Skip to content

Instantly share code, notes, and snippets.

@denniskigen
Last active November 16, 2020 06:59
Show Gist options
  • Star 0 You must be signed in to star a gist
  • Fork 0 You must be signed in to fork a gist
  • Save denniskigen/f753dd52080e6b8787200cb2a51fe970 to your computer and use it in GitHub Desktop.
Save denniskigen/f753dd52080e6b8787200cb2a51fe970 to your computer and use it in GitHub Desktop.

Oncology POC Breast Cancer Screening Form v1.3

  • encounter_purpose
  • other_encounter_purpose
  • menstruation_before_age_12
  • menses_stopped_permanently
  • menses_stop_age
  • hrt_use
  • hrt_start_age
  • hrt_end_age
  • hrt_use_years
  • hrt_type_used
  • age_at_first_birth
  • gravida
  • parity
  • cigarette_smoking
  • cigarette_sticks_smoked_per_day
  • tobacco_use
  • tobacco_use_duration_yrs
  • alcohol_drinking
  • alcohol_type
  • alcohol_use_period_yrs
  • hiv_status
  • breast_complaints_3months
  • breast_lump_location
  • nipple_discharge_location
  • nipple_or_skin_retraction_location
  • breast_erythema_or_swelling_location
  • breast_rash_scaling_or_itching_location
  • breast_pain_location
  • other_breast_changes_location
  • other_breast_changes_freetext
  • previous_by_a_doctor_or_nurse
  • previous_results
  • date_of_previous
  • history_of_mammogram
  • previous_mammogram_results
  • date_of_previous_mammogram
  • breast_ultrasound_history
  • breast_ultrasound_result
  • date_of_previous_ultrasound
  • history_of_breast_biopsy
  • number_of_biopsies
  • biopsy_type
  • breast_biopsy_results
  • date_of_breast_biopsy_results
  • previous_radiation_treatment_to_chest
  • reason_for_radiation_treatment
  • previous_breast_surgery_not_for_cancer
  • reason_for_breast_surgery
  • breast_surgery_type
  • breast_surgery_type_freetext
  • any_family_member_diagnosed_ca_breast
  • fam_ca_breast_at_or_before_50
  • fam_ca_breast_after_50
  • fam_ca_breast_male_family_member
  • fam_ca_ovary
  • fam_history_other_related_cancers
  • other_cancers
  • other_related_cancers_freetext
  • physical_breast_exam_findings
  • breast_finding_location
  • breast_finding_quadrant
  • breast_mass_shape
  • breast_mass_margins
  • breast_mass_size
  • breast_mass_texture
  • breast_mass_mobility
  • other_breast_findings_freetext
  • breast_symmetry
  • lymph_nodes_findings
  • axillary_lymph_nodes_location
  • clavicular_supra_location
  • clavicular_infra_location
  • patient_education
  • patient_education_freetext
  • referrals_ordered
  • referral_date
  • breast_screening_rtc_date

Oncology POC CBE Case Management Form v1.0

  • mammogram_results
  • tumor_size_cm
  • mammogram_workup_date
  • mammogram_results_description
  • ultrasound_findings
  • ultrasound_workup_date
  • ultrasound_results_description
  • cbe_and_imaging_results_concordance
  • fna_breast_results
  • benign_fna_workup_date
  • benign_fna_results_description
  • benign_fna_diagnosis_date
  • fna_degree_of_malignancy
  • malignant_fna_workup_date
  • malignant_fna_results_description
  • malignant_fna_diagnosis_date
  • breast_biopsy_results_case_mgmt
  • benign_breast_biopsy_workup_date
  • benign_biopsy_results_description
  • benign_biopsy_diagnosis_date
  • biopsy_degree_of_malignancy
  • malignant_breast_biopsy_workup_date
  • malignant_biopsy_results_description
  • malignant_biopsy_diagnosis_date
  • mode_of_breast_screening
  • date_patient_informed_and_referred
  • cbe_case_mgmt_referrals_ordered
  • cbe_case_mgmt_referrals_ordered_freetext
  • cbe_case_mgmt_assessment_notes
  • cbe_case_mgmt_rtc_date
  • diagnosis
  • cancer_staging
  • encounter_purpose_clinical_breast_exam
  • other_encounter_purpose_freetext
  • physical_breast_exam_findings
  • breast_finding_location
  • breast_finding_quadrant
  • breast_mass_shape_repeating
  • breast_symmetry
  • breast_mass_shape
  • breast_mass_margins
  • breast_mass_size
  • breast_mass_texture
  • breast_mass_mobility
  • other_discrete_mass_freetext
  • discrete_breast_mass_shape
  • discrete_breast_mass_margins
  • discrete_breast_mass_size
  • discrete_breast_mass_texture
  • discrete_breast_mass_mobility
  • lymph_nodes_findings
  • axillary_lymph_nodes_location
  • clavicular_supra_location
  • clavicular_infra_location
  • cbe_assessment_notes
  • cbe_referrals_ordered
  • cbe_referral_date
  • other_referral_freetext
  • cbe_patient_education
  • other_patient_education_freetext
  • cbe_rtc_date

Oncology POC Breast Cancer History & Risk Assessment Form (FOR MASS SCREENING) v1.0

  • encounter_purpose
  • menstruation_before_age_12
  • menses_stopped_permanently
  • menses_stop_age
  • hrt_use
  • hrt_start_age
  • hrt_end_age
  • hrt_use_years
  • hrt_type_used
  • given_birth
  • age_at_first_birth
  • gravida
  • parity
  • cigarette_smoking
  • cigarette_sticks_smoked_per_day
  • tobacco_use
  • tobacco_use_duration_yrs
  • alcohol_drinking
  • alcohol_type
  • alcohol_use_period_yrs
  • breast_complaints_3months
  • breast_lump_location
  • nipple_discharge_location
  • nipple_or_skin_retraction_location
  • breast_erythema_or_swelling_location
  • breast_rash_scaling_or_itching_location
  • breast_pain_location
  • other_breast_changes_location
  • other_breast_changes_freetext
  • previous_by_a_doctor_or_nurse
  • previous_results
  • date_of_previous
  • history_of_mammogram
  • previous_mammogram_results
  • date_of_previous_mammogram
  • breast_ultrasound_history
  • breast_ultrasound_result
  • date_of_previous_ultrasound
  • history_of_breast_biopsy
  • number_of_biopsies
  • biopsy_type
  • breast_biopsy_results
  • date_of_breast_biopsy_results
  • previous_radiation_treatment_to_chest
  • reason_for_radiation_treatment
  • previous_breast_surgery_not_for_cancer
  • reason_for_breast_surgery
  • breast_surgery_type
  • breast_surgery_type_freetext
  • any_family_member_diagnosed_ca_breast
  • fam_ca_breast_at_or_before_50
  • fam_ca_breast_after_50
  • fam_ca_breast_male_family_member
  • fam_ca_ovary
  • fam_history_other_related_cancers
  • other_cancers
  • other_related_cancers_freetext
Sign up for free to join this conversation on GitHub. Already have an account? Sign in to comment