Argonaut Questionnaire

This page is part of the Argonaut Questionnaire Implementation Guide (v1.0.0: Release) based on FHIR R3. This is the current published version. For a full list of available versions, see the Directory of published versions
XML Format: Questionnaire-questionnaire-example-phq9

Download Raw xml

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    <div xmlns="http://www.w3.org/1999/xhtml"><h3>Patient Health Questionnaire (PHQ-9)</h3><img src="data:image/gif;base64,R0lGODdhwAPQAncAACH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACwAAAAAwAPQAof///8A
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"alt="Patient Health Questionnaire (PHQ-9)"/><p>Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from
Pfizer Inc. No permission required to reproduce, translate, display or distribute.</p></div>
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  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://argonautwiki.hl7.org"/>
    </telecom>
  </contact>
  <copyright
             value="Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from
Pfizer Inc. No permission required to reproduce, translate, display or distribute."/>
  <code>
    <system value="http://loinc.org"/>
    <code value="44249-1"/>
    <display value="PHQ-9 quick depression assessment panel"/>
  </code>
  <subjectType value="Patient"/>
  <item>
    <extension
               url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
      <valueInteger value="0"/>
    </extension>
    <linkId value="g1"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="44249-1"/>
    </code>
    <type value="group"/>
    <required value="true"/>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="0"/>
      </extension>
      <linkId value="g1.d"/>
      <text
            value="Over the last 2 weeks, how often have you been bothered by any of the following problems? (Use “X” to indicate your answer)"/>
      <type value="display"/>
    </item>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="1"/>
      </extension>
      <linkId value="g1.q1"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44250-9"/>
      </code>
      <prefix value="1."/>
      <text value="Little interest or pleasure in doing things,"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL358-3"/>
        <display
                 value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
      </options>
    </item>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="2"/>
      </extension>
      <linkId value="g1.q2"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44255-8"/>
      </code>
      <prefix value="2."/>
      <text value="Feeling down, depressed, or hopeless,"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL358-3"/>
        <display
                 value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
      </options>
    </item>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="3"/>
      </extension>
      <linkId value="g1.q3"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44259-0"/>
      </code>
      <prefix value="3."/>
      <text value="Trouble falling or staying asleep, or sleeping too much"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL358-3"/>
        <display
                 value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
      </options>
    </item>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="4"/>
      </extension>
      <linkId value="g1.q4"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44254-1"/>
      </code>
      <prefix value="4."/>
      <text value="Feeling tired or having little energy,"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL358-3"/>
        <display
                 value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
      </options>
    </item>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="5"/>
      </extension>
      <linkId value="g1.q5"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44251-7"/>
      </code>
      <prefix value="5."/>
      <text value="Poor appetite or overeating,"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL358-3"/>
        <display
                 value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
      </options>
    </item>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="6"/>
      </extension>
      <linkId value="g1.q6"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44258-2"/>
      </code>
      <prefix value="6."/>
      <text
            value="Feeling bad about yourself - or that you are a failure or have let yourself or your family down,"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL358-3"/>
        <display
                 value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
      </options>
    </item>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="7"/>
      </extension>
      <linkId value="g1.q7"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44252-5"/>
      </code>
      <prefix value="7."/>
      <text
            value="Trouble concentrating on things, such as reading the newspaper or watching television,"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL358-3"/>
        <display
                 value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
      </options>
    </item>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="8"/>
      </extension>
      <linkId value="g1.q8"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44253-3"/>
      </code>
      <prefix value="8."/>
      <text
            value="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,"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL358-3"/>
        <display
                 value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
      </options>
    </item>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="9"/>
      </extension>
      <linkId value="g1.q9"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44260-8"/>
      </code>
      <prefix value="9."/>
      <text
            value="Thoughts that you would be better off dead, or of hurting yourself"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL358-3"/>
        <display
                 value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
      </options>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-hidden">
        <valueBoolean value="true"/>
      </extension>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="10"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/designNote">
        <valueMarkdown
                       value="this is hidden text/should not be displayed to the user"/>
      </extension>
      <linkId value="g1.s"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="44261-6"/>
      </code>
      <text
            value="Scoring: 
Add up all checked boxes on PHQ-9. 

For every:
Not at all = 0;
Several days = 1;
More than half the days = 2;
Nearly every day = 3

Interpretation of Total Score
Total Score Depression Severity
1-4 Minimal depression
5-9 Mild depression
10-14 Moderate depression
15-19 Moderately severe depression
20-27 Severe depression"/>
      <type value="display"/>
      <repeats value="false"/>
    </item>
  </item>
  <item>
    <extension
               url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
      <valueInteger value="1"/>
    </extension>
    <linkId value="g2"/>
    <type value="group"/>
    <required value="true"/>
    <item>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
        <valueInteger value="0"/>
      </extension>
      <linkId value="g2.q1"/>
      <code>
        <system value="http://loinc.org"/>
        <code value="69722-7"/>
      </code>
      <text
            value="If you checked off any problems, 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,"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference value="#LL359-1"/>
        <display
                 value="Not difficult at all/Somewhat difficult/Very difficult/Extremely difficult-Perceived difficulty (PHQ-9)"/>
      </options>
    </item>
  </item>
</Questionnaire>