<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="HdBe-PainScore" />
  <language value="en-US" />
  <extension url="http://hl7.org/fhir/StructureDefinition/resource-effectivePeriod">
    <valuePeriod>
      <start value="2020-09-01T00:00:00+02:00" />
    </valuePeriod>
  </extension>
  <url value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-PainScore" />
  <name value="HdBePainScore">
    <extension url="http://hl7.org/fhir/StructureDefinition/translation">
      <extension url="lang">
        <valueCode value="nl-NL" />
      </extension>
      <extension url="content">
        <valueMarkdown value="HdBePijnscore" />
      </extension>
    </extension>
  </name>
  <title value="HdBe PainScore" />
  <status value="draft" />
  <date value="2022-07-07T15:04:03.2592055+00:00" />
  <publisher value="Healthdata.be (Sciensano)" />
  <contact>
    <name value="Service portal – healthdata.be" />
    <telecom>
      <system value="url" />
      <value value="https://sciensano.service-now.com/sp" />
      <use value="work" />
    </telecom>
  </contact>
  <description value="The pain score is a general measurement for pain experience, not a description of specific, localized pain. &#xD;&#xA;&#xD;&#xA;The following are used as an easily reproducible measurement for pain experience: &#xD;&#xA;&#xD;&#xA;1. NRS (Numeric Rating Scale) in which the patient gives the pain a number on a scale of 1 (no pain) to 10 (unbearable pain). &#xD;&#xA;1. 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. &#xD;&#xA;The results of both scores have the same meaning, but the visual analogue method (VAS) is seen as more reliable than the NRS pain score. &#xD;&#xA;#### Purpose&#xD;&#xA;The purpose of the pain score is to quantify and objectify the patient’s subjective pain experience.">
    <extension url="http://hl7.org/fhir/StructureDefinition/translation">
      <extension url="lang">
        <valueCode value="nl-NL" />
      </extension>
      <extension url="content">
        <valueMarkdown value="De pijnscore is een algemene maat voor de pijnbeleving, geen beschrijving van specifieke, gelocaliseerde pijn.&#xD;&#xA;&#xD;&#xA;Als goed reproduceerbare maat voor de beleving van pijn worden gebruikt:&#xD;&#xA;&#xD;&#xA;1. NRS (Numeric Rating Scale) waarbij de patiënt een cijfer geeft aan de pijn op een schaal van 1 (geen pijn) en 10 (ondraaglijke pijn).&#xD;&#xA;1. VAS (Visual Analogue Score) , waarbij de patiënt op een lat met een lijn aangeeft hoe de pijn ervaren wordt en op de achterkant van de lat staat een schaal van 0 (geen pijn) tot 10 (ondraaglijke pijn).&#xD;&#xA;De uitslag van beide scores hebben dezelfde betekenis, maar de visueel analoge methode (VAS) wordt als betrouwbaarder aangemerkt dan de NRS pijnscore.&#xD;&#xA;&#xD;&#xA;&#xD;&#xA;#### Purpose&#xD;&#xA;Het doel van de pijnscore is het kwantificeren en objectiveren van de subjectieve pijnbeleving van de patiënt. &#xD;&#xA;&#xD;&#xA;&#xD;&#xA;**References**&#xD;&#xA;1. openEHR-EHR-OBSERVATION.symptom-pain.v1[Online] Beschikbaar op: http://www.openehr.org/knowledge/ [Geraadpleegd: 23 december 2014]." />
      </extension>
    </extension>
  </description>
  <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
  <fhirVersion value="4.0.1" />
  <kind value="logical" />
  <abstract value="true" />
  <type value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/PainScore" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element" />
  <derivation value="specialization" />
  <snapshot>
    <element id="PainScore">
      <path value="PainScore" />
      <short value="PainScore">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="PijnScore" />
          </extension>
        </extension>
      </short>
      <definition value="Root concept of the PainScore information model. This root concept contains all data elements of the PainScore information model.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="Rootconcept van de bouwsteen Pijnscore. Dit rootconcept bevat alle gegevenselementen van de bouwsteen Pijnscore." />
          </extension>
        </extension>
      </definition>
      <min value="0" />
      <max value="*" />
      <base>
        <path value="PainScore" />
        <min value="0" />
        <max value="*" />
      </base>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="PainScore.id">
      <path value="PainScore.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="PainScore.extension">
      <path value="PainScore.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="PainScore.PainScoreValue">
      <path value="PainScore.PainScoreValue" />
      <short value="PainScoreValue">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="PijnscoreWaarde" />
          </extension>
        </extension>
      </short>
      <definition value="The score is a general measurement of pain experience, not a description of specific, localized pain. &#xD;&#xA;&#xD;&#xA;Depending 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. &#xD;&#xA;&#xD;&#xA;Sometimes a value range of 0-100 is used instead of 0-10.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="De score is een algemene maat voor de pijnbeleving, geen beschrijving van specifieke, gelocaliseerde pijn.&#xD;&#xA;&#xD;&#xA;Afhankelijk van de gebruikte meetmethode geeft het de door de patiënt beleefde mate van pijn aan op een schaal van 0 tot en met 10: 0 = geen pijn en 10 = de ergst voorstelbare pijn. Voor de tussenliggende waarden zijn geen omschrijvingen in gebruik, zodat de waarde als een getal en niet als een code wordt weergegeven. &#xD;&#xA;&#xD;&#xA;Soms wordt een waardebereik van 0-100 gebruikt i.p.v. 0-10." />
          </extension>
        </extension>
      </definition>
      <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="PainScore.PainScoreValue" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Count" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="qty-3" />
        <severity value="error" />
        <human value="If a code for the unit is present, the system SHALL also be present" />
        <expression value="code.empty() or system.exists()" />
        <xpath value="not(exists(f:code)) or exists(f:system)" />
        <source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
      </constraint>
      <constraint>
        <key value="cnt-3" />
        <severity value="error" />
        <human value="There SHALL be a code with a value of &quot;1&quot; if there is a value and it SHALL be an expression of length.  If system is present, it SHALL be UCUM.  If present, the value SHALL a whole number." />
        <expression value="(code or value.empty()) and (system.empty() or system = %ucum) and (code.empty() or code = '1') and (value.empty() or value.toString().contains('.').not())" />
        <xpath value="(f:code or not(f:value)) and (not(exists(f:system)) or (f:system/@value='http://unitsofmeasure.org' and f:code/@value='1')) and not(contains(f:value/@value, '.'))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Count" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="SN (see also Range) or CQ" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values" />
      </mapping>
    </element>
    <element id="PainScore.PainScoreDateTime">
      <path value="PainScore.PainScoreDateTime" />
      <short value="PainScoreDateTime">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="PijnscoreDatumTijd" />
          </extension>
        </extension>
      </short>
      <definition value="The date and time at which the pain score was measured.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="De datum en het tijdstip waarop de pijnscore gemeten is." />
          </extension>
        </extension>
      </definition>
      <min value="1" />
      <max value="1" />
      <base>
        <path value="PainScore.PainScoreDateTime" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="PainScore.PainMeasuringMethod">
      <path value="PainScore.PainMeasuringMethod" />
      <short value="PainMeasuringMethod">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="PijnMeetmethode" />
          </extension>
        </extension>
      </short>
      <definition value="The measuring method describes the method used to determine the pain score. The measurement involves a visualization of the pain scale.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="De meetmethode beschrijft de gebruikte methodiek om de pijnscore vast te leggen. Bij de meting wordt gebruik gemaakt van een visualisatie van de pijnschaal." />
          </extension>
        </extension>
      </definition>
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="PainScore.PainMeasuringMethod" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <binding>
        <strength value="required" />
        <description value="PainMeasuringMethod codes" />
        <valueSet value="https://fhir.healthdata.be/ValueSet/PijnMeetmethode" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
    </element>
    <element id="PainScore.Comment">
      <path value="PainScore.Comment" />
      <short value="Comment">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="Toelichting" />
          </extension>
        </extension>
      </short>
      <definition value="Comment on the pain score measurement, including comments on for example the circumstances and/or disruptive factors that may influence the result.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="Toelichting op de pijnscore meting, bijvoorbeeld opmerkingen betreffende de omstandigheden en storende factoren die het meetresultaat kunnen beïnvloeden." />
          </extension>
        </extension>
      </definition>
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="PainScore.Comment" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="PainScore">
      <path value="PainScore" />
      <short value="PainScore">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="PijnScore" />
          </extension>
        </extension>
      </short>
      <definition value="Root concept of the PainScore information model. This root concept contains all data elements of the PainScore information model.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="Rootconcept van de bouwsteen Pijnscore. Dit rootconcept bevat alle gegevenselementen van de bouwsteen Pijnscore." />
          </extension>
        </extension>
      </definition>
      <min value="0" />
      <max value="*" />
    </element>
    <element id="PainScore.PainScoreValue">
      <path value="PainScore.PainScoreValue" />
      <short value="PainScoreValue">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="PijnscoreWaarde" />
          </extension>
        </extension>
      </short>
      <definition value="The score is a general measurement of pain experience, not a description of specific, localized pain. &#xD;&#xA;&#xD;&#xA;Depending 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. &#xD;&#xA;&#xD;&#xA;Sometimes a value range of 0-100 is used instead of 0-10.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="De score is een algemene maat voor de pijnbeleving, geen beschrijving van specifieke, gelocaliseerde pijn.&#xD;&#xA;&#xD;&#xA;Afhankelijk van de gebruikte meetmethode geeft het de door de patiënt beleefde mate van pijn aan op een schaal van 0 tot en met 10: 0 = geen pijn en 10 = de ergst voorstelbare pijn. Voor de tussenliggende waarden zijn geen omschrijvingen in gebruik, zodat de waarde als een getal en niet als een code wordt weergegeven. &#xD;&#xA;&#xD;&#xA;Soms wordt een waardebereik van 0-100 gebruikt i.p.v. 0-10." />
          </extension>
        </extension>
      </definition>
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Count" />
      </type>
    </element>
    <element id="PainScore.PainScoreDateTime">
      <path value="PainScore.PainScoreDateTime" />
      <short value="PainScoreDateTime">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="PijnscoreDatumTijd" />
          </extension>
        </extension>
      </short>
      <definition value="The date and time at which the pain score was measured.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="De datum en het tijdstip waarop de pijnscore gemeten is." />
          </extension>
        </extension>
      </definition>
      <min value="1" />
      <max value="1" />
      <type>
        <code value="dateTime" />
      </type>
    </element>
    <element id="PainScore.PainMeasuringMethod">
      <path value="PainScore.PainMeasuringMethod" />
      <short value="PainMeasuringMethod">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="PijnMeetmethode" />
          </extension>
        </extension>
      </short>
      <definition value="The measuring method describes the method used to determine the pain score. The measurement involves a visualization of the pain scale.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="De meetmethode beschrijft de gebruikte methodiek om de pijnscore vast te leggen. Bij de meting wordt gebruik gemaakt van een visualisatie van de pijnschaal." />
          </extension>
        </extension>
      </definition>
      <min value="1" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="required" />
        <description value="PainMeasuringMethod codes" />
        <valueSet value="https://fhir.healthdata.be/ValueSet/PijnMeetmethode" />
      </binding>
    </element>
    <element id="PainScore.Comment">
      <path value="PainScore.Comment" />
      <short value="Comment">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="Toelichting" />
          </extension>
        </extension>
      </short>
      <definition value="Comment on the pain score measurement, including comments on for example the circumstances and/or disruptive factors that may influence the result.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
          <extension url="lang">
            <valueCode value="nl-NL" />
          </extension>
          <extension url="content">
            <valueMarkdown value="Toelichting op de pijnscore meting, bijvoorbeeld opmerkingen betreffende de omstandigheden en storende factoren die het meetresultaat kunnen beïnvloeden." />
          </extension>
        </extension>
      </definition>
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
    </element>
  </differential>
</StructureDefinition>