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Inhaltsverzeichnis
  1. 1. Klinische Studie
  2. 2. Routinedokumentation
  3. 3. Register-/Kohortenstudien
  4. 4. Qualitätssicherung
  5. 5. Datenstandard
  6. 6. Patientenfragebogen
  7. 7. Medizinische Fachrichtung
    1. 7.1. Anästhesie
    1. 7.2. Dermatologie
    1. 7.3. HNO
    1. 7.4. Geriatrie
    1. 7.5. Gynäkologie/Geburtshilfe
    1. 7.6. Innere Medizin
      1. Hämatologie
      1. Infektiologie
      1. Kardiologie/Angiologie
      1. Pneumologie
      1. Gastroenterologie
      1. Nephrologie
      1. Endokrinologie/Stoffwechsel
      1. Rheumatologie
    1. 7.7. Neurologie
    1. 7.8. Augenheilkunde
    1. 7.9. Palliativmedizin
    1. 7.10. Pathologie/Rechtsmedizin
    1. 7.11. Kinderheilkunde
    1. 7.12. Psychiatrie/Psychosomatik
    1. 7.13. Radiologie
    1. 7.14. Chirurgie
      1. Allgemein-/Viszeralchirurgie
      1. Neurochirurgie
      1. Plastische Chirurgie
      1. Herz-/Thoraxchirurgie
      1. Unfallchirurgie/Orthopädie
      1. Gefäßchirurgie
    1. 7.15. Urologie
    1. 7.16. Zahnmedizin/MKG
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German Examination Booklet for Children G-BA - German Examination Booklet for Children G-BA U9

- 03.02.17 - 19 Formulare, 17 Itemgruppen, 63 Datenelemente, 1 Sprache
Itemgruppen: findings, body measurements, Examination of skin, findings Thorax organ heart neck, lungs findings, finding Abdominal organ, findings Genitalia, findings urine, findings Vertebral column, findings limbs, findings eye, findings Mouth, findings Nose, findings Ear, findings Motor function nervous system, additional information, Physical Examination
German Kinderuntersuchungsheft (resolution in June 2008 by G-BA) for early detection of diseases in children. The scope of early detection measures for children is specified in the G-BA Paediatrics Directive. Findings are documented in the “Examination Booklet for Children”. This yellow booklet is issued to parents following delivery, either by the delivery ward or the midwife. Medical measures to be performed in accordance with the directives target the early detection of diseases that could jeopardize normal physical or mental development. The examinations provided must be administered within specific periods. Source: Gemeinsamer Bundesausschuss (G-BA), juristische Person des öffentlichen Rechts, Wegelystr. 8, 10623 Berlin, https://www.g-ba.de/institution/themenschwerpunkte/frueherkennung/kinder/, Publication granted by Dr. Beate Axmann.

German Examination Booklet for Children G-BA U7a

17 Itemgruppen 61 Datenelemente

German Examination Booklet for Children G-BA U7

17 Itemgruppen 66 Datenelemente

German Examination Booklet for Children G-BA U8

18 Itemgruppen 63 Datenelemente

German Examination Booklet for Children G-BA U6

17 Itemgruppen 70 Datenelemente

German Examination Booklet for Children G-BA U4

18 Itemgruppen 68 Datenelemente

German Examination Booklet for Children G-BA U3

18 Itemgruppen 89 Datenelemente

German Dental Examination Booklet for Children - UZ 5 Permanent teeth Examination (5 years old)

- 03.02.17 - 7 Formulare, 2 Itemgruppen, 22 Datenelemente, 1 Sprache
Itemgruppen: dental examination, report
The Child‘s Dental Examination Book is used to help to look after a child‘s dental health from the very beginning. Children are examined specifically with regard to particular risks, such as baby tooth decay and all the precautionary examinations are documented in this book. The examinations provided must be administered within specific periods. Source: Chamber of Dental Surgeons Westfalen-Lippe, Chamber of Dental Surgeons Nordrhein, Association of Health Service Dental Surgeons Westfalen-Lippe) and Association of Health Service Dental Surgeons Nordrhein.

UZ 6 Permanent teeth Examination (6 years old)

2 Itemgruppen 22 Datenelemente

UZ 2 Milk Teeth Examination (2 years old)

2 Itemgruppen 19 Datenelemente

UZ 3 Milk Teeth Examination (3 years old)

2 Itemgruppen 19 Datenelemente

UZ 4 Milk Teeth Examination (4 years old)

2 Itemgruppen 19 Datenelemente

UZ 1 Milk Teeth Examination (1 year old)

1 Itemgruppe 10 Datenelemente

Intro

1 Itemgruppe 8 Datenelemente

Modified Rankin Scale

- 28.11.17 - 1 Formular, 1 Itemgruppe, 1 Datenelement, 4 Sprachen
Itemgruppe: Modified Rankin Scale
https://en.wikipedia.org/wiki/Modified_Rankin_Scale The modified Rankin Scale (mRS) is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability. It has become the most widely used clinical outcome measure for stroke clinical trials.

ATRIA Stroke Risk Score

- 25.01.18 - 1 Formular, 1 Itemgruppe, 9 Datenelemente, 1 Sprache
Itemgruppe: ATRIA Stroke Risk Score
The ATRIA stroke risk score can be used to optimize optimize anticoagulation decision making in patients with atrial fibrillation (AF) by predicting severe events. Reference: Singer, D. E., Chang, Y., Borowsky, L. H., Fang, M. C., Pomernacki, N. K., Udaltsova, N., ... & Go, A. S. (2013). A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score. Journal of the American Heart Association, 2(3), e000250. Publication granted by Daniel E. Singer.

NIHSS - NIH Stroke Scale

- 20.09.21 - 1 Formular, 1 Itemgruppe, 16 Datenelemente, 9 Sprachen
Itemgruppe: NIHSS
https://en.wikipedia.org/wiki/National_Institutes_of_Health_Stroke_Scale

Clinical risk index for babies II (CRIB II) score

- 27.09.21 - 1 Formular, 1 Itemgruppe, 7 Datenelemente, 1 Sprache
Itemgruppe: CRIB II
The five-item CRIB II score is an update of the with clinical risk index for babies (CRIB) score, a risk-adjustment instrument widely used in neonatal intensive care. Parry, G., Tucker, J., Tarnow-Mordi, W., & UK Neonatal Staffing Study Collaborative Group. (2003). CRIB II: an update of the clinical risk index for babies score. The Lancet, 361(9371), 1789-1791.

WHO-5 - WHO (Five) Well-Being Index

- 02.04.25 - 1 Formular, 1 Itemgruppe, 5 Datenelemente, 30 Sprachen
Itemgruppe: Over the last two weeks
WHO (Five) Well-Being Index (1998 version) Also called : WHO Five, WHO 5 [Topp CW, Østergaard SD, Søndergaard S, Bech P. The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom. 2015;84(3):167-76. doi: 10.1159/000376585]

Center for Epidemiologic Studies Depression Scale (CES-D)

- 08.04.17 - 1 Formular, 2 Itemgruppen, 22 Datenelemente, 1 Sprache
Itemgruppen: General information, Symptoms of depression past week
The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The scale should be a useful tool for epidemiologic studies of depression. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1:385-401.

Center for Epidemiologic Studies Depression Scale – Revised (CESD-R)

- 27.09.21 - 1 Formular, 1 Itemgruppe, 20 Datenelemente, 1 Sprache
Itemgruppe: Symptoms of depression past week
The Center for Epidemiologic Studies Depression Scale (CESD) was created in 1977 by Laurie Radloff, and revised in 2004 by William Eaton and others. The 20 items in CESD-R scale measure symptoms of depression in nine different groups as defined by the American Psychiatric Association Diagnostic and Statistical Manual, fifth edition. References: Eaton WW, Muntaner C, Smith C, Tien A, Ybarra M. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). In: Maruish ME, ed. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004:363-377. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1:385-401. http://cesd-r.com/

Montreal Cognitive Assessment (MoCA) - MoCA

- 28.11.17 - 1 Formular, 10 Itemgruppen, 30 Datenelemente, 7 Sprachen
Itemgruppen: Alternating Trail Making, Visuoconstructional Skills, Naming, Memory, Attention, Language, Abstraction, Delayed Recall, Orientation, MoCA
https://en.wikipedia.org/wiki/Montreal_Cognitive_Assessment

Stability and Workload Index for Transfer (SWIFT) score

- 25.01.18 - 1 Formular, 1 Itemgruppe, 6 Datenelemente, 1 Sprache
Itemgruppe: SWIFT score
"The Stability and Workload Index for Transfer score is derived from information readily available at the time of ICU dismissal and acceptably predicts ICU readmission. Reference: Gajic, O., Malinchoc, M., Comfere, T. B., Harris, M. R., Achouiti, A., Yilmaz, M., ... & Farmer, J. C. (2008). The Stability and Workload Index for Transfer score predicts unplanned intensive care unit patient readmission: initial development and validation. Critical care medicine, 36(3), 676-682. Publication granted by Ognjen Gajic.

Framingham Risk Score

- 20.09.21 - 1 Formular, 1 Itemgruppe, 7 Datenelemente, 1 Sprache
Itemgruppe: Score items
The Framingham Risk Score is a sex-specific algorithm used to estimate the 10-year cardiovascular risk of an individual. The Framingham Risk Score was first developed based on data obtained from the Framingham Heart Study, to estimate the 10-year risk of developing coronary heart disease. In order to assess the 10-year cardiovascular disease risk, cerebrovascular events, peripheral artery disease and heart failure were subsequently added as disease outcomes for the 2008 Framingham Risk Score, on top of coronary heart disease. (http://en.wikipedia.org/wiki/Framingham_Risk_Score)

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