{
  "resourceType": "StructureDefinition",
  "id": "logicalmodel-Saraataxiascale-R4",
  "url": "http://linkehr.com/fhir/logicalmodel-saraataxiascale-R4",
  "identifier": [
    {
      "system": "openEHR-CKM",
      "value": "openEHR-EHR-OBSERVATION.sara_scale.v0"
    }
  ],
  "version": "0",
  "name": "Saraataxiascale",
  "title": "SARA ataxia scale",
  "status": "draft",
  "date": "2024-06-18",
  "publisher": "openEHR",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.veratech.es"
        }
      ]
    }
  ],
  "description": "Scale for the assessment and rating of ataxia.",
  "purpose": "SARA is a clinical scale that is based on a semiquantitative assessment of cerebellar ataxia on an impairment level. SARA has 8 items that are related to gait, stance, sitting, speech, finger-chase test, nose-finger test, fast alternating movements and heel-shin test. Although the cerebellum is directly involved in the coordination of eye movements, oculomotor functions are not considered, as the validation trials indicated that they are determined by other factors than appendicular and midline ataxia. SARA underwent a rigorous validation procedure involving three large multi-center trials in SCA and non-SCA ataxia patients, as well as controls.",
  "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": {
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        "id": "SARA_ataxia_scale",
        "path": "SARA_ataxia_scale",
        "short": "SARA ataxia scale",
        "definition": "Scale for the assessment and rating of ataxia.",
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        "short": "Tree",
        "definition": "@ internal @",
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        "max": "1",
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        "id": "SARA_ataxia_scale.protocol.Extension",
        "path": "SARA_ataxia_scale.protocol.Extension",
        "short": "Extension",
        "definition": "Additional information required to capture local context or to align with other reference models/formalisms.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "SARA_ataxia_scale.protocol.Extension",
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        "id": "SARA_ataxia_scale.Event_Series.Point_in_time",
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        "short": "3. Sitting",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.3__Sitting.value",
        "short": "3. Sitting",
        "definition": "Assessment of sitting.",
        "min": 0,
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.4__Speech_disturbance",
        "short": "4. Speech disturbance",
        "definition": "Assessment of speech.",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.4__Speech_disturbance.value",
        "short": "4. Speech disturbance",
        "definition": "Assessment of speech.",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.5L__Finger_chase_left",
        "short": "5L. Finger chase left",
        "definition": "Assessment of ability to follow movements with left index finger.",
        "min": 0,
        "max": "1",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.5L__Finger_chase_left.value",
        "short": "5L. Finger chase left",
        "definition": "Assessment of ability to follow movements with left index finger.",
        "min": 0,
        "max": "1",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.5R__Finger_chase_right",
        "short": "5R. Finger chase right",
        "definition": "Assessment of ability to follow movements with right index finger.",
        "min": 0,
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.5R__Finger_chase_right.value",
        "short": "5R. Finger chase right",
        "definition": "Assessment of ability to follow movements with right index finger.",
        "min": 0,
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        "base": {
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.5__Finger_chase_mean_score",
        "short": "5. Finger chase mean score",
        "definition": "Mean score for both sides of finger chase assessment.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.5__Finger_chase_mean_score",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.5__Finger_chase_mean_score.value",
        "short": "5. Finger chase mean score",
        "definition": "Mean score for both sides of finger chase assessment.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.5__Finger_chase_mean_score.value",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6L__Nose_finger_test_left",
        "short": "6L. Nose-finger test left",
        "definition": "Assessment of ability to point with left index finger from proband's nose to examiner's finger.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6L__Nose_finger_test_left",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6L__Nose_finger_test_left.value",
        "short": "6L. Nose-finger test left",
        "definition": "Assessment of ability to point with left index finger from proband's nose to examiner's finger.",
        "min": 0,
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        "base": {
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6R__Nose_finger_test_right",
        "short": "6R. Nose-finger test right",
        "definition": "Assessment of ability to point with right index finger from proband's nose to examiner's finger.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6R__Nose_finger_test_right",
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        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6R__Nose_finger_test_right.value",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6R__Nose_finger_test_right.value",
        "short": "6R. Nose-finger test right",
        "definition": "Assessment of ability to point with right index finger from proband's nose to examiner's finger.",
        "min": 0,
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6__Nose_finger_test_mean_score",
        "short": "6. Nose-finger test mean score",
        "definition": "Mean score for both sides of nose-finger test.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6__Nose_finger_test_mean_score",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6__Nose_finger_test_mean_score.value",
        "short": "6. Nose-finger test mean score",
        "definition": "Mean score for both sides of nose-finger test.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.6__Nose_finger_test_mean_score.value",
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        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7L__Fast_alternating_hand_movements_left",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7L__Fast_alternating_hand_movements_left",
        "short": "7L. Fast alternating hand movements left",
        "definition": "Assessment of ability to perform fast alternating left hand movements.",
        "min": 0,
        "max": "1",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7L__Fast_alternating_hand_movements_left.value",
        "short": "7L. Fast alternating hand movements left",
        "definition": "Assessment of ability to perform fast alternating left hand movements.",
        "min": 0,
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          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7L__Fast_alternating_hand_movements_left.value",
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        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7R__Fast_alternating_hand_movements_right",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7R__Fast_alternating_hand_movements_right",
        "short": "7R. Fast alternating hand movements right",
        "definition": "Assessment of ability to perform fast alternating left hand movements.",
        "min": 0,
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          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7R__Fast_alternating_hand_movements_right",
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7R__Fast_alternating_hand_movements_right.value",
        "short": "7R. Fast alternating hand movements right",
        "definition": "Assessment of ability to perform fast alternating left hand movements.",
        "min": 0,
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7__Fast_alternating_hand_movements_mean_score",
        "short": "7. Fast alternating hand movements mean score",
        "definition": "Mean score for both sides of the fast alternating hand movements test.",
        "min": 0,
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        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.7__Fast_alternating_hand_movements_mean_score.value",
        "short": "7. Fast alternating hand movements mean score",
        "definition": "Mean score for both sides of the fast alternating hand movements test.",
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      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8L__Heel_shin_slide_left",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8L__Heel_shin_slide_left",
        "short": "8L. Heel-shin slide left",
        "definition": "Assessment of ability to perform heel-shin slide with the left leg.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8L__Heel_shin_slide_left",
          "min": 0,
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      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8L__Heel_shin_slide_left.value",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8L__Heel_shin_slide_left.value",
        "short": "8L. Heel-shin slide left",
        "definition": "Assessment of ability to perform heel-shin slide with the left leg.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8L__Heel_shin_slide_left.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8R__Heel_shin_slide_right",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8R__Heel_shin_slide_right",
        "short": "8R. Heel-shin slide right",
        "definition": "Assessment of ability to perform heel-shin slide with the right leg.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8R__Heel_shin_slide_right",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8R__Heel_shin_slide_right.value",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8R__Heel_shin_slide_right.value",
        "short": "8R. Heel-shin slide right",
        "definition": "Assessment of ability to perform heel-shin slide with the right leg.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8R__Heel_shin_slide_right.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8__Heel_shin_slide_mean_score",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8__Heel_shin_slide_mean_score",
        "short": "8. Heel-shin slide mean score",
        "definition": "Mean score for heel-shin slide assessment on both sides.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8__Heel_shin_slide_mean_score",
          "min": 0,
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      },
      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8__Heel_shin_slide_mean_score.value",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8__Heel_shin_slide_mean_score.value",
        "short": "8. Heel-shin slide mean score",
        "definition": "Mean score for heel-shin slide assessment on both sides.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.8__Heel_shin_slide_mean_score.value",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.Total_score",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.Total_score",
        "short": "Total score",
        "definition": "Total score obtained from the sum of the individual scores for 1. to 4. and the sum of the mean scores for 5. to 8.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.Total_score",
          "min": 0,
          "max": "1"
        }
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        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.data.Total_score.value",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.Total_score.value",
        "short": "Total score",
        "definition": "Total score obtained from the sum of the individual scores for 1. to 4. and the sum of the mean scores for 5. to 8.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.data.Total_score.value",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.state",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.state",
        "short": "Tree",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.state",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.state.Confounding_factors",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.state.Confounding_factors",
        "short": "Confounding factors",
        "definition": "Record any issues or factors that may impact on the use of the scale and the overall score.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.state.Confounding_factors",
          "min": 0,
          "max": "*"
        }
      },
      {
        "id": "SARA_ataxia_scale.Event_Series.Point_in_time.state.Confounding_factors.value",
        "path": "SARA_ataxia_scale.Event_Series.Point_in_time.state.Confounding_factors.value",
        "short": "Confounding factors",
        "definition": "Record any issues or factors that may impact on the use of the scale and the overall score.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "SARA_ataxia_scale.Event_Series.Point_in_time.state.Confounding_factors.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      }
    ]
  }
}