1. StudyEvent: HIS
    1. HIS
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Overview
Age
Item
Age
string
C0001779 (UMLS CUI 2011AA)
397669002 (SNOMED CT 2011_0131)
Height
Item
Height
string
C0005890 (UMLS CUI-1)
MTHU005354 (LOINC Version 232)
Weight
Item
Weight
string
C0005910 (UMLS)
107647005 (SNOMED CT 2011_0131)
10047890 (MedDRA 14.1)
LP18015-5 (LOINC Version 232)
Temperature
Item
Temperature
string
C0039476 (UMLS CUI 2011AA)
246508008 (SNOMED CT 2011_0131)
MTHU009008 (LOINC Version 232)
Pulse Rate
Item
Pulse Rate
string
C0232117 (UMLS CUI 2011AA)
78564009 (SNOMED CT 2011_0131)
10037485 (MedDRA 14.1)
Respiratory rate
Item
Respiration rate, Breathing rate (BR)
string
C0231832 (UMLS CUI 2011AA)
86290005 (SNOMED CT 2011_0131)
10038709 (MedDRA 14.1)
MTHU008344 (LOINC Version 232)
Blood Pressure
Item
Blood pressure (BP)
string
C0005823 (UMLS CUI 2011AA)
75367002 (SNOMED CT 2011_0131)
MTHU008342 (LOINC Version 232)
PT'S RESIDENCE
Item
PT'S RESIDENCE
string
LANGUAGE/COMMUNICATION BARRIER
Item
LANGUAGE/COMMUNICATION BARRIER
string
PRIMARY LANGUAGE
Item
PRIMARY LANGUAGE
string
CHIEF COMPLAINT
Item
Chief complaint (CC)
string
C0277786 (UMLS CUI 2011AA)
33962009 (SNOMED CT 2011_0131)
MTHU001077 (LOINC Version 232)
Primary Care Physician (PCP)
Item
General practitioner (GP)
string
C0033131, C0017319 (UMLS CUI 2011AA)
446050000, 59058001 (SNOMED CT 2011_0131)
PCP (HL7 V3 2006_05)
Item Group
Anesthesia Specific
Allergies
Item
Hypersensitivities
string
C0020517 (UMLS CUI 2011AA)
257550005 (SNOMED CT 2011_0131)
T78.40 (ICD-10-CM Version 2010)
Are you allergic to adhesive tape?
Item
Are you allergic to adhesive tape?
boolean
Are you allergic to rubber products?
Item
Are you allergic to rubber products?
boolean
Previous Surgeries?
Item
Previous Surgeries?
string
Surgery involving an anesthetic?
Item
Surgery involving an anesthetic?
string
General Anesthesia
Item
General anaesthesia (GA)
boolean
C0002915 (UMLS CUI 2011AA)
50697003 (SNOMED CT 2011_0131)
10018060 (MedDRA 14.1)
Spinal Anesthesia
Item
Spinal Anaesthesia
boolean
C0002928 (UMLS CUI 2011AA)
231249005 (SNOMED CT 2011_0131)
10041536 (MedDRA 14.1)
Epidural anaesthesia
Item
epidural anesthesia
boolean
C0002913 (UMLS CUI 2011AA)
18946005 (SNOMED CT 2011_0131)
10015011 (MedDRA 14.1)
Regional anesthesia
Item
Regional Anesthesia Procedure
boolean
C0002911 (UMLS CUI 2011AA)
27372005 (SNOMED CT 2011_0131)
Local anesthesia
Item
Local anaesthesia (LA)
boolean
C0002921 (UMLS CUI 2011AA)
386761002 (SNOMED CT 2011_0131)
10024758 (MedDRA 14.1)
anesthetic: Moderate sedation
Item
anesthetic: Moderate sedation
boolean
anesthetic: Axillary block
Item
anesthetic: Axillary block
boolean
Have you or a family member ever had a problem with an anesthesic? If Yes, describe:
Item
Have you or a family member ever had a problem with an anesthesic? If Yes, describe:
string
Item Group
Health History - Endocrine
Diabetes
Item
Diabetes mellitus
boolean
C0011849 (UMLS CUI 2011AA)
191044006 (SNOMED CT 2011_0131)
If Diabetes, last time med taken
Item
If Diabetes, last time med taken
string
Hyperthyroidism
Item
Hyperthyroidism
boolean
C0020550 (UMLS CUI 2011AA)
34486009 (SNOMED CT 2011_0131)
10020850 (MedDRA 14.1)
MTHU020782 (LOINC Version 232)
E05.9 (ICD-10-CM Version 2010)
242.9 (ICD-9-CM Version 2011)
E10322 (CTCAE 1105E)
Hypothyroidism
Item
Hypothyroidism
boolean
C0020676 (UMLS CUI 2011AA)
40930008 (SNOMED CT 2011_0131)
10021114 (MedDRA 14.1)
MTHU020783 (LOINC Version 232)
E03.9 (ICD-10-CM Version 2010)
244.9 (ICD-9-CM Version 2011)
E10334 (CTCAE 1105E)
Item Group
Health History - Neurologic
CVA/Stroke/TIA
Item
Cerebrovascular accident (CVA)
string
C0038454 (UMLS CUI 2011AA)
230690007 (SNOMED CT 2011_0131)
10042244 (MedDRA 14.1)
I63.9 (ICD-10-CM Version 2010)
E12826 (CTCAE 1105E)
Seizures
Item
Convulsion
string
C0036572 (UMLS CUI 2011AA)
91175000 (SNOMED CT 2011_0131)
10039910 (MedDRA 14.1)
780.39 (ICD-9-CM Version 2011)
Numbness/Tingling to Arms/Legs
Item
Loss of Sensation
string
C0028643 (UMLS CUI 2011AA)
44077006 (SNOMED CT 2011_0131)
10029829 (MedDRA 14.1)
782.0 (ICD-9-CM Version 2011)
Migraines and/or Headaches
Item
Migraines and/or Headaches
string
C0149931, C0018681 (UMLS CUI 2011AA)
37796009, 25064002 (SNOMED CT 2011_0131)
10027599,1 (MedDRA 14.1)
MTHU020860 (LOINC Version 232)
G43, R51 (ICD-10-CM Version 2010)
346, 784.0 (ICD-9-CM Version 2011)
E12678 (CTCAE 1105E)
Blackout or Fainting Spells
Item
Blackout or Fainting Spells
string
C0312422 (UMLS CUI 2011AA)
418648005 (SNOMED CT 2011_0131)
10004982 (MedDRA 14.1)
R55 (ICD-10-CM Version 2010)
780.2 (ICD-9-CM Version 2011)
Item Group
Health History - Cardiovascular
Heart Attack/MI
Item
Heart Attack/MI
string
C0027051 (UMLS CUI 2011AA)
22298006 (SNOMED CT 2011_0131)
10028596 (MedDRA 14.1)
MTHU035551 (LOINC Version 232)
I21-I22 (ICD-10-CM Version 2010)
410 (ICD-9-CM Version 2011)
E10152 (CTCAE 1105E)
High Blood Pressure
Item
Hypertension
string
C0020538 (UMLS CUI 2011AA)
38341003 (SNOMED CT 2011_0131)
10020772 (MedDRA 14.1)
MTHU020789 (LOINC Version 232)
I10 (ICD-10-CM Version 2010)
997.91 (ICD-9-CM Version 2011)
E13785 (CTCAE 1105E)
Rapid Heart Rate
Item
Rapid heart beat, high heart frequency, heart rate increased
string
C0039231 (UMLS CUI 2011AA)
3424008 (SNOMED CT 2011_0131)
10019303 (MedDRA 14.1)
R00.0 (ICD-10-CM Version 2010)
785.0 (ICD-9-CM Version 2011)
Irregular Heart Beat
Item
Cardiac Arrhythmia
string
C0003811 (UMLS CUI 2011AA)
44808001 (SNOMED CT 2011_0131)
10003119 (MedDRA 14.1)
427.9 (ICD-9-CM Version 2011)
Cardiovascular Disease, Stents, Angioplasty, Heart Catherization
Item
Disease affecting entire cardiovascular system
string
C0007222 (UMLS CUI 2011AA)
105980002 (SNOMED CT 2011_0131)
10007649 (MedDRA 14.1)
429.2 (ICD-9-CM Version 2011)
Chest Pain/Angina
Item
Ischemic chest pain
string
C0002962 (UMLS CUI 2011AA)
194828000 (SNOMED CT 2011_0131)
10002383 (MedDRA 14.1)
I20 (ICD-10-CM Version 2010)
413 (ICD-9-CM Version 2011)
Item Group
Health History - Respiratory
Lung Disease
Item
Lung diseases
string
C0024115 (UMLS CUI 2011AA)
19829001 (SNOMED CT 2011_0131)
10025082 (MedDRA 14.1)
J98.4 (ICD-10-CM Version 2010)
Congestive Heart Failure
Item
Chronic congestive heart failure
string
C0264722 (UMLS CUI 2011AA)
42343007 (SNOMED CT 2011_0131)
10007559 (MedDRA 14.1)
MTHU020787 (LOINC Version 232)
I50 (ICD-10-CM Version 2010)
428 (ICD-9-CM Version 2011)
Chronic Cough
Item
Chronic cough
string
C0010201 (UMLS CUI 2011AA)
68154008 (SNOMED CT 2011_0131)
10066656 (MedDRA 14.1)
Asthma/Wheezing
Item
Asthma
string
C0004096 (UMLS CUI 2011AA)
195967001 (SNOMED CT 2011_0131)
10003553 (MedDRA 14.1)
MTHU020815 (LOINC Version 232)
J45 (ICD-10-CM Version 2010)
493 (ICD-9-CM Version 2011)
COPD/Bronchitis/Emphysema
Item
Chronic Obstructive Pulmonary Disease, Bronchial infection, Pulmonary Emphysema
string
C0024117, C0006277, C0034067 (UMLS CUI 2011AA)
13645005, 32398004, 87433001 (SNOMED CT 2011_0131)
10009033, 10006451, 10014561 (MedDRA 14.1)
J44.9, J40, J43 (ICD-10-CM Version 2010)
496, 490, 492 (ICD-9-CM Version 2011)
E11323 (CTCAE 1105E)
Pneumonia
Item
Pneumonitis
string
C0032285 (UMLS CUI 2011AA)
233604007 (SNOMED CT 2011_0131)
10035664 (MedDRA 14.1)
MTHU020831 (LOINC Version 232)
J18.9 (ICD-10-CM Version 2010)
E13502 (CTCAE 1105E)
Item Group
Health History - Genitourinary
Abnormal Kidney function
Item
Abnormal Kidney function
string
C1565489 (UMLS CUI 2011AA)
10038474 (MedDRA 14.1)
On Hemodialysis
Item
Haemodialysis
boolean
C0019004 (UMLS CUI 2011AA)
302497006 (SNOMED CT 2011_0131)
10018875 (MedDRA 14.1)
E71.43 (ICD-10-CM Version 2010)
39.95 (ICD-9-CM Version 2011)
On Peritoneal Dialysis
Item
Peritoneal Dialysis (PD)
boolean
C0031139 (UMLS CUI 2011AA)
71192002 (SNOMED CT 2011_0131)
10034660 (MedDRA 14.1)
54.98 (ICD-9-CM Version 2011)
Item Group
Health History - Gastrointestinal
Yellow Jaundice
Item
Icterus
string
C0022346 (UMLS CUI 2011AA)
18165001 (SNOMED CT 2011_0131)
10023126 (MedDRA 14.1)
R17 (ICD-10-CM Version 2010)
Hepatitis/Liver Disease
Item
Hepatitis
string
C0019158 (UMLS CUI 2011AA)
29001004 (SNOMED CT 2011_0131)
10019717 (MedDRA 14.1)
Freq. Indigestion/Reflux Disease
Item
gastric reflux
string
C0558176 (UMLS CUI 2011AA)
225587003 (SNOMED CT 2011_0131)
Gastric Ulcers
Item
Peptic Ulcer
string
C0030920 (UMLS CUI 2011AA)
13200003 (SNOMED CT 2011_0131)
10034341 (MedDRA 14.1)
K27 (ICD-10-CM Version 2010)
533 (ICD-9-CM Version 2011)
Item Group
Health History - Other
Bleed or Bruise Easily
Item
Bleeding diathesis
string
C1458140 (UMLS CUI 2011AA)
248250000 (SNOMED CT 2011_0131)
10005134 (MedDRA 14.1)
Blood Transfusions
Item
Transfusion
string
C1879316 (UMLS CUI 2011AA)
5447007 (SNOMED CT 2011_0131)
10066152 (MedDRA 14.1)
Cancer
Item
Malignant Neoplasms
string
C0006826 (UMLS CUI 2011AA)
363346000 (SNOMED CT 2011_0131)
10028997 (MedDRA 14.1)
MTHU010328 (LOINC Version 232)
C00-C96 (ICD-10-CM Version 2010)
Bleeding Disorders
Item
Bleeding Disorders
string
Obstructive Sleep Apnea
Item
SAS - Sleep apnea syndrome
string
C0037315 (UMLS CUI 2011AA)
73430006 (SNOMED CT 2011_0131)
10040979 (MedDRA 14.1)
G47.30 (ICD-10-CM Version 2010)
780.57 (ICD-9-CM Version 2011)
E13566 (CTCAE 1105E)
HAVE YOU HAD ANY MAJOR ILLNESS
Item
HAVE YOU HAD ANY MAJOR ILLNESS
string
DO YOU HAVE DENTURES
Item
DO YOU HAVE DENTURES
boolean
DO YOU HAVE BRIDGEWORK
Item
DO YOU HAVE BRIDGEWORK
boolean
DO YOU HAVE CAPPED TEETH
Item
DO YOU HAVE CAPPED TEETH
boolean
DO YOU HAVE LOOSE TEETH
Item
DO YOU HAVE LOOSE TEETH
boolean
Are you taking any medications NOW?
Item
Medication
string
C0013227 (UMLS CUI 2011AA)
Have you taken steroids in the last 6 months?
Item
Steroids
string
C0038317 (UMLS CUI 2011AA)
116566001 (SNOMED CT 2011_0131)
Item Group
Health History - Women's health
DATE OF LAST PERIOD
Item
DATE OF LAST PERIOD
date
Are pregnant?
Item
pregnant
boolean
C0549206 (UMLS CUI 2011AA)
10036586 (MedDRA 14.1)
Weeks Gestation
Item
Weeks Gestation
integer
EDC
Item
Estimated date of confinement (delivery date)
date
Item Group
Health History - Substance abuse and Smoking
Substance abuse
Item
Substance abuse problem
string
C0740858 (UMLS CUI 2011AA)
66214007 (SNOMED CT 2011_0131)
10066169 (MedDRA 14.1)
MTHU019364 (LOINC Version 232)
Do you currently smoke/use tobacco products?
Item
Smoker
boolean
CL025861 (UMLS CUI 2011AA)
What type of tobacco products?
Item
What type of tobacco products?
string
How much?
Item
How much?
string
Have you ever smoked /used tobacco products?
Item
Have you ever smoked /used tobacco products?
boolean
When did you quit?(If has used products in the past 12 months,MUST give smoking cessation advice/information)
Item
When did you quit?(If has used products in the past 12 months,MUST give smoking cessation advice/information)
date
What type of tobacco products?
Item
What type of tobacco products?
string
How much?
Item
How much?
string
Pediatric Smoking: Does anyone in your household currently use tobacco products?
Item
Pediatric Smoking: Does anyone in your household currently use tobacco products?
boolean
What type of tobacco products?
Item
What type of tobacco products?
string
How much?
Item
How much?
string
Has anyone in the house hold quit using tobacco products in the last 12 months?
Item
Has anyone in the house hold quit using tobacco products in the last 12 months?
boolean
When did the person in your house hold quit?(If has used products in the past 12 months, MUST give smoking cessation advice/information)
Item
When did the person in your house hold quit?(If has used products in the past 12 months, MUST give smoking cessation advice/information)
date
What type of tobacco products?
Item
What type of tobacco products?
string
How much?
Item
How much?
string
Tobacco/Smoking Cessation information/advice given to Patient
Item
Tobacco/Smoking Cessation information/advice given to Patient
boolean
Tobacco/Smoking Cessation information/advice given to Other
Item
Tobacco/Smoking Cessation information/advice given to Other
boolean
In what format was the smoking cessation given (Verbal, Handwritten, Pre-printed)?
Item
In what format was the smoking cessation given (Verbal, Handwritten, Pre-printed)?
integer
How much alcohol?
Item
How much alcohol?
string
How often alcohol?
Item
How often alcohol?
string
RECREATIONAL DRUGS
Item
RECREATIONAL DRUGS
string
Item Group
Immunizations
Immunizations
Item
Immunisation
string
C0020971 (UMLS CUI 2011AA)
127785005 (SNOMED CT 2011_0131)
10021431 (MedDRA 14.1)
IMMUNIZ (HL7 V3 2006_05)
Item Group
SPECIALTY CLINIC specific
SPECIALTY CLINIC specific
Item
SPECIALTY CLINIC specific
string
Item Group
Nutrition
Current Weight
Item
Current Weight
integer
Have you experienced any unexplained weight loss or gain in the past 6 months?
Item
Have you experienced any unexplained weight loss or gain in the past 6 months?
boolean
As compared to normal, would you rate your food intake during the past month as either: CHANGED- MORE- LESS
Item
As compared to normal, would you rate your food intake during the past month as either: CHANGED- MORE- LESS
integer
Item Group
Assistance / Mobility
Do you live alone?
Item
Do you live alone?
boolean
Does anyone assist you at home?
Item
Needs assistance at home
boolean
C0578564 (UMLS CUI 2011AA)
301887005 (SNOMED CT 2011_0131)
If yes, Name and phone number of person and/or facility that assists
Item
If yes, Name and phone number of person and/or facility that assists
string
Equipment needed for WOUND(S)
Item
Equipment needed for WOUND(S)
string
Where is your wound(s) located?
Item
Wound
string
C0043250 (UMLS CUI 2011AA)
13924000 (SNOMED CT 2011_0131)
10052428 (MedDRA 14.1)
MTHU001326 (LOINC Version 232)
How long have you had the wound(s)?
Item
How long have you had the wound(s)?
date
How did the wounds start?
Item
How did the wounds start?
string
How have you been treating the wound(s)?
Item
How have you been treating the wound(s)?
string

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

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