{
  "resourceType": "StructureDefinition",
  "id": "logicalmodel-Clinicalopiatewithdrawalscale_cows_-R4",
  "url": "http://linkehr.com/fhir/logicalmodel-clinicalopiatewithdrawalscale_cows_-R4",
  "identifier": [
    {
      "system": "openEHR-CKM",
      "value": "openEHR-EHR-OBSERVATION.cow_score.v0"
    }
  ],
  "version": "0",
  "name": "Clinicalopiatewithdrawalscale_cows_",
  "title": "Clinical Opiate Withdrawal Scale (COWS)",
  "status": "draft",
  "date": "2024-06-18",
  "publisher": "openEHR",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.veratech.es"
        }
      ]
    }
  ],
  "description": "Assessment tool used to measures the severity of opiate withdrawal.",
  "purpose": "To record individual COWS parameters and total score.",
  "fhirVersion": "4.0.0",
  "mapping": [
    {
      "identity": "openEHR",
      "uri": "http://openehr.org",
      "name": "openEHR Mapping"
    },
    {
      "identity": "openEHR-natural",
      "uri": "http://openehr.org",
      "name": "openEHR natural path"
    }
  ],
  "kind": "logical",
  "abstract": false,
  "type": "StructureDefinition",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Element",
  "snapshot": {
    "element": [
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS)",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS)",
        "short": "Clinical Opiate Withdrawal Scale (COWS)",
        "definition": "Assessment tool used to measures the severity of opiate withdrawal.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS)",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).protocol",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).protocol",
        "short": "Item tree",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).protocol",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).protocol.Extension",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).protocol.Extension",
        "short": "Extension",
        "definition": "Additional information required to extend the model with local content or to align with other reference models or formalisms.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).protocol.Extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series",
        "short": "Event Series",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event",
        "short": "Any event",
        "definition": "Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data",
        "short": "Tree",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Resting_pulse_rate_(BPM)",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Resting_pulse_rate_(BPM)",
        "short": "Resting pulse rate (BPM)",
        "definition": "Measure pulse rate after patient is sitting or lying down for 1 minute.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Resting_pulse_rate_(BPM)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Resting_pulse_rate_(BPM).value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Resting_pulse_rate_(BPM).value",
        "short": "Resting pulse rate (BPM)",
        "definition": "Measure pulse rate after patient is sitting or lying down for 1 minute.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Resting_pulse_rate_(BPM).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Sweating",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Sweating",
        "short": "Sweating",
        "definition": "Sweating not accounted for by room temperature or patient activity over the last 0.5 hours.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Sweating",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Sweating.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Sweating.value",
        "short": "Sweating",
        "definition": "Sweating not accounted for by room temperature or patient activity over the last 0.5 hours.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Sweating.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Restlessness_observation_during_assessment",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Restlessness_observation_during_assessment",
        "short": "Restlessness observation during assessment",
        "definition": "ELEMENT",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Restlessness_observation_during_assessment",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Restlessness_observation_during_assessment.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Restlessness_observation_during_assessment.value",
        "short": "Restlessness observation during assessment",
        "definition": "DvOrdinal",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Restlessness_observation_during_assessment.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Pupil_size",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Pupil_size",
        "short": "Pupil size",
        "definition": "ELEMENT",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Pupil_size",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Pupil_size.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Pupil_size.value",
        "short": "Pupil size",
        "definition": "DvOrdinal",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Pupil_size.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Bone_or_joint_aches",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Bone_or_joint_aches",
        "short": "Bone or joint aches",
        "definition": "If patient was having pain previously, only the additional component attributed to opiate withdrawal is scored.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Bone_or_joint_aches",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Bone_or_joint_aches.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Bone_or_joint_aches.value",
        "short": "Bone or joint aches",
        "definition": "If patient was having pain previously, only the additional component attributed to opiate withdrawal is scored.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Bone_or_joint_aches.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Runny_nose_or_tearing",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Runny_nose_or_tearing",
        "short": "Runny nose or tearing",
        "definition": "Not accounted for by cold symptoms or allergies.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Runny_nose_or_tearing",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Runny_nose_or_tearing.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Runny_nose_or_tearing.value",
        "short": "Runny nose or tearing",
        "definition": "Not accounted for by cold symptoms or allergies.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Runny_nose_or_tearing.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.GI_upset",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.GI_upset",
        "short": "GI upset",
        "definition": "Over last 0.5 hours.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.GI_upset",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.GI_upset.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.GI_upset.value",
        "short": "GI upset",
        "definition": "Over last 0.5 hours.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.GI_upset.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Tremor_observation_of_outstretched_hands",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Tremor_observation_of_outstretched_hands",
        "short": "Tremor observation of outstretched hands",
        "definition": "ELEMENT",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Tremor_observation_of_outstretched_hands",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Tremor_observation_of_outstretched_hands.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Tremor_observation_of_outstretched_hands.value",
        "short": "Tremor observation of outstretched hands",
        "definition": "DvOrdinal",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Tremor_observation_of_outstretched_hands.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Yawning_observation_during_assessment",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Yawning_observation_during_assessment",
        "short": "Yawning observation during assessment",
        "definition": "ELEMENT",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Yawning_observation_during_assessment",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Yawning_observation_during_assessment.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Yawning_observation_during_assessment.value",
        "short": "Yawning observation during assessment",
        "definition": "DvOrdinal",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Yawning_observation_during_assessment.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Anxiety_or_irritability",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Anxiety_or_irritability",
        "short": "Anxiety or irritability",
        "definition": "ELEMENT",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Anxiety_or_irritability",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Anxiety_or_irritability.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Anxiety_or_irritability.value",
        "short": "Anxiety or irritability",
        "definition": "DvOrdinal",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Anxiety_or_irritability.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Gooseflesh_skin",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Gooseflesh_skin",
        "short": "Gooseflesh skin",
        "definition": "ELEMENT",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Gooseflesh_skin",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Gooseflesh_skin.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Gooseflesh_skin.value",
        "short": "Gooseflesh skin",
        "definition": "DvOrdinal",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Gooseflesh_skin.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Total_score",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Total_score",
        "short": "Total score",
        "definition": "The total sum of each component parameter for COWS.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Total_score",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Total_score.value",
        "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Total_score.value",
        "short": "Total score",
        "definition": "The total sum of each component parameter for COWS.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Clinical_Opiate_Withdrawal_Scale_(COWS).Event_Series.Any_event.data.Total_score.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      }
    ]
  }
}