Smart Bear Implementation Guide
0.3.2 - ci-build
Smart Bear Implementation Guide - Local Development build (v0.3.2). See the Directory of published versions
| Draft as of 2023-08-01 |
{
"resourceType" : "Questionnaire",
"id" : "MOCAQuestionnaire",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkId for the item\">LinkId</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the itemcan appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description & Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> MOCAQuestionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">https://smart-bear.eu/fhir/Questionnaire/MOCAQuestionnaire#0.3.2</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 0</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient to trace the diagram in order</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.0\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient to copy cube</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.1\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 2</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient to draw a clock (ten past eleven)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.2\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 3</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient to name the first animal</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.3\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.4\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 4</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient to name the second animal</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.4\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 5</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient to name the third animal</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.5\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 6</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Read Face, Velvet, Church, Daisy, Red, and ask patient to repeat (do two trials and a recall later in exam)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.6\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 7</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Read list of digits (2, 1, 8, 5, 4) at 1 digit/sec and ask patient to repeat them in the forward order</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.7\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 8</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Read list of digits (7, 4, 2) at 1 digit/sec and ask patient to repeat them in the backward order</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.8\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 9</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Read list of letters and ask patient to tap with their hand at each letter A: FBAC MNAA JKLB AFAK DEAA AJAM OFAAB </td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.9\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.10\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 10</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient to do five serial 7 subtractions starting at 100; Patient should say 93, 86, 79, 72, 65 </td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.10\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.11\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 11</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Read and ask patient to repeat:I only know that John is the one to help today</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.11\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.12\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> 12</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Read and ask patient to repeat:The cat always hid under the couch when dogs were in the room</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.12\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.13\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Integer\" class=\"hierarchy\"/> 13</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient to name maximum number of words in 1 minute that begin with the letter F</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.13\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.14\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Integer\" class=\"hierarchy\"/> 14</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient similarity between train and bicycle (e.g. both are modes of transportation)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.14\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.15\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Integer\" class=\"hierarchy\"/> 15</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient similarity between watch and ruler (e.g. both are measuring tools)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.15\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.16\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Integer\" class=\"hierarchy\"/> 16</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"> Ask patient to recall the words with no cue from the memory test previously conducted [ Face, Velvet, Church, Daisy, Red ]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.16\">6 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.17\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Integer\" class=\"hierarchy\"/> 17</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ask patient the date, month, year, day, place, and city</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.17\">7 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.18\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Integer\" class=\"hierarchy\"/> 18</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"> Does patient have more than a 12th grade education?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.18\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.score\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Integer\" class=\"hierarchy\"/> score</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Score</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Option Sets</b></p><a name=\"opt-item.0\"> </a><p><b>Answer options for 0</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IntegerResp#0 ("Did not complete correctly")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IntegerResp#1 ("Completed correctly")</li></ul><a name=\"opt-item.1\"> </a><p><b>Answer options for 1</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IntegerResp#0 ("Did not complete correctly")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IntegerResp#1 ("Completed correctly")</li></ul><a name=\"opt-item.2\"> </a><p><b>Answer options for 2</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS#0 ("None of the above")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS#1 ("Correctly drew hands only or Correctly drew numbers only or Correctly drew contour only")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS#2 ("Correctly drew two out of three features (i.e., two out of contour, numbers, and hands)")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS#3 ("Correctly drew all features (i.e., contour, numbers, and hands)")</li></ul><a name=\"opt-item.3\"> </a><p><b>Answer options for 3</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/LionName#0 ("Did not name lion")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/LionName#1 ("Named lion")</li></ul><a name=\"opt-item.4\"> </a><p><b>Answer options for 4</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RhinocerosName#0 ("Did not name rhinoceros")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RhinocerosName#1 ("Named rhinoceros")</li></ul><a name=\"opt-item.5\"> </a><p><b>Answer options for 5</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CamelName#0 ("Did not name camel")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CamelName#1 ("Named camel")</li></ul><a name=\"opt-item.6\"> </a><p><b>Answer options for 6</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RepeatTrials#0 ("Did not complete both trials correctly")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RepeatTrials#1 ("Completed both trials correctly")</li></ul><a name=\"opt-item.7\"> </a><p><b>Answer options for 7</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#0 ("Did not repeat correctly")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#1 ("Repeated correctly")</li></ul><a name=\"opt-item.8\"> </a><p><b>Answer options for 8</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#0 ("Did not repeat correctly")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#1 ("Repeated correctly")</li></ul><a name=\"opt-item.9\"> </a><p><b>Answer options for 9</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/ReadLetterA#0 ("≥2 errors")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/ReadLetterA#1 ("<2 errors")</li></ul><a name=\"opt-item.10\"> </a><p><b>Answer options for 10</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/FiveSerial#0 ("0 correct")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/FiveSerial#1 ("1 correct")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/FiveSerial#2 ("2 or 3 correct")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/FiveSerial#3 ("4 or 5 correct")</li></ul><a name=\"opt-item.11\"> </a><p><b>Answer options for 11</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#0 ("Did not repeat correctly")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#1 ("Repeated correctly")</li></ul><a name=\"opt-item.12\"> </a><p><b>Answer options for 12</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#0 ("Did not repeat correctly")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#1 ("Repeated correctly")</li></ul><a name=\"opt-item.13\"> </a><p><b>Answer options for 13</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/MaximumNamedLetterF#0 ("Named <11 words")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/MaximumNamedLetterF#3 ("Named ≥11 words")</li></ul><a name=\"opt-item.14\"> </a><p><b>Answer options for 14</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered#0 ("Did not answer correctly")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered#3 ("Answered correctly")</li></ul><a name=\"opt-item.15\"> </a><p><b>Answer options for 15</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered#0 ("Did not answer correctly")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered#3 ("Answered correctly")</li></ul><a name=\"opt-item.16\"> </a><p><b>Answer options for 16</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RecallWords#0 ("Did not recall any words")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RecallWords#1 ("Recalled 1 words")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RecallWords#2 ("Recalled 2 words")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RecallWords#3 ("Recalled 3 words")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RecallWords#4 ("Recalled 4 words")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/RecallWords#5 ("Recalled all words")</li></ul><a name=\"opt-item.17\"> </a><p><b>Answer options for 17</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#0 ("None correct")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#1 ("1 correct")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#2 ("2 correct")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#3 ("3 correct")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#4 ("4 correct")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#5 ("5 correct")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#6 ("All correct")</li></ul><a name=\"opt-item.18\"> </a><p><b>Answer options for 18</b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/GradeEducation#0 ("No")</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/GradeEducation#1 ("Yes")</li></ul></div>"
},
"url" : "https://smart-bear.eu/fhir/Questionnaire/MOCAQuestionnaire",
"version" : "0.3.2",
"name" : "MOCAQuestionnaire",
"title" : "Montreal Cognitive Assessment",
"status" : "draft",
"date" : "2023-08-01T11:22:15+02:00",
"item" : [
{
"linkId" : "0",
"text" : "Ask patient to trace the diagram in order",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/IntegerResp",
"code" : "0",
"display" : "Did not complete correctly"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/IntegerResp",
"code" : "1",
"display" : "Completed correctly"
}
}
]
},
{
"linkId" : "1",
"text" : "Ask patient to copy cube",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/IntegerResp",
"code" : "0",
"display" : "Did not complete correctly"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/IntegerResp",
"code" : "1",
"display" : "Completed correctly"
}
}
]
},
{
"linkId" : "2",
"text" : "Ask patient to draw a clock (ten past eleven)",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS",
"code" : "0",
"display" : "None of the above"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS",
"code" : "1",
"display" : "Correctly drew hands only or Correctly drew numbers only or Correctly drew contour only"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS",
"code" : "2",
"display" : "Correctly drew two out of three features (i.e., two out of contour, numbers, and hands)"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS",
"code" : "3",
"display" : "Correctly drew all features (i.e., contour, numbers, and hands)"
}
}
]
},
{
"linkId" : "3",
"text" : "Ask patient to name the first animal",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/LionName",
"code" : "0",
"display" : "Did not name lion"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/LionName",
"code" : "1",
"display" : "Named lion"
}
}
]
},
{
"linkId" : "4",
"text" : "Ask patient to name the second animal",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RhinocerosName",
"code" : "0",
"display" : "Did not name rhinoceros"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RhinocerosName",
"code" : "1",
"display" : "Named rhinoceros"
}
}
]
},
{
"linkId" : "5",
"text" : "Ask patient to name the third animal",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CamelName",
"code" : "0",
"display" : "Did not name camel"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CamelName",
"code" : "1",
"display" : "Named camel"
}
}
]
},
{
"linkId" : "6",
"text" : "Read Face, Velvet, Church, Daisy, Red, and ask patient to repeat (do two trials and a recall later in exam)",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RepeatTrials",
"code" : "0",
"display" : "Did not complete both trials correctly"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RepeatTrials",
"code" : "1",
"display" : "Completed both trials correctly"
}
}
]
},
{
"linkId" : "7",
"text" : "Read list of digits (2, 1, 8, 5, 4) at 1 digit/sec and ask patient to repeat them in the forward order",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat",
"code" : "0",
"display" : "Did not repeat correctly"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat",
"code" : "1",
"display" : "Repeated correctly"
}
}
]
},
{
"linkId" : "8",
"text" : "Read list of digits (7, 4, 2) at 1 digit/sec and ask patient to repeat them in the backward order",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat",
"code" : "0",
"display" : "Did not repeat correctly"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat",
"code" : "1",
"display" : "Repeated correctly"
}
}
]
},
{
"linkId" : "9",
"text" : "Read list of letters and ask patient to tap with their hand at each letter A: FBAC MNAA JKLB AFAK DEAA AJAM OFAAB ",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/ReadLetterA",
"code" : "0",
"display" : "≥2 errors"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/ReadLetterA",
"code" : "1",
"display" : "<2 errors"
}
}
]
},
{
"linkId" : "10",
"text" : "Ask patient to do five serial 7 subtractions starting at 100; Patient should say 93, 86, 79, 72, 65 ",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/FiveSerial",
"code" : "0",
"display" : "0 correct"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/FiveSerial",
"code" : "1",
"display" : "1 correct"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/FiveSerial",
"code" : "2",
"display" : "2 or 3 correct"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/FiveSerial",
"code" : "3",
"display" : "4 or 5 correct"
}
}
]
},
{
"linkId" : "11",
"text" : "Read and ask patient to repeat:I only know that John is the one to help today",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat",
"code" : "0",
"display" : "Did not repeat correctly"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat",
"code" : "1",
"display" : "Repeated correctly"
}
}
]
},
{
"linkId" : "12",
"text" : "Read and ask patient to repeat:The cat always hid under the couch when dogs were in the room",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat",
"code" : "0",
"display" : "Did not repeat correctly"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat",
"code" : "1",
"display" : "Repeated correctly"
}
}
]
},
{
"linkId" : "13",
"text" : "Ask patient to name maximum number of words in 1 minute that begin with the letter F",
"type" : "integer",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/MaximumNamedLetterF",
"code" : "0",
"display" : "Named <11 words"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/MaximumNamedLetterF",
"code" : "3",
"display" : "Named ≥11 words"
}
}
]
},
{
"linkId" : "14",
"text" : "Ask patient similarity between train and bicycle (e.g. both are modes of transportation)",
"type" : "integer",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered",
"code" : "0",
"display" : "Did not answer correctly"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered",
"code" : "3",
"display" : "Answered correctly"
}
}
]
},
{
"linkId" : "15",
"text" : "Ask patient similarity between watch and ruler (e.g. both are measuring tools)",
"type" : "integer",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered",
"code" : "0",
"display" : "Did not answer correctly"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered",
"code" : "3",
"display" : "Answered correctly"
}
}
]
},
{
"linkId" : "16",
"text" : " Ask patient to recall the words with no cue from the memory test previously conducted [ Face, Velvet, Church, Daisy, Red ]",
"type" : "integer",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RecallWords",
"code" : "0",
"display" : "Did not recall any words"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RecallWords",
"code" : "1",
"display" : "Recalled 1 words"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RecallWords",
"code" : "2",
"display" : "Recalled 2 words"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RecallWords",
"code" : "3",
"display" : "Recalled 3 words"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RecallWords",
"code" : "4",
"display" : "Recalled 4 words"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/RecallWords",
"code" : "5",
"display" : "Recalled all words"
}
}
]
},
{
"linkId" : "17",
"text" : "Ask patient the date, month, year, day, place, and city",
"type" : "integer",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity",
"code" : "0",
"display" : "None correct"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity",
"code" : "1",
"display" : "1 correct"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity",
"code" : "2",
"display" : "2 correct"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity",
"code" : "3",
"display" : "3 correct"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity",
"code" : "4",
"display" : "4 correct"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity",
"code" : "5",
"display" : "5 correct"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity",
"code" : "6",
"display" : "All correct"
}
}
]
},
{
"linkId" : "18",
"text" : " Does patient have more than a 12th grade education?",
"type" : "integer",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/GradeEducation",
"code" : "0",
"display" : "No"
}
},
{
"valueCoding" : {
"system" : "https://smart-bear.eu/fhir/CodeSystem/GradeEducation",
"code" : "1",
"display" : "Yes"
}
}
]
},
{
"linkId" : "score",
"text" : "Score",
"type" : "integer",
"required" : true
}
]
}
IG © 2021+ . Package smartbear#0.3.2 based on FHIR 4.0.1. Generated 2023-08-01
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QA Report