<status value="draft" /> <publisher value="Nictiz" /> <contact> <name value="Nictiz" /> <telecom> <system value="url" /> <value value="https://www.nictiz.nl" /> <use value="work" /> </telecom> </contact> <description value="The pain score is a general measurement for pain experience, not a description of specific, localized pain. The following are used as an easily reproducible measurement for pain experience: NRS (Numeric Rating Scale) in which the patient gives the pain a number on a scale of 1 (no pain) to 10 (unbearable pain). VAS (Visual Analogue Score), in which the patient points to a bar with a line to indicate the pain they feel. The back of the bar has a scale from 0 (no pain) to 10 (unbearable pain) on it. The results of both scores have the same meaning, but the visual analogue method (VAS) is seen as more reliable than the NRS pain score." /> <purpose value="This Observation resource represents the Dutch [zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) PainScore v4.0 (2020)](https://zibs.nl/wiki/PainScore-v4.0(2020EN))." /> <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." /> <fhirVersion value="4.0.1" /> <mapping> <identity value="zib-painscore-v4.0-2020EN" /> <uri value="https://zibs.nl/wiki/PainScore-v4.0(2020EN)" /> <name value="zib PainScore-v4.0(2020EN)" /> </mapping> <kind value="resource" /> <abstract value="true" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Observation" /> <derivation value="constraint" /> <differential> <element id="Observation"> <path value="Observation" /> <short value="PainScore" /> <alias value="PijnScore" /> <constraint> <key value="zib-PainScore-1" /> <severity value="error" /> <human value="The maximum value is 10 if method is VAS10 or NRS, or 100 if method is VAS100" /> <expression value="(method.coding.code in ('VAS10' | 'NRS') implies value <= 10) and (method.coding.code = 'VAS100' implies value <= 100)" /> </constraint> <constraint> <key value="zib-PainScore-2" /> <severity value="error" /> <human value="The minimum value is 0" /> <expression value="value >= 0" /> </constraint> <mapping> <identity value="zib-painscore-v4.0-2020EN" /> <map value="NL-CM:12.9.1" /> <comment value="PainScore" /> </mapping> </element> <element id="Observation.code"> <path value="Observation.code" /> <patternCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="225908003" /> </coding> </patternCodeableConcept> </element> <element id="Observation.effective[x]"> <path value="Observation.effective[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Observation.effective[x]:effectiveDateTime"> <path value="Observation.effective[x]" /> <sliceName value="effectiveDateTime" /> <short value="PainScoreDateTime" /> <definition value="The date and time at which the pain score was measured." /> <alias value="PijnscoreDatumTijd" /> <type> <code value="dateTime" /> </type> <mapping> <identity value="zib-painscore-v4.0-2020EN" /> <map value="NL-CM:12.9.3" /> <comment value="PainScoreDateTime" /> </mapping> </element> <element id="Observation.value[x]"> <path value="Observation.value[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Observation.value[x]:valueInteger"> <path value="Observation.value[x]" /> <sliceName value="valueInteger" /> <short value="PainScoreValue" /> <definition value="The score is a general measurement of pain experience, not a description of specific, localized pain. Depending on the measuring method used, it indicates the level of pain experienced by the patient on a scale of 0 to 10: 0 = no pain and 10 = the worst pain imaginable. No descriptions are used for the intermediate values, so that the value is displayed as a number and not as a code. Sometimes a value range of 0-100 is used instead of 0-10." /> <alias value="PijnscoreWaarde" /> <type> <code value="integer" /> </type> <condition value="zib-PainScore-1" /> <condition value="zib-PainScore-2" /> <mapping> <identity value="zib-painscore-v4.0-2020EN" /> <map value="NL-CM:12.9.2" /> <comment value="PainScoreValue" /> </mapping> </element> <element id="Observation.note"> <path value="Observation.note" /> <max value="1" /> </element> <element id="Observation.note.text"> <path value="Observation.note.text" /> <short value="Comment" /> <definition value="Comment on the pain score measurement, including comments on for example the circumstances and/or disruptive factors that may influence the result." /> <alias value="Toelichting" /> <mapping> <identity value="zib-painscore-v4.0-2020EN" /> <map value="NL-CM:12.9.5" /> <comment value="Comment" /> </mapping> </element> <element id="Observation.method"> <path value="Observation.method" /> <short value="PainMeasuringMethod" /> <definition value="The measuring method describes the method used to determine the pain score. The measurement involves a visualization of the pain scale." /> <comment value="PijnMeetmethodeCodelijst uses codes from a custom code system. Although more standardized LOINC codes are available for VAS and NRS, these are about the *result* of the measurement (as determined by the method) rather than the method itself, and thus are not suitable as a drop-in replacement (they should be used on `Observation.code` rather than `Observation.method`). In future versions of the zib, the data model may be redesigned to adopt these standardized codes. See [ZIB-2199](https://nictiz.atlassian.net/browse/ZIB-2199) for more information." /> <alias value="PijnMeetmethode" /> <condition value="zib-PainScore-1" /> <condition value="zib-PainScore-2" /> <binding> <strength value="required" /> <valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.12.9.1--20200901000000" /> </binding> <mapping> <identity value="zib-painscore-v4.0-2020EN" /> <map value="NL-CM:12.9.4" /> <comment value="PainMeasuringMethod" /> </mapping> </element> </differential> </StructureDefinition>

No narrative is provided for definitional resources. A human-readable rendering can be found in the implementation guide(s) where this resource is used.