Important: This is a draft IG for trial use. Click here to give feedback.

HdBe-DOSScore

WARNING This page contains a draft CBB, as raw output from the zib export and automatic conversion to CBB. It requires thorough review and adaption to the Belgian realm. This CBB is merely added for informative use.

CBB	Concept	Status
HdBe-DOSScore	De DOSS (Delirium Observatie Screening Schaal) is een hulpmiddel om te bepalen of er sprake is van een delier. De DOSS bevat 13 observaties van gedrag (verbaal en non-verbaal) die de symptomen van het delier weergeven. Deze observaties kunnen gedaan worden tijdens reguliere contacten met de patiënt. Purpose Het delier is een van de meest voorkomende vormen van psychopathologie bij oude patiënten en bij patiënten in de laatste fase van het leven. Kenmerkend voor het delier zijn het snelle ontstaan en de wisseling van de symptomen. De DOSS is bedoeld om de aard en ernst van de symptomen van een delier te kwalificeren en kwantificeren. Hierdoor kan snel een behandeling worden ingezet. De DOSS wordt gebruikt als risicosignalering en als evaluatie instrument. Evidence Base De definities van de concepten zijn gebaseerd op de DOS scorelijst.	draft

CBB

Concept

Status

HdBe-DOSScore

De DOSS (Delirium Observatie Screening Schaal) is een hulpmiddel om te bepalen of er sprake is van een delier. De DOSS bevat 13 observaties van gedrag (verbaal en non-verbaal) die de symptomen van het delier weergeven. Deze observaties kunnen gedaan worden tijdens reguliere contacten met de patiënt.

Purpose

Het delier is een van de meest voorkomende vormen van psychopathologie bij oude patiënten en bij patiënten in de laatste fase van het leven. Kenmerkend voor het delier zijn het snelle ontstaan en de wisseling van de symptomen. De DOSS is bedoeld om de aard en ernst van de symptomen van een delier te kwalificeren en kwantificeren. Hierdoor kan snel een behandeling worden ingezet. De DOSS wordt gebruikt als risicosignalering en als evaluatie instrument.

Evidence Base

De definities van de concepten zijn gebaseerd op de DOS scorelijst.

draft

DOSScore			DOSScore	Element id DOSScore Short description DOSScore Definition Rootconcept van de bouwsteen DOSScore. Dit rootconcept bevat alle gegevenselementen van de bouwsteen DOSScore. Data type DOSScore Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id DOSScore.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id DOSScore.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
DosscoreTotal		0..1	positiveInt	Element id DOSScore.DosscoreTotal Short description DOSScoreTotaal Definition Per dienst wordt een totaal score berekend (minimaal 0 en maximaal 13). De totaal scores van drie diensten (dag, late en nachtdienst) worden opgeteld tot de totaal score van deze dag (minimaal 0 en maximaal 39). De DOS schaal eindscore wordt berekend door de totaal score van deze dag te delen door 3 (minimaal 0 en maximaal 13). Een DOS schaal eindscore < 3 betekent dat de patiënt waarschijnlijk niet delirant is. Een DOS schaal eindscore > 3 betekent dat de patiënt waarschijnlijk wel delirant is. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
DosscoreDateTime		1..1	dateTime	Element id DOSScore.DosscoreDateTime Short description DOSScoreDatumTijd Definition De datum waarop de DOS score is vastgelegd. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
DozesOff		0..1	positiveInt	Element id DOSScore.DozesOff Short description ZaktWeg Definition DOS observatie: patiënt zakt weg tijdens gesprek of bezigheden. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
EasilyDistracted		0..1	positiveInt	Element id DOSScore.EasilyDistracted Short description SnelAfgeleid Definition DOS observatie: patiënt is snel afgeleid door prikkels uit de omgeving. Iemand is snel afgeleid door prikkels uit de omgeving wanneer hij/zij verbaal of nonverbaal reageert op geluiden of bewegingen die geen betrekking op hem/haar hebben en die van dien aard zijn dat je geen reactie van hem/haar zou verwachten. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
MaintainsAttention		0..1	positiveInt	Element id DOSScore.MaintainsAttention Short description HeeftAandacht Definition DOS observatie: patiënt heeft aandacht voor gesprek of handeling. Iemand heeft aandacht voor gesprek of handeling als hij /zij verbaal of nonverbaal blijk geeft het gesprek of de handeling te volgen. Score: 1: nooit 0: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
UnfinishedQuestionAnswer		0..1	positiveInt	Element id DOSScore.UnfinishedQuestionAnswer Short description VraagAntwoordNietAf Definition DOS observatie: patiënt maakt vraag of antwoord niet af. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
AnswersNoFit		0..1	positiveInt	Element id DOSScore.AnswersNoFit Short description AntwoordenNietPassend Definition DOS observatie: patiënt geeft antwoorden die niet passen bij de vraag. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
ReactsSlowly		0..1	positiveInt	Element id DOSScore.ReactsSlowly Short description ReageertTraag Definition DOS observatie: patiënt reageert traag op opdrachten. Iemand reageert traag op opdrachten wanneer het handelen is vertraagd en/of er momenten van stilte/inactiviteit zijn voordat tot handelen wordt overgegaan. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
ThinksSomewhereElse		0..1	positiveInt	Element id DOSScore.ThinksSomewhereElse Short description DenktErgensAnders Definition DOS observatie: patiënt denkt ergens anders te zijn. Iemand denkt ergens anders te zijn als hij/zij in woorden of handelen dit laat blijken. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
KnowsPartDay		0..1	positiveInt	Element id DOSScore.KnowsPartDay Short description BeseftDagdeel Definition DOS observatie: patiënt beseft wel welk dagdeel het is. Iemand beseft welk dagdeel het is als hij/zij in woorden of handelen dit laat blijken. Score: 1: nooit 0: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
RemembersRecent		0..1	positiveInt	Element id DOSScore.RemembersRecent Short description HerinnertRecent Definition DOS observatie: patiënt herinnert zich recente gebeurtenis. Iemand herinnert zich recente gebeurtenissen wanneer hij/zij bijvoorbeeld juist kan vertellen of er bezoek is geweest of wat hij/zij gegeten heeft. Score: 1: nooit 0: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Restless		0..1	positiveInt	Element id DOSScore.Restless Short description Rusteloos Definition DOS observatie: patiënt is plukkerig, rommelig, rusteloos. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
PullsWires		0..1	positiveInt	Element id DOSScore.PullsWires Short description TrektDraden Definition DOS observatie: patiënt trekt aan infuus, sonde, catheter, enz. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
EasilyEmotional		0..1	positiveInt	Element id DOSScore.EasilyEmotional Short description SnelGeemotioneerd Definition DOS observatie: patiënt is snel of plotseling geëmotioneerd. Iemand is snel of plotseling geëmotioneerd wanneer hij/zij reageert met een heftige emotie zonder aanleiding of wanneer de heftigheid van de emotie niet in overeenstemming lijkt met de aanleiding. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Hallucinations		0..1	positiveInt	Element id DOSScore.Hallucinations Short description Hallucinaties Definition DOS observatie: patiënt ziet/hoort dingen die er niet zijn. Iemand ziet/hoort dingen die er niet zijn wanneer hij/zij hiervan verbaal (navragen!) of nonverbaal blijk geeft. Score: 0: nooit 1: soms-altijd -: weet niet Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Comment		0..1	string	Element id DOSScore.Comment Short description Toelichting Definition Toelichting op de DOS score. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a

DOSScore		0..*
DOSScore.DosscoreTotal	positiveInt	0..1
DOSScore.DosscoreDateTime	dateTime	1..1
DOSScore.DozesOff	positiveInt	0..1
DOSScore.EasilyDistracted	positiveInt	0..1
DOSScore.MaintainsAttention	positiveInt	0..1
DOSScore.UnfinishedQuestionAnswer	positiveInt	0..1
DOSScore.AnswersNoFit	positiveInt	0..1
DOSScore.ReactsSlowly	positiveInt	0..1
DOSScore.ThinksSomewhereElse	positiveInt	0..1
DOSScore.KnowsPartDay	positiveInt	0..1
DOSScore.RemembersRecent	positiveInt	0..1
DOSScore.Restless	positiveInt	0..1
DOSScore.PullsWires	positiveInt	0..1
DOSScore.EasilyEmotional	positiveInt	0..1
DOSScore.Hallucinations	positiveInt	0..1
DOSScore.Comment	string	0..1

DOSScore
Definition	Root concept of the DOSScore information model. This root concept contains all data elements of the DOSScore information model.
Cardinality	0...*
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
DOSScore.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
DOSScore.DosscoreTotal
Definition	Per shift a total score is calculated (minimum 0 and maximum 13). The total scores of three shifts (day, evening and night shifts) are summed to the total score of the day (minimum 0 and maximum 39). The DOS scale final score is calculated by dividing the total score of the day by 3 (minimum 0 and maximum 13). A DOS scale final score < 3 means that the patient is probably not delirious. A DOS scale final score > 3 means that the patiënt is probably delirious.
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.DosscoreDateTime
Definition	The date on which the DOS score is registered.
Cardinality	1...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.DozesOff
Definition	DOS observation: patient dozes off during conversation or activities. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.EasilyDistracted
Definition	DOS observation: patient is easily distracted by stimuli from the environment. Someone is easily distracted by stimuli from the environment when he/she responds verbally or non-verbally to sounds or movements that have no relation to him/her and the nature of which does not make you expect a reaction from him/her. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.MaintainsAttention
Definition	DOS observation: patient maintains attention to conversation or action. Someone is maintaining attention to a conversation or action if he/she verbally or non-verbally shows that they are following the conversation or action. Score: 1: never 0: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.UnfinishedQuestionAnswer
Definition	DOS observation: patient does not finish question or answer. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.AnswersNoFit
Definition	DOS observation: patient gives answers that do not fit the question. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.ReactsSlowly
Definition	DOS observation: patient reacts slowly to instructions. Someone reacts slowly to instructions when acting is delayed and/or there are moments of stillness/inactivity before moving into action. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.ThinksSomewhereElse
Definition	DOS observation: patient thinks they are somewhere else. Someone thinks they are somewhere else when he/she shows this in words or actions. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.KnowsPartDay
Definition	DOS observation: patient knows which part of the day it is. Someone knows what part of the day it is when he/she shows such in words or actions. Score: 1: never 0: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.RemembersRecent
Definition	DOS observation: patient remembers recent events. Someone remembers recent events when he/she can for example tell whether they had visitors or what he/she ate. Score: 1: never 0: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.Restless
Definition	DOS observation: patient is picking, disorderly, restless. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.PullsWires
Definition	DOS observation: patient pulls IV tubing, feeding tubes, catheters, etc. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.EasilyEmotional
Definition	DOS observation: patient is easily or suddenly emotional. Someone is easily or suddenly emotional when he/she responds with a fierce emotion without provocation or when the fierceness of the emotion does not seem to match the provocation. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.Hallucinations
Definition	DOS observation: patient sees/hears things which are not there. Someone sees/hears things which are not there when he/she shows this verbally (ask!) or non-verbally. Score: 0: never 1: sometimes-always -: don't know
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DOSScore.Comment
Definition	Comment on the DOS score.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a

Example instances

[CBB name]
[Concept name ]	[example value]

// example of NameInformation

## Example instances

| NameInformation      |                   |
|----------------------|-------------------|
| FirstNames | Johanna Petronella Maria   
| Initials | J.P.M. 
| GivenName | Jo 
| NameUsage | Geslachtsnaam partner gevolgd door eigen geslachtsnaam
| LastName.Prefix | van
| LastName.LastName | Putten
| LastNamePartner.PartnerPrefix | van der
| LastNamePartner.PartnerLastName | Giessen
| Titles |

zib [zib name + version](https://zibs.nl/wiki/[zib name + version(release)]) difference

Concept	Category	Description
`[element.path]`	[category of change]	[Description of change]([Reference to ticket/issue/zulip chat using MarkDown link])

HdBe-DOSScore

Purpose

Evidence Base

Example instances

zib [zib name + version](https://zibs.nl/wiki/[zib name + version(release)]) difference

Terminology Bindings