| ARCHETYPE ID | openEHR-EHR-OBSERVATION.nihss.v0 |
| Concept | NIHSS |
| Description | 15-item neurologic examination stroke scale that provides a quantitative measure of stroke-related neurological deficit. |
| Use | Used to record the results of NIHSS scoring as a quantitative measurement of stroke-related neurological deficits. The total score is the arithmetic sum of all 15 responses, with all 'untestable' values excluded. The ordinal value '99' is included to represent the non-numeric value 'untestable'. Currently, neither modeling tools nor existing openEHR journal systems allow for a combination of numeric and non-numeric values within a single value set. |
| Purpose | To record the results of NIHSS as a quantitative measurement of stroke-related neurologic deficit. |
| References | National Institute of Health. NIH Stroke Scale [Internet]. Bethesda, MD: National Institute of Health; [cited 2025 Mar 11]. Available from: https://www.ninds.nih.gov/health-information/stroke/assess-and-treat/nih-stroke-scale Kristensen DV, Johnsen NT, Amthor KF, Lunde L, Strømmen LB, Vestby EM, et al. Validated translation of the NIHSS with cultural adaptation [Internet]. Sykepleien Research. 2020;15(82736):e-82736. Available from: https://sykepleien.no/forskning/2020/11/validert-oversettelse-av-nihss-med-kulturell-tilpasning |
| Copyright | © openEHR Foundation |
| Authors | Author name: Gustavo M Bacelar-Silva Organisation: Healthcare Designs Email: mail@gustavobacelar.com Date originally authored: 2012-05-11 |
| Other Details Language | Author name: Gustavo M Bacelar-Silva Organisation: Healthcare Designs Email: mail@gustavobacelar.com Date originally authored: 2012-05-11 |
| OtherDetails Language Independent | {licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=openEHR Foundation, references=National Institute of Health. NIH Stroke Scale [Internet]. Bethesda, MD: National Institute of Health; [cited 2025 Mar 11]. Available from: https://www.ninds.nih.gov/health-information/stroke/assess-and-treat/nih-stroke-scale
Kristensen DV, Johnsen NT, Amthor KF, Lunde L, Strømmen LB, Vestby EM, et al. Validated translation of the NIHSS with cultural adaptation [Internet]. Sykepleien Research. 2020;15(82736):e-82736. Available from: https://sykepleien.no/forskning/2020/11/validert-oversettelse-av-nihss-med-kulturell-tilpasning, current_contact=Heather Leslie, Atomica Informatics |
| Keywords | scale, neurological, stroke, assessment, examination, NIHSS |
| Lifecycle | in_development |
| UID | 6359150e-4104-4044-b81d-855ba7c4b643 |
| Language used | en |
| Citeable Identifier | 1013.1.2041 |
| Revision Number | 0.0.1-alpha |
| All | Archetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=15-item neurologic examination stroke scale that provides a quantitative measure of stroke-related neurological deficit., archetypeConceptComment=NIHSS - National Institutes of Health Stroke Scale., otherContributors=Gustavo Bacelar-Silva, Healthcare Designs, Portugal Silje Ljosland Bakke, Nasjonal IKT HF, Norway (openEHR Editor) Rong Chen, Cambio Healthcare Systems, Sweden Ricardo Cruz-Correia, Faculty of Medicine of Porto University, Portugal Heather Leslie, Atomica Informatics, Australia (openEHR Editor), originalLanguage=en, translators=
1: Not alert, but arousable [Not alert; but arousable by minor stimulation to obey, answer or respond.] 2: Not alert, requires repeated stimulation [Not Alert; requires repeated stimulation to attend, or is obtunded and requires strong or painful stimulation to make movements (not stereotyped).] 3: Reflex reponses only or totally unreponsive [Responds only with reflex motor or autonomic effects, or totally unresponsive, flaccid, and areflexic.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0009], code=at0009, itemType=ELEMENT, level=4, text=LOC questions, description=The patient is asked the month and his/her age., comment=The patient is asked the month and his/her age. The answer must be correct - there is no partial credit for being close. Aphasic and stuporous patients who do not comprehend the questions will score 2. Patients unable to speak because of endotracheal intubation, orotracheal trauma, severe dysarthria from any cause, language barrier, or any other problem not secondary to aphasia are given a 1. It is important that only the initial answer be graded and that the examiner not “help” the patient with verbal or non-verbal cues., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Both correct [Answers both questions correctly.] 1: One correct [Answers one question correctly.] 2: Neither correct [Answers neither question correctly.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0013], code=at0013, itemType=ELEMENT, level=4, text=LOC commands, description=The patient is asked to open and close the eyes and then to grip and release the nonparetic hand., comment=The patient is asked to open and close the eyes and then to grip and release the nonparetic hand. Substitute another one-step command if the hands cannot be used. Credit is given if an unequivocal attempt is made but not completed due to weakness. If the patient does not respond to command, the task should be demonstrated to him or her (pantomime), and the result scored (i.e., follows none, one, or two commands). Patients with trauma, amputation, or other physical impediments should be given suitable one-step commands. Only the first attempt is scored., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Both correct [Patient performs both tasks correctly.] 1: One correct [Patient performs one task correctly.] 2: Neither correct [Patient performs neither task correctly.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0017], code=at0017, itemType=ELEMENT, level=4, text=Best Gaze, description=Horizontal eye movement observation., comment=Only horizontal eye movements will be tested. Voluntary or reflexive (oculocephalic) eye movements will be scored, but caloric testing is not done. If the patient has a conjugate deviation of the eyes that can be overcome by voluntary or reflexive activity, the score will be 1. If a patient has an isolated peripheral nerve paresis (CN III, IV, or VI), score a 1. Gaze is testable in all aphasic patients. Patients with ocular trauma, bandages, pre-existing blindness, or other disorder of visual acuity or fields should be tested with reflexive movements, and a choice made by the investigator. Establishing eye contact and then moving about the patient from side to side will occasionally clarify the presence of a partial gaze palsy., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Normal [Normal eye movement.] 1: Partial gaze palsy [Gaze is abnormal in one or both eyes, but forced deviation or total gaze paresis is not present.] 2: Forced deviation or total gaze paresis [Forced deviation or total gaze paresis is not overcome by the oculocephalic maneuver.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0021], code=at0021, itemType=ELEMENT, level=4, text=Visual, description=Visual field test observation., comment=Visual fields (upper and lower quadrants) are tested by confrontation, using finger counting or visual threat, as appropriate. Patients may be encouraged, but if they look at the side of the moving fingers appropriately, this can be scored as normal. If there is unilateral blindness or enucleation, visual fields in the remaining eye are scored. Score 1 only if a clear-cut asymmetry, including quadrantanopia, is found. If patient is blind from any cause, score 3. Double simultaneous stimulation is performed at this point., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No visual loss [No visual loss detected.] 1: Partial hemianopia [Partial hemianopia or complete quadrantanopia detected.] 2: Complete hemianopia [Complete hemianopia detected.] 3: Bilateral hemianopia [Blindness from any cause, including cortical blindness.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0026], code=at0026, itemType=ELEMENT, level=4, text=Facial palsy, description=Facial palsy observation., comment=Ask - or use pantomime to encourage - the patient to show teeth or raise eyebrows and close eyes. Score symmetry of grimace in response to noxious stimuli in the poorly responsive or non-comprehending patient. If facial trauma/ bandages, orotracheal tube, tape, or other physical barriers obscure the face, these should be removed to the extent possible., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Normal [Normal symmetrical movements.] 1: Minor paralysis [Flattened nasolabial fold, asymmetry on smiling.] 2: Partial paralysis [Total or near-total paralysis of lower face.] 3: Complete paralysis of one or both sides [Absence of facial movement in the upper and lower face.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0031], code=at0031, itemType=ELEMENT, level=4, text=Motor - left arm, description=Observation of left arm motor function., comment=Only in the case of amputation or joint fusion at the shoulder, the examiner should record the score as 'Untestable' and record the reason in the 'Reason left arm untestable' data element. Implementation note: Although the 'Untestable' value is included in the ordinal to allow its inclusion in the user interface dropdown menu, NIHSS does not assign a numerical score for the 'Untestable' option in the total NIHSS score., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No drift [Limb holds 90 (or 45) degrees for full 10 seconds.] 1: Drift [Limb holds 90 (or 45) degrees, but drifts down before full 10 seconds; does not hit bed or other support.] 2: Some effort against gravity [Limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.] 3: No effort against gravity [Limb falls.] 4: No movement [There is no observed limb movement.] 99: Untestable [Amputation or joint fusion at the shoulder.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0037], code=at0037, itemType=ELEMENT, level=4, text=Reason left arm untestable, description=Narrative description about why the left arm motor function was untestable., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0038], code=at0038, itemType=ELEMENT, level=4, text=Motor - right arm, description=Observation of right arm motor function., comment=Only in the case of amputation or joint fusion at the shoulder, the examiner should record the score as 'Untestable' and record the reason in the 'Reason right arm untestable' data element. Implementation note: Although the 'Untestable' value is included in the ordinal to allow its inclusion in the user interface dropdown menu, NIHSS does not assign a numerical score for the 'Untestable' option in the total NIHSS score., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No drift [Limb holds 90 (or 45) degrees for full 10 seconds.] 1: Drift [Limb holds 90 (or 45) degrees, but drifts down before full 10 seconds; does not hit bed or other support.] 2: Some effort against gravity [Limb cannot get to or maintain (if cued) 90 (or 45) degrees, drifts down to bed, but has some effort against gravity.] 3: No effort against gravity [Limb falls.] 4: No movement [There is no observed limb movement.] 99: Untestable [Amputation or joint fusion at the shoulder.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0045], code=at0045, itemType=ELEMENT, level=4, text=Reason right arm untestable, description=Narrative description about why the right arm motor function was untestable., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0046], code=at0046, itemType=ELEMENT, level=4, text=Motor - left leg, description=Observation of left leg motor function., comment=Only in the case of amputation or joint fusion at the hip, the examiner should record the score as 'Untestable' and record the reason in the 'Reason left leg untestable' data element. Implementation note: Although the 'Untestable' value is included in the ordinal to allow its inclusion in the user interface dropdown menu, NIHSS does not assign a numerical score for the 'Untestable' option in the total NIHSS score., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No drift [Leg holds 30-degree position for full 5 seconds.] 1: Drift [Leg falls by the end of the 5-second period but does not hit the bed.] 2: Some effort against gravity [Leg falls to bed by 5 seconds but has some effort against gravity.] 3: No effort against gravity [Leg falls to bed immediately.] 4: No movement [There is no observed leg movement.] 99: Untestable [Amputation or joint fusion at the hip.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0053], code=at0053, itemType=ELEMENT, level=4, text=Reason left leg untestable, description=Narrative description about why the left leg motor function was untestable., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0141], code=at0141, itemType=ELEMENT, level=4, text=Motor - right leg, description=Observation of right leg motor function., comment=Only in the case of amputation or joint fusion at the hip, the examiner should record the score as 'Untestable' and record the reason in the 'Reason right leg untestable' data element. Implementation note: Although the 'Untestable' value is included in the ordinal to allow its inclusion in the user interface dropdown menu, NIHSS does not assign a numerical score for the 'Untestable' option in the total NIHSS score., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No drift [Leg holds 30-degree position for full 5 seconds.] 1: Drift [Leg falls by the end of the 5-second period but does not hit the bed.] 2: Some effort against gravity [Leg falls to bed by 5 seconds but has some effort against gravity.] 3: No effort against gravity [Leg falls to bed immediately.] 4: No movement [There is no observed leg movement.] 99: Untestable [Amputation or joint fusion at the hip.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0060], code=at0060, itemType=ELEMENT, level=4, text=Reason right leg untestable, description=Narrative description about why the right leg motor function was untestable., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0061], code=at0061, itemType=ELEMENT, level=4, text=Limb ataxia, description=Observation of limb ataxia as evidence of a unilateral cerebellar lesion., comment=Only in the case of amputation or joint fusion, the examiner should record the score as 'Untestable' and record the reason in the 'Reason limb ataxia untestable' data element. Implementation note: Although the 'Untestable' value is included in the ordinal to allow its inclusion in the user interface dropdown menu, NIHSS does not assign a numerical score for the 'Untestable' option in the total NIHSS score., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Absent [No limb ataxia observed.] 1: Present in one limb [Limb ataxia observed in one limb.] 2: Present in two limbs [Limb ataxia observed in two limbs.] 99: Untestable [Amputation or joint fusion.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0066], code=at0066, itemType=ELEMENT, level=4, text=Reason limb ataxia untestable, description=Narrative description about why limb ataxia was untestable., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067], code=at0067, itemType=ELEMENT, level=4, text=Sensory, description=Observation of sensory loss., comment=Sensation or grimace to pinprick when tested, or withdrawal from noxious stimulus in the obtunded or aphasic patient. Only sensory loss attributed to stroke is scored as abnormal and the examiner should test as many body areas (arms [not hands], legs, trunk, face) as needed to accurately check for hemisensory loss. A score of 2, “severe or total sensory loss,” should only be given when a severe or total loss of sensation can be clearly demonstrated. Stuporous and aphasic patients will, therefore, probably score 1 or 0. The patient with brainstem stroke who has bilateral loss of sensation is scored 2. If the patient does not respond and is quadriplegic, score 2. Patients in a coma (item 1a=3) are automatically given a 2 on this item., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Normal [No sensory loss.] 1: Mild-to-moderate sensory loss [Patient feels pinprick is less sharp or is dull on the affected side; or there is a loss of superficial pain with pinprick, but patient is aware of being touched.] 2: Severe or total sensory loss [Patient is not aware of being touched in the face, arm, and leg.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0071], code=at0071, itemType=ELEMENT, level=4, text=Best Language, description=Observation of language capability., comment=Comprehension is judged from responses here, as well as to all of the commands in the preceding general neurological exam. If visual loss interferes with the tests, ask the patient to identify objects placed in the hand, repeat, and produce speech. The intubated patient should be asked to write. The patient in a coma (item 1a=3) will automatically score 3 on this item. The examiner must choose a score for the patient with stupor or limited cooperation, but a score of 3 should be used only if the patient is mute and follows no one-step commands., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No aphasia [Normal] 1: Mild-to-moderate aphasia [Some obvious loss of fluency or facility of comprehension, without significant limitation on ideas expressed or form of expression. Reduction of speech and/or comprehension, however, makes conversation about provided materials difficult or impossible. For example, in conversation about provided materials, examiner can identify picture or naming card content from patient’s response.] 2: Severe aphasia [All communication is through fragmentary expression; great need for inference, questioning, and guessing by the listener. Range of information that can be exchanged is limited; listener carries burden of communication. Examiner cannot identify materials provided from patient response.] 3: Mute, global aphasia [No usable speech or auditory comprehension.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0076], code=at0076, itemType=ELEMENT, level=4, text=Dysarthria, description=Observation about speech capability., comment=Only if the patient is intubated or has other physical barriers to producing speech, the examiner should record the score as 'Untestable' and record the reason in the 'Reason speech untestable' data element. Implementation note: Although the 'Untestable' value is included in the ordinal to allow its inclusion in the user interface dropdown menu, NIHSS does not assign a numerical score for the 'Untestable' option in the total NIHSS score., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Normal [Normal speech.] 1: Mild-to-moderate dysarthria [Patient slurs at least some words and, at worst, can be understood with some difficulty.] 2: Severe dysarthria [Patient's speech is so slurred as to be unintelligible in the absence of or out of proportion to any dysphasia, or is mute/anarthric.] 99: Untestable [Intubated or other physical barrier.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0081], code=at0081, itemType=ELEMENT, level=4, text=Reason speech untestable, description=Narrative description about why speech was untestable., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0082], code=at0082, itemType=ELEMENT, level=4, text=Extinction and inattention, description=Observation of any evidence of extinction or inattention., comment=Extinction and Inattention (formerly Neglect): Sufficient information to identify neglect may be obtained during the prior testing. If the patient has a severe visual loss preventing visual double simultaneous stimulation, and the cutaneous stimuli are normal, the score is normal. If the patient has aphasia but does appear to attend to both sides, the score is normal. The presence of visual spatial neglect or anosagnosia may also be taken as evidence of abnormality. Since the abnormality is scored only if present, the item is never untestable., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No abnormality [No abnormality observed.] 1: Inattention, or bilateral extinction in one sensory modality [Visual, tactile, auditory, spatial, or personal inattention, or extinction to bilateral simultaneous stimulation in one of the sensory modalities.] 2: Profound hemi-inattention or extinction to more than one modality [Does not recognize own hand or orients to only one side of space.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0086], code=at0086, itemType=ELEMENT, level=4, text=Total score, description=The total score is the arithmetic sum of all 15 responses, excluding any untestable responses., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0; max: <=42 , extendedValues=null]], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0092]/items[at0093], code=at0093, itemType=SLOT, level=2, text=Extension, description=Additional information required to extend the model with local content or to align with other reference models or formalisms., comment=For example: local information requirements; or additional metadata to align with FHIR., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: All not explicitly excluded archetypes, extendedValues=null]], source=[], capabilities=[], contacts=[], provider=[], details=[], items=[], credentials=[], state=[], activities=[], other_participations=[], context=[]}, topLevelItems={data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001]/events[at0002]/data[at0003], code=at0003, itemType=ITEM_TREE, level=2, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0092], code=at0092, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0092]/items[at0093], code=at0093, itemType=SLOT, level=2, text=Extension, description=Additional information required to extend the model with local content or to align with other reference models or formalisms., comment=For example: local information requirements; or additional metadata to align with FHIR., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: All not explicitly excluded archetypes, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null] |