This enumeration represents a value set of possible responses to the SF-MPQ question: "Aching".

"The Alcohol Use Disorder Identification Test (AUDIT) was developed by the World Health Organization (WHO) as a simple method of screening for excessive drinking and to assist in brief assessment." - LOINC

This subtype of the Assessment Event is used to bind the total score concept and total score meaning properties to the proper coded values for the Alcohol Use Disorders Identification Test (AUDIT), and to set the limits on the total score value to range from 0 to 40. Logically, we're saying that this Assessment Event is a AUDIT Assessment Event, although physically, there is little difference between this and other instrument-specific subclasses. In a database implementation, this would not result in a separate table - it would simply set the rules that dictate what the Assessment Event values may take. Not shown in this UML model is that the assessmentInstrument property must be a AUDIT instrument (LOINC code 72110-0). This could have been done by creating an association from this class to the AlcoholUseDisordersIdentificationTest class using the same name (assessmentInstrument), thus redefining the parent property, but this technique can cause confusion and so the limitation on the type of assessment instrument is merely implied.

"Ambulatory aids: This is scored as 0 if the patient walks without a walking aid (even if assisted by a nurse), uses a wheelchair, or is on a bed rest and does not get out of bed at all. If the patient uses crutches, a cane, or a walker, this item scores 15; if the patient ambulates clutching onto the furniture for support, score this item 30." - LOINC

This enumeration represents a value set of possible responses to the CAGE question: "During the past 12 months: Have people annoyed you by criticizing your drinking?".

This class represents a response to an Assessment Instrument question upon the administration of the Assessment Instrument. It contains a pointer to the question as well as the response itself. Note that the response might be entered by an interviewer, entered by the interviewee, or populated by a software system (e.g., a system could automatically populate a question such as Date Administered).

"One of the permitted answers for a "choice" or "open-choice" question." - HL7 FHIR, Questionnaire.item.answerOption

This class describes the performance of an assessment of a particular aspect of a patient’s condition. Such assessments employ a test or instrument, often a questionnaire, that quantify otherwise subjective observations. These instruments employ scoring systems which have been systemetized and validated. Standardized assessment tools create scores and (sometimes) sub-scores which are then used to determine the optimal placement and treatment plans for the patient and to track patient progress over time. Standardized assessment tools facilitate the collection of accurate information in a reliable and consistent manner, provide clinicians and treatment agencies with increased accountability, identify patient progress over time, and provide a basis to adjust treatment plans.

"A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection." - HL7 FHIR, Questionnaire

This class represents a question on the Alcohol Use Disorders Identification Test (AUDIT) Assessment Instrument. This abstract class exists primarily to re-define the generic AssessmentInstrument.item.question property to the AuditAssessment.item.question. In other words, of all the possible questions on all the possible assessment instruments, we are explicitly identifying the ten Audit questions. Note that because this class is abstract, implementers would likely not instantiate this class, but rather the six concrete sub classes.

This class represents an answer or a response to a question on the Alcohol Use Disorders Identification Test (AUDIT) Assessment Instrument. This abstract class exists primarily to re-define the generic AssessmentEvent.responseItem.answer property to the AuditAssessment.responseItem.answer. In other words, of all the possible answers on all the possible kinds of assessment instruments, we are explicitly identifying the possible answers to the ten AUDIT questions. Note that because this class is abstract, implementers would likely not instantiate this class, but rather the six concrete sub classes.

The CAGE instrument used to screen for alcohol abuse, and is often the first instrument used. Based on the CAGE score, the Clinician may then use other instruments (such as the Alcohol Use Disorders Identification Test (AUDIT) instrument) to gather more information about possible alcohol use and abuse. CAGE is not a acronymn, but rather a mnemonic representing the four questions (Cut down, Annoyed, Guilty, Eye-opener). The CAGE instrument is in the public domain, and is based on "Detecting Alcoholism: The CAGE Questionnaire," JAMA 252: 1905-1907, 1984.

This subtype of the Assessment Event is used to bind the total score concept and total score meaning properties to the proper coded values for the CAGE, and to set the limits on the total score value to range from 0 to 4. Logically, we're saying that this Assessment Event is a CAGE Assessment Event, although physically, there is little difference between this and other instrument-specific subclasses. In a database implementation, this would not result in a separate table - it would simply set the rules that dictate what the Assessment Event values may take. Not shown in this UML model is that the assessmentInstrument property must be a CAGE instrument (LOINC code TBD). This could have been done by creating an association from this class to the CAGE class using the same name (assessmentInstrument), thus redefining the parent property, but this technique can cause confusion and so the limitation on the type of assessment instrument is merely implied.

This class represents a question on the CAGE Assessment Instrument. This abstract class exists primarily to re-define the generic AssessmentInstrument.item.question property to the CAGE.item.question. In other words, of all the possible questions on all the possible assessment instruments, we are explicitly identifying the four CAGE questions. Note that because this class is abstract, implementers would likely not instantiate this class, but rather the four concrete sub classes.

This class represents an answer or a response to a question on the CAGE Assessment Instrument. This abstract class exists primarily to re-define the generic AssessmentEvent.responseItem.answer property to the CAGE.responseItem.answer. In other words, of all the possible answers on all the possible kinds of assessment instruments, we are explicitly identifying the possible answers to the four CAGE questions. Note that because this class is abstract, implementers would likely not instantiate this class, but rather the four concrete sub classes.

This enumeration represents a value set of possible responses to the PHQ-9 question: "If you checked off any problems, how difficult have these made it for you to do your work, take care of things at home, or get along with other people?".

This enumeration represents a value set of possible responses to the SF-MPQ question: "Cramping".

This enumeration represents a value set of possible responses to the CAGE question: "During the past 12 months: Have you ever felt you should cut down on your drinking?".

This class represents an answer or a response to a question on the Quality of Life Questionnaire for Dialysis Patients Assessment Instrument. This abstract class exists primarily to re-define the generic AssessmentEvent.responseItem.answer property to the DialysisPatientQOL.responseItem.answer. In other words, of all the possible answers on all the possible kinds of assessment instruments, we are explicitly identifying the possible answers to the sixteen DialysisPatientQOL questions. Note that because this class is abstract, implementers would likely not instantiate this class, but rather the sixteen concrete sub classes.

This enumeration represents a value set of possible responses to the question of how many drinks containing alcohol that the respondent consumes on a typical day when he or she is drinking.

"A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true." - HL7 FHIR, Questionnaire.item.enableWhen

This enumeration represents a value set of possible responses to the CAGE question: "During the past 12 months: Have you had an eye opener first thing in the morning to steady nerves or to get rid of a hangover?".

This enumeration represents a value set of possible responses to the SF-MPQ question: "Fearful".

"Gait: A normal gait is characterized by the patient walking with head erect, arms swinging freely at the side, and striding without hesitant. This gait scores 0. With a weak gait (score as 10), the patient is stooped but is able to lift the head while walking without losing balance. Steps are short and the patient may shuffle. With an impaired gait (score 20), the patient may have difficulty rising from the chair, attempting to get up by pushing on the arms of the chair/or by bouncing (i.e., by using several attempts to rise). The patient’s head is down, and he or she watches the ground when walking. Because the patient’s balance is poor, the patient grasps onto the furniture, a support person, or a walking aid for support and cannot walk without this assistance." - LOINC

This enumeration represents a value set of possible responses to the DialysisPatientQOL question: "[Categorize the patient's] geographical area of residence".

This enumeration represents a value set of possible responses to the SF-MPQ question: "Gnawing".

This class is concrete Questionnaire Item which contains a grouping of questions to ask the user. These groupings may be activated or deactivated together (e.g., don't ask pregnancy-related questions of male respondents).