====== UIATS ======
<form>
Action mail mngld@proton.me
Thanks "Eine Email mit dem endgültigen Score wurde versandt!"
Fieldset "Age"
select "Please select the corresponding age" "< 40 years|40-60 years|61-70 years|71-80 years|> 80 years"
Fieldset "Risk factor incidence (multiple, please select all that apply)"
yesno "Previous SAH from a different aneurysm" "=4" "!No"
yesno "Familial intracranial aneurysms or SAH" "=3" "!No"
yesno "Japanese, Finnish, Inuit ethnicity" "=2" "!0"
yesno "Current cigarette smoking" "=3" "!0"
yesno "Hypertension (systolic BP > 140 mmHg" "=2" "!0"
yesno "Autosomal-polycystic kidney disease" "=2" "!0"
yesno "Current drug abuse (cocain, amphetamine)" "=2" "!0"
yesno "Current alcohol abuse" "=1" "!0"
Fieldset "Clinical symptoms related to UAI (multiple, please select all that apply)"
yesno "Cranial nerve deficit" "=4" "!0"
yesno "Clinical or radiological mass effect" "=4" "!0"
yesno "Thromboembolic events from the aneurysm" "=3" "!0"
yesno "Epilepsy" "=1" "!0"
Fieldset "Other (multiple, please select all that apply)"
yesno "Reduced quality of life due to fear of rupture" "=2" "!0"
yesno "Aneurysm multiplicity" "=1" "!0"
Fieldset "Life expectancy due to chronic and/or malignant diseases (single, please select one option)"
select "Please select:" "< 5 years|5-10 years|> 10 years"
Fieldset "Comorbid diseases (multiple, please select all that apply)"
yesno "Neurocognitive disorder" "=3" "!0"
yesno "Coagulopathies, thrombophilic diseases" "=2" "!0"
yesno "Psychiatric disorder" "=2" "!0"
Fieldset "Maximum diameter of the Aneurysm"
select "Please select:" "< 3.9 mm |4.0-6.9 mm |7.0-12.9 mm|13.0-24.9 mm|>25 mm"
Fieldset "Aneurysm Morphology"
yesno "Irregularity or lobulation" "=3" "!0"
yesno "Size ration > 3 or aspect ration > 1.6" "=1" "!0"
Fieldset "Location of the aneurysm"
select "Please select:" "BasA bifurcation|Vertrebral/basilar artery|AcomA or PcomA"
Fieldset "Other (multiple, please select all that apply)"
yesno "Aneurysm growth on serial imaging" "=4" "!0"
yesno "Aneurysm de novo formation on serial imaging" "=3" "!0"
yesno "Contralateral stenoocclusive vessel disease" "=1" "!0"
Fieldset "Age-related risk"
select "Please select:" "< 40 years|41-60 years|61-70 years|71-80 years|> 80 years"
Fieldset "Aneurysm size-related risk"
select "Please select:" "< 6.0 mm|6.0 - 10 mm|10.1-20 mm| > 20 mm"
Fieldset "Aneurysm complexity-related risk"
select "Please select:" "High|Low"
</form>