ARCHETYPE 4AT (openEHR-EHR-OBSERVATION.aaaa_test.v0)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.aaaa_test.v0
Concept4AT
DescriptionScreening instrument designed for rapid initial assessment of delirium and cognitive impairment.
UseUse to record the 4AT score after screening for delirium in clinical practice. Note that the 4AT is not designed for repeated daily monitoring for new onset delirium (because of practice effects with the Months Backwards task). Altered level of arousal (Item 1), and change or fluctuation (Item 4) can readily be used daily or even more frequently, along with general clinical judgement and/or use of tools specifically designed for ongoing monitoring of delirium.
MisuseNot to be used for repeated daily monitoring for new onset delirium (because of practice effects with the Months Backwards task).
PurposeTo record the 4AT score after screening for delirium in clinical practice.
References4AT Rapid Clinical Test For Delirium [Internet]. 2014 [cited 2019 Dec 26]. Available from: https://www.the4at.com/
Copyright© openEHR Foundation, Nasjonal IKT HF
AuthorsAuthor name: John Tore Valand
Organisation: Helse Bergen HF
Date originally authored: 2019-02-18
Other Details LanguageAuthor name: John Tore Valand
Organisation: Helse Bergen HF
Date originally authored: 2019-02-18
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=4AT Rapid Clinical Test For Delirium [Internet]. 2014 [cited 2019 Dec 26]. Available from: https://www.the4at.com/, current_contact=John Tore Valand, john.tore.valand@helse-bergen.no, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=959A8882C46631A346A9AF9A58E169CA, build_uid=0ebaf060-047e-4f95-b823-7a1045837e4e, revision=0.0.1-alpha}
Keywordsdelirium, assessment, alertness
Lifecyclein_development
UID3a4419db-5442-4f8d-8786-29d5414e48fd
Language useden
Citeable Identifier1013.1.4304
Revision Number0.0.1-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Screening instrument designed for rapid initial assessment of delirium and cognitive impairment., archetypeConceptComment=null, otherContributors=Heather Leslie, Atomica Informatics, Australia, originalLanguage=en, translators=Norwegian Bokmål: John Tore Valand, Haukeland Universitetssjukehus, john.tore.valand@helse-bergen.no
, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={details=[], credentials=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=[1] ALERTNESS, description=This includes patients who may be markedly drowsy (eg. difficult to rouse and/or obviously sleepy during assessment) or agitated/hyperactive. Observe the patient. If asleep, attempt to wake with speech or gentle touch on shoulder. Ask the patient to state their name and address to assist rating., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Normal (fully alert, but not agitated, throughout assessment) [*]
4: Clearly abnormal [*]
0: Mild sleepiness for <11 seconds after waking, then normal [*]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0008], code=at0008, itemType=ELEMENT, level=4, text=[2] AMT4, description=Age, date of birth, place (name of the hospital or building), current year., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No mistakes [*]
1: 1 mistake [*]
2: 2 or more mistakes/untestable [*]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0012], code=at0012, itemType=ELEMENT, level=4, text=[3] ATTENTION, description=Months of the year backwards., comment=Ask the patient: “Please tell me the months of the year in backwards order, starting at December.” To assist initial understanding one prompt of “what is the month before December?” is permitted., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: Achieves 7 months or more correctly [*]
1: Starts but scores <7 months / refuses to start [*]
2: Untestable (cannot start because unwell, drowsy, inattentive) [*]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0016], code=at0016, itemType=ELEMENT, level=4, text=[4] ACUTE CHANGE OR FLUCTUATING COURSE, description=Evidence of significant change or fluctuation in: alertness, cognition, other mental function., comment=eg. paranoia, hallucinations) arising over the last 2 weeks and still evident in last 24hrs., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [*]
4: Yes [*]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0019], code=at0019, itemType=ELEMENT, level=4, text=4AT score, description=The sum of the 4 ordinal scores for each component parameter., 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: <=15

, extendedValues=null]], identities=[], ism_transition=[], capabilities=[], items=[], context=[], provider=[], activities=[], content=[], target=[], state=[], relationships=[], other_participations=[], source=[], contacts=[], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0020]/items[at0021], code=at0021, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents., 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]], description=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=POINT_EVENT, level=2, text=Any point in time event, description=Unspecified point in time event which may be explicitly defined in a template or at run-time., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=POINT_EVENT, bindings=null, values=null, extendedValues=null]]}, 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=1..1, cardinalityText=mandatory, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0020], code=at0020, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..1, cardinalityText=mandatory, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0020]/items[at0021], code=at0021, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents., 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]