{
"description": null,
"_filename": "Questionnaire-questionnaire-example-phq9.json",
"package_name": "fhir.argonaut.questionnaire",
"subjectType": [ "Patient" ],
"date": "2018-07-26",
"meta": {
"profile": [ "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-questionnaire" ]
},
"publisher": "Argonaut Project",
"jurisdiction": [ {
"coding": [ {
"code": "US",
"system": "urn:iso:std:iso:3166",
"display": "United States of America"
} ]
} ],
"name": null,
"item": [ {
"code": [ {
"code": "44249-1",
"system": "http://loinc.org"
} ],
"item": [ {
"text": "Over the last 2 weeks, how often have you been bothered by any of the following problems? (Use “X” to indicate your answer)",
"type": "display",
"linkId": "g1.d",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 0
} ]
}, {
"linkId": "g1.q1",
"repeats": false,
"type": "choice",
"prefix": "1.",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 1
} ],
"code": [ {
"code": "44250-9",
"system": "http://loinc.org"
} ],
"options": {
"display": "Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day",
"reference": "#LL358-3"
},
"required": true,
"text": "Little interest or pleasure in doing things,"
}, {
"linkId": "g1.q2",
"repeats": false,
"type": "choice",
"prefix": "2.",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 2
} ],
"code": [ {
"code": "44255-8",
"system": "http://loinc.org"
} ],
"options": {
"display": "Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day",
"reference": "#LL358-3"
},
"required": true,
"text": "Feeling down, depressed, or hopeless,"
}, {
"linkId": "g1.q3",
"repeats": false,
"type": "choice",
"prefix": "3.",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 3
} ],
"code": [ {
"code": "44259-0",
"system": "http://loinc.org"
} ],
"options": {
"display": "Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day",
"reference": "#LL358-3"
},
"required": true,
"text": "Trouble falling or staying asleep, or sleeping too much"
}, {
"linkId": "g1.q4",
"repeats": false,
"type": "choice",
"prefix": "4.",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 4
} ],
"code": [ {
"code": "44254-1",
"system": "http://loinc.org"
} ],
"options": {
"display": "Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day",
"reference": "#LL358-3"
},
"required": true,
"text": "Feeling tired or having little energy,"
}, {
"linkId": "g1.q5",
"repeats": false,
"type": "choice",
"prefix": "5.",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 5
} ],
"code": [ {
"code": "44251-7",
"system": "http://loinc.org"
} ],
"options": {
"display": "Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day",
"reference": "#LL358-3"
},
"required": true,
"text": "Poor appetite or overeating,"
}, {
"linkId": "g1.q6",
"repeats": false,
"type": "choice",
"prefix": "6.",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 6
} ],
"code": [ {
"code": "44258-2",
"system": "http://loinc.org"
} ],
"options": {
"display": "Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day",
"reference": "#LL358-3"
},
"required": true,
"text": "Feeling bad about yourself - or that you are a failure or have let yourself or your family down,"
}, {
"linkId": "g1.q7",
"repeats": false,
"type": "choice",
"prefix": "7.",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 7
} ],
"code": [ {
"code": "44252-5",
"system": "http://loinc.org"
} ],
"options": {
"display": "Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day",
"reference": "#LL358-3"
},
"required": true,
"text": "Trouble concentrating on things, such as reading the newspaper or watching television,"
}, {
"linkId": "g1.q8",
"repeats": false,
"type": "choice",
"prefix": "8.",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 8
} ],
"code": [ {
"code": "44253-3",
"system": "http://loinc.org"
} ],
"options": {
"display": "Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day",
"reference": "#LL358-3"
},
"required": true,
"text": "Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual,"
}, {
"linkId": "g1.q9",
"repeats": false,
"type": "choice",
"prefix": "9.",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 9
} ],
"code": [ {
"code": "44260-8",
"system": "http://loinc.org"
} ],
"options": {
"display": "Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day",
"reference": "#LL358-3"
},
"required": true,
"text": "Thoughts that you would be better off dead, or of hurting yourself"
}, {
"code": [ {
"code": "44261-6",
"system": "http://loinc.org"
} ],
"text": "Scoring: \nAdd up all checked boxes on PHQ-9. \n\nFor every:\nNot at all = 0;\nSeveral days = 1;\nMore than half the days = 2;\nNearly every day = 3\n\nInterpretation of Total Score\nTotal Score Depression Severity\n1-4 Minimal depression\n5-9 Mild depression\n10-14 Moderate depression\n15-19 Moderately severe depression\n20-27 Severe depression",
"type": "display",
"linkId": "g1.s",
"repeats": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}, {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 10
}, {
"url": "http://hl7.org/fhir/StructureDefinition/designNote",
"valueMarkdown": "this is hidden text/should not be displayed to the user"
} ]
} ],
"type": "group",
"linkId": "g1",
"required": true,
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 0
} ]
}, {
"item": [ {
"code": [ {
"code": "69722-7",
"system": "http://loinc.org"
} ],
"text": "If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people,",
"type": "choice",
"linkId": "g2.q1",
"options": {
"display": "Not difficult at all/Somewhat difficult/Very difficult/Extremely difficult-Perceived difficulty (PHQ-9)",
"reference": "#LL359-1"
},
"repeats": false,
"required": true,
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 0
} ]
} ],
"type": "group",
"linkId": "g2",
"required": true,
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder",
"valueInteger": 1
} ]
} ],
"useContext": [ {
"code": {
"code": "task",
"system": "http://hl7.org/fhir/usage-context-type",
"display": "Workflow Task"
},
"valueCodeableConcept": {
"coding": [ {
"code": "example",
"system": "http://acme.org",
"display": "Example of Use"
} ]
}
} ],
"copyright": "Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from\nPfizer Inc. No permission required to reproduce, translate, display or distribute.",
"type": null,
"experimental": null,
"resourceType": "Questionnaire",
"title": "Patient Health Questionnaire (PHQ-9)",
"package_version": "1.0.0",
"extension": [ {
"url": "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-timeLimit",
"valueDuration": {
"code": "wk",
"unit": "week",
"value": 1,
"system": "http://unitsofmeasure.org"
}
} ],
"contained": [ {
"date": "2018-06-27",
"meta": {
"profile": [ "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-questionnaire-valueset" ]
},
"copyright": "This content LOINC is copyright 1995 Regenstrief Institute, Inc. and the LOINC Committee, and available at no cost under the license at http://loinc.org/terms-of-use .",
"resourceType": "ValueSet",
"expansion": {
"total": 4,
"contains": [ {
"code": "LA6568-5",
"system": "http://loinc.org",
"display": "Not at all",
"version": "2.64",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-conceptOrder",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-ordinalValue",
"valueDecimal": 0
} ]
}, {
"code": "LA6569-3",
"system": "http://loinc.org",
"display": "Several days",
"version": "2.64",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-conceptOrder",
"valueInteger": 2
}, {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-ordinalValue",
"valueDecimal": 1
} ]
}, {
"code": "LA6570-1",
"system": "http://loinc.org",
"display": "More than half the days",
"version": "2.64",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-conceptOrder",
"valueInteger": 3
}, {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-ordinalValue",
"valueDecimal": 2
} ]
}, {
"code": "LA6571-9",
"system": "http://loinc.org",
"display": "Nearly every day",
"version": "2.64",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-conceptOrder",
"valueInteger": 4
}, {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-ordinalValue",
"valueDecimal": 3
} ]
} ],
"timestamp": "2018-06-27T22:49:08Z",
"identifier": "LL358-3ver2.64"
},
"title": "Patient Health Questionnaire (PHQ-9)",
"status": "active",
"id": "LL358-3",
"url": "http://fhir.org/guides/argonaut/questionnaire/ValueSet/LL358-3",
"identifier": [ {
"value": "LL358-3"
} ],
"version": "0.0.0"
}, {
"date": "2018-06-27",
"meta": {
"profile": [ "http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-questionnaire-valueset" ]
},
"copyright": "This content LOINC is copyright 1995 Regenstrief Institute, Inc. and the LOINC Committee, and available at no cost under the license at http://loinc.org/terms-of-use .",
"resourceType": "ValueSet",
"expansion": {
"total": 4,
"contains": [ {
"code": "LA6572-7",
"system": "http://loinc.org",
"display": "Not difficult at all",
"version": "2.64",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-conceptOrder",
"valueInteger": 1
} ]
}, {
"code": "LA6573-5",
"system": "http://loinc.org",
"display": "Somewhat difficult",
"version": "2.64",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-conceptOrder",
"valueInteger": 2
} ]
}, {
"code": "LA6575-0",
"system": "http://loinc.org",
"display": "Very difficult",
"version": "2.64",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-conceptOrder",
"valueInteger": 3
} ]
}, {
"code": "LA6574-3",
"system": "http://loinc.org",
"display": "Extremely difficult",
"version": "2.64",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/valueset-conceptOrder",
"valueInteger": 4
} ]
} ],
"timestamp": "2018-06-27T22:27:03Z",
"identifier": "LL359"
},
"title": "PHQ.10 / Not difficult at all/Somewhat difficult/Very difficult/Extremely difficult-Perceived difficulty (PHQ-9)",
"status": "active",
"id": "LL359-1",
"url": "http://fhir.org/guides/argonaut/questionnaire/ValueSet/LL359-1",
"identifier": [ {
"value": "LL359-1ver2.64"
} ],
"version": "0.0.0"
} ],
"status": "draft",
"id": "1585f775-65c0-4904-b07a-b8e146a63663",
"kind": null,
"url": "http://fhir.org/guides/argonaut/questionnaire/Questionnaire/questionnaire-example-phq9",
"code": [ {
"code": "44249-1",
"system": "http://loinc.org",
"display": "PHQ-9 quick depression assessment panel"
} ],
"identifier": [ {
"value": "phq9",
"system": "http://acme.org/q-identifiers"
} ],
"version": "0.0.0",
"contact": [ {
"telecom": [ {
"value": "http://argonautwiki.hl7.org",
"system": "url"
} ]
} ]
}