Keywords
Medical History Taking ×
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Table of contents
  1. 1. Clinical Trial
  2. 2. Routine Documentation
  3. 3. Registry/Cohort Study
  4. 4. Quality Assurance
  5. 5. Data Standard
  6. 6. Patient-Reported Outcome
  7. 7. Medical Specialty
Selected data models

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594 Search results.

Smart Device System Meta Data Definitions - Family History

- 2/4/20 - 7 forms, 1 itemgroup, 2 items, 2 languages
Itemgroup: Family history
Metadata definitions for the Smart Device System for Movement Disorders. Clinical Protocol and Registration Information available on: https://clinicaltrials.gov/ct2/show/NCT03638479 Principal Investigator: Julian Varghese Description for Assessment Steps for Neurologic Examination are available under: Varghese J, Niewöhner S, Soto-Rey I, et al. A Smart Device System to Identify New Phenotypical Characteristics in Movement Disorders. Front Neurol. 2019;10:48. doi:10.3389/fneur.2019.00048

Medication

1 itemgroup, 3 items31

Vital Signs

1 itemgroup, 1 item31

PD NMS

1 itemgroup, 1 item31

Demography

2 itemgroups, 5 items31
2 other form meeting the search is available in the detailed view.

Telemedical Interventional Management in Heart Failure II (TIM-HF II) NCT01878630 - Baseline Visit

- 11/14/17 - 1 form, 10 itemgroups, 71 items, 2 languages
Itemgroups: Physical Examination / Medical History taking, Signs and Symptoms of heart failure, Cardiovascular Diseases, Comorbidities, Current medication, Cardiovascular interventions, Implantation of a cardiac device, Hematology, ECG, Baseline visit
Short title: TIM-HF II Permission to publish granted by: Prof. Dr. Friedrich Köhler, FESC Charité - Universitätsmedizin Berlin Further study details on: https://www.clinicaltrials.gov/ct2/show/NCT01878630 Baseline Visit (BV-Form)

26672_Common Data Elements Myeloid Leukemia (MDS AML CML) - Lab: Cytology/Cytogenetics/Cytochemistry

- 4/21/18 - 13 forms, 1 itemgroup, 29 items, 1 language
Itemgroup: Cytology/Cytogenetics/Cytochemistry
Common Data Elements Myeloid Leukemia (MDS, AML, CML) for use in clinical routine and clinical trial documentation. https://www.ncbi.nlm.nih.gov/pubmed/27577388

Lab: Molecular Genetics

1 itemgroup, 27 items31

Bone Marrow Transplant

1 itemgroup, 13 items31

GVHD

3 itemgroups, 11 items31

Global Disease Course

3 itemgroups, 11 items31
8 more forms meeting the search are available in the detailed view.

Family history - HIS

- 6/4/17 - 1 form, 3 itemgroups, 33 items, 2 languages
Itemgroups: Maternal Family History, Paternal Family History, Siblings Family History
Form from HIS OpenVistA

EHR4CR Complete Data Inventory - EHR4CR Data Inventory

- 2/10/17 - 1 form, 13 itemgroups, 122 items, 1 language
Itemgroups: Demographics, Diagnoses and Procedures, Vital Signs, Laboratory, Generic Laboratory Data, Medication, Adverse Events, Medical History, Clinical Findings, ECG, Patient Reported Outcome, Substance Use, Study Participation Status
Compilation of Feasibility, Patient Identification & Recruitment and Clinical Trial Execution data inventories. https://www.ncbi.nlm.nih.gov/pubmed/24410735 https://www.ncbi.nlm.nih.gov/pubmed/25991199 https://www.ncbi.nlm.nih.gov/pubmed/27875988

CDASH Medical History

- 6/20/18 - 1 form, 4 itemgroups, 13 items, 3 languages
Itemgroups: General information, High Blood Pressure, Appendectomy, Other
modified from http://www.cdisc.org

Persönliches Interview SHIP-Trend-1 Herz-Kreislauf-Erkrankungen

- 11/2/17 - 1 form, 1 itemgroup, 5 items, 1 language
Itemgroup: Herz-Kreislauf-Erkrankungen
Herz-Kreislauf-Erkrankungen form of SHIP Study (Study of Health in Pomerania), conducted by the University of Greifswald. SHIP unique domain name TREND.TREND1.INT.KHK.KHK. ODM derived from https://www.fvcm.med.uni-greifswald.de/dd_service/data_use_explore.php. Further information: http://www2.medizin.uni-greifswald.de/cm/fv/ship.html.
 Publication granted by Prof. Völzke. Reference: Völzke H, et al. Cohort profile: the study of health in Pomerania. Int J Epidemiol. 2011;40(2):294-307. PMID: 20167617

HIS Review of Systems - HIS

- 5/21/14 - 1 form, 13 itemgroups, 111 items, 2 languages
Itemgroups: GENERAL, EYE, EAR, NOSE, MOUTH, RESPIRATORY, CARDIOVASCULAR, GASTROINTESTINAL, GENITOURINARY, MUSCULOSKELETAL, NEUROLOGIC, PAIN, GERIATRIC
Form from HIS OpenVistA

Cardiovascular Unit of Rhön-Klinikum Bad Neustadt - Cardiologic Medical History and Findings (Kardiologische Anamnese der Herz- und Gefäßklinik)

- 2/10/20 - 1 form, 24 itemgroups, 201 items, 2 languages
Itemgroups: Cardiologic medical history and findings, Angina pectoris symptoms, Signs for heart failure, Myocardial Infarction History, Cardiac Arrhythmias, Medical History: diagnostic cardiac catheter, Medical History: coronary angioplasty, Medical history: electrophysiological diagnosis/therapy, Medical history: cardiac pre-operation, Current medication and dosage, Current medication name and dosage, Cardiac risk factors, Arteriosclerosis, Other diseases, Other complaints, Physical examination: general, Physical examination: cor, Physical examination: pulmo, Edemas, Physical examination: arteries, Physical examination: venous system, Physical examination: Scar conditions, Other pathological examination findings, Signature
Form for documentation of cardiologic medical history and findings of the Cardiovascular Unit (Herz- und Gefäßklinik) of the Rhön-Klinikum Campus Bad Neustadt, Germany. Provided by the Medical Documentation Department of the Rhön-Klinikum Campus Bad Neustadt. The English Version is not an official translation.

Polyclinic Medical History University Hospital Cologne

- 3/5/17 - 1 form, 13 itemgroups, 77 items, 1 language
Itemgroups: Patient data, Vital Signs, Medical History, Medication, Operative Surgical Procedures, Pregnancy, Pregnancy, Medical History, Physical Examination, Ultrasonography, Diagnosis, Procedure, Signature
Hospital Routine Documentation Subform at the University Hospital Cologne. Original Form Name: Poliklinik Anamnese

Pazopanib Eye Drops versus Ranibizumab Intravitreal Injections for the Treatment of Neovascular Age-Related Macular Degeneration NCT01134055 - Screen - Administrative; Demography; Cardiovascular medical conditions; Medical Conditions; Ocular Medical Conditions

- 1/10/20 - 1 form, 10 itemgroups, 25 items, 1 language
Itemgroups: Inform Screening, Inform Enrollment, Date of Visit/ Assessment, Subject identification, Demography, Cardiovascular medical conditions, Medical conditions, Ocular medical conditions - Right Eye, Ocular medical conditions - Left Eye, Other ocular conditions
Study ID: 110852 Clinical Study ID: 110852 Study Title: MD7110852, A Phase 2b Dose-Ranging Study of Pazopanib Eye Drops versus Ranibizumab Intravitreal Injections for the Treatment of Neovascular Age-Related Macular Degeneration Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01134055 Sponsor: GlaxoSmithKline Phase: Phase 2 Study Recruitment Status: Completed Generic Name: pazopanib eye drops, ranibizumab intravitreal injection, placebo Trade Name: pazopanib, ranibizumab Study Indication: Macular Degeneration

Ropinirole prolonged release (PR) as adjunctive treatment to L-Dopa in patients with advanced Parkinson's disease (NCT01494532) - Screening - Medical History; PD Stage Prior Med; PR/ Conmeds

- 1/9/20 - 1 form, 8 itemgroups, 34 items, 1 language
Itemgroups: Administrative, General Medical History - Cardiovascular Risk Factors, Family history - Cardiovascular Risk Factors , Medical Conditions, Tobacco Use, Parkinson's Disease History, Pre-study Parkinson's Disease Medication, Prior/ Current Concomitant Medications
Study ID: 111569 Clinical Study ID: 111569 Study Title: A fixed dose, dose-response study for ropinirole prolonged release (PR) as adjunctive treatment to L-Dopa in patients with advanced Parkinson's disease Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01494532 Sponsor: GlaxoSmithKline Phase: Phase 4 Study Recruitment Status: Completed Generic Name: Ropinirole, placebo Study Indication: Parkinson's Disease