| Package | fhir.paciosampledata |
| Resource Type | Questionnaire |
| Id | Questionnaire-Brief-Interview-for-Mental-Status |
| FHIR Version | R4 |
| Source | http://mitre.org/paciowg/https://build.fhir.org/ig/paciowg/sample-data-fsh/Questionnaire-Questionnaire-Brief-Interview-for-Mental-Status.html |
| URL | http://mitre.org/paciowg/Questionnaire/Questionnaire-Brief-Interview-for-Mental-Status |
| Version | 0.1.0 |
| Status | draft |
| Date | 2025-07-15T20:44:39+00:00 |
| Name | Brief_Interview_for_Mental_Status_BIMS |
| Title | Brief Interview for Mental Status (BIMS) |
| Realm | us |
| Authority | hl7 |
| Copyright | This material contains content from LOINC (http://loinc.org). LOINC is copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. All rights reserved. LOINC is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc. |
No resources found
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Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire Questionnaire-Brief-Interview-for-Mental-Status
Structure| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  Brief_Interview_for_Mental_Status_BIMS | Questionnaire | http://mitre.org/paciowg/Questionnaire/Questionnaire-Brief-Interview-for-Mental-Status#0.1.0 | ||
  97479 | C0200. Repetition of Three Words. Number of words repeated after first attempt | 0..1 | choice | Options: 4 options |
 97480 | C0300. Temporal Orientation (orientation to year, month, and day) | 1..1 | group | |
 97481 | C0300A. Able to report correct year | 0..1 | choice | Options: 4 options |
| 97482 | C0300B. Able to report correct month | 0..1 | choice | Options: 3 options |
 97483 | C0300C. Able to report correct day of the week | 0..1 | choice | Options: 2 options |
| 97484 | C0400. Recall | 1..1 | group | |
| 97485 | C0400A. Able to recall "sock" | 0..1 | choice | Options: 3 options |
| 97486 | C0400B. Able to recall "blue" | 0..1 | choice | Options: 3 options |
| 97487 | C0400C. Able to recall "bed" | 0..1 | choice | Options: 3 options |
 97488 | C0500. BIMS Summary Score | 0..1 | decimal | |
| Documentation for this format | ||||
Options Sets
Answer options for 97479
Answer options for 97481
Answer options for 97482
Answer options for 97483
Answer options for 97485
Answer options for 97486
Answer options for 97487
FHIR{
"resourceType": "Questionnaire",
"id": "Questionnaire-Brief-Interview-for-Mental-Status",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "http://mitre.org/paciowg/Questionnaire/Questionnaire-Brief-Interview-for-Mental-Status",
"version": "0.1.0",
"name": "Brief_Interview_for_Mental_Status_BIMS",
"title": "Brief Interview for Mental Status (BIMS)",
"status": "draft",
"subjectType": [
"Patient"
],
"date": "2025-07-15T20:44:39+00:00",
"publisher": "MITRE",
"contact": [
{
"name": "MITRE",
"telecom": [
{
"system": "url",
"value": "http://www.mitre.org"
}
]
},
{
"name": "May Terry",
"telecom": [
{
"system": "email",
"value": "mayT@mitre.org",
"use": "work"
}
]
}
],
"copyright": "This material contains content from LOINC (http://loinc.org). LOINC is copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. All rights reserved. LOINC is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.",
"code": [
{
"system": "http://loinc.org",
"code": "52491-8",
"display": "Brief Interview for Mental Status (BIMS)"
}
],
"item": [
{
"linkId": "97479",
"code": [
{
"system": "http://loinc.org",
"code": "52731-7",
"display": "Repetition of Three Words. Number of words repeated after first attempt"
}
],
"prefix": "C0200",
"text": "Repetition of Three Words. Number of words repeated after first attempt",
"type": "choice",
"repeats": false,
"answerOption": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA137-2",
"display": "None"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6306-0",
"display": "One"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6404-3",
"display": "Two"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA6395-3",
"display": "Three"
}
}
]
},
{
"linkId": "97480",
"prefix": "C0300",
"text": "Temporal Orientation (orientation to year, month, and day)",
"type": "group",
"required": true,
"item": [
{
"linkId": "97481",
"code": [
{
"system": "http://loinc.org",
"code": "52732-5",
"display": "Able to report correct year"
}
],
"prefix": "C0300A",
"text": "Able to report correct year",
"type": "choice",
"repeats": false,
"answerOption": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10965-4",
"display": "Missed by > 5 years or no answer"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10966-2",
"display": "Missed by 2-5 years"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10008-3",
"display": "Missed by 1 year"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA9960-1",
"display": "Correct"
}
}
]
},
{
"linkId": "97482",
"code": [
{
"system": "http://loinc.org",
"code": "52733-3",
"display": "Able to report correct month"
}
],
"prefix": "C0300B",
"text": "Able to report correct month",
"type": "choice",
"repeats": false,
"answerOption": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10969-6",
"display": "Missed by > 1 month or no answer"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10010-9",
"display": "Missed by 6 days to 1 month"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA9927-0",
"display": "Accurate within 5 days"
}
}
]
},
{
"linkId": "97483",
"code": [
{
"system": "http://loinc.org",
"code": "54609-3",
"display": "Able to report correct day of the week"
}
],
"prefix": "C0300C",
"text": "Able to report correct day of the week",
"type": "choice",
"repeats": false,
"answerOption": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA9981-7",
"display": "Incorrect or no answer"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA9960-1",
"display": "Correct"
}
}
]
}
]
},
{
"linkId": "97484",
"prefix": "C0400",
"text": "Recall",
"type": "group",
"required": true,
"item": [
{
"linkId": "97485",
"code": [
{
"system": "http://loinc.org",
"code": "52735-8",
"display": "Able to recall \"sock\""
}
],
"prefix": "C0400A",
"text": "Able to recall \"sock\"",
"type": "choice",
"repeats": false,
"answerOption": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10974-6",
"display": "No - could not recall"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10126-3",
"display": "Yes, after cueing (\"something to wear\")"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10134-7",
"display": "Yes, no cue required"
}
}
]
},
{
"linkId": "97486",
"code": [
{
"system": "http://loinc.org",
"code": "52736-6",
"display": "Able to recall \"blue\""
}
],
"prefix": "C0400B",
"text": "Able to recall \"blue\"",
"type": "choice",
"repeats": false,
"answerOption": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10974-6",
"display": "No - could not recall"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10978-7",
"display": "Yes, after cueing (\"a color\")"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10134-7",
"display": "Yes, no cue required"
}
}
]
},
{
"linkId": "97487",
"code": [
{
"system": "http://loinc.org",
"code": "52737-4",
"display": "Able to recall \"bed\""
}
],
"prefix": "C0400C",
"text": "Able to recall \"bed\"",
"type": "choice",
"repeats": false,
"answerOption": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10974-6",
"display": "No - could not recall"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10125-5",
"display": "Yes, after cueing (\"a piece of furniture\")"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10134-7",
"display": "Yes, no cue required"
}
}
]
}
]
},
{
"linkId": "97488",
"prefix": "C0500",
"text": "BIMS Summary Score",
"type": "decimal"
}
]
}