{
  "resourceType": "StructureDefinition",
  "id": "zib-SNAQrcScore",
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-SNAQrcScore",
  "version": "1.0.3",
  "name": "Zib SNAQrcScore",
  "title": "HCIM SNAQrcScore",
  "status": "active",
  "publisher": "Nictiz",
  "contact": [
    {
      "name": "Nictiz",
      "telecom": [
        {
          "system": "url",
          "value": "https://www.nictiz.nl",
          "use": "work"
        }
      ]
    }
  ],
  "description": "A Observation resource as defined by the Dutch HCIM SNAQrcScore-v1.0(2017EN). The Short Nutritional Assessment Questionnaire for Residential Care (SNAQ rc is a (validated) measuring tool for determining the extent of a patient’s malnutrition. The tool comprises three questions, each of which is assigned a score. The total score determines the extent of malnutrition. The SNAQrc helps to recognize and treat malnutrition at an early stage. Four varieties of the measuring tool were developed for different care settings: hospitals (adults and children), nursing and retirement homes and independently living seniors. This concept describes the tool intended for the nursing and retirement homes setting.",
  "purpose": "#Purpose\r\nThe SNAQrcscore is used to determine the extent of malnutrition or the risk of malnutrition. To treat malnutrition quickly and effectively, it is important to identify the malnutrition at an early stage.\r\n\r\n#Rationale\r\nHL7 uses observations for defining scores like APGAR, to stay consistent, Nictiz chose to the Observation resource too.",
  "copyright": "CC0",
  "fhirVersion": "3.0.2",
  "mapping": [
    {
      "identity": "hcim-SNAQrcScore-v1.0-2017EN",
      "uri": "https://zibs.nl/wiki/SNAQrcScore-v1.0(2017EN)",
      "name": "SNAQrcScore-v1.0(2017EN)"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://fhir.nl/fhir/StructureDefinition/nl-core-observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "short": "SNAQrcScore",
        "alias": [
          "SNAQrcScore"
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQrcScore-v1.0-2017EN",
            "map": "NL-CM:4.29.1",
            "comment": "SNAQrcScore"
          }
        ]
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.code.coding:SNAQrcScoreCode",
        "path": "Observation.code.coding",
        "sliceName": "SNAQrcScoreCode",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.code.coding:SNAQrcScoreCode.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.code.coding:SNAQrcScoreCode.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "fixedCode": "108311000146106"
      },
      {
        "id": "Observation.code.coding:SNAQrcScoreCode.display",
        "path": "Observation.code.coding.display",
        "defaultValueString": "Short Nutritional Questionnaire for residential care"
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "short": "SNAQrcScoreDateTime",
        "definition": "The date and time at which the SNAQ score was determined.",
        "alias": [
          "SNAQrcScoreDatumTijd"
        ],
        "min": 1,
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQrcScore-v1.0-2017EN",
            "map": "NL-CM:4.29.6",
            "comment": "SNAQrcScoreDateTime"
          }
        ]
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "short": "TotalScore",
        "definition": "The total score is the sum of all the individual scores. The total score has a range from 0 - 5.",
        "alias": [
          "TotaalScore"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQrcScore-v1.0-2017EN",
            "map": "NL-CM:4.29.2",
            "comment": "TotalScore"
          }
        ]
      },
      {
        "id": "Observation.value[x].value",
        "path": "Observation.value[x].value",
        "minValueDecimal": 0,
        "maxValueDecimal": 5
      },
      {
        "id": "Observation.comment",
        "path": "Observation.comment",
        "definition": "A comment on the circumstances during the measurement.",
        "alias": [
          "Toelichting"
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQrcScore-v1.0-2017EN",
            "map": "NL-CM:4.29.7"
          }
        ]
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "code"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:WeightLossScore",
        "path": "Observation.component",
        "sliceName": "WeightLossScore",
        "max": "1"
      },
      {
        "id": "Observation.component:WeightLossScore.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.29.3"
            }
          ]
        }
      },
      {
        "id": "Observation.component:WeightLossScore.code.coding.display",
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Weightloss score"
      },
      {
        "id": "Observation.component:WeightLossScore.value[x]",
        "path": "Observation.component.value[x]",
        "short": "WeightLossScore",
        "definition": "The score based on undesired weight loss over the past month(s).",
        "alias": [
          "GewichtsverliesScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of WeightLossScore",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.19.1",
                  "code": "G1",
                  "display": "Meer dan 6 kg in de laatste 6 maanden"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SNAQrcGewichtsverliesScoreCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.29.1--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-SNAQrcScore-v1.0-2017EN",
            "map": "NL-CM:4.29.3",
            "comment": "WeightLossScore"
          }
        ]
      },
      {
        "id": "Observation.component:AppetiteScore",
        "path": "Observation.component",
        "sliceName": "AppetiteScore",
        "max": "1"
      },
      {
        "id": "Observation.component:AppetiteScore.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.29.4"
            }
          ]
        }
      },
      {
        "id": "Observation.component:AppetiteScore.code.coding.display",
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Appetite score"
      },
      {
        "id": "Observation.component:AppetiteScore.value[x]",
        "path": "Observation.component.value[x]",
        "short": "AppetiteScore",
        "definition": "The score based on a reduced appetite over the past month.",
        "alias": [
          "EetlustScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of AppetiteScore",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.19.2",
                  "code": "B1",
                  "display": "GeenEetlust"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SNAQrcEetlustScoreCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.29.2--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-SNAQrcScore-v1.0-2017EN",
            "map": "NL-CM:4.29.4",
            "comment": "AppetiteScore"
          }
        ]
      },
      {
        "id": "Observation.component:BMIScore",
        "path": "Observation.component",
        "sliceName": "BMIScore",
        "max": "1"
      },
      {
        "id": "Observation.component:BMIScore.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.29.5"
            }
          ]
        }
      },
      {
        "id": "Observation.component:BMIScore.code.coding.display",
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "BMI score"
      },
      {
        "id": "Observation.component:BMIScore.value[x]",
        "path": "Observation.component.value[x]",
        "short": "BMIScore",
        "definition": "The score based on the BMI of the patient. For a BMI >28 (overweight) the score is not applicable.",
        "alias": [
          "BMIScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of BMIScore",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.19.3",
                  "code": "B0",
                  "display": "Gezond (22 <=BMI <28)"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SNAQrcBMIScoreCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.29.3--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-SNAQrcScore-v1.0-2017EN",
            "map": "NL-CM:4.29.5",
            "comment": "BMIScore"
          }
        ]
      },
      {
        "id": "Observation.component:AssistedEating",
        "path": "Observation.component",
        "sliceName": "AssistedEating",
        "max": "1"
      },
      {
        "id": "Observation.component:AssistedEating.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.29.8"
            }
          ]
        }
      },
      {
        "id": "Observation.component:AssistedEating.code.coding.display",
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Assisted eating"
      },
      {
        "id": "Observation.component:AssistedEating.value[x]",
        "path": "Observation.component.value[x]",
        "short": "AssistedEating",
        "definition": "The score based on the ability of the patient to eat and drink without assistance.",
        "alias": [
          "HulpBijEten"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of AssistedEating",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://snomed.info/sct",
                  "code": "165224005",
                  "display": "Independent feeding"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SNAQrcHulpBijEtenCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.29.4--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-SNAQrcScore-v1.0-2017EN",
            "map": "NL-CM:4.29.8",
            "comment": "AssistedEating"
          }
        ]
      }
    ]
  }
}