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Packagemyhie.v4
Resource TypeQuestionnaire
Idq-audit-10.json
FHIR VersionR4

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Source1

{
  "resourceType": "Questionnaire",
  "id": "q-audit-10",
  "url": "http://fhir.hie.moh.gov.my/Questionnaire/q-audit-10",
  "title": "Alcohol Use Disorder Identification Test 10 [AUDIT-10]",
  "status": "active",
  "date": "2024-02-12T04:04:09.5621857+00:00",
  "description": "The AUDIT-10 has 10 questions and the range of possible scores is from 0 to 40 where 0 indicates an abstainer who has never had any problems from alcohol, 1 to 7 suggests low risk consumption, 8 to 14 suggest harmful alcohol consumption and ≥15 Likelihood of alcohol dependence (moderate-severe alcohol use disorder)",
  "useContext": [
    {
      "code": {
        "system": "http://hl7.org/fhir/CodeSystem/usage-context-type",
        "code": "workflow",
        "display": "Workflow Setting"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "code": "self-assessment",
            "display": "Self-Assessment"
          }
        ]
      }
    }
  ],
  "purpose": "The AUDIT questionnaire is designed to help in the self-assessment of alcohol consumption and to identify any implications for the person's health and wellbeing, now and in the future.",
  "code": [
    {
      "system": "http://loinc.org",
      "code": "72110-0",
      "display": "Alcohol Use Disorder Identification Test [AUDIT]"
    }
  ],
  "item": [
    {
      "linkId": "00",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "46098-0",
          "display": "Sex"
        }
      ],
      "prefix": "1",
      "text": "Please select your gender",
      "type": "choice",
      "required": false,
      "answerOption": [
        {
          "valueCoding": {
            "system": "http://hl7.org/fhir/administrative-gender",
            "code": "male",
            "display": "Male"
          }
        },
        {
          "valueCoding": {
            "system": "http://hl7.org/fhir/administrative-gender",
            "code": "female",
            "display": "Female"
          }
        }
      ]
    },
    {
      "linkId": "01",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "68518-0",
          "display": "How often do you have a drink containing alcohol"
        }
      ],
      "prefix": "2",
      "text": "How often do you have a drink containing alcohol?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6270-8",
            "display": "Never"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18933-4",
            "display": "Monthly or less"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18876-5",
            "display": "2-4 times a month"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18891-4",
            "display": "2-3 times a week"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18934-2",
            "display": "4 or more times a week"
          }
        }
      ]
    },
    {
      "linkId": "02",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "68519-8",
          "display": "How many standard drinks containing alcohol do you have on a typical day"
        }
      ],
      "prefix": "3",
      "text": "How many standard drinks containing alcohol do you have on a typical day when drinking?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6270-8",
            "display": "1 or 2"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18926-8",
            "display": "3 or 4"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18927-6",
            "display": "5 or 6"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18928-4",
            "display": "7 to 9"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18929-2",
            "display": "10 or more"
          }
        }
      ]
    },
    {
      "linkId": "03",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "68520-6",
          "display": "How often do you have 6 or more drinks on 1 occasion"
        }
      ],
      "prefix": "4",
      "text": "How often do you have six or more drinks on one occasion?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6270-8",
            "display": "Never"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18926-8",
            "display": "Less than monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18927-6",
            "display": "Monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18928-4",
            "display": "Weekly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18929-2",
            "display": "Daily or almost daily"
          }
        }
      ]
    },
    {
      "linkId": "04",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "97734-8",
          "display": "Inability to stop drinking once started"
        }
      ],
      "prefix": "5",
      "text": "During the past year, how often have you found that you were not able to stop drinking once you had started?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6270-8",
            "display": "Never"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18933-4",
            "display": "Less than monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18876-5",
            "display": "Monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18891-4",
            "display": "Weekly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18934-2",
            "display": "Daily or almost daily"
          }
        }
      ]
    },
    {
      "linkId": "05",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "97735-5",
          "display": "Failed expectations due to drinking"
        }
      ],
      "prefix": "6",
      "text": "During the past year, how often have you failed to do what was normally expected of you because of drinking?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6270-8",
            "display": "Never"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18933-4",
            "display": "Less than monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18876-5",
            "display": "Monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18891-4",
            "display": "Weekly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18934-2",
            "display": "Daily or almost daily"
          }
        }
      ]
    },
    {
      "linkId": "06",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "97736-3",
          "display": "Drink needed in morning to begin activities after drinking session"
        }
      ],
      "prefix": "7",
      "text": "During the past year, how often have you needed a drink in the morning to get yourself going after a heavy drinking session?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6270-8",
            "display": "Never"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18933-4",
            "display": "Less than monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18876-5",
            "display": "Monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18891-4",
            "display": "Weekly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18934-2",
            "display": "Daily or almost daily"
          }
        }
      ]
    },
    {
      "linkId": "07",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "97737-1",
          "display": "Guilt or remorse after drinking"
        }
      ],
      "prefix": "8",
      "text": "During the past year, how often have you had a feeling of guilt or remorse after drinking?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6270-8",
            "display": "Never"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18933-4",
            "display": "Less than monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18876-5",
            "display": "Monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18891-4",
            "display": "Weekly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18934-2",
            "display": "Daily or almost daily"
          }
        }
      ]
    },
    {
      "linkId": "08",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "97738-9",
          "display": "Inability to recall events from night before due to drinking"
        }
      ],
      "prefix": "9",
      "text": "During the past year, how often have you been unable to remember what happened the night before because you had been drinking?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA6270-8",
            "display": "Never"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 1
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18933-4",
            "display": "Less than monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18876-5",
            "display": "Monthly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 3
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18891-4",
            "display": "Weekly"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA18934-2",
            "display": "Daily or almost daily"
          }
        }
      ]
    },
    {
      "linkId": "09",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "97739-7",
          "display": "Injury to you or someone else resulting from drinking"
        }
      ],
      "prefix": "10",
      "text": "Have you or someone else been injured as a result of your drinking?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA32-8",
            "display": "No"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA32279-4",
            "display": "Yes, but not in the past year"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA32280-2",
            "display": "Yes, during the past year"
          }
        }
      ]
    },
    {
      "linkId": "10",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "97740-5",
          "display": "Has anyone expressed concern about your drinking or suggested you cut down"
        }
      ],
      "prefix": "11",
      "text": "Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested you cut down?",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 0
            }
          ],
          "valueCoding": {
            "code": "LA32-8",
            "display": "No"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 2
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA32279-4",
            "display": "Yes, but not in the past year"
          }
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue-my-core",
              "valueDecimal": 4
            }
          ],
          "valueCoding": {
            "system": "http://loinc.org",
            "code": "LA32280-2",
            "display": "Yes, during the past year"
          }
        }
      ]
    },
    {
      "id": "score",
      "linkId": "11",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "75624-7",
          "display": "Total score [AUDIT]"
        }
      ],
      "prefix": "12",
      "text": "Total score [AUDIT]",
      "type": "integer",
      "required": true,
      "readOnly": true
    },
    {
      "id": "outcome",
      "linkId": "12",
      "code": [
        {
          "code": "outcome"
        }
      ],
      "prefix": "13",
      "text": "Outcome Summary [AUDIT]",
      "type": "choice",
      "required": true,
      "readOnly": true,
      "answerOption": [
        {
          "valueCoding": {
            "system": "http://fhir.hie.moh.gov.my/CodeSystem/outcome-audit-10-my-core",
            "code": "a0",
            "display": "Indicates an abstainer who has never had any problems from alcohol"
          }
        },
        {
          "valueCoding": {
            "system": "http://fhir.hie.moh.gov.my/CodeSystem/outcome-audit-10-my-core",
            "code": "a1",
            "display": "Suggests low risk consumption"
          }
        },
        {
          "valueCoding": {
            "system": "http://fhir.hie.moh.gov.my/CodeSystem/outcome-audit-10-my-core",
            "code": "a2",
            "display": "Suggest harmful alcohol consumption"
          }
        },
        {
          "valueCoding": {
            "system": "http://fhir.hie.moh.gov.my/CodeSystem/outcome-audit-10-my-core",
            "code": "a3",
            "display": "Likelihood of alcohol dependence (moderate-severe alcohol use disorder)"
          }
        }
      ]
    }
  ]
}