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General information
Name: nl.zorg.template.PatientQuestionnaire 
Version: 1.0
HCIM Status:Final
Release status: Published
Release date: 01-09-2020
Metadata
| DCM::CoderList |
*
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| DCM::ContactInformation.Address |
*
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| DCM::ContactInformation.Name |
*
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| DCM::ContactInformation.Telecom |
*
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| DCM::ContentAuthorList |
*
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| DCM::CreationDate |
15/05/2020
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| DCM::DeprecatedDate |
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| DCM::DescriptionLanguage |
nl
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| DCM::EndorsingAuthority.Address |
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| DCM::EndorsingAuthority.Name |
*
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| DCM::EndorsingAuthority.Telecom |
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| DCM::Id |
2.16.840.1.113883.2.4.3.11.60.40.3.21.2
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| DCM::KeywordList |
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| DCM::LifecycleStatus |
Final
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| DCM::ModelerList |
*
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| DCM::Name |
nl.zorg.template.PatientVragenlijst
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| DCM::PublicationDate |
01-09-2020
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| DCM::PublicationStatus |
Published
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| DCM::ReviewerList |
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| DCM::RevisionDate |
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| DCM::Supersedes |
*
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| DCM::Version |
1.0
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| HCIM::PublicationLanguage |
EN
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Revision History
Only available in Dutch
Publicatieversie 1.0 (01-09-2020).
Concept
A Patient questionnaire is a structured questionnaire in which a care provider asks the patient or a contact person a number of questions about his health, (disease) history or experiences during a care process.
This is a template HCIM. For actual use, meaningful element names and filling of the value lists will have to be provided for derived HCIMs.
Purpose
The purpose of a patient questionnaire is to request information from the patient that is important to know for the treatment, the result of a treatment or his experiences in the care process.
Evidence Base
Question (text) and answer (options) connected to container 'Item' in the information model
Validated and often translated questionnaires pose a challenge in terms of version management. This is only partly the concern to the manager of a single HCIM questionnaire, but the publisher or author of the questionnaire is in the lead.
- For example, an English version of a questionnaire can have various translations into other languages ??and this translation can also have various versions. Often it is not just a translation, but the questions are more applied to the country in which the respondents are located. An English question "Are you able to walk uphill?" Is often adapted for the Netherlands to "Are you able to walk up the stairs?" Simply because there are few hills in the Netherlands. This is often done by special agencies and translations must also be validated by the publisher of a questionnaire. Internationally, people often speak more often of 'cultural adaptations' than simply translations. Due to the validation in various studies, when a new version of an existing questionnaire is published in the maker's native language, it will take quite some time for this list to be translated into all languages.
- In addition, new versions can contain changes in the text of the question as well as the answer options and / or their weighting when calculating scores. Backward compatibility is not always possible. The rule of thumb is that a receiving system or person must be able to receive and map answers from various versions and process them properly in, for example, reports including benchmarks.
- Also in the healthcare proces it is desirable that it is always possible for the receiving care provider to see exactly to which version of a question a patient has answered, but also which questions has been skipped by the patient or when questionnaires have not been completed at all.
- In addition to version management of question text and answer options (see example in the value lists), there are a number of challenges surrounding absence of an answer to a questionnaire question. This is important for the analysis of data and / or benchmarks. There are several reasons why an answer to a question is not received which are also important to the receiving healthcare provider, analysis or benchmarks. for example:
- This may have been skipped by the person completing this.
- The person completing the questionnaire can only have completed a questionnaire halfway.
- The person completing the question may never have seen the question because the question only became visible through previous answers provided.
- Other preconditions specific to the patient's situation (for example, gender, certain condition that prevents certain questions from appearing).
How to do this depends on the questionnaire. In due time, more information will be available on the zibs wiki about the possibilities.
Information Model
| Type |
Id |
Concept |
Card. |
Definition |
DefinitionCode |
Reference
|
|
NL-CM:21.2.1
|
 [PatientQuestionnaire]
|
|
Root concept of the [PatientQuestionnaire] information model.This root concept contains all data elements of the [PatientQuestionnaire] template.
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|
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NL-CM:21.2.30
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[Respondent]
|
0..1
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Container of the [Respondent] concept.This container contains all data elements of the [Respondent] concept.
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|
|
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NL-CM:21.2.31
|
|
|
 Patient
|
(0..1)
|
The patient as questionnaire respondent
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|
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NL-CM:21.2.32
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|
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HealthProfessional
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(0..1)
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The health professional as respondent of the questionnaire
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|
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NL-CM:21.2.33
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|
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ContactPerson
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(0..1)
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The related person (parent, caregiver, ...) as respondent of the questionnaire
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|
|
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NL-CM:21.2.24
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|
[TimingLabel]
|
0..1
|
The relative moment in time when the quesionnaire is completed (e.g. at 12 years old, before surgery, 5 years after implantation)
|
|
|
|
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NL-CM:21.2.38
|
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[DateTime]::TimeInterval
|
0..1
|
The start date and time and / or the end date and time and / or the duration of completing the questionnaire.
|
|
|
|
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NL-CM:21.2.12
|
|
[Section]
|
1..*
|
Container of the [Section] concept.This container contains all data elements of the [Section] concept.
|
|
|
|
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NL-CM:21.2.27
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|
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[Sectie]Naam
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0..1
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The name of the section of the questionnaire. This usually relates to the specific subject of the section in the questionnaire.
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|
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NL-CM:21.2.28
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[Item]
|
*
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Container of the [Item] concept.This container contains all data elements of the [Item] concept.
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|
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|
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NL-CM:21.2.17
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[Text]
|
1
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The question text in the questionnaire or other item.
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|
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NL-CM:21.2.39
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[Answer]
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0..*
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The answer to a question.
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NL-CM:21.2.29
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[Answer]Options
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0..*
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The answer options for a question.
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NL-CM:21.2.26
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|
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[Score]
|
0..*
|
Container of the [Score] concept.This container contains all data elements of the [Score] concept.
|
|
|
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NL-CM:21.2.18
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|
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[Score]
|
0..1
|
A (total)score calculated on the basis of the answers to the questionnaire.
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|
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NL-CM:21.2.25
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[Formula]
|
0..1
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The formula used to calculate the score.
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NL-CM:21.2.37
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[InformationSource]
|
0..1
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Container of the [InformationSource] concept.This container contains all data elements of the [InformationSource] concept.
|
|
|
|
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NL-CM:21.2.34
|
|
|
Patient
|
(0..1)
|
The patient as source of the information for completing the questionnaire
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|
|
|
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NL-CM:21.2.36
|
|
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ContactPerson
|
(0..1)
|
The related person (parent, caregiver, ...) as source of the information about the patient while completing the questionnaire
|
|
|
Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page 
Instructions
With this template, single HCIMs can be made that model one questionnaire with one or more sections.
If a HCIM of a questionnaire becomes very large and it contains a complex flow with conditionally visible or hidden questions, the modeller may decide to divide it into several smaller HCIMs. Alternative is to model these (pre-)conditions in a HCIM with the help of constraints.
It is also possible to refer to a website or place where this information can be found instead of doing this in a HCIM.
The sequence of completing and exact design of a questionnaire may be difficult to described in a HCIM and this is actually not what an HCIM is intended for. This information must be available from the publisher or creator of the questionnaire. not a modeller of an HCIM. The publisher is also the content manager of a questionnaire.
With every change by the content manager, one should check and track whether a single HCIM must be adapted.
The version management of validated questionnaires in particular requires attention and can be complex due to various translations in circulation.
Valuesets
[Answer]OptionsCodelist
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.21.2.6
|
Binding: Example
|
| Conceptname
|
Conceptcode
|
Conceptvalue
|
Codesystem name |
Codesystem OID
|
Description
|
| Not at all
|
A1NL
|
1
|
CLEFTFACE_A
|
2.16.840.1.113883.2.4.3.11.60.40.4.23.1998
|
Helemaal niet
|
| A little bit
|
A2NL
|
2
|
CLEFTFACE_A
|
2.16.840.1.113883.2.4.3.11.60.40.4.23.1998
|
Een Klein beetje
|
| Quite a bit
|
A3NL
|
3
|
CLEFTFACE_A
|
2.16.840.1.113883.2.4.3.11.60.40.4.23.1998
|
Best wel
|
| Very much
|
A4NL
|
4
|
CLEFTFACE_A
|
2.16.840.1.113883.2.4.3.11.60.40.4.23.1998
|
Heel veel [DEPRECATED]
|
| Very much
|
A4-2NL
|
4
|
CLEFTFACE_A
|
2.16.840.1.113883.2.4.3.11.60.40.4.23.1998
|
Heel erg
|
[Sectie]NameCodelist
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.21.2.4
|
Binding: Example
|
| Conceptname
|
Conceptcode
|
Codesystem name |
Codesystem OID
|
Description
|
| Social wellbeing
|
69909001
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Social welbevinden [DEPRECATED]
|
| General wellbeing
|
363800008
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Algemeen welbevinden
|
[Text]Codelist
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.21.2.1
|
Binding: Example
|
| Conceptname
|
Conceptcode
|
Codesystem name |
Codesystem OID
|
Description
|
| CLEFTFACEQ1_EN
|
Q1EN
|
CLEFTFACE
|
2.16.11.1.113113.1.968
|
HOW MUCH DO YOU LIKE…1: ..how your face looks when you look your best?
|
| CLEFTFACEQ1_NL
|
Q1NL
|
CLEFTFACE
|
2.16.11.1.113113.1.968
|
HOE TEVREDEN BEN JE MET... 1: ...hoe je eruitziet als je er op je best uit ziet? [DEPRECATED]
|
| CLEFTFACEQ1_NL
|
Q1-2NL
|
CLEFTFACE
|
2.16.11.1.113113.1.968
|
HOE TEVREDEN BEN JE MET... 1: ...hoe je gezicht eruitziet als je er op je best uit ziet? [DEPRECATED]
|
[TimingLabel]Codelist
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.21.2.3
|
Binding: Example
|
| Conceptname
|
Conceptcode
|
Codesystem name |
Codesystem OID
|
Description
|
| 12 years
|
12Y
|
CLEFTQ_TIM
|
2.16.840.1.113883.2.4.3.11.60.40.4.23.1997
|
12 jaar oud
|
| 21 years
|
21Y
|
CLEFTQ_TIM
|
2.16.840.1.113883.2.4.3.11.60.40.4.23.1997
|
12 jaar oud
|
| Other
|
OTH
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
Anders, namelijk
|
About this information
The information in this wikipage is based on Release 2020
SNOMED CT and LOINC codes are based on:
- SNOMED Clinical Terms version: 20200309 [R] (March 2020 Interim Release)
- LOINC version 2.67
Conditions for use are located on the mainpage
This page is generated on 03/09/2020 14:29:30 with ZibExtraction v. 4.0.7551.21411
