308 lines
12 KiB
Plaintext
308 lines
12 KiB
Plaintext
English French Notes Complete/Exclude
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] New order(s) placed.
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] New DC order(s) placed.
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Abnormal labs - [
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Abnormal lab:
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Order requires electronic signature.
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] Order placed:
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] Result available:
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Procedure uses non-barium contrast media - abnormal biochem result:
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Recent Cholecystogram:
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Patient >65. Renal Results:
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Missing Labs for Angiogram:
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Patient allergic to contrast medias:
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Recent Barium study:
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WBC < 3.0 and/or ANC < 1.5 - pharmacy cannot fill clozapine order. Most recent results -
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Clozapine orders require a CBC/Diff within past 7 days. Please order CBC/Diff with WBC and ANC immediately. Most recent results -
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Most recent results -
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WBC between 3.0 and 3.5 with ANC >= 1.5 - please repeat CBC/Diff including WBC and ANC immediately and twice weekly. Most recent results -
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Clozapine - most recent results -
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Aminoglycoside - est. CrCl:
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Patient may be
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Est. CrCl:
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ordered - adjust diet accordingly.
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Procedure uses non-barium contrast media and patient is taking glucophage.
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Potential polypharmacy - patient currently receiving
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Labs resulted - [
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Glucophage - Creatinine results:
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Glucophage - no serum creatinine within past
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] Lab threshold exceeded - [
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Patient has no allergy assessment.
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Duplicate opioid medications:
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When the transport routine encounters locally
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altered rule data at a site, do you want to:
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(O)verwrite, (D)isplay, or (A)sk the site ?
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Locally altered data will be overwritten without asking.
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Locally altered data will be displayed only.
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Sites will be asked before locally altered data is overwritten.
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Enter Patch ID (ex. OR*3*96):
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OR*
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v = Package Version.
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ppp = Patch Number.
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(Delete after Install of
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Scanning for old rule transport routines...
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No old rule transport routines found...
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These routines will be deleted and overwritten.
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Do you want to proceed?
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Old rule transport routines not deleted (^%ZOSF(
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Not Deleted...
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Select an
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***** Already selected for transport. *****
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None Selected for transport
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Already selected for transport:
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Press <Enter> to continue...
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added to list.
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removed from list.
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Select a
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selected for transport.
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ORDER CHECK
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OCX MDD
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unknown lookup error.
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could not resolve name.
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End Transport.
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already existed.
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record missing...
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Unresolved subscript.
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^DIE filer data error...
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...Correct data Filed
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Rule Transport aborted, version mismatch.
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Rule Transport Version: |CVER|
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Order Check Expert System Rule Transporter
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data filing error
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Some expert system rules may be incomplete.
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No data filing errors.
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Transport Finished...
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] ERROR - RECORD NOT FOUND
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ACD EXTRACT V10.1
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Available record layouts:
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1) VAACCR Record Layout Version 10.1 (VA Registry)
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2) NAACCR State Record Layout Version 10.1
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Select record layout:
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Select the record layout to use
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VACCR EXTRACT V10.1
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STATE EXTRACT V10.1
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DISPLAY/PRINT on-line instructions
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STATE REPORTING ACOS INFOA
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PRIMARY ACOS INFO (850)
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Select start date:
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Select end date:
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Analytic cases only
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Answer 'YES' if you want only analytic cases (CLASS OF CASE 0-2) extracted.
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Answer 'NO' if you want all cases (analytic and non-analytic) extracted.
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|Please activate your PC capture program. The data will be sent|
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| in 30 seconds or when you press the return key. |
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No records extracted.
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ACoS Report Print
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State Extract Print
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Report Canceled!
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Report Queued!
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These are your current settings:
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Record layout.......................:
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Facility Identification Number (FIN):
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State to be extracted...............:
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Accession Year......................:
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Start date..........................:
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End date............................:
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Analytic cases only.................:
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Are these settings correct
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Accession Year:
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Facility Identification Number (FIN)
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The site paramaters record is being edited by another user.
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Press ENTER to Continue or
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to Quit:
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Col#
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Data item
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Data Value
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ONC(
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ICDO-TOPOGRAPHY is not defined
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.........: Surgery performed
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.........: Radiation performed
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The Accession Year is not 1995.
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The Diagnostic Confirmation code is not 1.
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The Class of Case code is not 0, 1 or 2.
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Date DX and/or First Treatment Date not in 1995.
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Select table
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This primary does not satisfy the PCE eligibility criteria:
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Patient Care Evaluation Study of Cancers of the Urinary Bladder
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ACCESSION/SEQUENCE NUMBER
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CLASS OF CASE
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REFERRED FOR TREATMENT TO
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ZIP AT DIAGNOSIS
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SPANISH ORIGIN
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PRIMARY PAYER AT DIAGNOSIS
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PATIENT HISTORY OF OTHER CANCER
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FAMILY HISTORY OF CANCER
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SMOKING HISTORY
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DURATION OF SMOKING HISTORY
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DURATION OF SMOKE-FREE HISTORY
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TABLE I - GENERAL INFORMATION
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ACCESSION/SEQUENCE NUMBER.....:
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CLASS OF CASE.................:
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300REFERRED FOR TREATMENT TO.....
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9ZIP AT DIAGNOSIS..............
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DATE OF BIRTH.................:
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9SPANISH ORIGIN................
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18PRIMARY PAYER AT DIAGNOSIS....
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301LENGTH OF STAY................
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PATIENT HISTORY OF OTHER CANCER:
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305 HEAD AND NECK...............
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FAMILY HISTORY OF CANCER:
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314SMOKING HISTORY (PACKS/DAY)...
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315DURATION OF SMOKING HISTORY...
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316DURATION OF SMOKE-FREE HISTORY
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GO TO:
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CLINICAL DETECTION
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ONSET OF SYMPTOMS
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DURATION OF SYMPTOMS BEFORE DIAGNOSIS
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DIAGNOSTIC PROCEDURES
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DATE OF INITIAL DIAGNOSIS
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SPECIALTY MAKING DIAGNOSIS
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PRIMARY SITE (ICD-O-2)
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HISTOLOGY (ICD-O-2)
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TABLE II- DIAGNOSTIC INFORMATION
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CLINICAL DETECTION:
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317 GROSS HEMATURIA................
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318 MICROSCOPIC HEMATURIA..........
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319 URINARY FREQUENCY..............
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320 BLADDER IRRITABILITY...........
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323ONSET OF SYMPTOMS................
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DURATION OF SYMPTOMS (months) BEFORE DIAGNOSIS:
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324 GROSS HEMATURIA................
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DIAGNOSTIC PROCEDURES:
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326 BIMANUAL EXAMINATION OF BLADDER
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327 CYSTOSCOPY WITH BIOPSY.........
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328 CYSTOSCOPY WITHOUT BIOPSY......
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329 FLOW CYTOMETRY.................
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330 INTRAVENOUS PYELOGRAM..........
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331 URINE CYTOLOGY.................
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DATE OF INITIAL DIAGNOSIS........:
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334SPECIALTY MAKING DIAGNOSIS.......
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PRIMARY SITE (ICD-O-2)...........:
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HISTOLOGY (ICD-O-2)..............:
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STAGING PROCEDURES
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PRESENCE OF HYDRONEPHROSIS
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TUMOR SIZE (mm)
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PRESENCE OF MULTIPLE TUMORS
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REGIONAL NODES EXAMINED
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REGIONAL NODES POSITIVE
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SITES OF DISTANT METASTASIS
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AJCC CLINICAL STAGE (cTNM)
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AJCC PATHOLOGIC STAGE (pTNM)
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STAGED BY
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TABLE III- EXTENT OF DISEASE AND AJCC STAGE
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STAGING PROCEDURES:
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335 ABDOMINAL ULTRASOUND.........
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336 BONE IMAGING.................
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338 CT CHEST/LUNG................
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339 CT ABDOMEN/PELVIS............
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340 CT OTHER.....................
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341 MRI PELVIS/ABDOMEN...........
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342 MRI OTHER....................
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344PRESENCE OF HYDRONEPHROSIS.....
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29TUMOR SIZE (mm)................
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345PRESENCE OF MULTIPLE TUMORS....
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33REGIONAL NODES EXAMINED........
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32REGIONAL NODES POSITIVE........
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SITES OF DISTANT METASTASIS:
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34 SITE OF DISTANT METASTASIS #1
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SITE OF DISTANT METASTASIS #2: None
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SITE OF DISTANT METASTASIS #3: None
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34.1 SITE OF DISTANT METASTASIS #2
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34.2 SITE OF DISTANT METASTASIS #3
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AJCC CLINICAL STAGE (cTNM):
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38AJCC STAGE.....................
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AJCC PATHOLOGIC STAGE (pTNM):
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88AJCC STAGE.....................
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STAGED BY:
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19 CLINICAL STAGE....................
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89 PATHOLOGIC STAGE..................
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DATE OF INITIAL TREATMENT
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PROTOCOL ELIGIBILITY STATUS
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MANAGING PHYSICIANS
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RADIATION THERAPY
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TABLE IV - FIRST COURSE OF TREATMENT
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DATE OF INITIAL TREATMENT...........:
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346PROTOCOL ELIGIBILITY STATUS.........
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MANAGING PHYSICIANS:
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347 PRIMARY PHYSICIAN.................
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348 SECONDARY PHYSICIAN...............
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SURGERY:
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DATE OF SURGERY...................:
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TYPE OF SURGERY...................:
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TUMOR RESECTION DURING TURB.......: Not applicable
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349 TUMOR RESECTION DURING TURB.......
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TYPE OF URINARY DIVERSION.........: Not applicable
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350 TYPE OF URINARY DIVERSION.........
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PELVIC LYMPH NODE DISSECTION......: Not applicable
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351 PELVIC LYMPH NODE DISSECTION......
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SURGICAL COMPLICATIONS:
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BLEEDING REQUIRING TRANSFUSION..: No
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DEEP VENOUS THROMBOSIS..........: No
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MYOCARDIAL INFARCTION/ARRHYTHMIA: No
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PELVIC ABSCESS..................: No
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PNEUMONIA REQUIRING ANTIBIOTICS.: No
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POST-OPERATIVE DEATH (30 DAYS)..: No
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PULMONARY EMBOLISM/THROMBOSIS...: No
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352 BLEEDING REQUIRING TRANSFUSION..
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353 DEEP VENOUS THROMBOSIS..........
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354 MYOCARDIAL INFARCTION/ARRHYTHMIA
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355 PELVIC ABSCESS..................
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356 PNEUMONIA REQUIRING ANTIBIOTICS.
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357 POST-OPERATIVE DEATH (30 DAYS)..
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358 PULMONARY EMBOLISM/THROMBOSIS...
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RADIATION THERAPY:
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RADIATION THERAPY.................:
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DATE RADIATION THERAPY STARTED....:
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DATE RADIATION THERAPY ENDED......: 00/00/0000
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TOTAL RAD (cGy/rad) DOSE..........: 00000
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REGIONAL TREATMENT MODALITY.......: No radiation therapy
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RADIATION COMPLICATIONS:
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URINARY INCONTINENCE............: Not applicable
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HEMATURIA.......................: Not applicable
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RADIATION BOWEL INJURY..........: Not applicable
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DATE RADIATION THERAPY ENDED......: 99/99/9999
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TOTAL RAD (cGy/rad) DOSE..........: 99999
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REGIONAL TREATMENT MODALITY.......: Unknown
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URINARY INCONTINENCE............: Unknown
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RADIATION BOWEL INJURY..........: Unknown
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361 DATE RADIATION THERAPY ENDED......
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362 TOTAL RAD (cGy/rad) DOSE..........
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363 REGIONAL TREATMENT MODALITY.......
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364 URINARY INCONTINENCE............
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366 RADIATION BOWEL INJURY..........
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CHEMOTHERAPY:
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DATE CHEMOTHERAPY STARTED.........:
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DATE CHEMOTHERAPY ENDED...........: 00/00/0000
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ROUTE CHEMOTHERAPY ADMINISTERED...: No chemotherapy
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TYPES OF AGENTS ADMINISTERED:
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ADRIAMYCIN......: None IFOSFAMIDE......: None
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CARBOPLATINUM...: None METHOTREXATE....: None
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CISPLATIN.......: None TAXOL...........: None
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CYCLOPHOSPHAMIDE: None THIOTEPA........: None
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5-FLUOROURACIL..: None VINBLASTINE.....: None
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GALLIUM NITRATE.: None OTHER...........: None
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INDICATION FOR ADMIN OF AGENTS....: No agents administered, NA
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REASON CHEMOTHERAPY STOPPED.......: Treatment completed, NA
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DATE CHEMOTHERAPY ENDED...........: 99/99/9999
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ROUTE CHEMOTHERAPY ADMINISTERED...: Unknown
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ADRIAMYCIN......: Unknown IFOSFAMIDE......: Unknown
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CARBOPLATINUM...: Unknown METHOTREXATE....: Unknown
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CISPLATIN.......: Unknown TAXOL...........: Unknown
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CYCLOPHOSPHAMIDE: Unknown THIOTEPA........: Unknown
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5-FLUOROURACIL..: Unknown VINBLASTINE.....: Unknown
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GALLIUM NITRATE.: Unknown OTHER...........: Unknown
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INDICATION FOR ADMIN OF AGENTS....: Unknown
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REASON CHEMOTHERAPY STOPPED.......: Unknown
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367 DATE CHEMOTHERAPY ENDED...........
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368 ROUTE CHEMOTHERAPY ADMINISTERED...
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374 GALLIUM NITRATE.................
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380 OTHER AGENT.....................
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381 INDICATION FOR ADMIN OF AGENTS....
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382 REASON CHEMOTHERAPY STOPPED.......
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IMMUNOTHERAPY:
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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