Medizininformatik Initiative - ImplementationGuide - Modul PRO v2026
MIDOS2 (Minimales Dokumentationssystem für Palliativpatienten)
Überblick
Das Minimale Dokumentationssystem für Palliativpatienten (MIDOS2) ist ein etabliertes deutsches Symptom-Screening-Instrument für die Palliativmedizin. Es wurde von der Deutschen Gesellschaft für Palliativmedizin (DGP) als deutsche Adaption des Edmonton Symptom Assessment System (ESAS, Bruera et al. 1991) entwickelt und durch Stiel et al. (2010, 2012) validiert und weiterentwickelt.
Grundlegende Eigenschaften:
- 13 Items: 11 Symptom-Items + 1 Wohlbefinden-Item + 1 Freitext für sonstige Beschwerden
- Antwortskala: 4-stufige DGP-Skala für Symptome (keine / leichte / mittlere / starke), separate 4-stufige Skala für Wohlbefinden
- Zeitbezug: Aktuell (letzte Tage)
- Lizenz: DGP, frei für klinische und Forschungszwecke
- Validierung (DE): Stiel et al. 2010, 2012
- Administration: 2-5 Minuten
Ressourcen in Simplifier:
| Questionnaire |
| id : mii-qst-pro-midos-midos2 |
| meta |
| profile : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-pr-pro-questionnaire|2027.0.0-ballot.1 |
| language : de |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm |
| value |
| system : http://hl7.org/fhir/version-algorithm |
| code : natural |
| display : Natural |
| extension |
| extension |
| url : displayable |
| value : True |
| extension |
| url : collectable |
| value : True |
| extension |
| url : calculatable |
| value : True |
| extension |
| url : extractable |
| value : True |
| extension |
| url : domainAligned |
| value : True |
| url : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-ex-pro-questionnaire-capabilities |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/variable |
| value |
| name : symptomSumScore |
| language : text/fhirpath |
| expression : %resource.item.where(linkId.matches('^midos2-q(0[1-9]|1[01])-')).answer.value.weight().sum() |
| url : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-midos-midos2 |
| version : 2027.0.0-ballot.1 |
| name : MII_QST_PRO_MIDOS_MIDOS2 |
| title : MII QST PRO MIDOS2 |
| status : draft |
| experimental : True |
| publisher : Medizininformatik-Initiative |
| description : MIDOS2 (Minimales Dokumentationssystem für Palliativpatienten, v2) — Symptom-Screening für die Palliativmedizin nach DGP. 11 Symptom-Items mit 4-stufiger DGP-Skala, ein Wohlbefinden-Item, ein offenes Item für sonstige Beschwerden. |
| copyright : MIDOS2 ist ein Instrument der Deutschen Gesellschaft für Palliativmedizin (DGP), frei verwendbar für klinische und Forschungszwecke. |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-questionnaire-catalogue |
| code : midos-midos2 |
| display : MIDOS2 (Minimales Dokumentationssystem für Palliativpatienten, DGP) |
| item |
| linkId : midos2-instruction |
| text : Bitte geben Sie an, wie stark Sie in den letzten Tagen unter folgenden Beschwerden gelitten haben. |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Please indicate how severely you have suffered from the following complaints over the past few days. |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : display |
| item |
| linkId : midos2-q01-schmerz |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q01-schmerz |
| prefix : 1 |
| text : Schmerz |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Pain |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q02-uebelkeit |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q02-uebelkeit |
| prefix : 2 |
| text : Übelkeit |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Nausea |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q03-erbrechen |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q03-erbrechen |
| prefix : 3 |
| text : Erbrechen |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Vomiting |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q04-luftnot |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q04-luftnot |
| prefix : 4 |
| text : Luftnot |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Shortness of breath |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q05-verstopfung |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q05-verstopfung |
| prefix : 5 |
| text : Verstopfung |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Constipation |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q06-schwaeche |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q06-schwaeche |
| prefix : 6 |
| text : Schwäche |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Weakness |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q07-muedigkeit |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q07-muedigkeit |
| prefix : 7 |
| text : Müdigkeit |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Tiredness |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q08-appetitmangel |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q08-appetitmangel |
| prefix : 8 |
| text : Appetitmangel |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Loss of appetite |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q09-depressivitaet |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q09-depressivitaet |
| prefix : 9 |
| text : Depressivität |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Depression |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q10-angst |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q10-angst |
| prefix : 10 |
| text : Angst |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Anxiety |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q11-anspannung |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q11-anspannung |
| prefix : 11 |
| text : Anspannung |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Tension |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity |
| item |
| linkId : midos2-q12-wohlbefinden |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q12-wohlbefinden |
| prefix : 12 |
| text : Wie würden Sie Ihr Wohlbefinden insgesamt einschätzen? |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : How would you rate your overall wellbeing? |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : choice |
| required : True |
| answerValueSet : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-wellbeing |
| item |
| linkId : midos2-q13-sonstiges |
| code |
| system : https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2 |
| code : midos2-q13-sonstiges |
| prefix : 13 |
| text : Andere Beschwerden (bitte angeben) |
| extension |
| extension |
| url : lang |
| value : en |
| extension |
| url : content |
| value : Other complaints (please specify) |
| url : http://hl7.org/fhir/StructureDefinition/translation |
| type : string |
| required : False |
{
"resourceType": "Questionnaire",
"id": "mii-qst-pro-midos-midos2",
"meta": {
"profile": [
"https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-pr-pro-questionnaire|2027.0.0-ballot.1"
]
},
"language": "de",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm",
"valueCoding": {
"system": "http://hl7.org/fhir/version-algorithm",
"code": "natural",
"display": "Natural"
}
},
{
"extension": [
{
"url": "displayable",
"valueBoolean": true
},
{
"url": "collectable",
"valueBoolean": true
},
{
"url": "calculatable",
"valueBoolean": true
},
{
"url": "extractable",
"valueBoolean": true
},
{
"url": "domainAligned",
"valueBoolean": true
}
],
"url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-ex-pro-questionnaire-capabilities"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "symptomSumScore",
"language": "text/fhirpath",
"expression": "%resource.item.where(linkId.matches('^midos2-q(0[1-9]|1[01])-')).answer.value.weight().sum()"
}
}
],
"url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-midos-midos2",
"version": "2027.0.0-ballot.1",
"name": "MII_QST_PRO_MIDOS_MIDOS2",
"title": "MII QST PRO MIDOS2",
"status": "draft",
"experimental": true,
"publisher": "Medizininformatik-Initiative",
"description": "MIDOS2 (Minimales Dokumentationssystem für Palliativpatienten, v2) — Symptom-Screening für die Palliativmedizin nach DGP. 11 Symptom-Items mit 4-stufiger DGP-Skala, ein Wohlbefinden-Item, ein offenes Item für sonstige Beschwerden.",
"copyright": "MIDOS2 ist ein Instrument der Deutschen Gesellschaft für Palliativmedizin (DGP), frei verwendbar für klinische und Forschungszwecke.",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-questionnaire-catalogue",
"code": "midos-midos2",
"display": "MIDOS2 (Minimales Dokumentationssystem für Palliativpatienten, DGP)"
}
],
"item": [
{
"linkId": "midos2-instruction",
"text": "Bitte geben Sie an, wie stark Sie in den letzten Tagen unter folgenden Beschwerden gelitten haben.",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Please indicate how severely you have suffered from the following complaints over the past few days."
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "display"
},
{
"linkId": "midos2-q01-schmerz",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q01-schmerz"
}
],
"prefix": "1",
"text": "Schmerz",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Pain"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q02-uebelkeit",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q02-uebelkeit"
}
],
"prefix": "2",
"text": "Übelkeit",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Nausea"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q03-erbrechen",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q03-erbrechen"
}
],
"prefix": "3",
"text": "Erbrechen",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Vomiting"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q04-luftnot",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q04-luftnot"
}
],
"prefix": "4",
"text": "Luftnot",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Shortness of breath"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q05-verstopfung",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q05-verstopfung"
}
],
"prefix": "5",
"text": "Verstopfung",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Constipation"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q06-schwaeche",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q06-schwaeche"
}
],
"prefix": "6",
"text": "Schwäche",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Weakness"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q07-muedigkeit",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q07-muedigkeit"
}
],
"prefix": "7",
"text": "Müdigkeit",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Tiredness"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q08-appetitmangel",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q08-appetitmangel"
}
],
"prefix": "8",
"text": "Appetitmangel",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Loss of appetite"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q09-depressivitaet",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q09-depressivitaet"
}
],
"prefix": "9",
"text": "Depressivität",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Depression"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q10-angst",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q10-angst"
}
],
"prefix": "10",
"text": "Angst",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Anxiety"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q11-anspannung",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q11-anspannung"
}
],
"prefix": "11",
"text": "Anspannung",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Tension"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity"
},
{
"linkId": "midos2-q12-wohlbefinden",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q12-wohlbefinden"
}
],
"prefix": "12",
"text": "Wie würden Sie Ihr Wohlbefinden insgesamt einschätzen?",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "How would you rate your overall wellbeing?"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"required": true,
"answerValueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-wellbeing"
},
{
"linkId": "midos2-q13-sonstiges",
"code": [
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2",
"code": "midos2-q13-sonstiges"
}
],
"prefix": "13",
"text": "Andere Beschwerden (bitte angeben)",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "en"
},
{
"url": "content",
"valueString": "Other complaints (please specify)"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "string",
"required": false
}
]
}
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="mii-qst-pro-midos-midos2" />
<meta>
<profile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-pr-pro-questionnaire|2027.0.0-ballot.1" />
</meta>
<language value="de" />
<extension url="http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm">
<valueCoding>
<system value="http://hl7.org/fhir/version-algorithm" />
<code value="natural" />
<display value="Natural" />
</valueCoding>
</extension>
<extension url="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-ex-pro-questionnaire-capabilities">
<extension url="displayable">
<valueBoolean value="true" />
</extension>
<extension url="collectable">
<valueBoolean value="true" />
</extension>
<extension url="calculatable">
<valueBoolean value="true" />
</extension>
<extension url="extractable">
<valueBoolean value="true" />
</extension>
<extension url="domainAligned">
<valueBoolean value="true" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/variable">
<valueExpression>
<name value="symptomSumScore" />
<language value="text/fhirpath" />
<expression value="%resource.item.where(linkId.matches('^midos2-q(0[1-9]|1[01])-')).answer.value.weight().sum()" />
</valueExpression>
</extension>
<url value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-midos-midos2" />
<version value="2027.0.0-ballot.1" />
<name value="MII_QST_PRO_MIDOS_MIDOS2" />
<title value="MII QST PRO MIDOS2" />
<status value="draft" />
<experimental value="true" />
<publisher value="Medizininformatik-Initiative" />
<description value="MIDOS2 (Minimales Dokumentationssystem für Palliativpatienten, v2) — Symptom-Screening für die Palliativmedizin nach DGP. 11 Symptom-Items mit 4-stufiger DGP-Skala, ein Wohlbefinden-Item, ein offenes Item für sonstige Beschwerden." />
<copyright value="MIDOS2 ist ein Instrument der Deutschen Gesellschaft für Palliativmedizin (DGP), frei verwendbar für klinische und Forschungszwecke." />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-questionnaire-catalogue" />
<code value="midos-midos2" />
<display value="MIDOS2 (Minimales Dokumentationssystem für Palliativpatienten, DGP)" />
</code>
<item>
<linkId value="midos2-instruction" />
<text value="Bitte geben Sie an, wie stark Sie in den letzten Tagen unter folgenden Beschwerden gelitten haben.">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Please indicate how severely you have suffered from the following complaints over the past few days." />
</extension>
</extension>
</text>
<type value="display" />
</item>
<item>
<linkId value="midos2-q01-schmerz" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q01-schmerz" />
</code>
<prefix value="1" />
<text value="Schmerz">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Pain" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q02-uebelkeit" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q02-uebelkeit" />
</code>
<prefix value="2" />
<text value="Übelkeit">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Nausea" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q03-erbrechen" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q03-erbrechen" />
</code>
<prefix value="3" />
<text value="Erbrechen">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Vomiting" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q04-luftnot" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q04-luftnot" />
</code>
<prefix value="4" />
<text value="Luftnot">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Shortness of breath" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q05-verstopfung" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q05-verstopfung" />
</code>
<prefix value="5" />
<text value="Verstopfung">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Constipation" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q06-schwaeche" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q06-schwaeche" />
</code>
<prefix value="6" />
<text value="Schwäche">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Weakness" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q07-muedigkeit" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q07-muedigkeit" />
</code>
<prefix value="7" />
<text value="Müdigkeit">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Tiredness" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q08-appetitmangel" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q08-appetitmangel" />
</code>
<prefix value="8" />
<text value="Appetitmangel">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Loss of appetite" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q09-depressivitaet" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q09-depressivitaet" />
</code>
<prefix value="9" />
<text value="Depressivität">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Depression" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q10-angst" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q10-angst" />
</code>
<prefix value="10" />
<text value="Angst">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Anxiety" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q11-anspannung" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q11-anspannung" />
</code>
<prefix value="11" />
<text value="Anspannung">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Tension" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-severity" />
</item>
<item>
<linkId value="midos2-q12-wohlbefinden" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q12-wohlbefinden" />
</code>
<prefix value="12" />
<text value="Wie würden Sie Ihr Wohlbefinden insgesamt einschätzen?">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="How would you rate your overall wellbeing?" />
</extension>
</extension>
</text>
<type value="choice" />
<required value="true" />
<answerValueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ValueSet/mii-vs-pro-midos2-wellbeing" />
</item>
<item>
<linkId value="midos2-q13-sonstiges" />
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-midos2" />
<code value="midos2-q13-sonstiges" />
</code>
<prefix value="13" />
<text value="Andere Beschwerden (bitte angeben)">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="en" />
</extension>
<extension url="content">
<valueString value="Other complaints (please specify)" />
</extension>
</extension>
</text>
<type value="string" />
<required value="false" />
</item>
</Questionnaire>
Fragebogenstruktur
Symptom-Skala (4-stufig)
| Wert | Deutsch | Englisch |
|---|---|---|
| 0 | keine | none |
| 1 | leichte | mild |
| 2 | mittlere | moderate |
| 3 | starke | severe |
Wohlbefinden-Skala (4-stufig)
| Wert | Deutsch | Englisch |
|---|---|---|
| 0 | sehr gut | very good |
| 1 | eher gut | rather good |
| 2 | eher schlecht | rather poor |
| 3 | sehr schlecht | very poor |
Symptom-Items
| # | Symptom | SNOMED CT (Kandidat) |
|---|---|---|
| 1 | Schmerz | 22253000 |Pain (finding)| |
| 2 | Übelkeit | 422587007 |Nausea (finding)| |
| 3 | Erbrechen | 422400008 |Vomiting (disorder)| |
| 4 | Luftnot | 267036007 |Dyspnea (finding)| |
| 5 | Verstopfung | 14760008 |Constipation (finding)| |
| 6 | Schwäche | zu verifizieren |
| 7 | Müdigkeit | 84229001 |Fatigue (finding)| |
| 8 | Appetitmangel | 79890006 |Loss of appetite (finding)| |
| 9 | Depressivität | 35489007 |Depressed mood (finding)| |
| 10 | Angst | 48694002 |Anxiety (finding)| |
| 11 | Anspannung | zu verifizieren |
| 12 | Wohlbefinden gesamt | — |
| 13 | Andere Beschwerden (freitext) | — |
SNOMED-Kandidaten sind Stand der Recherche und müssen via Terminologieserver-Validierung bestätigt werden.
Score-Berechnung
Symptom-Summen-Score
Summe der 11 Symptom-Items (jeweils 0-3), Wertebereich 0-33:
symptomSumScore = Summe(Item 1..11) ∈ [0, 33]
Höhere Werte indizieren stärkere Symptomlast.
Wohlbefinden-Score
Einzelnes Item, Wertebereich 0-3 — wird nicht in den Summen-Score eingerechnet, sondern separat als globale Lebensqualitäts-Komponente berichtet.
Verhältnis zum PRO-CTCAE Onkologischen Basisscreening
MIDOS2 und das PRO-CTCAE Onkologische Basisscreening bilden konzeptuell dieselbe Symptomliste ab — mit unterschiedlicher Granularität der Antwortskalen:
| Aspekt | MIDOS2 | Onkologisches Basisscreening |
|---|---|---|
| Skalenformat | 4-stufig (DGP) | 5-stufig (PRO-CTCAE) |
| Items pro Symptom | 1 (Severity) | 1-3 (Frequency/Severity/Interference) |
| Zielgruppe | Palliativmedizin | Onkologie |
| Authority | DGP | DKG (Symptomauswahl) + NCI (Items) |
Eine ConceptMap zwischen den Antwortskalen ist für eine spätere Iteration vorgesehen.
FHIR-Implementierung
Sprachstrategie: Deutsch als Primärsprache, Englisch als Translation. MIDOS2 ist ein originär deutsches Instrument.
Terminologie-Strategie: MII-kontrollierte Antwort-Codes (eigene CodeSystem). Symptom-Items mit SNOMED-Property für externe Interoperabilität.
Questionnaire
Canonical URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-midos-midos2
Implementierte Capabilities:
- Displayable, Collectable, Calculatable, Extractable, Domain-aligned
CodeSystem und ValueSets
CodeSystem: mii-cs-pro-midos2 — Item-Codes und beide Antwortskalen mit deutschen Primärtexten und englischen Translations
ValueSets:
mii-vs-pro-midos2-severity— DGP-Symptom-Skalamii-vs-pro-midos2-wellbeing— Wohlbefinden-Skala
Score-Berechnung (FHIRPath)
// FHIR Variable: symptomSumScore
%resource.item.where(linkId.matches('^midos2-q(0[1-9]|1[01])-')).answer.value.ordinal().sum()
Literatur
Stiel S, Pollok A, Elsner F, et al. (2012) Validation of the Symptom and Problem Checklist of the German Hospice and Palliative Care Evaluation (HOPE) Schmerz. (DOI 10.1007/s00482-011-1124-7)
Stiel S, Matthes ME, Bertram L, et al. (2010) Evaluation und Weiterentwicklung der Minimal Documentation System (MIDOS) Schmerz. 24(4):416-424 (DOI 10.1007/s00482-010-0972-5)
Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. (1991) The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients Journal of Palliative Care. 7(2):6-9 (PMID 1714502)
Hui D, Bruera E. (2017) The Edmonton Symptom Assessment System 25 Years Later: Past, Present, and Future Developments Journal of Pain and Symptom Management. 53(3):630-643 (DOI 10.1016/j.jpainsymman.2016.10.370)
Status: Diese Implementierung ist als
draftundexperimentalmarkiert. Die Quellverifikation gegen Stiel et al. 2010/2012 ist Teil von Beadkerndatensatzmodul-proms-5jdund steht aus.