{
  "resourceType": "StructureDefinition",
  "id": "zib-StrongKidsScore",
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-StrongKidsScore",
  "version": "1.0.0",
  "name": "Zib StrongKidsScore",
  "title": "HCIM StrongKidsScore",
  "status": "active",
  "publisher": "Nictiz",
  "description": "An Observation resource as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) HCIM StrongKidsScore v1.0 2017EN\r\n\r\nThe StrongKids score is a (validated) measuring tool for determining the extent of a child’s malnutrition. \r\nStrongKids is developed to recognize and treat malnutrition in children aged > 1 month to 18 years in a hospital setting.\r\nThe tool comprises four questions, each of which is assigned a score. The total score determines the extent of malnutrition.  \r\n(STRONGkids= Screening Tool Risk On Nutritional Status and Growth)",
  "purpose": "#Purpose\r\nThe StrongKids 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\nClinical Assessments are generally Observations. Although a more specialized Resource exists, the ClinicalImpression, it is not suitable because it is too immature and doesn't fit this information model well.",
  "copyright": "CC0",
  "fhirVersion": "3.0.2",
  "mapping": [
    {
      "identity": "hcim-strongkidsscore-v1.0-2017EN",
      "uri": "https://zibs.nl/wiki/StrongKidsScore-v1.0(2017EN)",
      "name": "HCIM StrongKidsScore-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": "StrongKidsScore",
        "alias": [
          "StrongKidsScore"
        ],
        "mapping": [
          {
            "identity": "hcim-strongkidsscore-v1.0-2017EN",
            "map": "NL-CM:4.28.1",
            "comment": "StrongKidsScore"
          }
        ]
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "system"
            },
            {
              "type": "value",
              "path": "code"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.code.coding:strongKidsScoreCode",
        "path": "Observation.code.coding",
        "sliceName": "strongKidsScoreCode",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.code.coding:strongKidsScoreCode.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.code.coding:strongKidsScoreCode.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "fixedCode": "108341000146107"
      },
      {
        "id": "Observation.code.coding:strongKidsScoreCode.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.code.coding.display",
        "defaultValueString": "STRONGkids risk screening tool (assessment scale)"
      },
      {
        "id": "Observation.effective[x]:effectiveDateTime",
        "path": "Observation.effectiveDateTime",
        "sliceName": "effectiveDateTime",
        "short": "ScoreDateTime",
        "definition": "The date and time at which the StrongKids score was determined.",
        "alias": [
          "ScoreDatumTijd"
        ],
        "min": 1,
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-strongkidsscore-v1.0-2017EN",
            "map": "NL-CM:4.28.6",
            "comment": "ScoreDateTime"
          }
        ]
      },
      {
        "id": "Observation.value[x]:valueQuantity",
        "path": "Observation.value[x]",
        "sliceName": "valueQuantity",
        "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-strongkidsscore-v1.0-2017EN",
            "map": "NL-CM:4.28.2",
            "comment": "TotalScore"
          }
        ]
      },
      {
        "id": "Observation.value[x]:valueQuantity.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-strongkidsscore-v1.0-2017EN",
            "map": "NL-CM:4.28.7",
            "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"
      },
      {
        "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": "4.28.3"
            }
          ]
        }
      },
      {
        "id": "Observation.component:WeightLossScore.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Weightloss score"
      },
      {
        "id": "Observation.component:WeightLossScore.value[x]:valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "short": "WeightLossScore",
        "definition": "The score based on undesired weight loss or arrest in growth or weight gain over the past weeks to month(s).",
        "alias": [
          "GewichtsverliesScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of WeightLossScore CodeableConcept",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.17.1",
                  "code": "G0",
                  "display": "NoLoss"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SKWeightLossScoreCodelist",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.28.1--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-strongkidsscore-v1.0-2017EN",
            "map": "NL-CM:4.28.3",
            "comment": "WeightLossScore"
          }
        ]
      },
      {
        "id": "Observation.component:ConditionScore",
        "path": "Observation.component",
        "sliceName": "ConditionScore"
      },
      {
        "id": "Observation.component:ConditionScore.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.28.4"
            }
          ]
        }
      },
      {
        "id": "Observation.component:ConditionScore.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Condition score"
      },
      {
        "id": "Observation.component:ConditionScore.value[x]:valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "short": "ConditionScore",
        "definition": "The score based on the presence of a condition that can cause an increased risk of malnutrition. A list with conditions with increased risk is given is reference [1]",
        "alias": [
          "ZiekteBeeldScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of ConditionScore CodeableConcept",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.17.2",
                  "code": "R0",
                  "display": "NoRisk"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SKConditionScoreCodelist",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.28.2--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-strongkidsscore-v1.0-2017EN",
            "map": "NL-CM:4.28.4",
            "comment": "ConditionScore"
          }
        ]
      },
      {
        "id": "Observation.component:NutritionScore",
        "path": "Observation.component",
        "sliceName": "NutritionScore"
      },
      {
        "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": "4.28.5"
            }
          ]
        }
      },
      {
        "id": "Observation.component:NutritionScore.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Nutrition score"
      },
      {
        "id": "Observation.component:NutritionScore.value[x]:valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "short": "NutritionScore",
        "definition": "The score based on the presence of aspects that indicate a deteriorated nutrition status:\r\n- excessive diarrhea and/or vomiting\r\n- use of fluid or enteral nutrition\r\n- reduced intake of food during the past 1-3 days\r\n- obstruction of food intake by pain",
        "alias": [
          "VoedingsScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of NutritionScore CodeableConcept",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.2.4.28.3",
                  "code": "Z0",
                  "display": "Normaal"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SKNutritionScoreCodelist",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.28.3--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-strongkidsscore-v1.0-2017EN",
            "map": "NL-CM:4.28.5",
            "comment": "NutritionScore"
          }
        ]
      },
      {
        "id": "Observation.component:NutritionStatusScore",
        "path": "Observation.component",
        "sliceName": "NutritionStatusScore"
      },
      {
        "id": "Observation.component:NutritionStatusScore.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "4.28.8"
            }
          ]
        }
      },
      {
        "id": "Observation.component:NutritionStatusScore.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Nutrition status score"
      },
      {
        "id": "Observation.component:NutritionStatusScore.value[x]:valueCodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "short": "NutritionStatusScore",
        "definition": "The score gives an indication of the nutrition status of the patient based on the professional opinion of the healthcare professional.",
        "alias": [
          "VoedingstoestandScore"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Example of NutritionStatusScore CodeableConcept",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.17.4",
                  "code": "T0",
                  "display": "Goed"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "SKNutritionStatusScoreCodelist",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.28.4--20171231000000"
          }
        },
        "mapping": [
          {
            "identity": "hcim-strongkidsscore-v1.0-2017EN",
            "map": "NL-CM:4.28.8",
            "comment": "NutritionStatusScore"
          }
        ]
      }
    ]
  }
}