{
  "resourceType": "StructureDefinition",
  "id": "zib-SNAQScore",
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-SNAQScore",
  "version": "1.0.2",
  "name": "Zib SNAQScore",
  "title": "HCIM SNAQScore",
  "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 SNAQScore-v3.1(2017EN). The Short Nutritional Assessment Questionnaire (SNAQ) 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 SNAQ helps to recognize and treat malnutrition at an early stage. Three varieties of the measuring tool were developed for different care settings: hospitals, nursing and retirement homes and independently living seniors. This concept describes the tool intended for the hospital setting.",
  "purpose": "#Purpose\r\nThe SNAQ score 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-snaqscore-v3.1-2017EN",
      "uri": "https://zibs.nl/wiki/SNAQScore-v3.1(2017EN)",
      "name": "SNAQScore-v3.1(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": "SNAQScore",
        "definition": "The Short Nutritional Assessment Questionnaire (SNAQ) 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.  \r\nThe SNAQ helps to recognize and treat malnutrition at an early stage. \r\nThree varieties of the measuring tool were developed for different care settings: hospitals, nursing and retirement homes and independently living seniors. This concept describes the tool intended for the hospital setting.",
        "alias": [
          "SNAQScore"
        ],
        "constraint": [
          {
            "key": "Zib-SNAQScore-1",
            "severity": "error",
            "human": "If one of the component codes is present, all SHALL be present.",
            "expression": "( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').empty() ) or ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').exists() )"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-snaqscore-v3.1-2017EN",
            "map": "NL-CM:4.6.1",
            "comment": "SNAQScore"
          }
        ]
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.code.coding:SNAQScoreCode",
        "path": "Observation.code.coding",
        "sliceName": "SNAQScoreCode",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.code.coding:SNAQScoreCode.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.code.coding:SNAQScoreCode.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "fixedCode": "8881000146104"
      },
      {
        "id": "Observation.code.coding:SNAQScoreCode.display",
        "path": "Observation.code.coding.display",
        "defaultValueString": "Short Nutritional Assessment Questionnaire"
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "short": "SNAQScoreDateTime",
        "definition": "The date and time at which the SNAQ score was determined.",
        "alias": [
          "SNAQScoreDatumTijd"
        ],
        "min": 1,
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQScore-v3.0-2017EN",
            "map": "NL-CM:4.6.6",
            "comment": "SNAQScoreDateTime"
          }
        ]
      },
      {
        "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-SNAQScore-v3.0-2017EN",
            "map": "NL-CM:4.6.2",
            "comment": "TotalScore"
          }
        ]
      },
      {
        "id": "Observation.value[x].value",
        "path": "Observation.value[x].value",
        "minValueDecimal": 0,
        "maxValueDecimal": 5
      },
      {
        "id": "Observation.comment",
        "path": "Observation.comment",
        "short": "Comment",
        "definition": "A comment on the circumstances during the measurement.",
        "alias": [
          "Toelichting"
        ],
        "mapping": [
          {
            "identity": "hcim-SNAQScore-v3.0-2017EN",
            "map": "NL-CM:4.6.7",
            "comment": "Comment"
          }
        ]
      },
      {
        "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": "4.6.3"
            }
          ]
        }
      },
      {
        "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:2.16.840.1.113883.2.4.3.11.60.40.4.5.1",
                  "code": "G2",
                  "display": "Meer dan 6 kg in de laatste 6 maanden"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SNAQGewichtsverliesScoreCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.1--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-SNAQScore-v3.0-2017EN",
            "map": "NL-CM:4.6.3",
            "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": "4.6.4"
            }
          ]
        }
      },
      {
        "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:2.16.840.1.113883.2.4.3.11.60.40.4.5.2",
                  "code": "B1",
                  "display": "Verminderde eetlust de afgelopen maand"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "EetlustScoreCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.2--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-SNAQScore-v3.0-2017EN",
            "map": "NL-CM:4.6.4",
            "comment": "AppetiteScore"
          }
        ]
      },
      {
        "id": "Observation.component:NutritionScore",
        "path": "Observation.component",
        "sliceName": "NutritionScore",
        "max": "1"
      },
      {
        "id": "Observation.component:NutritionScore.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.6.5"
            }
          ]
        }
      },
      {
        "id": "Observation.component:NutritionScore.code.coding.display",
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Nutrition score"
      },
      {
        "id": "Observation.component:NutritionScore.value[x]",
        "path": "Observation.component.value[x]",
        "short": "NutritionScore",
        "definition": "The score based on the use of fluid or enteral nutrition over the past month.",
        "alias": [
          "VoedingsScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of NutritionScore",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.3",
                  "code": "Z0",
                  "display": "GeenVoeding"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "VoedingsScoreCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.3--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-SNAQScore-v3.0-2017EN",
            "map": "NL-CM:4.6.5",
            "comment": "NutritionScore"
          }
        ]
      }
    ]
  }
}