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Patient Health Questionnaire PHQ-9(C-CDAR2.1).xml
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Patient Health Questionnaire PHQ-9(C-CDAR2.1).xml
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<section>
<!-- Mental Status Section -->
<!-- An assessment should be included in the section where it is appropriate in clinical context -->
<!-- Other asssessments may go into other sections. Depression screening is clinically appropriate for Mental Status -->
<templateId root="2.16.840.1.113883.10.20.22.2.56" extension="2015-08-01"/>
<code code="10190-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
displayName="Mental status Narrative"/>
<title>MENTAL STATUS</title>
<text>
<table>
<thead>
<tr>
<th>Date</th>
<th>Assessment</th>
<th>Value</th>
<th>Relevant Reference Range</th>
<th>Interpretation</th>
</tr>
</thead>
<tbody>
<!-- Note that sending the total score may be adequate for some use cases, although both total and detail responses shown below -->
<!-- PHQ-9 Total Score -->
<tr>
<td ID="assessment" colspan="5">PHQ-9 Questionnaire (panel)</td>
</tr>
<tr ID="assessmentTotal">
<td>06/22/2015</td>
<td>PHQ-9 Total Score</td>
<td>12</td>
<td ID="assessmentReferenceRange">0-4</td>
<td>High</td>
</tr>
<!-- PHQ-9 Component Questions -->
<tr ID="assessment1">
<td>06/22/2015</td>
<td>PHQ-9 Question: Little interest or pleasure in doing things?</td>
<td>0 (Not at all)</td>
<td/>
<td/>
</tr>
<tr ID="assessment2">
<td>06/22/2015</td>
<td>PHQ-9 Question: Feeling down, depressed, or hopeless?</td>
<td>1 (Several days)</td>
<td/>
<td/>
</tr>
<tr ID="assessment3">
<td>06/22/2015</td>
<td>PHQ-9 Question: Trouble falling or staying asleep, or sleeping too
much?</td>
<td>2 (More than half the days)</td>
<td/>
<td/>
</tr>
<tr ID="assessment4">
<td>06/22/2015</td>
<td>PHQ-9 Question: Feeling tired or having little energy?</td>
<td>0 (Not at all)</td>
<td/>
<td/>
</tr>
<tr ID="assessment5">
<td>06/22/2015</td>
<td>PHQ-9 Question: Poor appetite or overeating?</td>
<td>1 (Several days)</td>
<td/>
<td/>
</tr>
<tr ID="assessment6">
<td>06/22/2015</td>
<td>PHQ-9 Question: Feeling bad about yourself-or that you are a failure or have
let yourself or your family down?</td>
<td>3 (Nearly Every Day)</td>
<td/>
<td/>
</tr>
<tr ID="assessment7">
<td>06/22/2015</td>
<td>PHQ-9 Question: Trouble concentrating on things, such as reading the
newspaper or watching television?</td>
<td>2 (More than half the days)</td>
<td/>
<td/>
</tr>
<tr ID="assessment8">
<td>06/22/2015</td>
<td>PHQ-9 Question: Moving or speaking so slowly that other people could have
noticed. Or the opposite-being so fidgety or restless that you have been
moving around a lot more than usual?</td>
<td>3 (Nearly Every Day)</td>
<td/>
<td/>
</tr>
<tr ID="assessment9">
<td>06/22/2015</td>
<td>PHQ-9 Question: Thoughts that you would be better off dead, or of hurting
yourself in some way?</td>
<td>0 (Not at all)</td>
<td/>
<td/>
</tr>
<tr ID="assessment10">
<td>06/22/2015</td>
<td>PHQ-9 How difficult have these problems made it for you to do your work,
take care of things at home, or get along with other people?</td>
<td>(Not difficult at all)</td>
<td/>
<td/>
</tr>
</tbody>
</table>
</text>
<entry typeCode="DRIV">
<observation classCode="OBS" moodCode="EVN">
<!-- Assessment Scale Observation -->
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<id root="f1aa44dd-6f39-4f5c-b267-897c3824b673"/>
<code code="44249-1" displayName="PHQ-9 quick depression assessment panel"
codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<text>
<reference value="#assessment"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- Note that the value attribute is required in an assessment scale observation. Since LOINC organizes this information -->
<!-- where the total score is part of the panel, that total score code is shown through entryRelationship to supporting observation -->
<!-- The total score, however, is the most relevant value of the panel, so it has also been elevated to the panel value -->
<!-- INT is preferred for assessments such as a questionnaire. Units are not allowed for xsi:type="INT" -->
<value xsi:type="INT" value="12"/>
<interpretationCode code="H" codeSystem="2.16.840.1.113883.5.83" displayName="High" />
<entryRelationship typeCode="COMP">
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<text>
<reference value="#assessmentTotal"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- Definition of "PQ" A dimensioned quantity expressing the result of a measurement act.-->
<!-- Definition of "INT" Integer numbers (-1,0,1,2, 100, 3398129, etc.) are precise numbers that are results of counting and enumerating..-->
<!-- INT is preferred for assessments such as a questionnaire. Units are not allowed for xsi:type="INT" -->
<value xsi:type="INT" value="12"/>
</observation>
</entryRelationship>
<!-- The total score may be adequate for some use cases, although detail components can be sent as shown below as warranted by use case -->
<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
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<text>
<reference value="#assessment1"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="INT" value="0"/>
<!-- Systems may send a second value with LOINC answer concept -->
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6568-5" displayName="Not at all"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
</entryRelationship>
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<text>
<reference value="#assessment2"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="INT" value="1"/>
<!-- Systems may send a second value with LOINC answer concept -->
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6569-3" displayName="Several days"
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</observation>
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<text>
<reference value="#assessment3"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="INT" value="2"/>
<!-- Systems may send a second value with LOINC answer concept -->
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6570-1" displayName="More than half the days"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
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<code code="44254-1" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<text>
<reference value="#assessment4"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="INT" value="0"/>
<!-- Systems may send a second value with LOINC answer concept -->
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6568-5" displayName="Not at all"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<observation classCode="OBS" moodCode="EVN">
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<text>
<reference value="#assessment5"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="INT" value="1"/>
<!-- Systems may send a second value with LOINC answer concept -->
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6569-3" displayName="Several days"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
</entryRelationship>
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<observation classCode="OBS" moodCode="EVN">
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<text>
<reference value="#assessment6"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="INT" value="3"/>
<!-- Systems may send a second value with LOINC answer concept -->
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6571-9" displayName="Nearly every day"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<observation classCode="OBS" moodCode="EVN">
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<text>
<reference value="#assessment7"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="INT" value="2"/>
<!-- Systems may send a second value with LOINC answer concept -->
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6570-1" displayName="More than half the days"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<observation classCode="OBS" moodCode="EVN">
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<code code="44253-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<text>
<reference value="#assessment8"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="INT" value="3"/>
<!-- Systems may send a second value with LOINC answer concept -->
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6571-9" displayName="Nearly every day"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
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<id root="36792a59-7905-406e-a920-701a2ae746be"/>
<code code="44260-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<text>
<reference value="#assessment9"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<value xsi:type="INT" value="0"/>
<!-- Systems may send a second value with LOINC answer concept -->
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6568-5" displayName="Not at all"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
</entryRelationship>
<!-- New question for PHQ9 (question 10) not included in score -->
<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
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<text>
<reference value="#assessment10"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA6572-7" displayName="Not difficult at all"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
</entryRelationship>
<referenceRange>
<observationRange>
<text>
<reference value="#assessmentReferenceRange"/>
</text>
<value xsi:type="IVL_INT">
<low value="0"/>
<high value="4"/>
</value>
<!-- This interpretation code denotes that this reference range is for normal results. This is not the interpretation a specific patient value-->
<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" displayName="Normal" />
</observationRange>
<!-- Other ranges may be included as well (such as a high range) as considered appropriate per observation and use case -->
</referenceRange>
</observation>
</entry>
</section>