archetype (adl_version=1.4; uid=50193e29-f9f6-4b41-9f50-0b8179ca51e8)
	openEHR-EHR-OBSERVATION.denwis.v0

concept
	[at0000]	-- DENWIS
language
	original_language = <[ISO_639-1::en]>
description
	original_author = <
		["name"] = <"Alan Fish">
		["organisation"] = <"The Apperta Foundation">
		["email"] = <"alan.fish@apperta.org">
		["date"] = <"2019-11-07">
	>
	details = <
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"For the recording of subjective assessment for completion by nurse to give a DENWIS score.">
			use = <"">
			misuse = <"">
			copyright = <"© The Apperta Foundation CIC, Apperta Foundation">
		>
	>
	lifecycle_state = <"in_development">
	other_contributors = <>
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.">
		["custodian_organisation"] = <"Apperta UK">
		["references"] = <"https://www.ncbi.nlm.nih.gov/pubmed/27222458">
		["current_contact"] = <"Alan Fish">
		["original_namespace"] = <"uk.org.clinicalmodels">
		["original_publisher"] = <"Apperta UK">
		["custodian_namespace"] = <"uk.org.clinicalmodels">
		["MD5-CAM-1.0.1"] = <"372CBDFAC15E28DB5AB00940D2E98A81">
		["build_uid"] = <"fcfa319d-d8ef-498f-a9fa-f7ee1b120377">
		["revision"] = <"0.0.1-alpha">
	>

definition
	OBSERVATION[at0000] matches {    -- DENWIS
		data matches {
			HISTORY[at0001] matches {    -- Event Series
				events cardinality matches {1..*; unordered} matches {
					POINT_EVENT[at0002] occurrences matches {0..1} matches {    -- Point in time
						data matches {
							ITEM_TREE[at0003] matches {    -- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0028] occurrences matches {0..1} matches {    -- Q1 Breathing
										value matches {
											0|[local::at0032],
											1|[local::at0031]
										}
									}
									ELEMENT[at0062] occurrences matches {0..*} matches {    -- Breathing indicator
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0067,    -- Noisy breathing
													at0068,    -- Short of breath
													at0069,    -- Unable to speak full sentences
													at0070]    -- Use accessory muscles
												}
											}
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0033] occurrences matches {0..1} matches {    -- Q2 Circulation
										value matches {
											0|[local::at0037],
											1|[local::at0036]
										}
									}
									ELEMENT[at0071] occurrences matches {0..*} matches {    -- Circulation indicator
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0096,    -- Colour changes: pale, grey
													at0097,    -- Sweaty/clammy
													at0098,    -- Coldness
													at0099]    -- Impaired perfusion
												}
											}
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0038] occurrences matches {0..1} matches {    -- Q3 Temperature
										value matches {
											0|[local::at0042],
											1|[local::at0105]
										}
									}
									ELEMENT[at0076] occurrences matches {0..*} matches {    -- Temperature indicator
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::at0100]    -- Rigors
												}
											}
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0043] occurrences matches {0..1} matches {    -- Q4 Mentation
										value matches {
											0|[local::at0046],
											1|[local::at0045]
										}
									}
									ELEMENT[at0078] occurrences matches {0..*} matches {    -- Mentation indicator
										value matches {
											DV_TEXT matches {*}
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0101,    -- Lethargic
													at0102]    -- Confused
												}
											}
										}
									}
									ELEMENT[at0047] occurrences matches {0..1} matches {    -- Q5 Agitation
										value matches {
											0|[local::at0048],
											1|[local::at0049]
										}
									}
									ELEMENT[at0081] occurrences matches {0..*} matches {    -- Agitation indicator
										value matches {
											DV_TEXT matches {*}
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0103,    -- Restless
													at0104]    -- Anxious
												}
											}
										}
									}
									ELEMENT[at0050] occurrences matches {0..1} matches {    -- Q6 Pain
										value matches {
											0|[local::at0051],
											1|[local::at0052]
										}
									}
									ELEMENT[at0084] occurrences matches {0..*} matches {    -- Pain indicator
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0106,    -- New pain
													at0107]    -- Increasing or consisting pain
												}
											}
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0053] occurrences matches {0..1} matches {    -- Q7 Trajectory
										value matches {
											0|[local::at0054],
											1|[local::at0055]
										}
									}
									ELEMENT[at0087] occurrences matches {0..*} matches {    -- Trajectory indicator
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0108,    -- No progress
													at0109]    -- Abdominal distension/nausea/bleeding
												}
											}
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0056] occurrences matches {0..1} matches {    -- Q8 Patient subjective
										value matches {
											0|[local::at0057],
											1|[local::at0058]
										}
									}
									ELEMENT[at0090] occurrences matches {0..*} matches {    -- Patient indicator
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0110,    -- Not feeling well
													at0111]    -- Feeling of impending doom
												}
											}
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0059] occurrences matches {0..1} matches {    -- Q9 Nurse subjective
										value matches {
											0|[local::at0060],
											1|[local::at0061]
										}
									}
									ELEMENT[at0093] occurrences matches {0..*} matches {    -- Nurse subjective indicator
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0112,    -- Change in behaviour
													at0113]    -- Doesn't look good
												}
											}
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0008] occurrences matches {0..1} matches {    -- Total score
										value matches {
											DV_COUNT matches {
												magnitude matches {|0..9|}
											}
										}
									}
									ELEMENT[at0027] occurrences matches {0..1} matches {    -- Comment
										value matches {
											DV_TEXT matches {*}
										}
									}
								}
							}
						}
						state matches {
							ITEM_TREE[at0006] matches {    -- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0007] occurrences matches {0..*} matches {    -- Confounding factors
										value matches {
											DV_TEXT matches {*}
										}
									}
								}
							}
						}
					}
				}
			}
		}
		protocol matches {
			ITEM_TREE[at0004] matches {    -- Tree
				items cardinality matches {0..*; unordered} matches {
					allow_archetype CLUSTER[at0005] occurrences matches {0..*} matches {    -- Extension
						include
							archetype_id/value matches {/.*/}
					}
				}
			}
		}
	}


ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"DENWIS">
					description = <"Dutch Early Nurse Worry Indicator Score (DENWIS)">
				>
				["at0001"] = <
					text = <"Event Series">
					description = <"@ internal @">
				>
				["at0002"] = <
					text = <"Point in time">
					description = <"A specific date and/or time which may be explicitly defined in a template or at run-time.">
				>
				["at0003"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0004"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0005"] = <
					text = <"Extension">
					description = <"Additional information required to capture local context or to align with other reference models/formalisms.">
					comment = <"e.g. Local hospital departmental infomation or additional metadata to align with HL7 or CDISC equivalents.">
				>
				["at0006"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0007"] = <
					text = <"Confounding factors">
					description = <"Record any issues or factors that may impact on the overall assessment or score.">
				>
				["at0008"] = <
					text = <"Total score">
					description = <"The total score for the four questions.">
				>
				["at0027"] = <
					text = <"Comment">
					description = <"Narrative comment.">
				>
				["at0028"] = <
					text = <"Q1 Breathing">
					description = <"Nurse recorded changes in breathing.">
				>
				["at0031"] = <
					text = <"Change in breathing">
					description = <"Change in breathing.">
				>
				["at0032"] = <
					text = <"No change in breathing">
					description = <"No change in breathing.">
				>
				["at0033"] = <
					text = <"Q2 Circulation">
					description = <"Nurse recorded changes in circulation.">
				>
				["at0036"] = <
					text = <"Change in circulation">
					description = <"Change in circulation.">
				>
				["at0037"] = <
					text = <"No change in circulation">
					description = <"No change in circulation.">
				>
				["at0038"] = <
					text = <"Q3 Temperature">
					description = <"Nurse recorded changes in temperature.">
				>
				["at0042"] = <
					text = <"No change in temperature">
					description = <"No change in temperature.">
				>
				["at0043"] = <
					text = <"Q4 Mentation">
					description = <"Nurse recorded changes in mentation.">
				>
				["at0045"] = <
					text = <"Change in mentation">
					description = <"Change in mentation.">
				>
				["at0046"] = <
					text = <"No change in mentation">
					description = <"No change in mentation.">
				>
				["at0047"] = <
					text = <"Q5 Agitation">
					description = <"Nurse recorded changes in agitation.">
				>
				["at0048"] = <
					text = <"No agitation">
					description = <"No agitation.">
				>
				["at0049"] = <
					text = <"Agitation">
					description = <"Agitation.">
				>
				["at0050"] = <
					text = <"Q6 Pain">
					description = <"Nurse recorded changes in pain.">
				>
				["at0051"] = <
					text = <"No change in pain">
					description = <"No change in pain.">
				>
				["at0052"] = <
					text = <"Change in pain">
					description = <"Change in pain.">
				>
				["at0053"] = <
					text = <"Q7 Trajectory">
					description = <"Nurse recorded unexpected trajectory.">
				>
				["at0054"] = <
					text = <"No change in trajectory">
					description = <"No change in trajectory.">
				>
				["at0055"] = <
					text = <"Change in trajectory">
					description = <"Change in trajectory.">
				>
				["at0056"] = <
					text = <"Q8 Patient subjective">
					description = <"Nurse recorded patient indicators.">
				>
				["at0057"] = <
					text = <"No subjective patient indicator">
					description = <"No subjective patient indicator.">
				>
				["at0058"] = <
					text = <"Subjective patient indicator">
					description = <"Subjective patient indicator.">
				>
				["at0059"] = <
					text = <"Q9 Nurse subjective">
					description = <"Nurse recorded subjective observation.">
				>
				["at0060"] = <
					text = <"No nurse subjective indicator">
					description = <"No nurse subjective indicator.">
				>
				["at0061"] = <
					text = <"Nurse subjective indicator">
					description = <"Nurse subjective indicator.">
				>
				["at0062"] = <
					text = <"Breathing indicator">
					description = <"Nurse recorded the indication that there are changes in breathing.">
				>
				["at0067"] = <
					text = <"Noisy breathing">
					description = <"Noisy breathing.">
				>
				["at0068"] = <
					text = <"Short of breath">
					description = <"Short of breath.">
				>
				["at0069"] = <
					text = <"Unable to speak full sentences">
					description = <"Unable to speak in full sentences.">
				>
				["at0070"] = <
					text = <"Use accessory muscles">
					description = <"Use accessory muscles.">
				>
				["at0071"] = <
					text = <"Circulation indicator">
					description = <"Nurse recorded changes in circulation.">
				>
				["at0076"] = <
					text = <"Temperature indicator">
					description = <"Nurse recorded changes in temperature.">
				>
				["at0078"] = <
					text = <"Mentation indicator">
					description = <"Nurse recorded changes in mentation.">
				>
				["at0081"] = <
					text = <"Agitation indicator">
					description = <"Nurse recorded changes in agitation.">
				>
				["at0084"] = <
					text = <"Pain indicator">
					description = <"Nurse recorded changes in pain.">
				>
				["at0087"] = <
					text = <"Trajectory indicator">
					description = <"Nurse recorded unexpected trajectory.">
				>
				["at0090"] = <
					text = <"Patient indicator">
					description = <"Nurse recorded patient indicators.">
				>
				["at0093"] = <
					text = <"Nurse subjective indicator">
					description = <"Nurse recorded subjective observation.">
				>
				["at0096"] = <
					text = <"Colour changes: pale, grey">
					description = <"Colour changes: pale, grey.">
				>
				["at0097"] = <
					text = <"Sweaty/clammy">
					description = <"Sweaty/clammy.">
				>
				["at0098"] = <
					text = <"Coldness">
					description = <"Coldness.">
				>
				["at0099"] = <
					text = <"Impaired perfusion">
					description = <"Impaired perfusion.">
				>
				["at0100"] = <
					text = <"Rigors">
					description = <"Rigors.">
				>
				["at0101"] = <
					text = <"Lethargic">
					description = <"Lethargic.">
				>
				["at0102"] = <
					text = <"Confused">
					description = <"Confused.">
				>
				["at0103"] = <
					text = <"Restless">
					description = <"Restless.">
				>
				["at0104"] = <
					text = <"Anxious">
					description = <"Anxious.">
				>
				["at0105"] = <
					text = <"Change in temperature">
					description = <"Change in temperature.">
				>
				["at0106"] = <
					text = <"New pain">
					description = <"New pain.">
				>
				["at0107"] = <
					text = <"Increasing or consisting pain">
					description = <"Increasing or consisting pain.">
				>
				["at0108"] = <
					text = <"No progress">
					description = <"No progress.">
				>
				["at0109"] = <
					text = <"Abdominal distension/nausea/bleeding">
					description = <"Abdominal distension/nausea/bleeding.">
				>
				["at0110"] = <
					text = <"Not feeling well">
					description = <"Not feeling well.">
				>
				["at0111"] = <
					text = <"Feeling of impending doom">
					description = <"Feeling of impending doom.">
				>
				["at0112"] = <
					text = <"Change in behaviour">
					description = <"Change in behaviour.">
				>
				["at0113"] = <
					text = <"Doesn't look good">
					description = <"Doesn't look good.">
				>
			>
		>
	>