Module 4

Module 4 – Medical History

Moico Module 6 Alt
This module is completed when entering the patient registry and remains static, it collects information on the pathway to diagnosis including symptoms, diagnosing professional/s and any alternate diagnoses.
4.3 Hospitalisations and Surgical Procedures (ANGHospitalisations)
NoCodeQuestionResponse
4.3.1ANGHospitalVisitsHas your child/ adult ever been hospitalised?1 – Yes;
2 – No;
3 – Unknown
4.3.3ANGSurgicalProceduresHas your child/ adult had any surgical procedures?1 – Yes;
2 – No;
3 – Unknown
4.3.4ANGSurgeryNumberPlease indicate the number of surgeries 
4.3.5ANGAnaestheticHas your child/ adult ever undergone anaesthesia?1 – Yes;
2 – No;
3 – Unknown
4.3.6ANGAnaestheticNumberPlease indicate the number of anaesthesias1- None;
2 – One only;
3 – 2 – 5;
4 – 5 – 10;
6 – More than 10
4.4 Details of Hospitalisation/Surgery (ANGHospitalVisit1)
NoCodeQuestionResponse
4.4.3aANGAgeHospitalVisit1aChild/ adult’s age at admission 
4.4.5ANGHospitalVisit1ReasonHospitalisation reason1 – Seizure;
2 – Feeding problems;
3 – Surgery;
4 – Infection;
5 – Other 
4.4.6ANGHospSurgery1If surgery, what was the reason? (e.g. Corrective alignment (toe walking, scoliosis), strabismus 
4.4.7ANGHospOther1If other, what was the reason? 
4.4.8ANGHospitalVisit1DaysInHospitalNumber of days in hospital 
4.4.10ANGHospitalVisit1LevelOfCareLevel of care1 – Low (medical ward);
2 – Medium (high dependency unit);
3 – High (Intensive care) ;
4 – Emergency department
Providing Insight & Research into Angelman Syndrome
Creating new opportunities, insight & understanding.
Hi Holding Hands
Hi Patient Data

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