{
  "resourceType": "StructureDefinition",
  "id": "zib-SNAQ65plusScore",
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-SNAQ65plusScore",
  "version": "1.0.0",
  "name": "Zib SNAQ65+Score",
  "title": "HCIM SNAQ65+Score",
  "status": "active",
  "publisher": "Nictiz",
  "contact": [
    {
      "name": "Nictiz",
      "telecom": [
        {
          "system": "email",
          "value": "info@nictiz.nl",
          "use": "work"
        }
      ]
    }
  ],
  "description": "A Observation resource as defined by the Dutch HCIM SNAQ65+Score-v1.0(2017EN). The Short Nutritional Assessment Questionnaire 65+ (SNAQ65+) is a (validated) measuring tool for determining the extent of a patient’s malnutrition. The tool comprises a number of questions, each of which is assigned a score. The total score determines the extent of malnutrition. The SNAQ helps to recognize and treat malnutrition at an early stage. Three varieties of the measuring tool were developed for different care settings: hospitals (adults and children), nursing and retirement homes and independently living seniors. This concept describes the tool intended for the setting of independently living elderly.",
  "purpose": "#Purpose\r\nThe SNAQ65+score is used to determine the extent of malnutrition or the risk of malnutrition. To treat malnutrition quickly and effectively, it is important to identify the malnutrition at an early stage.\r\n\r\n#Rationale\r\nHL7 uses observations for defining scores like APGAR, to stay consistent, Nictiz chose to the Observation resource too.",
  "copyright": "CC0",
  "fhirVersion": "3.0.2",
  "mapping": [
    {
      "identity": "hcim-SNAQ65plusScore-v1.0-2017EN",
      "uri": "https://zibs.nl/wiki/SNAQ65+Score-v1.0(2017EN)",
      "name": "SNAQ65+Score-v1.0(2017EN)"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://fhir.nl/fhir/StructureDefinition/nl-core-observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "short": "SNAQ65+Score",
        "alias": [
          "SNAQ65+Score"
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQ65plusScore-v1.0-2017EN",
            "map": "NL-CM:4.30.1",
            "comment": "SNAQ65+Score"
          }
        ]
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.code.coding:SNAQ65plusScoreCode",
        "path": "Observation.code.coding",
        "sliceName": "SNAQ65plusScoreCode",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.code.coding:SNAQ65plusScoreCode.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.code.coding:SNAQ65plusScoreCode.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "fixedCode": "108321000146101"
      },
      {
        "id": "Observation.code.coding:SNAQ65plusScoreCode.display",
        "path": "Observation.code.coding.display",
        "defaultValueString": "Short Nutritional Questionaire for 65+ (assessment scale)"
      },
      {
        "id": "Observation.effective[x]:effectiveDateTime",
        "path": "Observation.effectiveDateTime",
        "sliceName": "effectiveDateTime",
        "short": "SNAQ65+ScoreDateTime",
        "definition": "The date and time at which the SNAQ score was determined.",
        "alias": [
          "SNAQ65+ScoreDatumTijd"
        ],
        "min": 1,
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQ65plusScore-v1.0-2017EN",
            "map": "NL-CM:4.30.6",
            "comment": "SNAQ65+ScoreDateTime"
          }
        ]
      },
      {
        "id": "Observation.value[x]:valueQuantity",
        "path": "Observation.value[x]",
        "sliceName": "valueQuantity",
        "short": "TotalScore",
        "definition": "The total score is the sum of all the individual scores. The total score has a range from 0 - 5.",
        "alias": [
          "TotaalScore"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQ65plusScore-v1.0-2017EN",
            "map": "NL-CM:4.30.2",
            "comment": "TotalScore"
          }
        ]
      },
      {
        "id": "Observation.value[x]:valueQuantity.value",
        "path": "Observation.value[x].value",
        "minValueDecimal": 0,
        "maxValueDecimal": 5
      },
      {
        "id": "Observation.comment",
        "path": "Observation.comment",
        "definition": "A comment on the circumstances during the measurement.",
        "alias": [
          "Toelichting"
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQ65plusScore-v1.0-2017EN",
            "map": "NL-CM:4.30.7"
          }
        ]
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "code"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:WeightLossScore",
        "path": "Observation.component",
        "sliceName": "WeightLossScore",
        "max": "1"
      },
      {
        "id": "Observation.component:WeightLossScore.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.30.3"
            }
          ]
        }
      },
      {
        "id": "Observation.component:WeightLossScore.code.coding.display",
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Weightloss score"
      },
      {
        "id": "Observation.component:WeightLossScore.value[x]:valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "short": "WeightLossScore",
        "definition": "The score based on undesired weight loss over the past month(s).",
        "alias": [
          "GewichtsverliesScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of WeightLossScore",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.18.1",
                  "code": "G2",
                  "display": "LossHigh"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SNAQ65+GewichtsverliesScoreCodelijst"
        },
        "mapping": [
          {
            "identity": "hcim-SNAQ65plusScore-v1.0-2017EN",
            "map": "NL-CM:4.30.3",
            "comment": "WeightLossScore"
          }
        ]
      },
      {
        "id": "Observation.component:AppetiteScore",
        "path": "Observation.component",
        "sliceName": "AppetiteScore",
        "max": "1"
      },
      {
        "id": "Observation.component:AppetiteScore.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.30.4"
            }
          ]
        }
      },
      {
        "id": "Observation.component:AppetiteScore.code.coding.display",
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Appetite score"
      },
      {
        "id": "Observation.component:AppetiteScore.value[x]:valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "short": "AppetiteScore",
        "definition": "The score based on a reduced appetite over the past month.",
        "alias": [
          "EetlustScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of AppetiteScore",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.18.2",
                  "code": "B0",
                  "display": "Eetlust"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SNAQ65+EetlustScoreCodelijst"
        },
        "mapping": [
          {
            "identity": "hcim-SNAQ65plusScore-v1.0-2017EN",
            "map": "NL-CM:4.30.4",
            "comment": "AppetiteScore"
          }
        ]
      },
      {
        "id": "Observation.component:UpperarmCircumference",
        "path": "Observation.component",
        "sliceName": "UpperarmCircumference",
        "max": "1"
      },
      {
        "id": "Observation.component:UpperarmCircumference.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.30.8"
            }
          ]
        }
      },
      {
        "id": "Observation.component:UpperarmCircumference.code.coding.display",
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Upperarm Circumference"
      },
      {
        "id": "Observation.component:UpperarmCircumference.value[x]:valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "short": "UpperarmCircumference",
        "definition": "The score based on circumference of the upper arm.",
        "alias": [
          "BovenarmOmtrekScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of UpperarmCircumference",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.18.4",
                  "code": "A0",
                  "display": "Normaal"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SNAQ65+BovenarmOmtrekScoreCodelijst"
        },
        "mapping": [
          {
            "identity": "hcim-SNAQ65plusScore-v1.0-2017EN",
            "map": "NL-CM:4.30.8",
            "comment": "UpperarmCircumference"
          }
        ]
      },
      {
        "id": "Observation.component:ExerciseScore",
        "path": "Observation.component",
        "sliceName": "ExerciseScore",
        "max": "1"
      },
      {
        "id": "Observation.component:ExerciseScore.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.30.5"
            }
          ]
        }
      },
      {
        "id": "Observation.component:ExerciseScore.code.coding.display",
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Exercise score"
      },
      {
        "id": "Observation.component:ExerciseScore.value[x]:valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "short": "ExerciseScore",
        "definition": "The score based on the ability of the patient to eat and drink without assistance.",
        "alias": [
          "InspanningsScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of ExerciseScore",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.18.3",
                  "code": "In0",
                  "display": "Mogelijk"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SNAQ65+InspanningsScoreCodelijst"
        },
        "mapping": [
          {
            "identity": "hcim-SNAQ65plusScore-v1.0-2017EN",
            "map": "NL-CM:4.30.5",
            "comment": "ExerciseScore"
          }
        ]
      }
    ]
  }
}