Smart Bear Implementation Guide - Local Development build (v0.3.2). See the Directory of published versions
Questionnaire: MOCAQuestionnaire
| Official URL: https://smart-bear.eu/fhir/Questionnaire/MOCAQuestionnaire | Version: 0.3.2 | |||
| Draft as of 2023-11-21 | Computable Name: MOCAQuestionnaire | |||
Structure
| LinkId | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  MOCAQuestionnaire | Questionnaire | https://smart-bear.eu/fhir/Questionnaire/MOCAQuestionnaire#0.3.2 | ||
  0 | Ask patient to trace the diagram in order | 1..1 | choice | Options: 2 options |
| 1 | Ask patient to copy cube | 1..1 | choice | Options: 2 options |
| 2 | Ask patient to draw a clock (ten past eleven) | 1..1 | choice | Options: 4 options |
| 3 | Ask patient to name the first animal | 1..1 | choice | Options: 2 options |
| 4 | Ask patient to name the second animal | 1..1 | choice | Options: 2 options |
| 5 | Ask patient to name the third animal | 1..1 | choice | Options: 2 options |
| 6 | Read Face, Velvet, Church, Daisy, Red, and ask patient to repeat (do two trials and a recall later in exam) | 1..1 | choice | Options: 2 options |
| 7 | Read list of digits (2, 1, 8, 5, 4) at 1 digit/sec and ask patient to repeat them in the forward order | 1..1 | choice | Options: 2 options |
| 8 | Read list of digits (7, 4, 2) at 1 digit/sec and ask patient to repeat them in the backward order | 1..1 | choice | Options: 2 options |
| 9 | Read list of letters and ask patient to tap with their hand at each letter A: FBAC MNAA JKLB AFAK DEAA AJAM OFAAB | 1..1 | choice | Options: 2 options |
| 10 | Ask patient to do five serial 7 subtractions starting at 100; Patient should say 93, 86, 79, 72, 65 | 1..1 | choice | Options: 4 options |
| 11 | Read and ask patient to repeat:I only know that John is the one to help today | 1..1 | choice | Options: 2 options |
| 12 | Read and ask patient to repeat:The cat always hid under the couch when dogs were in the room | 1..1 | choice | Options: 2 options |
 13 | Ask patient to name maximum number of words in 1 minute that begin with the letter F | 1..1 | integer | Options: 2 options |
| 14 | Ask patient similarity between train and bicycle (e.g. both are modes of transportation) | 1..1 | integer | Options: 2 options |
| 15 | Ask patient similarity between watch and ruler (e.g. both are measuring tools) | 1..1 | integer | Options: 2 options |
| 16 | Ask patient to recall the words with no cue from the memory test previously conducted [ Face, Velvet, Church, Daisy, Red ] | 1..1 | integer | Options: 6 options |
| 17 | Ask patient the date, month, year, day, place, and city | 1..1 | integer | Options: 7 options |
| 18 | Does patient have more than a 12th grade education? | 1..1 | integer | Options: 2 options |
 score | Score | 1..1 | integer | |
| Documentation for this format | ||||
Option Sets
Answer options for 0
- https://smart-bear.eu/fhir/CodeSystem/IntegerResp#0 ("Did not complete correctly")
- https://smart-bear.eu/fhir/CodeSystem/IntegerResp#1 ("Completed correctly")
Answer options for 1
- https://smart-bear.eu/fhir/CodeSystem/IntegerResp#0 ("Did not complete correctly")
- https://smart-bear.eu/fhir/CodeSystem/IntegerResp#1 ("Completed correctly")
Answer options for 2
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS#0 ("None of the above")
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS#1 ("Correctly drew hands only or Correctly drew numbers only or Correctly drew contour only")
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS#2 ("Correctly drew two out of three features (i.e., two out of contour, numbers, and hands)")
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyDrewCS#3 ("Correctly drew all features (i.e., contour, numbers, and hands)")
Answer options for 3
- https://smart-bear.eu/fhir/CodeSystem/LionName#0 ("Did not name lion")
- https://smart-bear.eu/fhir/CodeSystem/LionName#1 ("Named lion")
Answer options for 4
- https://smart-bear.eu/fhir/CodeSystem/RhinocerosName#0 ("Did not name rhinoceros")
- https://smart-bear.eu/fhir/CodeSystem/RhinocerosName#1 ("Named rhinoceros")
Answer options for 5
- https://smart-bear.eu/fhir/CodeSystem/CamelName#0 ("Did not name camel")
- https://smart-bear.eu/fhir/CodeSystem/CamelName#1 ("Named camel")
Answer options for 6
- https://smart-bear.eu/fhir/CodeSystem/RepeatTrials#0 ("Did not complete both trials correctly")
- https://smart-bear.eu/fhir/CodeSystem/RepeatTrials#1 ("Completed both trials correctly")
Answer options for 7
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#0 ("Did not repeat correctly")
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#1 ("Repeated correctly")
Answer options for 8
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#0 ("Did not repeat correctly")
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#1 ("Repeated correctly")
Answer options for 9
- https://smart-bear.eu/fhir/CodeSystem/ReadLetterA#0 ("≥2 errors")
- https://smart-bear.eu/fhir/CodeSystem/ReadLetterA#1 ("<2 errors")
Answer options for 10
- https://smart-bear.eu/fhir/CodeSystem/FiveSerial#0 ("0 correct")
- https://smart-bear.eu/fhir/CodeSystem/FiveSerial#1 ("1 correct")
- https://smart-bear.eu/fhir/CodeSystem/FiveSerial#2 ("2 or 3 correct")
- https://smart-bear.eu/fhir/CodeSystem/FiveSerial#3 ("4 or 5 correct")
Answer options for 11
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#0 ("Did not repeat correctly")
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#1 ("Repeated correctly")
Answer options for 12
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#0 ("Did not repeat correctly")
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyRepeat#1 ("Repeated correctly")
Answer options for 13
- https://smart-bear.eu/fhir/CodeSystem/MaximumNamedLetterF#0 ("Named <11 words")
- https://smart-bear.eu/fhir/CodeSystem/MaximumNamedLetterF#3 ("Named ≥11 words")
Answer options for 14
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered#0 ("Did not answer correctly")
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered#3 ("Answered correctly")
Answer options for 15
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered#0 ("Did not answer correctly")
- https://smart-bear.eu/fhir/CodeSystem/CorrectlyAnswered#3 ("Answered correctly")
Answer options for 16
- https://smart-bear.eu/fhir/CodeSystem/RecallWords#0 ("Did not recall any words")
- https://smart-bear.eu/fhir/CodeSystem/RecallWords#1 ("Recalled 1 words")
- https://smart-bear.eu/fhir/CodeSystem/RecallWords#2 ("Recalled 2 words")
- https://smart-bear.eu/fhir/CodeSystem/RecallWords#3 ("Recalled 3 words")
- https://smart-bear.eu/fhir/CodeSystem/RecallWords#4 ("Recalled 4 words")
- https://smart-bear.eu/fhir/CodeSystem/RecallWords#5 ("Recalled all words")
Answer options for 17
- https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#0 ("None correct")
- https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#1 ("1 correct")
- https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#2 ("2 correct")
- https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#3 ("3 correct")
- https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#4 ("4 correct")
- https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#5 ("5 correct")
- https://smart-bear.eu/fhir/CodeSystem/AskDatePlaceCity#6 ("All correct")
Answer options for 18
- https://smart-bear.eu/fhir/CodeSystem/GradeEducation#0 ("No")
- https://smart-bear.eu/fhir/CodeSystem/GradeEducation#1 ("Yes")