OpenEHR Apperta Mirror
Name
ICIQ-UI Short Form
Description
International Consultation on Incontinence (ICIQ) Urinary Incontinence (UI) Short Form.
Keywords
incontinence ICIQ score urine leakage leak questionnaire
Purpose
Intended to capture the result of the short form of the ICIQ (International Consultation on Incontinence Questionnaire), also referred to as ICIQ-UI Short Form. The form is used to obtain a brief yet comprehensive summary of the level, impact and perceived cause of symptoms of incontinence.
Use
Use to record ICIQ-UI Short form answers to questions and total score.
References
International Consultation on Incontinence Modular Questionnaire http://www.iciq.net/index.html
Archetype Id
openEHR-EHR-OBSERVATION.iciq_ui_short.v0
Copyright
© Clinical Models UK
Licencing
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/.
Original Author
Hildegard Franke
freshEHR Clinical Informatics Ltd.
Date Originally Authored
2016-05-30
Name Card Type Description
Frequency
0..1 DV_ORDINAL Frequency of urine leakage over past 4 weeks.
Comment
Prompt: On average over the past 4 weeks, how often do you leak urine?
Constraint for DV_ORDINAL
  • 0 : Never
  • 1 : About once a week or less often
  • 2 : Two or three times a week
  • 3 : About once a day
  • 4 : Several times a day
  • 5 : All the time
Quantity
0..1 DV_ORDINAL Perceived quantity of urine leakage.
Comment
Prompt: We would like to know how much urine you think leaks. How much urine do you usually leak (whether you wear protection or not)?
Constraint for DV_ORDINAL
  • 0 : None
  • 2 : A small amount
  • 4 : A moderate amount
  • 6 : A large amount
Interference with daily life
0..1 DV_COUNT Perceived interference of urine leakage with daily life on a scale of 0 - 10.
Comment
Prompt: Overall, how much does leaking urine interfere with your everyday life? Please record a number between 0 (not at all) and 10 (a great deal)
Constraint for DV_COUNT
min: >= 0; max: <= 10
ICIQ Score
0..1 DV_COUNT Sum of scores for frequency, quantity and interference.
Constraint for DV_COUNT
min: >= 0; max: <= 21
When does urine leak?
0..* DV_CODED_TEXT Occasions when urine leakage occurs.
Comment
Prompt: When does urine leak? (Please tick all that apply to you).
Constraint for DV_CODED_TEXT
  • Never
    [Urine never leaks.]
  • Before getting to toilet
    [Urine leaks before you can get to the toilet.]
  • Cough or sneeze
    [Urine leaks when you cough or sneeze.]
  • Asleep
    [Urine leaks when you are asleep.]
  • Physically active/exercising
    [Urine leaks when you are physically active or exercising.]
  • Finished urinating and are dressed
    [Urine leaks when you have finished urinating and are dressed.]
  • No obvious reason
    [Urine leaks for no obvious reason.]
  • All the time
    [Urine leaks all the time.]
Name Card Type Description
Extension
0..* Slot (Cluster) Additional information required to capture local content or to align with other reference models/formalisms.
Comment
e.g. Local information requirements or additional metadata to align with FHIR or CIMI equivalents.
Slot
Slot
archetype (adl_version=1.4; uid=83a0625f-b654-42e4-a779-797b6281d726)
	openEHR-EHR-OBSERVATION.iciq_ui_short.v0

concept
	[at0000]	-- ICIQ-UI Short Form
language
	original_language = <[ISO_639-1::en]>
description
	original_author = <
		["name"] = <"Hildegard Franke">
		["organisation"] = <"freshEHR Clinical Informatics Ltd.">
		["email"] = <"hildi@freshehr.com">
		["date"] = <"2016-05-30">
	>
	details = <
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"Intended to capture the result of the short form of the ICIQ (International Consultation on Incontinence Questionnaire), also referred to as ICIQ-UI Short Form. The form is used to obtain a brief yet comprehensive summary of the level, impact and perceived cause of symptoms of incontinence.">
			use = <"Use to record ICIQ-UI Short form answers to questions and total score.">
			keywords = <"incontinence", "ICIQ", "score", "urine", "leakage", "leak", "questionnaire">
			misuse = <"">
			copyright = <"© Clinical Models UK">
		>
	>
	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"] = <"UK Clinical Models">
		["references"] = <"International Consultation on Incontinence Modular Questionnaire  http://www.iciq.net/index.html">
		["current_contact"] = <"Hildegard Franke, freshEHR Clinical Informatics Ltd.<hildi@freshehr.com>">
		["original_namespace"] = <"uk.org.clinicalmodels">
		["original_publisher"] = <"UK Clinical Models">
		["custodian_namespace"] = <"uk.org.clinicalmodels">
		["MD5-CAM-1.0.1"] = <"57A40A521B6DA98E55E8F07BFA8DE34B">
		["build_uid"] = <"1f811f48-1849-4ff3-9943-b8ef1a9a1b4f">
		["revision"] = <"0.0.1-alpha">
	>

definition
	OBSERVATION[at0000] matches {	-- ICIQ-UI Short Form
		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[at0004] occurrences matches {0..1} matches {	-- Frequency
										value matches {
											0|[local::at0005], 	-- Never
											1|[local::at0006], 	-- About once a week or less often
											2|[local::at0007], 	-- Two or three times a week
											3|[local::at0008], 	-- About once a day
											4|[local::at0009], 	-- Several times a day
											5|[local::at0010]  	-- All the time
										}
									}
									ELEMENT[at0011] occurrences matches {0..1} matches {	-- Quantity
										value matches {
											0|[local::at0012], 	-- None
											2|[local::at0013], 	-- A small amount
											4|[local::at0014], 	-- A moderate amount
											6|[local::at0015]  	-- A large amount
										}
									}
									ELEMENT[at0016] occurrences matches {0..1} matches {	-- Interference with daily life
										value matches {
											DV_COUNT matches {
												magnitude matches {|0..10|}
											}
										}
									}
									ELEMENT[at0017] occurrences matches {0..1} matches {	-- ICIQ Score
										value matches {
											DV_COUNT matches {
												magnitude matches {|0..21|}
											}
										}
									}
									ELEMENT[at0018] occurrences matches {0..*} matches {	-- When does urine leak?
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0019, 	-- Never
													at0020, 	-- Before getting to toilet
													at0021, 	-- Cough or sneeze
													at0022, 	-- Asleep
													at0023, 	-- Physically active/exercising
													at0024, 	-- Finished urinating and are dressed
													at0025, 	-- No obvious reason
													at0026]	-- All the time
												}
											}
										}
									}
								}
							}
						}
						state matches {
							ITEM_TREE[at0027] matches {	-- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0028] occurrences matches {0..*} matches {	-- Confounding factors
										value matches {
											DV_TEXT matches {*}
										}
									}
								}
							}
						}
					}
				}
			}
		}
		protocol matches {
			ITEM_TREE[at0029] matches {	-- Tree
				items cardinality matches {0..*; unordered} matches {
					allow_archetype CLUSTER[at0030] occurrences matches {0..*} matches {	-- Extension
						include
							archetype_id/value matches {/.*/}
					}
				}
			}
		}
	}


ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"ICIQ-UI Short Form">
					description = <"International Consultation on Incontinence (ICIQ) Urinary Incontinence (UI) Short Form.">
				>
				["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 = <"Frequency">
					description = <"Frequency of urine leakage over past 4 weeks.">
					comment = <"Prompt: On average over the past 4 weeks, how often do you leak urine?">
				>
				["at0005"] = <
					text = <"Never">
					description = <"Over the past 4 weeks I have never leaked urine.">
				>
				["at0006"] = <
					text = <"About once a week or less often">
					description = <"Over the past 4 weeks I have leaked urine about once a week or less often on average.">
				>
				["at0007"] = <
					text = <"Two or three times a week">
					description = <"Over the past 4 weeks I have leaked urine two or three times a week on average.">
				>
				["at0008"] = <
					text = <"About once a day">
					description = <"Over the past 4 weeks I have leaked urine about once a day on average.">
				>
				["at0009"] = <
					text = <"Several times a day">
					description = <"Over the past 4 weeks I have leaked urine several times a day on average.">
				>
				["at0010"] = <
					text = <"All the time">
					description = <"Over the past 4 weeks I have leaked urine all the time.">
				>
				["at0011"] = <
					text = <"Quantity">
					description = <"Perceived quantity of urine leakage.">
					comment = <"Prompt: We would like to know how much urine you think leaks. 
How much urine do you usually leak (whether you wear protection or not)?">
				>
				["at0012"] = <
					text = <"None">
					description = <"Over the past 4 weeks I have not leaked any urine.">
				>
				["at0013"] = <
					text = <"A small amount">
					description = <"Over the past 4 weeks I have leaked a small amount of urine on average.">
				>
				["at0014"] = <
					text = <"A moderate amount">
					description = <"Over the past 4 weeks I have leaked a moderate amount of urine on average.">
				>
				["at0015"] = <
					text = <"A large amount">
					description = <"Over the past 4 weeks I have leaked a large amount of urine on average.">
				>
				["at0016"] = <
					text = <"Interference with daily life">
					description = <"Perceived interference of urine leakage with daily life on a scale of 0 - 10.">
					comment = <"Prompt: Overall, how much does leaking urine interfere with your everyday life?
 Please record a number between 0 (not at all) and 10 (a great deal)">
				>
				["at0017"] = <
					text = <"ICIQ Score">
					description = <"Sum of scores for frequency, quantity and interference.">
				>
				["at0018"] = <
					text = <"When does urine leak?">
					description = <"Occasions when urine leakage occurs.">
					comment = <"Prompt: When does urine leak? (Please tick all that apply to you).">
				>
				["at0019"] = <
					text = <"Never">
					description = <"Urine never leaks.">
				>
				["at0020"] = <
					text = <"Before getting to toilet">
					description = <"Urine leaks before you can get to the toilet.">
				>
				["at0021"] = <
					text = <"Cough or sneeze">
					description = <"Urine leaks when you cough or sneeze.">
				>
				["at0022"] = <
					text = <"Asleep">
					description = <"Urine leaks when you are asleep.">
				>
				["at0023"] = <
					text = <"Physically active/exercising">
					description = <"Urine leaks when you are physically active or exercising.">
				>
				["at0024"] = <
					text = <"Finished urinating and are dressed">
					description = <"Urine leaks when you have finished urinating and are dressed.">
				>
				["at0025"] = <
					text = <"No obvious reason">
					description = <"Urine leaks for no obvious reason.">
				>
				["at0026"] = <
					text = <"All the time">
					description = <"Urine leaks all the time.">
				>
				["at0027"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0028"] = <
					text = <"Confounding factors">
					description = <"Description of any incidental factors that may have contributed to the score.">
				>
				["at0029"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0030"] = <
					text = <"Extension">
					description = <"Additional information required to capture local content or to align with other reference models/formalisms.">
					comment = <"e.g. Local information requirements or additional metadata to align with FHIR or CIMI equivalents.">
				>
			>
		>
	>