TEMPLATE *CL 3.1.3 Otoscopy Report (*CL 3.1.3 Otoscopy Report)

TEMPLATE ID*CL 3.1.3 Otoscopy Report
Concept*CL 3.1.3 Otoscopy Report
DescriptionTo record the findings on examination of the external auditory canal and tympanic membrane using otoscopy
PurposeTo record the findings on examination of the external auditory canal and tympanic membrane using otoscopy
References
Other Details (Language Independent)
  • MetaDataSet:Sample Set : Template metadata sample set
Language useden
Citeable Identifier1013.26.799
Root archetype idopenEHR-EHR-COMPOSITION.report-result.v1
Otoscopy ReportOtoscopy Report: Document to communicate information to others about the result of a test or assessment.
Other Context
Report IDReport ID: Identification information about the report.
StatusStatus: The status of the entire report. Note: This is not the status of any of the report components.
Otoscopy findingsOtoscopy findings: Findings observed during the physical examination of a subject of care.
BaselineBaseline: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Examination of EarsExamination of Ears: Findings observed during the physical examination of the ears.
Clinical descriptionClinical description: Narrative description of the overall findings observed during a physical examination of the ears.
May be used to record a narrative summary of the complete clinical examination of the body system or anatomical strucutre or key aspects of physical examination findings, which will be further supported by the additional structured data, using CLUSTER archetypes in the 'Examination Detail' slot. This data element may be used to capture legacy data that is not available in a structured format.
Per earPer ear: Details about physical examination findings for the identified ear.
Name of the
SideSide: *
  • Right ear 
  • Left ear 
No abnormality detectedNo abnormality detected: Statement that no abnormality was detected (NAD) on overall examination of the right ear.
Examination of external auditory canalExamination of external auditory canal: Findings observed during the physical examination of the external auditory canal.
Ear examinedEar examined: Identification of the ear under examination.
  • Left 
  • Right 
No abnormality detectedNo abnormality detected: Statement that no abnormality was detected (NAD) on physical examination.
Record as True if no abnormality was detected on examination. Specific statements about the examination can be included in the 'Clinical Interpretation' data element.
Other findingsOther findings: Narrative description of the overall findings observed during the physical examination of the external auditory canal.
Wax descriptionWax description: Narrative description of the wax findings in the external auditory canal.
Discharge presenceDischarge presence: Presence of a discharge observed in the external auditory canal.
  • Present 
  • Absent 
Discharge typeDischarge type: Type of discharge observed in the external auditory canal or at the tympanic membrane.
  • Blood-stained 
  • Haemoserous 
  • Mucoid 
  • Mucopurulent 
  • Purulent 
  • Serous 
Discharge amountDischarge amount: Amount of discharge observed in the external auditory canal or at the tympanic membrane perforation.
  • Scant 
  • Moderate 
  • Profuse 
Foreign body presenceForeign body presence: Presence of a foreign body in the external auditory canal.
  • Present 
  • Absent 
Foreign body locationForeign body location: Location of the foreign body within the external auditory canal.
This data element is redundant if a foreign body is absent from the canal.
  • Outer Canal 
  • Deep Canal 
  • Middle ear 
Examination of tympanic membraneExamination of tympanic membrane: Findings observed during the physical examination of the tympanic membrane .
ViewView: Description about the examiner's view of the tympanic membrane.
  • Adequate 
  • Compromised 
  • Total occlusion 
Reason for occlusionReason for occlusion: Narrative description of the reason for occlusion of view of the tympanic membrane.
Ventilation tube present?Ventilation tube present?: Is a ventilation tube observed in the tympanic membrane?
  • Present 
  • Absent 
Ventilation tube positionVentilation tube position: Observed position of the ventilation tube (or grommet) in the tympanic membrane or the auditory canal.
  • In situ 
  • Partially extruded 
  • Extruded - remains in canal 
Ventilation tube descriptionVentilation tube description: Narrative description about the appearance of the ventilation tubes.
Membrane intact?Membrane intact?: Is the tympanic membrane intact?
  • Intact 
  • Indeterminate 
  • Perforated 
AppearanceAppearance: Category describing the appearance of the tympanic membrane.
  • Translucent 
  • Opaque 
ColourColour: Description of the overall colour of the tympanic membrane.
Light reflexLight reflex: Is a normal light reflex observed?
  • Normal 
  • Abnormal 
Surface featuresSurface features: Features observed on the surface of the tympanic membrane.
This data element has multiple occurrences to enable multiple selections, if required. In most situations, this data element would only be recorded if the tympanic membrane is intact.

Annotations

  • HHIMS.Value Set: 3.1-20
Location of tympanosclerosisLocation of tympanosclerosis: Description of the location of any tympanosclerosis observed on the tympanic membrane.
Position of tympanic membranePosition of tympanic membrane: Description of the position of the tympanic membrane.
  • Neutral 
  • Retracted 
  • Bulging 
  • Indeterminate 
Retraction descriptionRetraction description: Narrative description of the retraction of the tympanic membrane.
Sade ClassificationSade Classification: Grading of the degree of tympanic membrane pars tensa retraction / atelectasis.
Sade ClassificationSade Classification: Grading of the degree of tympanic membrane pars tensa retraction / atelectasis based on the Sade Classification.
  • 0: No visible retraction 
  • 1: Stage 1 : Mild retraction 
  • 2: Stage 2 : Retraction onto incudostapedial joint 
  • 3: Stage 3 : Retraction onto promontory 
  • 4: Stage 4 : Adhesion of pars tensa to medial wall 
Tos ClassificationTos Classification: A classification of the degree of tympanic membrane pars flaccida retraction, related to extent and severity and as described by Tos and Poulsen.
Tos ClassificationTos Classification: Grading of the degree of tympanic membrane pars tensa retraction / atelectasis based on the Tos & Poulson Classification.
  • 1: Grade 1 
  • 2: Grade 2 
  • 3: Grade 3 
  • 4: Grade 4 
  • 5: Grade 5 
Fluid level presenceFluid level presence: Observation of a fluid level behind the tympanic membrane.
  • Present 
  • Absent 
Fluid level descriptionFluid level description: Narrative description of the fluid level and other related features observed behind the tympanic membrane.
MobilityMobility: Description of mobility of the tympanic membrane.
Occurrences has been set to 0..* to enable multiple methods of observing mobility to be recorded. For example: 'Mobility (Pneumatic Otoscopy'; or 'Mobility (Valsalva) with Mobile or Indeterminate as only appropriate value set.
  • Immobile 
  • Hypomobile 
  • Mobile 
  • Hypermobile 
  • Indeterminate 
Perforation detailsPerforation details: Details about a perforation in the tympanic membrane.
Perforation descriptionPerforation description: Narrative description of the perforation of the tympanic membrane.
Estimation of sizeEstimation of size: Estimation of the size of the tympanic membrane perforation, based on anatomical landmarks.
  • Pinhole 
  • Intermediate 
  • Subtotal 
  • Total 
Intermediate estimationIntermediate estimation: Further detail about the size of an intermediate perforation.
  • <40% 
  • >40% 
Pars flaccida vs pars tensa?Pars flaccida vs pars tensa?: Description of the region of the tympanic membrane perforation.
To document explicitly whether the perforation is located in the Pars flaccida and may be potentially unsafe. If 'Total' or 'Subtotal' is selected in 'Estimation of Size' data element then this data element becomes redundant. Coding with a terminology is preferred, if possible.
  • Pars flaccida 
  • Pars tensa 
Marginal vs central?Marginal vs central?: Location of the tympanic membrane perforation.
To document explicitly whether the perforation is located marginally, and therefore might be clinically unsafe. If 'Total' is selected in 'Estimation of Size' data element then this data element becomes redundant.
  • Marginal 
  • Central 
Anterior?Anterior?: Is an anterior perforation present?
To document the presence of perforation in the anterior portions of the pars tensa, whcih can be more difficult to manage than perforations elsewhere. If 'Total' or 'Subtotal' is selected in 'Estimation of Size' data element then this data element becomes redundant.
  • Present 
  • Absent 
EdgeEdge: Narrative description of the edge of the perforation.
Multimedia ResourceMultimedia Resource: Details about an multimedia representation of the clinical data.
Multimedia resourceMultimedia resource: Multimedia representation of the clinical observation or finding.
TitleTitle: Name of the multimedia resource.
DescriptionDescription: Narrative description of the multimedia resource.
SourceSource: The source of the multimedia resource.
Date createdDate created: Date/time that the multimedia resource was created.
Clinical interpretationClinical interpretation: Single word, phrase or brief description that represents the clinical meaning and significance of the physical examination findings.
Exclusion of examinationExclusion of examination: Positive statement to record that the physical examination, or a specified part of the physical examination, was not performed.
Examination not doneExamination not done: Statement to explicity record that the examination was not performed.
Record as True if the examination was not performed.
ReasonReason: Reason for the 'not done' statement.
For example: patient factors, equipment factors, time constraints.

Annotations

  • HHIMS.Value Set: 3.1-18
Exclusion of examinationExclusion of examination: Positive statement to record that the physical examination, or a specified part of the physical examination, was not performed.
Examination not doneExamination not done: Statement to explicity record that the examination was not performed.
Record as True if the examination was not performed.
ReasonReason: Reason for the 'not done' statement.
For example: patient factors, equipment factors, time constraints.

Annotations

  • HHIMS.Value Set: 3.1-18
Multimedia representationMultimedia representation: Digital image or video taken, or a diagram drawn, during the physical examination of the ears.
Confounding factorsConfounding factors: Description of any incidental factors that may have contributed to the physical examination findings.
Post CleaningPost Cleaning: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Examination of EarsExamination of Ears: Findings observed during the physical examination of the ears.
Clinical descriptionClinical description: Narrative description of the overall findings observed during a physical examination of the ears.
May be used to record a narrative summary of the complete clinical examination of the body system or anatomical strucutre or key aspects of physical examination findings, which will be further supported by the additional structured data, using CLUSTER archetypes in the 'Examination Detail' slot. This data element may be used to capture legacy data that is not available in a structured format.
Per earPer ear: Details about physical examination findings for the identified ear.
Name of the
SideSide: *
  • Right ear 
  • Left ear 
No abnormality detectedNo abnormality detected: Statement that no abnormality was detected (NAD) on overall examination of the right ear.
Examination of external auditory canalExamination of external auditory canal: Findings observed during the physical examination of the external auditory canal.
Ear examinedEar examined: Identification of the ear under examination.
  • Left 
  • Right 
No abnormality detectedNo abnormality detected: Statement that no abnormality was detected (NAD) on physical examination.
Record as True if no abnormality was detected on examination. Specific statements about the examination can be included in the 'Clinical Interpretation' data element.
Other findingsOther findings: Narrative description of the overall findings observed during the physical examination of the external auditory canal.
Wax descriptionWax description: Narrative description of the wax findings in the external auditory canal.
Discharge presenceDischarge presence: Presence of a discharge observed in the external auditory canal.
  • Present 
  • Absent 
Discharge typeDischarge type: Type of discharge observed in the external auditory canal or at the tympanic membrane.
  • Blood-stained 
  • Haemoserous 
  • Mucoid 
  • Mucopurulent 
  • Purulent 
  • Serous 
Discharge amountDischarge amount: Amount of discharge observed in the external auditory canal or at the tympanic membrane perforation.
  • Scant 
  • Moderate 
  • Profuse 
Foreign body presenceForeign body presence: Presence of a foreign body in the external auditory canal.
  • Present 
  • Absent 
Foreign body locationForeign body location: Location of the foreign body within the external auditory canal.
This data element is redundant if a foreign body is absent from the canal.
  • Outer Canal 
  • Deep Canal 
  • Middle ear 
Examination of tympanic membraneExamination of tympanic membrane: Findings observed during the physical examination of the tympanic membrane .
ViewView: Description about the examiner's view of the tympanic membrane.
  • Adequate 
  • Compromised 
  • Total occlusion 
Reason for occlusionReason for occlusion: Narrative description of the reason for occlusion of view of the tympanic membrane.
Ventilation tube present?Ventilation tube present?: Is a ventilation tube observed in the tympanic membrane?
  • Present 
  • Absent 
Ventilation tube positionVentilation tube position: Observed position of the ventilation tube (or grommet) in the tympanic membrane or the auditory canal.
  • In situ 
  • Partially extruded 
  • Extruded - remains in canal 
Ventilation tube descriptionVentilation tube description: Narrative description about the appearance of the ventilation tubes.
Membrane intact?Membrane intact?: Is the tympanic membrane intact?
  • Intact 
  • Indeterminate 
  • Perforated 
AppearanceAppearance: Category describing the appearance of the tympanic membrane.
  • Translucent 
  • Opaque 
ColourColour: Description of the overall colour of the tympanic membrane.
Light reflexLight reflex: Is a normal light reflex observed?
  • Normal 
  • Abnormal 
Surface featuresSurface features: Features observed on the surface of the tympanic membrane.
This data element has multiple occurrences to enable multiple selections, if required. In most situations, this data element would only be recorded if the tympanic membrane is intact.

Annotations

  • HHIMS.Value Set: 3.1-20
Location of tympanosclerosisLocation of tympanosclerosis: Description of the location of any tympanosclerosis observed on the tympanic membrane.
Position of tympanic membranePosition of tympanic membrane: Description of the position of the tympanic membrane.
  • Neutral 
  • Retracted 
  • Bulging 
  • Indeterminate 
Retraction descriptionRetraction description: Narrative description of the retraction of the tympanic membrane.
Sade ClassificationSade Classification: Grading of the degree of tympanic membrane pars tensa retraction / atelectasis.
Sade ClassificationSade Classification: Grading of the degree of tympanic membrane pars tensa retraction / atelectasis based on the Sade Classification.
  • 0: No visible retraction 
  • 1: Stage 1 : Mild retraction 
  • 2: Stage 2 : Retraction onto incudostapedial joint 
  • 3: Stage 3 : Retraction onto promontory 
  • 4: Stage 4 : Adhesion of pars tensa to medial wall 
Tos ClassificationTos Classification: A classification of the degree of tympanic membrane pars flaccida retraction, related to extent and severity and as described by Tos and Poulsen.
Tos ClassificationTos Classification: Grading of the degree of tympanic membrane pars tensa retraction / atelectasis based on the Tos & Poulson Classification.
  • 1: Grade 1 
  • 2: Grade 2 
  • 3: Grade 3 
  • 4: Grade 4 
  • 5: Grade 5 
Fluid level presenceFluid level presence: Observation of a fluid level behind the tympanic membrane.
  • Present 
  • Absent 
Fluid level descriptionFluid level description: Narrative description of the fluid level and other related features observed behind the tympanic membrane.
MobilityMobility: Description of mobility of the tympanic membrane.
Occurrences has been set to 0..* to enable multiple methods of observing mobility to be recorded. For example: 'Mobility (Pneumatic Otoscopy'; or 'Mobility (Valsalva) with Mobile or Indeterminate as only appropriate value set.
  • Immobile 
  • Hypomobile 
  • Mobile 
  • Hypermobile 
  • Indeterminate 
Perforation detailsPerforation details: Details about a perforation in the tympanic membrane.
Perforation descriptionPerforation description: Narrative description of the perforation of the tympanic membrane.
Estimation of sizeEstimation of size: Estimation of the size of the tympanic membrane perforation, based on anatomical landmarks.
  • Pinhole 
  • Intermediate 
  • Subtotal 
  • Total 
Intermediate estimationIntermediate estimation: Further detail about the size of an intermediate perforation.
  • <40% 
  • >40% 
Pars flaccida vs pars tensa?Pars flaccida vs pars tensa?: Description of the region of the tympanic membrane perforation.
To document explicitly whether the perforation is located in the Pars flaccida and may be potentially unsafe. If 'Total' or 'Subtotal' is selected in 'Estimation of Size' data element then this data element becomes redundant. Coding with a terminology is preferred, if possible.
  • Pars flaccida 
  • Pars tensa 
Marginal vs central?Marginal vs central?: Location of the tympanic membrane perforation.
To document explicitly whether the perforation is located marginally, and therefore might be clinically unsafe. If 'Total' is selected in 'Estimation of Size' data element then this data element becomes redundant.
  • Marginal 
  • Central 
Anterior?Anterior?: Is an anterior perforation present?
To document the presence of perforation in the anterior portions of the pars tensa, whcih can be more difficult to manage than perforations elsewhere. If 'Total' or 'Subtotal' is selected in 'Estimation of Size' data element then this data element becomes redundant.
  • Present 
  • Absent 
EdgeEdge: Narrative description of the edge of the perforation.
Multimedia ResourceMultimedia Resource: Details about an multimedia representation of the clinical data.
Multimedia resourceMultimedia resource: Multimedia representation of the clinical observation or finding.
TitleTitle: Name of the multimedia resource.
DescriptionDescription: Narrative description of the multimedia resource.
SourceSource: The source of the multimedia resource.
Date createdDate created: Date/time that the multimedia resource was created.
Exclusion of examinationExclusion of examination: Positive statement to record that the physical examination, or a specified part of the physical examination, was not performed.
Examination not doneExamination not done: Statement to explicity record that the examination was not performed.
Record as True if the examination was not performed.
ReasonReason: Reason for the 'not done' statement.
For example: patient factors, equipment factors, time constraints.

Annotations

  • HHIMS.Value Set: 3.1-18
Exclusion of examinationExclusion of examination: Positive statement to record that the physical examination, or a specified part of the physical examination, was not performed.

Annotations

  • HHIMS.Value Set: 3.1-17
Examination not doneExamination not done: Statement to explicity record that the examination was not performed.
Record as True if the examination was not performed.
ReasonReason: Reason for the 'not done' statement.
For example: patient factors, equipment factors, time constraints.
Multimedia representationMultimedia representation: Digital image or video taken, or a diagram drawn, during the physical examination of the ears.
Confounding factorsConfounding factors: Description of any incidental factors that may have contributed to the physical examination findings.
Protocol
Otoscopy DeviceOtoscopy Device: An instrument, apparatus, implant, material or similar, used in the provision of healthcare. In this context, a medical device includes a broad range of devices which act through a variety of physical, mechanical, thermal or similar means but specifically excludes devices which act through medicinal means such as pharmacological, metabolic or immunological methods. The scope is inclusive of disposable devices as well as durable or persisting devices that require tracking, maintenance activities or regular calibration, recognising that each type of device has specific data recording requirements.
Device nameDevice name: Identification of the medical device, preferably by a common name, a formal fully descriptive name or, if required, by class or category of device.
This data element will capture the term, phrase or category used in clinical practice. For example: <brand name><machine> (XYZ Audiometer); <size> <brand name> <intravenous catheter> (14G Jelco IV catheter); or <brand name/type> <implant>. Coding with a terminology is desirable, where possible, although this may be local and depending on local supplies available.

Annotations

  • HHIMS.Value Set: 3.1-19