (3400)
CL Item
dermatology: day unit (for semi-residential care) (3460)
CL Item
dermatology (3490)
CL Item
dentistry, orthodontics, maxillofacial surgery (3500)
CL Item
intensive-care medicine (3600)
CL Item
intensive-care medicine: internal medicine (3601)
CL Item
intensive-care medicine: cardiology (3603)
CL Item
intensive-care medicine: pediatrics (3610)
CL Item
intensive-care medicine: neurosurgery (3617)
CL Item
intensive-care medicine: surgery (3618)
CL Item
intensive-care medicine: cardiac surgery (3621)
CL Item
intensive-care medicine: urology (3622)
CL Item
intensive-care medicine: gynecology and obstetrics (3624)
CL Item
intensive-care medicine: otolaryngology  (3626)
CL Item
intensive-care medicine: neurology (3628)
CL Item
operative intensive-care medicine: surgery (3650)
CL Item
intensive-care medicine: thorax-heart surgery (3651)
CL Item
intensive-care medicine: heart-thorax surgery (3652)
CL Item
intensive-care medicine (3690)
CL Item
other medical specialty (3700)
CL Item
angiology (3750)
CL Item
radiology (3751)
CL Item
palliative care (3752)
CL Item
pain therapy (3753)
CL Item
section for alternative health practice (3754)
CL Item
spinal surgery (3755)
CL Item
addiction medicine (3756)
CL Item
visceral surgery (3757)
CL Item
other medical specialty (3790)
Empfänger ID
Item
Recipient ID (ET-Number)
string
m (UMLS CUI-1)
Geburtsdatum
Item
Date of Birth (DD.MM.YYYY)
date
C0421451 (UMLS CUI-1)
Item
Gender
integer
C0079399 (UMLS CUI-1)
Geschlecht
Code List
Gender
CL Item
male (1)
CL Item
female (2)
Datum der letzten Transplantation
Item
Date of last transplant (dd.mm.yyyy)
date
C3262243 (UMLS CUI-1)
Datum der Follow-up-Erhebung
Item
Date of Follow-up examination (dd.mm.yyyy)
date
C3694716 (UMLS CUI-1)
Item
Type of follow-up inquiry
integer
C1710508 (UMLS CUI-1)
Art der Follow-up-Erhebung
Code List
Type of follow-up inquiry
CL Item
patient was personally in hospital (1)
CL Item
telephone contact with patient  (2)
CL Item
telephone contact with doctor further treatment (3)
CL Item
written information from the doctor further treatment (4)
CL Item
information about relatives/carers of patients  (5)
CL Item
no contact with patient, doctor further treatment or relatives/carers of patients (6)
Follow-up: Jahr(e) nach Transplantation
Item
Follow-up: Year(s) after transplant ((1, 2, 3))
string
Item
treated graft reactions since last follow-up year
integer
C0018129 (UMLS CUI-1)
behandelte Abstoßungsreaktionen seit dem letzten Jahres-Follow-up
Code List
treated graft reactions since last follow-up year
CL Item
no (0)
CL Item
yes, known number (1)
CL Item
yes, number unknown (2)
CL Item
unknown (9)
Anzahl der behandelten Abstoßungsepisoden seit dem letzten Jahres-Follow-up
Item
Number of treated rejection episodes since last follow-up year
string
C1265611 (UMLS CUI-1-1)
C1522326 (UMLS CUI-1-2)
C0877542 (UMLS CUI-1-3)
Item Group
Survival status of recipient
Item
Deceased patient
integer
C1306577 (UMLS CUI-1)
Patient verstorben
Code List
Deceased patient
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
Todesdatum
Item
Date of death (dd.mm.yyyy)
date
C1148348 (UMLS CUI-1)
Item
Causes of death in the course
integer
C0007465 (UMLS CUI-1)
Todesursache(n) im Verlauf
Code List
Causes of death in the course
CL Item
1: cause of death: uncertain - not determined (701)
CL Item
11: myocardial ischemia / infarction (711)
CL Item
12: hyperkalemia (712)
CL Item
13: hemorrhagic pericarditis (713)
CL Item
14: causes of cardiac failure / other (714)
CL Item
15: cardiac arrest - sudden death (715)
CL Item
16: hypertensive cardiac failure (716)
CL Item
17: hypokalemia (717)
CL Item
18: fluid overload (718)
CL Item
21: pulmonary embolus (721)
CL Item
22: cerebrovascular accident (AVC) (722)
CL Item
23: gastrointestinal hemorrhage (723)
CL Item
24: hemorrhage from graft site (724)
CL Item
25: hemorrhage from vascular access or dialysis circuit (725)
CL Item
26: hemorrhage from ruptured vascular aneurysm (AAA / etc) (726)
CL Item
27: hemorrhage from surgery (727)
CL Item
28: hemorrhage / other / specify (728)
CL Item
29: mesenteric infarction (729)
CL Item
30: infection (730)
CL Item
31: pulmonary infection ( bacterial ) (731)
CL Item
32: pulmonary infection ( viral ) (732)
CL Item
33: pulmonary infection ( fungal or protozoal ) (733)
CL Item
34: infections elsewhere (except viral hepatitis) (734)
CL Item
35: septicemia / MOF (735)
CL Item
36: tuberculosis ( lung ) (736)
CL Item
37: tuberculosis ( not lung ) (737)
CL Item
38: viral infection / generalized (738)
CL Item
39: peritonitis (739)
CL Item
41: liver disease due to hepatitis B virus (741)
CL Item
42: liver disease due to other viral hepatitis (742)
CL Item
43: liver disease due to drug toxicity (743)
CL Item
44: cirrhosis - not viral (744)
CL Item
45: cystic liver disease (745)
CL Item
46: liver failure / cause unknown (746)
CL Item
51: patient refused further dialysis treatment (751)
CL Item
52: suicide (752)
CL Item
53: dialysis ceased for any other reason (753)
CL Item
61: renal failure (761)
CL Item
62: pancreatitis (762)
CL Item
63: bone marrow depression (763)
CL Item
64: cachexia (764)
CL Item
66: malignant disease - lymphoproliferative disorder / specify (766)
CL Item
67: malignant disease - other / specify (767)
CL Item
69: dementia (769)
CL Item
70: sclerosing peritoneal disease (770)
CL Item
71: perforation of peptic ulcer (771)
CL Item
72: perforation of colon (772)
CL Item
80: accident / all causes / specify (780)
CL Item
81: accident related to dialysis treatment (781)
CL Item
82: accident unrelated to dialysis treatment (782)
CL Item
90: gastrointestinal / other / specify (790)
CL Item
99: other / specify (799)
CL Item
101: failure of transplant (801)
CL Item
102: surgical complications (802)
CL Item
103: pulmonary embolus (803)
CL Item
104: malignant disease - lymfoproliferative disorder (804)
CL Item
105: malignant disease - other (805)
CL Item
106: infection (806)
CL Item
107: cerebrovascular accident (CVA) (807)
CL Item
108: hemorrhage / other (808)
CL Item
109: other (809)
Item Group
Current immunosuppression
Item
Cyclosporine
integer
C0010592 (UMLS CUI-1)
Cyclosporin
Code List
Cyclosporine
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
Item
Tacrolimus
integer
C0085149 (UMLS CUI-1)
Tacrolimus
Code List
Tacrolimus
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
Item
Azathioprine
integer
C0004482 (UMLS CUI-1)
Azathioprin
Code List
Azathioprine
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
Item
Mycophenolat
integer
C0209368 (UMLS CUI-1)
Mycophenolat
Code List
Mycophenolat
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
Item
Steroids
integer
C0038317 (UMLS CUI-1)
Steroide
Code List
Steroids
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
Item
m-ToR-Inhibitor
integer
C2746052 (UMLS CUI-1)
m-ToR-Inhibitor
Code List
m-ToR-Inhibitor
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
Item
other
integer
andere
Code List
other
CL Item
no (0)
CL Item
yes (1)
CL Item
unknown (9)
Terug naar het begin van de pagina 

Contact

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial