MII-Initiative

Medizininformatik Initiative - ImplementationGuide - Modul PRO v2026

PHQ-9 (Patient Health Questionnaire-9)

Klinischer Kontext

Der PHQ-9 ist ein validiertes Screening-Instrument für Depression mit neun Items. Das Instrument erfasst die Häufigkeit von Depressionssymptomen über einen Zeitraum von zwei Wochen auf einer vierstufigen Skala.

Scoring und Interpretation:

  • 0-4: Keine/minimale Depression
  • 5-9: Milde Depression
  • 10-14: Moderate Depression
  • 15-19: Moderat schwere Depression
  • ≥20: Schwere Depression

Klinische Hinweise: Item 9 erfasst Suizidgedanken und erfordert bei jeder positiven Antwort eine sofortige klinische Bewertung, unabhängig vom Gesamtscore.

FHIR-Implementierung

Sprachstrategie: Der PHQ-9 wird mit Englisch als Primärsprache implementiert, da die Originalversion des Instruments in Englisch verfasst ist. Deutsche Übersetzungen sind als Translations hinterlegt. Dies gewährleistet die korrekte Validierung gegen LOINC-Terminologien.

Questionnaire

Canonical URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-phq-9

Implementierte Capabilities:

  • ✅ Displayable, Collectable, Populatable, Calculatable, Extractable, Domain-aligned

Besonderheiten:

  • Automatische Score-Berechnung via FHIRPath: %resource.item.where(linkId.matches('^phq-.*-q0[1-9]$')).answer.value.ordinal().sum()
  • Populatable für server-seitige Berechnungen implementiert
  • LOINC-kodierte Antwortoptionen
Questionnaire
{
"resourceType": "Questionnaire",
"id": "mii-qst-pro-phq-9",
"meta": {
"profile": [
"https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-pr-pro-questionnaire|2026.0.1"
]
},
"language": "en",
"extension": [
{
"extension": [
{
"url": "displayable",
"valueBoolean": true
},
{
"url": "collectable",
"valueBoolean": true
},
{
"url": "populatable",
"valueBoolean": true
},
{
"url": "calculatable",
"valueBoolean": true
},
{
"url": "extractable",
"valueBoolean": true
},
{
"url": "domainAligned",
"valueBoolean": true
}
],
"url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-ex-pro-questionnaire-capabilities"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "rawScore",
"language": "text/fhirpath",
"expression": "%resource.item.where(linkId.matches('^phq-phq9-q0[1-9]$')).answer.value.ordinal().sum()"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "phq9Score",
"language": "text/fhirpath",
"expression": "%resource.item.where(linkId.matches('^phq-phq9-q0[1-9]$')).answer.value.ordinal().sum()"
}
}
],
"url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-phq-9",
"version": "2026.0.1",
"title": "MII QST PRO PHQ-9",
"status": "active",
"experimental": true,
"description": "Patient Health Questionnaire (PHQ-9)",
"code": [
{
"system": "http://loinc.org",
"code": "44249-1",
"display": "PHQ-9 quick depression assessment panel [Reported.PHQ]"
},
{
"system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-questionnaire-catalogue",
"code": "phq-phq9",
"display": "PHQ-9 Questionnaire"
}
],
"item": [
{
"linkId": "PHQ-9.Description",
"text": "Over the last two weeks, how often have you been bothered by any of the following problems?",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Wie oft fühlten Sie sich im Verlauf der letzten 2 Wochen durch die folgenden Beschwerden beeinträchtigt?"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "display"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q01').answer.value, {})"
}
}
],
"linkId": "phq-phq9-q01",
"code": [
{
"system": "http://loinc.org",
"code": "44250-9"
}
],
"prefix": "1",
"text": "Little interest or pleasure in doing things",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Wenig Interesse oder Freude an Ihren Tätigkeiten"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 0
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Überhaupt nicht"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 1
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6569-3",
"display": "Several days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An einzelnen Tagen"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 2
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6570-1",
"display": "More than half the days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An mehr als der Hälfte der Tage"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 3
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Beinahe jeden Tag"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q02').answer.value, {})"
}
}
],
"linkId": "phq-phq9-q02",
"code": [
{
"system": "http://loinc.org",
"code": "44255-8"
}
],
"prefix": "2",
"text": "Feeling down, depressed, or hopeless",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Niedergeschlagenheit, Schwermut oder Hoffnungslosigkeit"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 0
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Überhaupt nicht"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 1
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6569-3",
"display": "Several days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An einzelnen Tagen"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 2
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6570-1",
"display": "More than half the days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An mehr als der Hälfte der Tage"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 3
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Beinahe jeden Tag"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q03').answer.value, {})"
}
}
],
"linkId": "phq-phq9-q03",
"code": [
{
"system": "http://loinc.org",
"code": "44259-0"
}
],
"prefix": "3",
"text": "Trouble falling or staying asleep, or sleeping too much",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Schwierigkeiten ein- oder durchzuschlafen oder vermehrter Schlaf"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 0
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Überhaupt nicht"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 1
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6569-3",
"display": "Several days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An einzelnen Tagen"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 2
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6570-1",
"display": "More than half the days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An mehr als der Hälfte der Tage"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 3
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Beinahe jeden Tag"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q04').answer.value, {})"
}
}
],
"linkId": "phq-phq9-q04",
"code": [
{
"system": "http://loinc.org",
"code": "44254-1"
}
],
"prefix": "4",
"text": "Feeling tired or having little energy",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Müdigkeit oder Gefühl, keine Energie zu haben"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 0
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Überhaupt nicht"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 1
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6569-3",
"display": "Several days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An einzelnen Tagen"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 2
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6570-1",
"display": "More than half the days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An mehr als der Hälfte der Tage"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 3
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Beinahe jeden Tag"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q05').answer.value, {})"
}
}
],
"linkId": "phq-phq9-q05",
"code": [
{
"system": "http://loinc.org",
"code": "44251-7"
}
],
"prefix": "5",
"text": "Poor appetite or overeating",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Verminderter Appetit oder übermäßiges Bedürfnis zu essen"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 0
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Überhaupt nicht"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 1
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6569-3",
"display": "Several days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An einzelnen Tagen"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 2
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6570-1",
"display": "More than half the days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An mehr als der Hälfte der Tage"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 3
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Beinahe jeden Tag"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q06').answer.value, {})"
}
}
],
"linkId": "phq-phq9-q06",
"code": [
{
"system": "http://loinc.org",
"code": "44258-2"
}
],
"prefix": "6",
"text": "Feeling bad about yourself - or that you are a failure or have let yourself or your family down",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Schlechte Meinung von sich selbst; Gefühl, ein Versager zu sein oder die Familie enttäuscht zu haben"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 0
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Überhaupt nicht"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 1
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6569-3",
"display": "Several days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An einzelnen Tagen"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 2
}
],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6570-1",
"display": "More than half the days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An mehr als der Hälfte der Tage"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
{
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"valueDecimal": 3
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],
"valueCoding": {
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"code": "LA6571-9",
"display": "Nearly every day",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Beinahe jeden Tag"
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],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
}
]
},
{
"extension": [
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"valueExpression": {
"language": "text/fhirpath",
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}
],
"linkId": "phq-phq9-q07",
"code": [
{
"system": "http://loinc.org",
"code": "44252-5"
}
],
"prefix": "7",
"text": "Trouble concentrating on things, such as reading the newspaper or watching television",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Schwierigkeiten, sich auf etwas zu konzentrieren, z.B. beim Zeitunglesen oder Fernsehen"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "choice",
"answerOption": [
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"valueDecimal": 0
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],
"valueCoding": {
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"code": "LA6568-5",
"display": "Not at all",
"_display": {
"extension": [
{
"extension": [
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"url": "lang",
"valueCode": "de"
},
{
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"valueString": "Überhaupt nicht"
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],
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}
]
}
}
},
{
"extension": [
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"valueDecimal": 1
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],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6569-3",
"display": "Several days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "An einzelnen Tagen"
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],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
},
{
"extension": [
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"valueDecimal": 2
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],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6570-1",
"display": "More than half the days",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
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{
"url": "content",
"valueString": "An mehr als der Hälfte der Tage"
}
],
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]
}
}
},
{
"extension": [
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"valueDecimal": 3
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],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Beinahe jeden Tag"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
}
]
},
{
"extension": [
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],
"linkId": "phq-phq9-q08",
"code": [
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"code": "44253-3"
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],
"prefix": "8",
"text": "Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Waren Ihre Bewegungen oder Ihre Sprache so verlangsamt, dass es auch anderen auffallen würde? Oder waren Sie im Gegenteil 'zappelig' oder ruhelos und hatten dadurch einen stärkeren Bewegungsdrang als sonst?"
}
],
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}
]
},
"type": "choice",
"answerOption": [
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"valueCoding": {
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"code": "LA6568-5",
"display": "Not at all",
"_display": {
"extension": [
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"extension": [
{
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"valueCode": "de"
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}
},
{
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"_display": {
"extension": [
{
"extension": [
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"valueCode": "de"
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{
"url": "content",
"valueString": "An einzelnen Tagen"
}
],
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},
{
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"valueCoding": {
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"code": "LA6570-1",
"display": "More than half the days",
"_display": {
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}
},
{
"extension": [
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"valueDecimal": 3
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],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day",
"_display": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
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{
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"valueString": "Beinahe jeden Tag"
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}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q09').answer.value, {})"
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],
"linkId": "phq-phq9-q09",
"code": [
{
"system": "http://loinc.org",
"code": "44260-8"
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],
"prefix": "9",
"text": "Thoughts that you would be better off dead or of hurting yourself in some way",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Gedanken, dass Sie lieber tot wären oder sich Leid zufügen möchten"
}
],
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}
]
},
"type": "choice",
"answerOption": [
{
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],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6568-5",
"display": "Not at all",
"_display": {
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"extension": [
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}
},
{
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],
"valueCoding": {
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"code": "LA6569-3",
"display": "Several days",
"_display": {
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{
"extension": [
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"valueCode": "de"
},
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}
},
{
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],
"valueCoding": {
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"code": "LA6570-1",
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"_display": {
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],
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}
},
{
"extension": [
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],
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
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"_display": {
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"valueCode": "de"
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{
"url": "content",
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],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
}
}
}
]
},
{
"extension": [
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"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression",
"valueExpression": {
"name": "Scoreberechnung",
"language": "text/fhirpath",
"expression": "%phq9Score"
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},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationExtract",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "{score}"
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},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observation-extract-category",
"valueCodeableConcept": {
"coding": [
{
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}
],
"linkId": "phq-phq9-score-total",
"code": [
{
"system": "http://loinc.org",
"code": "44261-6",
"display": "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]"
}
],
"prefix": "Auswertung",
"text": "PHQ-9 Total Score",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
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{
"url": "content",
"valueString": "PHQ-9 Gesamtwert"
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],
"url": "http://hl7.org/fhir/StructureDefinition/translation"
}
]
},
"type": "decimal",
"readOnly": true
},
{
"extension": [
{
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"linkId": "phq-phq9-q10",
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{
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"code": "69722-7"
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],
"prefix": "10",
"text": "If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?",
"_text": {
"extension": [
{
"extension": [
{
"url": "lang",
"valueCode": "de"
},
{
"url": "content",
"valueString": "Wenn eines oder mehrere dieser Probleme bei Ihnen vorliegen, geben Sie bitte an, wie sehr diese Probleme es Ihnen erschwert haben, Ihre Arbeit zu erledigen, Ihren Haushalt zu regeln oder mit anderen Menschen zurecht zu kommen"
}
],
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},
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}
},
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}
},
{
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],
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},
{
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}
]
},
{
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{
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"code": "77861-3",
"display": "PROMIS emotional distress - depression - version 1.0 Tscore"
}
],
"prefix": "T-Score",
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}
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="mii-qst-pro-phq-9" />
<meta>
<profile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-pr-pro-questionnaire|2026.0.1" />
</meta>
<language value="en" />
<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="populatable">
<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="rawScore" />
<language value="text/fhirpath" />
<expression value="%resource.item.where(linkId.matches('^phq-phq9-q0[1-9]$')).answer.value.ordinal().sum()" />
</valueExpression>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/variable">
<valueExpression>
<name value="phq9Score" />
<language value="text/fhirpath" />
<expression value="%resource.item.where(linkId.matches('^phq-phq9-q0[1-9]$')).answer.value.ordinal().sum()" />
</valueExpression>
</extension>
<url value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-phq-9" />
<version value="2026.0.1" />
<title value="MII QST PRO PHQ-9" />
<status value="active" />
<experimental value="true" />
<description value="Patient Health Questionnaire (PHQ-9)" />
<code>
<system value="http://loinc.org" />
<code value="44249-1" />
<display value="PHQ-9 quick depression assessment panel [Reported.PHQ]" />
</code>
<code>
<system value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/CodeSystem/mii-cs-pro-questionnaire-catalogue" />
<code value="phq-phq9" />
<display value="PHQ-9 Questionnaire" />
</code>
<item>
<linkId value="PHQ-9.Description" />
<text value="Over the last two weeks, how often have you been bothered by any of the following problems?">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Wie oft fühlten Sie sich im Verlauf der letzten 2 Wochen durch die folgenden Beschwerden beeinträchtigt?" />
</extension>
</extension>
</text>
<type value="display" />
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q01').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q01" />
<code>
<system value="http://loinc.org" />
<code value="44250-9" />
</code>
<prefix value="1" />
<text value="Little interest or pleasure in doing things">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Wenig Interesse oder Freude an Ihren Tätigkeiten" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6568-5" />
<display value="Not at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6569-3" />
<display value="Several days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An einzelnen Tagen" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6570-1" />
<display value="More than half the days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An mehr als der Hälfte der Tage" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Beinahe jeden Tag" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q02').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q02" />
<code>
<system value="http://loinc.org" />
<code value="44255-8" />
</code>
<prefix value="2" />
<text value="Feeling down, depressed, or hopeless">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Niedergeschlagenheit, Schwermut oder Hoffnungslosigkeit" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6568-5" />
<display value="Not at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6569-3" />
<display value="Several days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An einzelnen Tagen" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6570-1" />
<display value="More than half the days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An mehr als der Hälfte der Tage" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Beinahe jeden Tag" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q03').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q03" />
<code>
<system value="http://loinc.org" />
<code value="44259-0" />
</code>
<prefix value="3" />
<text value="Trouble falling or staying asleep, or sleeping too much">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Schwierigkeiten ein- oder durchzuschlafen oder vermehrter Schlaf" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6568-5" />
<display value="Not at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6569-3" />
<display value="Several days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An einzelnen Tagen" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6570-1" />
<display value="More than half the days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An mehr als der Hälfte der Tage" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Beinahe jeden Tag" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q04').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q04" />
<code>
<system value="http://loinc.org" />
<code value="44254-1" />
</code>
<prefix value="4" />
<text value="Feeling tired or having little energy">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Müdigkeit oder Gefühl, keine Energie zu haben" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6568-5" />
<display value="Not at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6569-3" />
<display value="Several days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An einzelnen Tagen" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6570-1" />
<display value="More than half the days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An mehr als der Hälfte der Tage" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Beinahe jeden Tag" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q05').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q05" />
<code>
<system value="http://loinc.org" />
<code value="44251-7" />
</code>
<prefix value="5" />
<text value="Poor appetite or overeating">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Verminderter Appetit oder übermäßiges Bedürfnis zu essen" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6568-5" />
<display value="Not at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6569-3" />
<display value="Several days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An einzelnen Tagen" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6570-1" />
<display value="More than half the days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An mehr als der Hälfte der Tage" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Beinahe jeden Tag" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q06').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q06" />
<code>
<system value="http://loinc.org" />
<code value="44258-2" />
</code>
<prefix value="6" />
<text value="Feeling bad about yourself - or that you are a failure or have let yourself or your family down">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Schlechte Meinung von sich selbst; Gefühl, ein Versager zu sein oder die Familie enttäuscht zu haben" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6568-5" />
<display value="Not at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6569-3" />
<display value="Several days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An einzelnen Tagen" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6570-1" />
<display value="More than half the days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An mehr als der Hälfte der Tage" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Beinahe jeden Tag" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q07').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q07" />
<code>
<system value="http://loinc.org" />
<code value="44252-5" />
</code>
<prefix value="7" />
<text value="Trouble concentrating on things, such as reading the newspaper or watching television">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Schwierigkeiten, sich auf etwas zu konzentrieren, z.B. beim Zeitunglesen oder Fernsehen" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6568-5" />
<display value="Not at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6569-3" />
<display value="Several days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An einzelnen Tagen" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6570-1" />
<display value="More than half the days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An mehr als der Hälfte der Tage" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Beinahe jeden Tag" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q08').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q08" />
<code>
<system value="http://loinc.org" />
<code value="44253-3" />
</code>
<prefix value="8" />
<text value="Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Waren Ihre Bewegungen oder Ihre Sprache so verlangsamt, dass es auch anderen auffallen würde? Oder waren Sie im Gegenteil 'zappelig' oder ruhelos und hatten dadurch einen stärkeren Bewegungsdrang als sonst?" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6568-5" />
<display value="Not at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6569-3" />
<display value="Several days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An einzelnen Tagen" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6570-1" />
<display value="More than half the days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An mehr als der Hälfte der Tage" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Beinahe jeden Tag" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q09').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q09" />
<code>
<system value="http://loinc.org" />
<code value="44260-8" />
</code>
<prefix value="9" />
<text value="Thoughts that you would be better off dead or of hurting yourself in some way">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Gedanken, dass Sie lieber tot wären oder sich Leid zufügen möchten" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6568-5" />
<display value="Not at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6569-3" />
<display value="Several days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An einzelnen Tagen" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6570-1" />
<display value="More than half the days">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="An mehr als der Hälfte der Tage" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3" />
</extension>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Beinahe jeden Tag" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">
<valueExpression>
<name value="Scoreberechnung" />
<language value="text/fhirpath" />
<expression value="%phq9Score" />
</valueExpression>
</extension>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationExtract">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
<valueCoding>
<system value="http://unitsofmeasure.org" />
<code value="{score}" />
</valueCoding>
</extension>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observation-extract-category">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/observation-category" />
<code value="survey" />
</coding>
</valueCodeableConcept>
</extension>
<linkId value="phq-phq9-score-total" />
<code>
<system value="http://loinc.org" />
<code value="44261-6" />
<display value="Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]" />
</code>
<prefix value="Auswertung" />
<text value="PHQ-9 Total Score">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="PHQ-9 Gesamtwert" />
</extension>
</extension>
</text>
<type value="decimal" />
<readOnly value="true" />
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<language value="text/fhirpath" />
<expression value="iif(%sourceResponse.exists(), %sourceResponse.item.where(linkId='phq-phq9-q10').answer.value, {})" />
</valueExpression>
</extension>
<linkId value="phq-phq9-q10" />
<code>
<system value="http://loinc.org" />
<code value="69722-7" />
</code>
<prefix value="10" />
<text value="If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Wenn eines oder mehrere dieser Probleme bei Ihnen vorliegen, geben Sie bitte an, wie sehr diese Probleme es Ihnen erschwert haben, Ihre Arbeit zu erledigen, Ihren Haushalt zu regeln oder mit anderen Menschen zurecht zu kommen" />
</extension>
</extension>
</text>
<type value="choice" />
<answerOption>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6572-7" />
<display value="Not difficult at all">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Überhaupt nicht erschwert" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6573-5" />
<display value="Somewhat difficult">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Etwas erschwert" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6575-0" />
<display value="Very difficult">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Relativ stark erschwert" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6574-3" />
<display value="Extremely difficult">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="Sehr stark erschwert" />
</extension>
</extension>
</display>
</valueCoding>
</answerOption>
</item>
<item>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">
<valueExpression>
<name value="promis-tscore-mapping" />
<language value="text/fhirpath" />
<expression value="iif(%phq9Score = 0, 37.4, iif(%phq9Score = 1, 42.7, iif(%phq9Score = 2, 45.9, iif(%phq9Score = 3, 48.3, iif(%phq9Score = 4, 50.5, iif(%phq9Score = 5, 52.5, iif(%phq9Score = 6, 54.2, iif(%phq9Score = 7, 55.8, iif(%phq9Score = 8, 57.2, iif(%phq9Score = 9, 58.6, iif(%phq9Score = 10, 59.9, iif(%phq9Score = 11, 61.1, iif(%phq9Score = 12, 62.3, iif(%phq9Score = 13, 63.5, iif(%phq9Score = 14, 64.7, iif(%phq9Score = 15, 65.8, iif(%phq9Score = 16, 66.9, iif(%phq9Score = 17, 68.0, iif(%phq9Score = 18, 69.2, iif(%phq9Score = 19, 70.3, iif(%phq9Score = 20, 71.5, iif(%phq9Score = 21, 72.7, iif(%phq9Score = 22, 74.0, iif(%phq9Score = 23, 75.3, iif(%phq9Score = 24, 76.7, iif(%phq9Score = 25, 78.3, iif(%phq9Score = 26, 80.0, iif(%phq9Score = 27, 82.3, 82.3))))))))))))))))))))))))))))" />
</valueExpression>
</extension>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationExtract">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
<valueCoding>
<system value="http://unitsofmeasure.org" />
<code value="{score}" />
</valueCoding>
</extension>
<extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observation-extract-category">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/observation-category" />
<code value="survey" />
</coding>
</valueCodeableConcept>
</extension>
<linkId value="phq-phq9-promis-tscore" />
<code>
<system value="http://loinc.org" />
<code value="77861-3" />
<display value="PROMIS emotional distress - depression - version 1.0 Tscore" />
</code>
<prefix value="T-Score" />
<text value="PROMIS Depression T-Score (derived from PHQ-9)">
<extension url="http://hl7.org/fhir/StructureDefinition/translation">
<extension url="lang">
<valueCode value="de" />
</extension>
<extension url="content">
<valueString value="PROMIS Depression T-Score (abgeleitet von PHQ-9)" />
</extension>
</extension>
</text>
<type value="decimal" />
<readOnly value="true" />
</item>
</Questionnaire>

Score-Repräsentation

Der PHQ-9 Score wird auf mehreren Ebenen repräsentiert:

  1. Als berechnetes Item in der QuestionnaireResponse (linkId: phq9-total-score)
  2. Als Observation mit LOINC-Code 44261-6 "PHQ-9 total score"
  3. Als Domain-Score gemappt auf PROMIS Depression T-Score

ObservationDefinition: mii-obsdef-pro-phq9-score

  • Definiert Wertebereich: 0-27
  • Spezifiziert Interpretationsrichtlinien

Domain-Mapping

Der PHQ-9 kann auf PROMIS Depression T-Scores gemappt werden:

PHQ-9 Score PROMIS T-Score Interpretation
0-4 ~41.0 Minimal
5-9 ~50.0 Mild
10-14 ~60.0 Moderat
15-19 ~70.0 Moderat schwer
20-27 ~77.5 Schwer

Beispiel-Ressourcen

PHQ-9 QuestionnaireResponse

QuestionnaireResponse
{
"resourceType": "QuestionnaireResponse",
"id": "mii-exa-pro-phq-9-response",
"meta": {
"profile": [
"https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-pr-pro-questionnaire-response|2026.2.0"
]
},
"language": "de",
"questionnaire": "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-phq-9",
"status": "completed",
"subject": {
"reference": "Patient/mii-exa-pro-patient"
},
"authored": "2023-10-01T12:00:00Z",
"item": [
{
"linkId": "phq-phq9-q01",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day"
}
}
]
},
{
"linkId": "phq-phq9-q02",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day"
}
}
]
},
{
"linkId": "phq-phq9-q03",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day"
}
}
]
},
{
"linkId": "phq-phq9-q04",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day"
}
}
]
},
{
"linkId": "phq-phq9-q05",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day"
}
}
]
},
{
"linkId": "phq-phq9-q06",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day"
}
}
]
},
{
"linkId": "phq-phq9-q07",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day"
}
}
]
},
{
"linkId": "phq-phq9-q08",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day"
}
}
]
},
{
"linkId": "phq-phq9-q09",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6571-9",
"display": "Nearly every day"
}
}
]
},
{
"linkId": "phq-phq9-score-total",
"answer": [
{
"valueDecimal": 27
}
]
},
{
"linkId": "phq-phq9-q10",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6574-3",
"display": "Extremely difficult"
}
}
]
}
]
}
<QuestionnaireResponse xmlns="http://hl7.org/fhir">
<id value="mii-exa-pro-phq-9-response" />
<meta>
<profile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-pr-pro-questionnaire-response|2026.2.0" />
</meta>
<language value="de" />
<questionnaire value="https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-phq-9" />
<status value="completed" />
<subject>
<reference value="Patient/mii-exa-pro-patient" />
</subject>
<authored value="2023-10-01T12:00:00Z" />
<item>
<linkId value="phq-phq9-q01" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day" />
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq-phq9-q02" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day" />
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq-phq9-q03" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day" />
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq-phq9-q04" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day" />
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq-phq9-q05" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day" />
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq-phq9-q06" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day" />
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq-phq9-q07" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day" />
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq-phq9-q08" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day" />
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq-phq9-q09" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6571-9" />
<display value="Nearly every day" />
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq-phq9-score-total" />
<answer>
<valueDecimal value="27" />
</answer>
</item>
<item>
<linkId value="phq-phq9-q10" />
<answer>
<valueCoding>
<system value="http://loinc.org" />
<code value="LA6574-3" />
<display value="Extremely difficult" />
</valueCoding>
</answer>
</item>
</QuestionnaireResponse>

Validierung

Technisch: Score-Bereich 0-27, alle Items für validen Score erforderlich, Ordinal-Werte: 0, 1, 2, 3

Klinisch: Sensitivität 88%, Spezifität 88% für Major Depression (Cut-off ≥10), Test-Retest-Reliabilität: 0.84

Referenzen

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13.

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