| 1 | English French Notes Complete/Exclude
|
|---|
| 2 | ] New order(s) placed.
|
|---|
| 3 | ] New DC order(s) placed.
|
|---|
| 4 | Abnormal labs - [
|
|---|
| 5 | Abnormal lab:
|
|---|
| 6 | Order requires electronic signature.
|
|---|
| 7 | ] Order placed:
|
|---|
| 8 | ] Result available:
|
|---|
| 9 | Procedure uses non-barium contrast media - abnormal biochem result:
|
|---|
| 10 | Recent Cholecystogram:
|
|---|
| 11 | Patient >65. Renal Results:
|
|---|
| 12 | Missing Labs for Angiogram:
|
|---|
| 13 | Patient allergic to contrast medias:
|
|---|
| 14 | Recent Barium study:
|
|---|
| 15 | WBC < 3.0 and/or ANC < 1.5 - pharmacy cannot fill clozapine order. Most recent results -
|
|---|
| 16 | Clozapine orders require a CBC/Diff within past 7 days. Please order CBC/Diff with WBC and ANC immediately. Most recent results -
|
|---|
| 17 | Most recent results -
|
|---|
| 18 | 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 -
|
|---|
| 19 | Clozapine - most recent results -
|
|---|
| 20 | Aminoglycoside - est. CrCl:
|
|---|
| 21 | Patient may be
|
|---|
| 22 | Est. CrCl:
|
|---|
| 23 | ordered - adjust diet accordingly.
|
|---|
| 24 | Procedure uses non-barium contrast media and patient is taking glucophage.
|
|---|
| 25 | Potential polypharmacy - patient currently receiving
|
|---|
| 26 | Labs resulted - [
|
|---|
| 27 | Glucophage - Creatinine results:
|
|---|
| 28 | Glucophage - no serum creatinine within past
|
|---|
| 29 | ] Lab threshold exceeded - [
|
|---|
| 30 | Patient has no allergy assessment.
|
|---|
| 31 | Duplicate opioid medications:
|
|---|
| 32 | When the transport routine encounters locally
|
|---|
| 33 | altered rule data at a site, do you want to:
|
|---|
| 34 | (O)verwrite, (D)isplay, or (A)sk the site ?
|
|---|
| 35 | Locally altered data will be overwritten without asking.
|
|---|
| 36 | Locally altered data will be displayed only.
|
|---|
| 37 | Sites will be asked before locally altered data is overwritten.
|
|---|
| 38 | Enter Patch ID (ex. OR*3*96):
|
|---|
| 39 | OR*
|
|---|
| 40 | v = Package Version.
|
|---|
| 41 | ppp = Patch Number.
|
|---|
| 42 | (Delete after Install of
|
|---|
| 43 | Scanning for old rule transport routines...
|
|---|
| 44 | No old rule transport routines found...
|
|---|
| 45 | These routines will be deleted and overwritten.
|
|---|
| 46 | Do you want to proceed?
|
|---|
| 47 | Old rule transport routines not deleted (^%ZOSF(
|
|---|
| 48 | Not Deleted...
|
|---|
| 49 | Select an
|
|---|
| 50 | ***** Already selected for transport. *****
|
|---|
| 51 | None Selected for transport
|
|---|
| 52 | Already selected for transport:
|
|---|
| 53 | Press <Enter> to continue...
|
|---|
| 54 | added to list.
|
|---|
| 55 | removed from list.
|
|---|
| 56 | Select a
|
|---|
| 57 | selected for transport.
|
|---|
| 58 | ORDER CHECK
|
|---|
| 59 | OCX MDD
|
|---|
| 60 | unknown lookup error.
|
|---|
| 61 | could not resolve name.
|
|---|
| 62 | End Transport.
|
|---|
| 63 | already existed.
|
|---|
| 64 | record missing...
|
|---|
| 65 | Unresolved subscript.
|
|---|
| 66 | ^DIE filer data error...
|
|---|
| 67 | ...Correct data Filed
|
|---|
| 68 | Rule Transport aborted, version mismatch.
|
|---|
| 69 | Rule Transport Version: |CVER|
|
|---|
| 70 | Order Check Expert System Rule Transporter
|
|---|
| 71 | data filing error
|
|---|
| 72 | Some expert system rules may be incomplete.
|
|---|
| 73 | No data filing errors.
|
|---|
| 74 | Transport Finished...
|
|---|
| 75 | ] ERROR - RECORD NOT FOUND
|
|---|
| 76 | ACD EXTRACT V10.1
|
|---|
| 77 | Available record layouts:
|
|---|
| 78 | 1) VAACCR Record Layout Version 10.1 (VA Registry)
|
|---|
| 79 | 2) NAACCR State Record Layout Version 10.1
|
|---|
| 80 | Select record layout:
|
|---|
| 81 | Select the record layout to use
|
|---|
| 82 | VACCR EXTRACT V10.1
|
|---|
| 83 | STATE EXTRACT V10.1
|
|---|
| 84 | DISPLAY/PRINT on-line instructions
|
|---|
| 85 | STATE REPORTING ACOS INFOA
|
|---|
| 86 | PRIMARY ACOS INFO (850)
|
|---|
| 87 | Select start date:
|
|---|
| 88 | Select end date:
|
|---|
| 89 | Analytic cases only
|
|---|
| 90 | Answer 'YES' if you want only analytic cases (CLASS OF CASE 0-2) extracted.
|
|---|
| 91 | Answer 'NO' if you want all cases (analytic and non-analytic) extracted.
|
|---|
| 92 | |Please activate your PC capture program. The data will be sent|
|
|---|
| 93 | | in 30 seconds or when you press the return key. |
|
|---|
| 94 | No records extracted.
|
|---|
| 95 | ACoS Report Print
|
|---|
| 96 | State Extract Print
|
|---|
| 97 | Report Canceled!
|
|---|
| 98 | Report Queued!
|
|---|
| 99 | These are your current settings:
|
|---|
| 100 | Record layout.......................:
|
|---|
| 101 | Facility Identification Number (FIN):
|
|---|
| 102 | State to be extracted...............:
|
|---|
| 103 | Accession Year......................:
|
|---|
| 104 | Start date..........................:
|
|---|
| 105 | End date............................:
|
|---|
| 106 | Analytic cases only.................:
|
|---|
| 107 | Are these settings correct
|
|---|
| 108 | Accession Year:
|
|---|
| 109 | Facility Identification Number (FIN)
|
|---|
| 110 | The site paramaters record is being edited by another user.
|
|---|
| 111 | Press ENTER to Continue or
|
|---|
| 112 | to Quit:
|
|---|
| 113 | Col#
|
|---|
| 114 | Data item
|
|---|
| 115 | Data Value
|
|---|
| 116 | ONC(
|
|---|
| 117 | ICDO-TOPOGRAPHY is not defined
|
|---|
| 118 | .........: Surgery performed
|
|---|
| 119 | .........: Radiation performed
|
|---|
| 120 | The Accession Year is not 1995.
|
|---|
| 121 | The Diagnostic Confirmation code is not 1.
|
|---|
| 122 | The Class of Case code is not 0, 1 or 2.
|
|---|
| 123 | Date DX and/or First Treatment Date not in 1995.
|
|---|
| 124 | Select table
|
|---|
| 125 | This primary does not satisfy the PCE eligibility criteria:
|
|---|
| 126 | Patient Care Evaluation Study of Cancers of the Urinary Bladder
|
|---|
| 127 | ACCESSION/SEQUENCE NUMBER
|
|---|
| 128 | CLASS OF CASE
|
|---|
| 129 | REFERRED FOR TREATMENT TO
|
|---|
| 130 | ZIP AT DIAGNOSIS
|
|---|
| 131 | SPANISH ORIGIN
|
|---|
| 132 | PRIMARY PAYER AT DIAGNOSIS
|
|---|
| 133 | PATIENT HISTORY OF OTHER CANCER
|
|---|
| 134 | FAMILY HISTORY OF CANCER
|
|---|
| 135 | SMOKING HISTORY
|
|---|
| 136 | DURATION OF SMOKING HISTORY
|
|---|
| 137 | DURATION OF SMOKE-FREE HISTORY
|
|---|
| 138 | TABLE I - GENERAL INFORMATION
|
|---|
| 139 | ACCESSION/SEQUENCE NUMBER.....:
|
|---|
| 140 | CLASS OF CASE.................:
|
|---|
| 141 | 300REFERRED FOR TREATMENT TO.....
|
|---|
| 142 | 9ZIP AT DIAGNOSIS..............
|
|---|
| 143 | DATE OF BIRTH.................:
|
|---|
| 144 | 9SPANISH ORIGIN................
|
|---|
| 145 | 18PRIMARY PAYER AT DIAGNOSIS....
|
|---|
| 146 | 301LENGTH OF STAY................
|
|---|
| 147 | PATIENT HISTORY OF OTHER CANCER:
|
|---|
| 148 | 305 HEAD AND NECK...............
|
|---|
| 149 | FAMILY HISTORY OF CANCER:
|
|---|
| 150 | 314SMOKING HISTORY (PACKS/DAY)...
|
|---|
| 151 | 315DURATION OF SMOKING HISTORY...
|
|---|
| 152 | 316DURATION OF SMOKE-FREE HISTORY
|
|---|
| 153 | GO TO:
|
|---|
| 154 | CLINICAL DETECTION
|
|---|
| 155 | ONSET OF SYMPTOMS
|
|---|
| 156 | DURATION OF SYMPTOMS BEFORE DIAGNOSIS
|
|---|
| 157 | DIAGNOSTIC PROCEDURES
|
|---|
| 158 | DATE OF INITIAL DIAGNOSIS
|
|---|
| 159 | SPECIALTY MAKING DIAGNOSIS
|
|---|
| 160 | PRIMARY SITE (ICD-O-2)
|
|---|
| 161 | HISTOLOGY (ICD-O-2)
|
|---|
| 162 | TABLE II- DIAGNOSTIC INFORMATION
|
|---|
| 163 | CLINICAL DETECTION:
|
|---|
| 164 | 317 GROSS HEMATURIA................
|
|---|
| 165 | 318 MICROSCOPIC HEMATURIA..........
|
|---|
| 166 | 319 URINARY FREQUENCY..............
|
|---|
| 167 | 320 BLADDER IRRITABILITY...........
|
|---|
| 168 | 323ONSET OF SYMPTOMS................
|
|---|
| 169 | DURATION OF SYMPTOMS (months) BEFORE DIAGNOSIS:
|
|---|
| 170 | 324 GROSS HEMATURIA................
|
|---|
| 171 | DIAGNOSTIC PROCEDURES:
|
|---|
| 172 | 326 BIMANUAL EXAMINATION OF BLADDER
|
|---|
| 173 | 327 CYSTOSCOPY WITH BIOPSY.........
|
|---|
| 174 | 328 CYSTOSCOPY WITHOUT BIOPSY......
|
|---|
| 175 | 329 FLOW CYTOMETRY.................
|
|---|
| 176 | 330 INTRAVENOUS PYELOGRAM..........
|
|---|
| 177 | 331 URINE CYTOLOGY.................
|
|---|
| 178 | DATE OF INITIAL DIAGNOSIS........:
|
|---|
| 179 | 334SPECIALTY MAKING DIAGNOSIS.......
|
|---|
| 180 | PRIMARY SITE (ICD-O-2)...........:
|
|---|
| 181 | HISTOLOGY (ICD-O-2)..............:
|
|---|
| 182 | STAGING PROCEDURES
|
|---|
| 183 | PRESENCE OF HYDRONEPHROSIS
|
|---|
| 184 | TUMOR SIZE (mm)
|
|---|
| 185 | PRESENCE OF MULTIPLE TUMORS
|
|---|
| 186 | REGIONAL NODES EXAMINED
|
|---|
| 187 | REGIONAL NODES POSITIVE
|
|---|
| 188 | SITES OF DISTANT METASTASIS
|
|---|
| 189 | AJCC CLINICAL STAGE (cTNM)
|
|---|
| 190 | AJCC PATHOLOGIC STAGE (pTNM)
|
|---|
| 191 | STAGED BY
|
|---|
| 192 | TABLE III- EXTENT OF DISEASE AND AJCC STAGE
|
|---|
| 193 | STAGING PROCEDURES:
|
|---|
| 194 | 335 ABDOMINAL ULTRASOUND.........
|
|---|
| 195 | 336 BONE IMAGING.................
|
|---|
| 196 | 338 CT CHEST/LUNG................
|
|---|
| 197 | 339 CT ABDOMEN/PELVIS............
|
|---|
| 198 | 340 CT OTHER.....................
|
|---|
| 199 | 341 MRI PELVIS/ABDOMEN...........
|
|---|
| 200 | 342 MRI OTHER....................
|
|---|
| 201 | 344PRESENCE OF HYDRONEPHROSIS.....
|
|---|
| 202 | 29TUMOR SIZE (mm)................
|
|---|
| 203 | 345PRESENCE OF MULTIPLE TUMORS....
|
|---|
| 204 | 33REGIONAL NODES EXAMINED........
|
|---|
| 205 | 32REGIONAL NODES POSITIVE........
|
|---|
| 206 | SITES OF DISTANT METASTASIS:
|
|---|
| 207 | 34 SITE OF DISTANT METASTASIS #1
|
|---|
| 208 | SITE OF DISTANT METASTASIS #2: None
|
|---|
| 209 | SITE OF DISTANT METASTASIS #3: None
|
|---|
| 210 | 34.1 SITE OF DISTANT METASTASIS #2
|
|---|
| 211 | 34.2 SITE OF DISTANT METASTASIS #3
|
|---|
| 212 | AJCC CLINICAL STAGE (cTNM):
|
|---|
| 213 | 38AJCC STAGE.....................
|
|---|
| 214 | AJCC PATHOLOGIC STAGE (pTNM):
|
|---|
| 215 | 88AJCC STAGE.....................
|
|---|
| 216 | STAGED BY:
|
|---|
| 217 | 19 CLINICAL STAGE....................
|
|---|
| 218 | 89 PATHOLOGIC STAGE..................
|
|---|
| 219 | DATE OF INITIAL TREATMENT
|
|---|
| 220 | PROTOCOL ELIGIBILITY STATUS
|
|---|
| 221 | MANAGING PHYSICIANS
|
|---|
| 222 | RADIATION THERAPY
|
|---|
| 223 | TABLE IV - FIRST COURSE OF TREATMENT
|
|---|
| 224 | DATE OF INITIAL TREATMENT...........:
|
|---|
| 225 | 346PROTOCOL ELIGIBILITY STATUS.........
|
|---|
| 226 | MANAGING PHYSICIANS:
|
|---|
| 227 | 347 PRIMARY PHYSICIAN.................
|
|---|
| 228 | 348 SECONDARY PHYSICIAN...............
|
|---|
| 229 | SURGERY:
|
|---|
| 230 | DATE OF SURGERY...................:
|
|---|
| 231 | TYPE OF SURGERY...................:
|
|---|
| 232 | TUMOR RESECTION DURING TURB.......: Not applicable
|
|---|
| 233 | 349 TUMOR RESECTION DURING TURB.......
|
|---|
| 234 | TYPE OF URINARY DIVERSION.........: Not applicable
|
|---|
| 235 | 350 TYPE OF URINARY DIVERSION.........
|
|---|
| 236 | PELVIC LYMPH NODE DISSECTION......: Not applicable
|
|---|
| 237 | 351 PELVIC LYMPH NODE DISSECTION......
|
|---|
| 238 | SURGICAL COMPLICATIONS:
|
|---|
| 239 | BLEEDING REQUIRING TRANSFUSION..: No
|
|---|
| 240 | DEEP VENOUS THROMBOSIS..........: No
|
|---|
| 241 | MYOCARDIAL INFARCTION/ARRHYTHMIA: No
|
|---|
| 242 | PELVIC ABSCESS..................: No
|
|---|
| 243 | PNEUMONIA REQUIRING ANTIBIOTICS.: No
|
|---|
| 244 | POST-OPERATIVE DEATH (30 DAYS)..: No
|
|---|
| 245 | PULMONARY EMBOLISM/THROMBOSIS...: No
|
|---|
| 246 | 352 BLEEDING REQUIRING TRANSFUSION..
|
|---|
| 247 | 353 DEEP VENOUS THROMBOSIS..........
|
|---|
| 248 | 354 MYOCARDIAL INFARCTION/ARRHYTHMIA
|
|---|
| 249 | 355 PELVIC ABSCESS..................
|
|---|
| 250 | 356 PNEUMONIA REQUIRING ANTIBIOTICS.
|
|---|
| 251 | 357 POST-OPERATIVE DEATH (30 DAYS)..
|
|---|
| 252 | 358 PULMONARY EMBOLISM/THROMBOSIS...
|
|---|
| 253 | RADIATION THERAPY:
|
|---|
| 254 | RADIATION THERAPY.................:
|
|---|
| 255 | DATE RADIATION THERAPY STARTED....:
|
|---|
| 256 | DATE RADIATION THERAPY ENDED......: 00/00/0000
|
|---|
| 257 | TOTAL RAD (cGy/rad) DOSE..........: 00000
|
|---|
| 258 | REGIONAL TREATMENT MODALITY.......: No radiation therapy
|
|---|
| 259 | RADIATION COMPLICATIONS:
|
|---|
| 260 | URINARY INCONTINENCE............: Not applicable
|
|---|
| 261 | HEMATURIA.......................: Not applicable
|
|---|
| 262 | RADIATION BOWEL INJURY..........: Not applicable
|
|---|
| 263 | DATE RADIATION THERAPY ENDED......: 99/99/9999
|
|---|
| 264 | TOTAL RAD (cGy/rad) DOSE..........: 99999
|
|---|
| 265 | REGIONAL TREATMENT MODALITY.......: Unknown
|
|---|
| 266 | URINARY INCONTINENCE............: Unknown
|
|---|
| 267 | RADIATION BOWEL INJURY..........: Unknown
|
|---|
| 268 | 361 DATE RADIATION THERAPY ENDED......
|
|---|
| 269 | 362 TOTAL RAD (cGy/rad) DOSE..........
|
|---|
| 270 | 363 REGIONAL TREATMENT MODALITY.......
|
|---|
| 271 | 364 URINARY INCONTINENCE............
|
|---|
| 272 | 366 RADIATION BOWEL INJURY..........
|
|---|
| 273 | CHEMOTHERAPY:
|
|---|
| 274 | DATE CHEMOTHERAPY STARTED.........:
|
|---|
| 275 | DATE CHEMOTHERAPY ENDED...........: 00/00/0000
|
|---|
| 276 | ROUTE CHEMOTHERAPY ADMINISTERED...: No chemotherapy
|
|---|
| 277 | TYPES OF AGENTS ADMINISTERED:
|
|---|
| 278 | ADRIAMYCIN......: None IFOSFAMIDE......: None
|
|---|
| 279 | CARBOPLATINUM...: None METHOTREXATE....: None
|
|---|
| 280 | CISPLATIN.......: None TAXOL...........: None
|
|---|
| 281 | CYCLOPHOSPHAMIDE: None THIOTEPA........: None
|
|---|
| 282 | 5-FLUOROURACIL..: None VINBLASTINE.....: None
|
|---|
| 283 | GALLIUM NITRATE.: None OTHER...........: None
|
|---|
| 284 | INDICATION FOR ADMIN OF AGENTS....: No agents administered, NA
|
|---|
| 285 | REASON CHEMOTHERAPY STOPPED.......: Treatment completed, NA
|
|---|
| 286 | DATE CHEMOTHERAPY ENDED...........: 99/99/9999
|
|---|
| 287 | ROUTE CHEMOTHERAPY ADMINISTERED...: Unknown
|
|---|
| 288 | ADRIAMYCIN......: Unknown IFOSFAMIDE......: Unknown
|
|---|
| 289 | CARBOPLATINUM...: Unknown METHOTREXATE....: Unknown
|
|---|
| 290 | CISPLATIN.......: Unknown TAXOL...........: Unknown
|
|---|
| 291 | CYCLOPHOSPHAMIDE: Unknown THIOTEPA........: Unknown
|
|---|
| 292 | 5-FLUOROURACIL..: Unknown VINBLASTINE.....: Unknown
|
|---|
| 293 | GALLIUM NITRATE.: Unknown OTHER...........: Unknown
|
|---|
| 294 | INDICATION FOR ADMIN OF AGENTS....: Unknown
|
|---|
| 295 | REASON CHEMOTHERAPY STOPPED.......: Unknown
|
|---|
| 296 | 367 DATE CHEMOTHERAPY ENDED...........
|
|---|
| 297 | 368 ROUTE CHEMOTHERAPY ADMINISTERED...
|
|---|
| 298 | 374 GALLIUM NITRATE.................
|
|---|
| 299 | 380 OTHER AGENT.....................
|
|---|
| 300 | 381 INDICATION FOR ADMIN OF AGENTS....
|
|---|
| 301 | 382 REASON CHEMOTHERAPY STOPPED.......
|
|---|
| 302 | IMMUNOTHERAPY:
|
|---|
| 303 | #################### #################### ####################
|
|---|
| 304 | #################### #################### ####################
|
|---|
| 305 | #################### #################### ####################
|
|---|
| 306 | #################### #################### ####################
|
|---|
| 307 | #################### #################### ####################
|
|---|
