Sentinel General Practices - Tick bites - suspicion of Lyme disease (SGP_lyme)

  • Start date: 12/04/2016
  • End date creation: 12/08/2024
  • End date submission: 12/08/2024
  • End date comments: 12/08/2024

1 Identification

Section help

Dit formulier is enkel bestemd voor artsen die deelnemen aan de huisartsenpeilpraktijken, een register bedoeld voor wetenschappelijk onderzoek.
Indien u interesse heeft om deel te nemen aan deze registratie, graag eerst contact opnemen met Viviane.VanCasteren@wiv-isp.be vooraleer te registreren.


Tekenbeten en/of vermoeden van ziekte van lyme
De registratie van tekenbeten omvat de EERSTE consultatie voor een BEVESTIGDE tekenbeet. Bij een bevestigde tekenbeet is de teek nog aanwezig of de patiënt bevestigt dat de teek verwijderd is. Het gaat zowel over bevestigde tekenbeten MET en ZONDER BIJKOMENDE SYMPTOMEN.
De registratie van het VERMOEDEN van de ziekte van Lyme omvat alle EERSTE consultaties voor een vermoeden van die ziekte op basis van de klinische symptomen, ongeacht of er een tekenbeet in de voorgeschiedenis was of niet. Als er een bevestigde tekenbeet in de voorgeschiedenis was die u nog niet registreerde, gelieve dan ook alle vragen over tekenbeten te beantwoorden.

text

NIHDI number of the treating physician

Technical specs

CSV column name:

nihdi_number_of_the_treating_physician

Length:

100

Reference list:

PHYSICIAN

Required:

true

Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.Caregiver

Data element:

CareGiverIdentificationNumber

patient identificator

National registry ID of the patient

Help

Please encode a social security identification number (SSIN). Please note that the patient ID is always pseudonymised before being transferred to Healthdata.

Technical specs

CSV column name:

patient_id

Required:

true

Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.Patient

Data element:

PatientIdentificationNumber

Validation

The validity of the national register number is checked with the mod97 check.

Fields
Section help

Please encode a social security identification number (SSIN). Please note that the patient ID is always pseudonymised before being transferred to Healthdata.

text

Internal patient ID

Help

This field can be used to enter an internal ID or reference number. It is available for internal use only and is not transferred to Healthdata. If there is an integration between HD4DP and your organisation's patient administration system, additional patient identification information such as date of birth, sex and SSIN can be automatically enriched based on this internal patient ID. Please do not encode the social security identification number (SSIN) in this field. The SSIN must be encoded in the field 'National registry ID of the patient'.

Technical specs

CSV column name:

patient_id|internal_patient_id

Length:

50

Required:

false

boolean

Generated

Help

The patient_id|generated column can be set to 'TRUE' for an automatically generated patient_id.This column should only be added in case the patient_id is empty. If the column is set to 'TRUE', a patient_id is automatically generated based on the name, first name, date of birth and sex of the patient.

Technical specs

CSV column name:

patient_id|generated

Required:

false

Options
LabelValue
YesTRUE
NoFALSE
text

Name

Help

The name of the patient is never transferred to Healthdata and is available for your information only.

Technical specs

CSV column name:

patient_id|name

Length:

50

Required:

noSSIN(Needed only if no national register number is entered)

Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.Patient

Data element:

LastName

text

First name

Help

The first name of the patient is never transferred and is available for your information only.

Technical specs

CSV column name:

patient_id|first_name

Length:

50

Required:

noSSIN(Needed only if no national register number is entered)

Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.Patient

Data element:

FirstNames

date

Date of birth

Technical specs

Format:

DD/MM/YYYY

CSV column name:

patient_id|date_of_birth

Required:

true

Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.Patient

Data element:

DateOfBirth

Validation
  • The date of birth cannot be in the future (error)
choice

Sex

Technical specs

CSV column name:

patient_id|sex

Required:

true

Options
LabelValue
MaleM
FemaleF
UnknownU
Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.Patient

Data element:

Gender

text

Place of residence

Technical specs

CSV column name:

patient_id|place_of_residence

Length:

5

Reference list:

POSTAL_CODE

Required:

false

Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.Patient

Data element:

Postcode

boolean

Deceased?

Technical specs

CSV column name:

patient_id|deceased

Required:

false

Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.Patient

Data element:

DeathIndicator

Options
LabelValue
YesTRUE
NoFALSE
date

Date of death

Technical specs

Format:

DD/MM/YYYY

CSV column name:

patient_id|date_of_death

Only when:

Required:

false

Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.Patient

Data element:

DateOfDeath

Validation
  • The date of death cannot be in the future (error)

2 Tick bite

choice

Confirmed tick bite?

Technical specs

CSV column name:

confirmed_tick_bite

Required:

true

Options
LabelValue
Yes1
No0
Unknown9
Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.TransferConcern

Data element:

ProblemName

choice

Did the tick bite occur in Belgium?

Technical specs

CSV column name:

did_the_tick_bite_occur_in_belgium

Only when:

Required:

false

Options
LabelValue
Yes1
No0
choice

Province where tick bite occurred

Technical specs

CSV column name:

country_where_tick_bite_occurred

Only when:

Required:

false

Options
LabelValue
AntwerpenBE-VAN
Oost-VlaanderenBE-VOV
Vlaams-BrabantBE-VBR
LimburgBE-VLI
West-VlaanderenBE-VWV
HainautBE-WHT
LiègeBE-WLG
LuxembourgBE-WLX
NamurBE-WNA
Brabant wallonBE-WBR
multichoice

Anatomical location of tick bite

Technical specs

CSV column name:

anatomical_location_of_tick_bite

Only when:

Required:

false

Options
LabelValue
Headhead
Torsotorso
Upper limbsupper_limbs
Lower limbslower_limbs
number

Number of hours between tick bite and removal of the tick

Technical specs

CSV column name:

number_of_hours_between_tick_bite_and_removal_of_the_tick

Only when:

Required:

false

Validation
  • cannot be negative. (error)
  • cannot be more than 1 week (error)

3 Symptoms, diagnosis and treatment

multichoice

Symptoms

Technical specs

CSV column name:

symptoms

Required:

true

Options
LabelValue
Infection of skin due to lymeinfection_of_skin_due_to_lyme
Lyme arthritislyme_arthritis
Neurological symptoms due to lymeneurological_symptoms_due_to_lyme
Lyme carditislyme_carditis
Other symptoms caused by lyme (eg. conjunctivitis, uveitis, keratitis, ear disease,...)other_symptoms_caused_by_lyme_eg_conjunctivitis_uveitis_keratitis_ear_disease
No symptomsno_symptoms
Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.TransferConcern

Data element:

ProblemName

Nested option fields
  • When infection_of_skin_due_to_lyme Is selected:
    multichoice

    Specify

    Technical specs

    CSV column name:

    symptoms|specify

    Required:

    false

    Options
    LabelValue
    Erythema chronica migrans1
    Other2
    Mapping of the clinical building blocks (indicative only)

    Concept:

    be.en.hd.TransferConcern

    Data element:

    ProblemName

    Nested option fields
    • When 2 Is selected:
      text

      Please specify

      Technical specs

      CSV column name:

      symptoms|specify|please_specify

      Length:

      200

      Required:

      false

  • When lyme_arthritis Is selected:
    multichoice

    Specify

    Technical specs

    CSV column name:

    symptoms|specify_1

    Required:

    false

    Options
    LabelValue
    Arthralgia / Arthritis1
    Other2
    Mapping of the clinical building blocks (indicative only)

    Concept:

    be.en.hd.TransferConcern

    Data element:

    ProblemName

    Mapping:

    { "choice_mapping": { "1": [ "L70.02", "M25.50", "M25.5", "M19.90", "M19.9" ] } }
    Nested option fields
    • When 2 Is selected:
      text

      Please specify

      Technical specs

      CSV column name:

      symptoms|specify_1|please_specify

      Length:

      200

      Required:

      false

  • When other_symptoms_caused_by_lyme_eg_conjunctivitis_uveitis_keratitis_ear_disease Is selected:
    text

    Specify

    Technical specs

    CSV column name:

    symptoms|specify_4

    Length:

    200

    Required:

    false

Validation
  • Symptoms: the option 'No symptoms' cannot be combined with other options (error)
choice

Did you request a serological test?

Technical specs

CSV column name:

did_you_request_a_serological_test

Required:

true

Options
LabelValue
Yes1
No0
Unknown9
Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.TransferPlannedCareActivity

Data element:

OrderStatus

choice

Certainty of diagnosis (only in case of suspicion of Lyme)

Technical specs

CSV column name:

certainty_of_diagnosis_only_in_case_of_suspicion_of_lyme

Required:

false

Options
LabelValue
Sure1
Rather sure2
Rather unsure3
Unsure4
multichoice

Treatment

Technical specs

CSV column name:

treatment

Required:

true

Options
LabelValue
Antibioticsantibiotics
Other treatmentother_treatment
No treatmentno_treatment
Nested option fields
  • When antibiotics Is selected:
    choice

    Specify

    Technical specs

    CSV column name:

    treatment|specify

    Required:

    false

    Options
    LabelValue
    Amoxicillin1
    Azithromycin2
    Cefotaxime3
    Ceftriaxone4
    Cefuroxime5
    Doxycycline6
    Penicillin G7
    Penicillin V8
    Other9
    Mapping of the clinical building blocks (indicative only)

    Concept:

    be.en.hd.MedicationPrescription

    Data element:

    ProductCode

    Nested option fields
    • When 9 Is selected:
      text

      Specify

      Technical specs

      CSV column name:

      treatment|specify|specify

      Length:

      200

      Required:

      false

    number

    Number of days of treatment

    Help

    Only numbers are accepted

    Technical specs

    CSV column name:

    treatment|number_of_days_of_treatment

    Required:

    false

    Mapping of the clinical building blocks (indicative only)

    Concept:

    be.en.hd.MedicationPrescription

    Data element:

    StartDate

  • When other_treatment Is selected:
    text

    Specify

    Technical specs

    CSV column name:

    treatment|specify_5

    Length:

    200

    Required:

    false

    Mapping of the clinical building blocks (indicative only)

    Concept:

    be.en.hd.MedicationPrescription

    Data element:

    ProductCode

Validation
  • Treatment: the option 'No treatment' cannot be combined with other options (error)

4 Follow-up

choice

Result of serological test

Technical specs

CSV column name:

result_of_serological_test

Only when:

,

Required:

true

Options
LabelValue
Positive1
Negative0
Unknown9
Mapping of the clinical building blocks (indicative only)

Concept:

be.en.hd.TransferLaboratoryResult

Data element:

Result

Nested option fields
  • When 1 Is selected:
    choice

    Result of confirmation test

    Technical specs

    CSV column name:

    result_of_serological_test|result_of_confirmation_test

    Required:

    false

    Options
    LabelValue
    Positive1
    Negative0
    Unknown9
    Mapping of the clinical building blocks (indicative only)

    Concept:

    be.en.hd.TransferLaboratoryResult

    Data element:

    Result