{
"description": "This profile is for submitting data to the NICE related to pain scores. The pain score is a general measurement for pain experience of an ICU patient at rest. It is not a description of specific, localized pain.",
"_filename": "NICE-PainScore.json",
"package_name": "niceprofiling.v23q1",
"date": "2022-03-22T10:49:40.0924639Z",
"derivation": "constraint",
"meta": {
"versionId": "2",
"lastUpdated": "2022-07-14T12:55:46.0435804+00:00"
},
"publisher": "NICE",
"fhirVersion": "3.0.2",
"purpose": "This profile is used to submit pain score related information to the Dutch National Intensive Care Evaluation (NICE). It was derived from the Nictiz Health and Care Information Model (HCIM; Dutch: Zorginformatiebouwsteen or ZIB) PainScore, 2017 release version 3.1",
"name": "NICE-PainScore",
"mapping": [ {
"uri": "https://www.stichting-nice.nl/dd/#791",
"name": "NICE2Improve (Actionable Indicators)",
"identity": "NICE-AI"
} ],
"abstract": false,
"copyright": "CC0",
"type": "Observation",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "NICE-PainScore",
"package_version": "0.2.0",
"status": "active",
"id": "190d5438-0058-4e6f-8540-378c538a3d58",
"kind": "resource",
"url": "https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-PainScore-2022Q1",
"version": null,
"differential": {
"element": [ {
"id": "Observation",
"path": "Observation",
"alias": [ "Pijnscore" ],
"short": "PainScore",
"mapping": [ {
"map": "https://www.stichting-nice.nl/dd/#752",
"comment": "Pain score",
"identity": "NICE-AI"
}, {
"map": "NL-CM:12.9.1",
"comment": "Pain score",
"identity": "hcim-painscore-v3.1-2017EN"
} ],
"constraint": [ {
"key": "maxValue-for-method",
"human": "maxValue of 10 if method is VAS10 or NRS, 100 if VAS100, 12 if BPS, 8 if CPTOT, or 20 if CIA",
"severity": "error",
"expression": "((method.coding.code = 'VAS10' or method.coding.code = 'NRS') and valueQuantity.value <= 10) or (method.coding.code='VAS100' and valueQuantity.value <= 100) or (method.coding.code = 'BPS' and valueQuantity.value <= 12) or (method.coding.code='CPTOT' and valueQuantity.value <= 8) or (method.coding.code='CIA' and valueQuantity.value <= 20)"
}, {
"key": "minValue-for-method",
"human": "minValue of 1 if method is NRS, 0 if VAS or CPTOT, 4 if BPS and 5 if CIA",
"severity": "error",
"expression": "((method.coding.code = 'VAS10' or method.coding.code = 'VAS100' or method.coding.code = 'CPTOT') and valueQuantity.value >= 0) or (method.coding.code='NRS' and valueQuantity.value >= 1) or (method.coding.code='BPS' and valueQuantity.value >= 4) or (method.coding.code='CIA' and valueQuantity.value >= 5)"
} ],
"definition": "The pain score is a general measurement for pain experience, not a description of specific, localized pain.\r\n\r\nThe following are used as an easily reproducible measurement for pain experience:\r\n\r\n NRS (Numeric Rating Scale) in which the patient gives the pain a number on a scale of 1 (no pain) to 10 (unbearable pain).\r\n VAS (Visual Analogue Score), in which the patient points to a bar with a line to indicate the pain they feel. The back of the bar has a scale from 0 (no pain) to 10 (unbearable pain) on it.\r\n BPS (Behavioural Pain Scale) in which the care provider scores pain based on three indicators: facial expression, upper limb movement and compliance with ventilation. Each indicator is scored a 1, 2, 3 or 4. High scores indicate more pain.\r\n CPOT (Critical-Care Pain Observation Tool) in which the care provider scores pain based on four indicators: facial expression, body movements muscle tension and compliance with the ventilator if intubated, or vocalization if extubated. Each indicator is scored a 0, 1 or 2. High scores indicate more pain.\r\n CIA (Critically Ill Assessment scale) in which five items are scored (alertness, facial tension, muscle tone, body movements and respiratory response) with a total score between 5 and 20"
}, {
"id": "Observation.extension",
"min": 1,
"path": "Observation.extension",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "Observation.identifier",
"max": "1",
"path": "Observation.identifier",
"mapping": [ {
"map": "https://www.stichting-nice.nl/dd/#750",
"comment": "Pijnmeting volgnummer",
"identity": "NICE-AI"
} ],
"mustSupport": true
}, {
"id": "Observation.status",
"path": "Observation.status",
"constraint": [ {
"key": "completed",
"human": "NICE observations SHALL be completed",
"severity": "error",
"expression": "$this = 'final' or $this = 'amended' or $this = 'corrected'"
} ],
"mustSupport": true
}, {
"id": "Observation.code",
"path": "Observation.code",
"mustSupport": true
}, {
"id": "Observation.code.coding",
"max": "1",
"path": "Observation.code.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "system",
"type": "value"
}, {
"path": "code",
"type": "value"
} ]
}
}, {
"id": "Observation.code.coding:PainScoreCode",
"max": "1",
"path": "Observation.code.coding",
"sliceName": "PainScoreCode"
}, {
"id": "Observation.code.coding:PainScoreCode.system",
"path": "Observation.code.coding.system",
"fixedUri": "http://snomed.info/sct"
}, {
"id": "Observation.code.coding:PainScoreCode.code",
"path": "Observation.code.coding.code",
"fixedCode": "225908003"
}, {
"id": "Observation.code.coding:PainScoreCode.display",
"path": "Observation.code.coding.display",
"defaultValueString": "Pain score (observable entity)"
}, {
"id": "Observation.subject",
"path": "Observation.subject",
"type": [ {
"code": "Reference",
"targetProfile": "https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Patient-2022Q1"
} ],
"mustSupport": true
}, {
"id": "Observation.context",
"path": "Observation.context",
"type": [ {
"code": "Reference",
"targetProfile": "https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Encounter-2022Q1"
} ],
"mustSupport": true
}, {
"id": "Observation.effective[x]:effectiveDateTime",
"path": "Observation.effectiveDateTime",
"type": [ {
"code": "dateTime"
} ],
"alias": [ "PijnscoreDatumTijd" ],
"mapping": [ {
"map": "NL-CM:12.9.3",
"comment": "Pain measurement time",
"identity": "hcim-painscore-v3.1-2017EN"
}, {
"map": "https://www.stichting-nice.nl/dd/#751",
"comment": "Pain measurement time",
"identity": "NICE-AI"
} ],
"sliceName": "effectiveDateTime"
}, {
"id": "Observation.value[x]:valueQuantity",
"path": "Observation.valueQuantity",
"type": [ {
"code": "Quantity"
} ],
"alias": [ "PijnscoreWaarde" ],
"example": [ {
"label": "Example of PainScore value",
"valueQuantity": {
"code": "{score}",
"value": 7.0,
"system": "http://unitsofmeasure.org"
}
} ],
"mapping": [ {
"map": "NL-CM:12.9.2",
"comment": "PainScoreValue",
"identity": "hcim-painscore-v3.1-2017EN"
} ],
"sliceName": "valueQuantity",
"definition": "The score is a general measurement of pain experience, not a description of specific, localized pain.\r\n\r\nDepending on the measuring method used, it indicates the level of pain experienced by the patient on a scale of 0 to 10: 0 = no pain and 10 = the worst pain imaginable. No descriptions are used for the intermediate values, so that the value is displayed as a number and not as a code.\r\n\r\nSometimes a value range of 0-100, 4-12, 0-8 or 5-20 is used instead of 0-10."
}, {
"id": "Observation.comment",
"path": "Observation.comment",
"alias": [ "Toelichting" ],
"mapping": [ {
"map": "NL-CM:12.9.5",
"comment": "Comment",
"identity": "hcim-painscore-v3.1-2017EN"
} ],
"definition": "Comment on the pain score measurement, including comments on for example the circumstances and/or disruptive factors that may influence the result."
}, {
"id": "Observation.bodySite.extension",
"min": 0,
"path": "Observation.bodySite.extension",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"path": "Observation.bodySite.extension",
"min": 0,
"definition": "Laterality adds information about body side to the anatomic location, e.g. left",
"mapping": [ {
"map": "NL-CM:12.9.7",
"comment": "Laterality",
"identity": "hcim-painscore-v3.1-2017EN"
} ],
"type": [ {
"code": "Extension",
"profile": "http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"
} ],
"sliceName": "Laterality",
"alias": [ "Lateraliteit" ],
"max": "1",
"id": "Observation.bodySite.extension:Laterality",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."
}, {
"id": "Observation.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept",
"path": "Observation.bodySite.extension.valueCodeableConcept",
"binding": {
"strength": "extensible",
"description": "Laterality",
"valueSetReference": {
"reference": "https://simplifier.net/nictizstu3-zib2017/2.16.840.1.113883.2.4.3.11.60.40.2.12.9.3--20171231000000"
}
},
"sliceName": "valueCodeableConcept"
}, {
"id": "Observation.method",
"min": 1,
"path": "Observation.method",
"short": "How it was performed",
"binding": {
"strength": "required",
"description": "NICE-methods for pain measurement",
"valueSetReference": {
"reference": "https://fhir.stichting-nice.nl/fhir/ValueSet/NICE-PainMeasurementToolCodeList"
}
},
"mapping": [ {
"map": "https://www.stichting-nice.nl/dd/#752",
"comment": "Pain score",
"identity": "NICE-AI"
} ],
"definition": "The pain score is a general measurement for pain experience, not a description of specific, localized pain.\r\n\r\nThe following are used as an easily reproducible measurement for pain experience:\r\n\r\n NRS (Numeric Rating Scale) in which the patient gives the pain a number on a scale of 1 (no pain) to 10 (unbearable pain).\r\n VAS (Visual Analogue Score), in which the patient points to a bar with a line to indicate the pain they feel. The back of the bar has a scale from 0 (no pain) to 10 (unbearable pain) on it.\r\n BPS (Behavioural Pain Scale) in which the care provider scores pain based on three indicators: facial expression, upper limb movement and compliance with ventilation. Each indicator is scored a 1, 2, 3 or 4. High scores indicate more pain.\r\n CPOT (Critical-Care Pain Observation Tool) in which the care provider scores pain based on four indicators: facial expression, body movements muscle tension and compliance with the ventilator if intubated, or vocalization if extubated. Each indicator is scored a 0, 1 or 2. High scores indicate more pain.\r\n CIA (Critically Ill Assessment scale) in which five items are scored (alertness, facial tension, muscle tone, body movements and respiratory response) with a total score between 5 and 20",
"mustSupport": true
} ]
},
"contact": [ {
"name": "NICE",
"telecom": [ {
"value": "vragen@stichting-nice.nl",
"system": "email"
} ]
} ],
"baseDefinition": "http://fhir.nl/fhir/StructureDefinition/nl-core-observation"
}