| SPECIFICATION |
{"test":[{"content":[{"choiceDisplay":42369,"choiceTypeId":null,"designator":"1.","hint":null,"id":5267,"instrument":85,"introDisplay":42370,"introId":null,"introText":null,"max":0,"min":0,"questionDisplay":42368,"questionId":4865,"question
\" Observation:","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":40},{"choice":[{"choiceId":1,"choiceText":"None","ien":49495,"legacyValue":0,"sequence":1},{"choiceId":2437,"choiceText":"Very mild itching, pins a
00:00):| <*Answer_4865*>|2. Pulse or heart rate (taken for one minute):| <*Answer_4866*>|3. Blood pressure:| <*Answer_4867*>|4. NAUSEA AND VOMITING - Ask, \"Do you feel \r\nsick to your stomach? Have you vomited?\" Observation:|
<*Answer_4868*>|5. TACTILE DISTURBANCES - Ask, \"Have you any itching, pins and needles sensations, any burning, any numbness, or do you feel \r\nbugs crawling on or under your skin?\" Observation:| <*Answer_4869*>|6. TREMOR - Arms exte
nded and fingers spread apart. Observation:| <*Answer_4870*>|7. AUDITORY DISTURBANCES - Ask, \"Are you
\r\nmore aware of sounds around you? Are they harsh? Do they frighten you? Are you hearing anything that is disturbing to you? Are you hearing things you know are not there?\" Observation: | \r\n<*Answer_4871*>|8. PAROXYSMAL SWEATS - Obs
ervation:| <*Answer_4872*>|9. VISUAL DISTURBANCES - Ask, \"Does the light appear to be too bright? Is its color different? Does it hurt your eyes? Are you \r\nseeing anything that is disturbing to you? Are you seeing things you know are
not there?\" Observation: | <*Answer_4873*>|10. ANXIETY - Ask, \"Do you feel nervous?\" Observation:| \r\n<*Answer_4874*>|11. HEADACHE, FULLNESS IN HEAD - Ask, \"Does your head feel different? Does it feel like there is a band around
your head?\" Do not rate for dizziness or lightheadedness. Otherwise, \r\nrate severity:| <*Answer_4875*>|12. AGITATION - Observation:| <*Answer_4876*>|13. ORIENTATION AND CLOUDING OF SENSORIUM - Ask, \"What day is this? Where are you
? Who am I?\"| \r\n<*Answer_4877*>|||Information contained in this note is based on a self-report assessment and is not sufficient to use alone for diagnostic purposes. Assessment results should be verified for \r\naccuracy and used in
conjunction with other diagnostic activities and procedures.| $~"},"scaleGroup":[{"grid1":0,"grid2":10,"grid3":20,"id":111,"instrument":85,"name":"CIWA-AR","ordInc":10,"ordMax":67,"ordMin":0,"ordTitle":"Score","scale":[{"groupId":111,"id":
548,"name":"Total Score","scoringKey":[{"id":6144,"questionId":4868,"scaleId":548,"targetText":"Intermittent nausea with dry heaves","value":4},{"id":6147,"questionId":4868,"scaleId":548,"targetText":"Constant nausea, frequent dry heaves an
nd needles, burning or numbness","ien":49496,"legacyValue":1,"sequence":2},{"choiceId":2438,"choiceText":"Mild itching, pins and needles, burning or numbness","ien":49497,"legacyValue":2,"sequence":3},{"choiceId":2755,"choiceText":"Moderate
d vomiting","value":7},{"id":6148,"questionId":4869,"scaleId":548,"targetText":"Very mild itching, pins and needles, burning or numbness","value":1},{"id":6149,"questionId":4869,"scaleId":548,"targetText":"Mild itching, pins and needles, bu
rning or numbness","value":2},{"id":6150,"questionId":4869,"scaleId":548,"targetText":"Moderate itching, pins and needles, burning or numbness","value":3},{"id":6151,"questionId":4869,"scaleId":548,"targetText":"Moderately severe hallucinat
ions","value":4},{"id":6152,"questionId":4869,"scaleId":548,"targetText":"Severe hallucinations","value":5},{"id":6153,"questionId":4869,"scaleId":548,"targetText":"Extremely severe hallucinations","value":6},{"id":6154,"questionId":4869,"s
caleId":548,"targetText":"Continuous hallucinations","value":7},{"id":6155,"questionId":4870,"scaleId":548,"targetText":"Not visible, but can be felt fingertip to fingertip","value":1},{"id":6156,"questionId":4871,"scaleId":548,"targetText"
:"Very mild harshness or ability to frighten","value":1},{"id":6157,"questionId":4871,"scaleId":548,"targetText":"Mild harshness or ability to frighten","value":2},{"id":6158,"questionId":4871,"scaleId":548,"targetText":"Moderate harshness
or ability to frighten","value":3},{"id":6159,"questionId":4871,"scaleId":548,"targetText":"Moderately severe hallucinations","value":4},{"id":6160,"questionId":4871,"scaleId":548,"targetText":"Severe hallucinations","value":5},{"id":6161,"
questionId":4871,"scaleId":548,"targetText":"Extremely severe hallucinations","value":6},{"id":6162,"questionId":4871,"scaleId":548,"targetText":"Continuous hallucinations","value":7},{"id":6163,"questionId":4872,"scaleId":548,"targetText":
"Barely perceptible sweating, palms moist","value":1},{"id":6166,"questionId":4872,"scaleId":548,"targetText":"Beads of sweat obvious on forehead","value":4},{"id":6169,"questionId":4872,"scaleId":548,"targetText":"Drenching sweats","value"
:7},{"id":6170,"questionId":4873,"scaleId":548,"targetText":"Very mild sensitivity","value":1},{"id":6171,"questionId":4873,"scaleId":548,"targetText":"Mild sensitivity","value":2},{"id":6172,"questionId":4873,"scaleId":548,"targetText":"Mo
derate sensitivity","value":3},{"id":6173,"questionId":4873,"scaleId":548,"targetText":"Moderately severe hallucinations","value":4},{"id":6174,"questionId":
itching, pins and needles, burning or numbness","ien":49498,"legacyValue":3,"sequence":4},{"choiceId":2440,"choiceText":"Moderately severe hallucinations","ien":49499,"legacyValue":4,"sequence":5},{"choiceId":2441,"choiceText":"Severe hall
4873,"scaleId":548,"targetText":"Severe hallucinations","value":5},{"id":6175,"questionId":4873,"scaleId":548,"targetText":"Extremely severe hallucinations","value":6},{"id":6176,"questionId":4873,"scaleId":548,"targetText":"Continuous hall
ucinations","value":7},{"id":6177,"questionId":4874,"scaleId":548,"targetText":"Mildly anxious","value":1},{"id":6180,"questionId":4874,"scaleId":548,"targetText":"Moderately anxious, or guarded, so anxiety is inferred","value":4},{"id":618
3,"questionId":4874,"scaleId":548,"targetText":"Equivalent to acute panic states as seen in severe delirium or acute schizophrenic reactions","value":7},{"id":6184,"questionId":4875,"scaleId":548,"targetText":"Very mild","value":1},{"id":61
85,"questionId":4875,"scaleId":548,"targetText":"Mild","value":2},{"id":6186,"questionId":4875,"scaleId":548,"targetText":"Moderate","value":3},{"id":6187,"questionId":4875,"scaleId":548,"targetText":"Moderately severe","value":4},{"id":618
8,"questionId":4875,"scaleId":548,"targetText":"Severe","value":5},{"id":6189,"questionId":4875,"scaleId":548,"targetText":"Very severe","value":6},{"id":6190,"questionId":4875,"scaleId":548,"targetText":"Extremely severe","value":7},{"id":
6191,"questionId":4876,"scaleId":548,"targetText":"Somewhat more than normal activity","value":1},{"id":6194,"questionId":4876,"scaleId":548,"targetText":"Moderately fidgety and restless","value":4},{"id":6197,"questionId":4876,"scaleId":54
8,"targetText":"Paces back and forth during most of the interview, or constantly thrashes about","value":7},{"id":6198,"questionId":4877,"scaleId":548,"targetText":"Cannot do serial additions or is uncertain about date","value":1},{"id":619
9,"questionId":4877,"scaleId":548,"targetText":"Disoriented for date by no more than 2 calendar days","value":2},{"id":6200,"questionId":4877,"scaleId":548,"targetText":"Disoriented for date by more than 2 calendar days","value":3},{"id":62
01,"questionId":4877,"scaleId":548,"targetText":"Disoriented for place\/or person","value":4},{"id":6204,"questionId":4870,"scaleId":548,"targetText":"Moderate, with patient's arms extended","value":4},{"id":6207,"questionId":4870,"scaleId"
:548,"targetText":"Severe, even with arms not extended","value":7},{"id":6208,"questionId":4868,"scaleId":548,"targetText":"Nausea 1","value":1},{"id":6209,"questionId":4868,"scaleId":548,"targetText":"Nausea 2","value":2},{"id":6210,"quest
ucinations","ien":49500,"legacyValue":5,"sequence":6},{"choiceId":2442,"choiceText":"Extremely severe hallucinations","ien":49501,"legacyValue":6,"sequence":7},{"choiceId":2443,"choiceText":"Continuous hallucinations","ien":49502,"legacyVal
ionId":4868,"scaleId":548,"targetText":"Nausea 3","value":3},{"id":6211,"questionId":4868,"scaleId":548,"targetText":"Nausea 5","value":5},{"id":6212,"questionId":4868,"scaleId":548,"targetText":"Nausea 6","value":6},{"id":6213,"questionId"
:4870,"scaleId":548,"targetText":"Tremor 2","value":2},{"id":6214,"questionId":4870,"scaleId":548,"targetText":"Tremor 3","value":3},{"id":6215,"questionId":4870,"scaleId":548,"targetText":"Tremor 5","value":5},{"id":6216,"questionId":4870,
"scaleId":548,"targetText":"Tremor 6","value":6},{"id":6217,"questionId":4872,"scaleId":548,"targetText":"Sweating 2","value":2},{"id":6218,"questionId":4872,"scaleId":548,"targetText":"Sweating 3","value":3},{"id":6219,"questionId":4872,"s
caleId":548,"targetText":"Sweating 5","value":5},{"id":6220,"questionId":4872,"scaleId":548,"targetText":"Sweating 6","value":6},{"id":6221,"questionId":4874,"scaleId":548,"targetText":"Anxiety 2","value":2},{"id":6222,"questionId":4874,"sc
aleId":548,"targetText":"Anxiety 3","value":3},{"id":6223,"questionId":4874,"scaleId":548,"targetText":"Anxiety 5","value":5},{"id":6224,"questionId":4874,"scaleId":548,"targetText":"Anxiety 6","value":6},{"id":6225,"questionId":4876,"scale
Id":548,"targetText":"Agitation 2","value":2},{"id":6226,"questionId":4876,"scaleId":548,"targetText":"Agitation 3","value":3},{"id":6227,"questionId":4876,"scaleId":548,"targetText":"Agitation 5","value":5},{"id":6228,"questionId":4876,"sc
aleId":548,"targetText":"Agitation 6","value":6}],"sequence":2,"xLabel":"Score"}],"sequence":1}],"section":[{"displayId":1095,"firstQuestion":5446,"id":267,
"instrument":85,"sectionCaption":" ","tabCaption":null},{"displayId":1095,"firstQuestion":5447,"id":268,"instrument":85,"sectionCaption":null,"tabCaption":null}],"verify":["601.71:85","601.72:4865","601.72:4866","601.72:4867","601.72:4868",
"601.72:4869","601.72:4870","601.72:4871","601.72:4872","601.72:4873","601.72:4874","601.72:4875","601.72:4876","601.72:4877","601.72:5446","601.72:5447","601.75:1","601.75:3","601.75:4","601.75:5","601.75:614","601.75:615","601.75:618","60
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ue":7,"sequence":8}],"choiceDisplay":42381,"choiceIdentifier":0,"choiceIdentifierIen":16057,"choiceTypeId":24564,"designator":"5.","hint":null,"id":5271,"instrument":85,"introDisplay":42382,"introId":null,"introText":null,"max":0,"min":0,"q
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uestionDisplay":42380,"questionId":4869,"questionText":"TACTILE DISTURBANCES - Ask, \"Have you any itching, pins and needles sensations, any burning, any numbness, or do you feel bugs crawling on or under your skin?\" Observation:","require
388","601.88:42389","601.88:42390","601.88:42391","601.88:42392","601.88:42393","601.88:42394","601.88:42395","601.88:42396","601.88:42397","601.88:42398","601.88:42399","601.88:42400","601.88:42401","601.88:42402","601.88:42403","601.88:42
404","601.88:42405","601.88:42406","601.89:16056","601.89:16057","601.89:16058","601.89:16059","601.89:16060","601.89:16061","601.89:16062","601.89:16063","601.89:16064","601.89:16065","601.91:6144","601.91:6147","601.91:6148","601.91:6149"
,"601.91:6150","601.91:6151","601.91:6152","601.91:6153","601.91:6154","601.91:6155","601.91:6156","601.91:6157","601.91:6158","601.91:6159","601.91:6160","601.91:6161","601.91:6162","601.91:6163","601.91:6166","601.91:6169","601.91:6170","
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01.91:6211","601.91:6212","601.91:6213","601.91:6214","601.91:6215","601.91:6216","601.91:6217","601.91:6218","601.91:6219","601.91:6220","601.91:6221","601.91:6222","601.91:6223","601.91:6224","601.91:6225","601.91:6226","601.91:6227","601
.91:6228"]},{"content":[{"choice":[{"choiceId":2886,"choiceText":"Receives no assistance (gets in and out of tub by self, if tub is usual means of bathing).","ien":81547,"legacyValue":1,"sequence":1},{"choiceId":2516,"choiceText":"Receives
assistance in bathing only one part of body (such as back or leg).","ien":81548,"legacyValue":2,"sequence":2},{"choiceId":2517,"choiceText":"Receives assistance in bathing more than one part of the body (or not bathed).","ien":81549,"legacy
Value":3,"sequence":3}],"choiceDisplay":43494,"choiceIdentifier":null,"choiceIdentifierIen":0,"choiceTypeId":25103,"designator":"1.","hint":null,"id":5323,"instrument":84,"introDisplay":43440,"introId":1040,"introText":"For each area of fun
ctioning listed below, check description that applies.\r\n(The word \"assistance\" means supervision, direction of personal assistance.)","max":0,"min":0,"questionDisplay":43493,"questionId":5132,"questionText":"Bathing: either sponge bath,
d":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":50},{"choice":[{"choiceId":1366,"choiceText":"No tremor","ien":49503,"legacyValue":0,"sequence":1},{"choiceId":2444,"choiceText":"Not visible, but can be felt fingertip to
tub bath or shower.","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":20},{"choice":[{"choiceId":2518,"choiceText":"Gets clothes and dresses self without assistance.","ien":81550,"legacyValue":1,"sequence":1},{"c
hoiceId":2519,"choiceText":"Gets clothes and dresses self without assistance except for tying shoes.","ien":81551,"legacyValue":2,"sequence":2},{"choiceId":2887,"choiceText":"Receives assistance in getting clothes, or dressing, or stays par
tly or completely undressed.","ien":81552,"legacyValue":3,"sequence":3}],"choiceDisplay":43496,"choiceIdentifier":null,"choiceIdentifierIen":0,"choiceTypeId":25104,"designator":"2.","hint":null,"id":5324,"instrument":84,"introDisplay":43440
,"introId":1040,"introText":"For each area of functioning listed below, check description that applies.\r\n(The word \"assistance\" means supervision, direction of personal assistance.)","max":0,"min":0,"questionDisplay":43495,"questionId":
5133,"questionText":"Dressing: gets clothes from closets and drawers, including under-clothes, outer garments and using fasteners (including braces if worn).","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":30},{
"choice":[{"choiceId":2900,"choiceText":"No assistance needed.","ien":81553,"legacyValue":1,"sequence":1},{"choiceId":2901,"choiceText":"Receives assistance with at least one procedure above.","ien":81554,"legacyValue":2,"sequence":2},{"cho
iceId":2890,"choiceText":"Does not go to \"toilet room\" for elimination procedure.","ien":81555,"legacyValue":3,"sequence":3}],"choiceDisplay":43498,"choiceIdentifier":null,"choiceIdentifierIen":0,"choiceTypeId":25105,"designator":"3.","hi
nt":null,"id":5325,"instrument":84,"introDisplay":43440,"introId":1040,"introText":"For each area of functioning listed below, check description that applies.\r\n(The word \"assistance\" means supervision, direction of personal assistance.)
","max":0,"min":0,"questionDisplay":43497,"questionId":5134,"questionText":"Toileting: going to the \"toilet room\" for bowel and urine elimination; cleaning self after elimination and arranging clothes. (May use cane, walker, or wheelchair
, and manage bedpan or commode, \r\nemptying same next morning).","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":40},{"choice":[{"choiceId":2891,"choiceText":"Moves in and out of bed, or chair, without assistanc
fingertip","ien":49504,"legacyValue":1,"sequence":2},{"choiceId":2739,"choiceText":"Tremor 2","ien":49505,"legacyValue":2,"sequence":3},{"choiceId":2740,
e (may use support object like cane or walker).","ien":81556,"legacyValue":1,"sequence":1},{"choiceId":2892,"choiceText":
"Moves in and out of bed with assistance.","ien":81557,"legacyValue":2,"sequence":2},{"choiceId":2526,"choiceText":"Does not get out of bed.","ien":81558,"legacyValue":3,"sequence":3}],"choiceDisplay":43500,"choiceIdentifier":null,"choiceId
entifierIen":0,"choiceTypeId":25106,"designator":"4.","hint":null,"id":5326,"instrument":84,"introDisplay":43440,"introId":1040,"introText":"For each area of functioning listed below, check description that applies.\r\n(The word \"assistanc
e\" means supervision, direction of personal assistance.)","max":0,"min":0,"questionDisplay":43499,"questionId":5135,"questionText":"Transfer:","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":50},{"choice":[{"cho
iceId":2527,"choiceText":"Controls urination and bowel movement completely by self.","ien":81559,"legacyValue":1,"sequence":1},{"choiceId":2893,"choiceText":"Has occasional \"accidents\" of urination or bowels.","ien":81560,"legacyValue":2,
"sequence":2},{"choiceId":2529,"choiceText":"Supervision helps keep urine or bowel control: catheter is used or is incontinent.","ien":81561,"legacyValue":3,"sequence":3}],"choiceDisplay":43502,"choiceIdentifier":null,"choiceIdentifierIen":
0,"choiceTypeId":25107,"designator":"5.","hint":null,"id":5327,"instrument":84,"introDisplay":43440,"introId":1040,"introText":"For each area of functioning listed below, check description that applies.\r\n(The word \"assistance\" means sup
ervision, direction of personal assistance.)","max":0,"min":0,"questionDisplay":43501,"questionId":5136,"questionText":"Continence:","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":60},{"choice":[{"choiceId":2530
,"choiceText":"Feeds self without assistance.","ien":81562,"legacyValue":1,"sequence":1},{"choiceId":2894,"choiceText":"Feed self except for geting assistance in cutting meat or buttering bread.","ien":81563,"legacyValue":2,"sequence":2},{"
choiceId":2895,"choiceText":"Receives assistance in feeding, or, is fed partly or completely by tubes or intravenous.","ien":81564,"legacyValue":3,"sequence":3}],"choiceDisplay":43504,"choiceIdentifier":null,"choiceIdentifierIen":0,"choiceT
"choiceText":"Tremor 3","ien":49506,"legacyValue":3,"sequence":4},{"choiceId":2446,"choiceText":"Moderate, with patient's arms extended","ien":49507,"legacyValue":4,"sequence":5},{"choiceId":2741,"choiceText":"Tremor 5","ien":49508,"legacyV
ypeId":25108,"designator":"6.","hint":null,"id":5328,"instrument":84,"introDisplay":43440,"introId":1040,"introText":"For each area of functioning listed below, check description that applies.\r\n(The word \"assistance\" means supervision,
direction of personal assistance.)","max":0,"min":0,"questionDisplay":43503,"questionId":5137,"questionText":"Feeding:","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":70}],"display":[{"alignment":"L","columns":n
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:false,"fontColor":"clWindowText","fontItalic":false,"fontName":"MS Sans Serif","fontSize":10,"fontUnderlined":false,"id":43493,"left":3,"mask":null},{"alignment":"L","columns":1,"component":"RA","fontBold":false,"fontColor":"clWindowText",
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others to help with activities of daily living.||Questions and Answers||1.Bathing: either sponge bath, tub bath or shower.| <*Answer_5132*>|2.Dressing: gets clothes from \r\nclosets and drawers, including under-clothes, outer garments a
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nd using fasteners (including braces if worn).| <*Answer_5133*>|3.Toileting: going to the \"toilet room\" for bowel and urine \r\nelimination; cleaning self after elimination and arranging clothes. (May use cane, walker, or wheelchair, a
nd manage bedpan or commode, emptying same next morning). | <*Answer_5134*>|4.Transfer:| \r\n <*Answer_5135*>|5.Continence:| <*Answer_5136*>|6.Feeding:| <*Answer_5137*>|||Sources:|Katz S, Downs TD, Cash HR, Grotz RC. Progress in
development of the index of ADL. Gerontologist. \r\n1970;10(1):20-30.|Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The Index of ADL: a standardized measure of biological and psychosocial function. JAM
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"id":3374,"instrument":42,"introDisplay":1464,"introId":45,"introText":"Over the past 2 weeks, how often have you been bothered by any of the following problems? Please read each item carefully and give your best response.","max":0,"min":0,
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,"sequence":2},{"choiceId":1009,"choiceText":"More than half the days","ien":2005,"legacyValue":3,"sequence":3},{"choiceId":1010,"choiceText":"Nearly every day","ien":2006,"legacyValue":4,"sequence":4}],"choiceDisplay":1465,"choiceIdentifie
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min":0,"questionDisplay":1464,"questionId":3381,"questionText":"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","require
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w DIFFICULT have these problems made it\r\nfor you to do your work, take care of things at home or get along with other\r\npeople?","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":120}],"display":[{"alignment":"L
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tEditedBy":"HOWELL,LYNN","legacy":false,"licenseCurrent":false,"name":"PHQ9","national":true,"normSample":null,"operational":"Y","printTitle":"Patient Health Questionnaire Depression Scale","publicationDate":2001,"publisher":"Can be reprodu
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Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN: <.Patient_SSN.>|DOB: \r\n<.Patient_Date_Of_Birth.> (<.Patient_Age.>)|Gender: <.Patient_Gender.>|| PHQ-9 Depression Sca
le Score: <-PHQ9->| <*Answer_7771*> | \r\n|The total score may range from 0 to 27.| Total Score Depression Severity| ----------- -------------------| 1-4 Minimal depression|\r\n 5-9 Mild depression|
? Are you hearing things you know are \r\nnot there?\" Observation:","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":70},{"choice":[{"choiceId":2453,"choiceText":"No sweat visible","ien":49519,"legacyValue":0,"se
10-14 Moderate depression| 15-19 Moderately severe depression| 20-27 Severe depression| \r\n|Questions and Answers||Over the last 2 weeks, how often have you been bothered by any of the \r\nfollowing pro
blems?|1. Little interest or pleasure in doing things| <*Answer_3374*>|2. Feeling down, depressed, or hopeless| <*Answer_3375*>|3. Trouble falling or staying asleep, or sleeping \r\ntoo much| <*Answer_3376*>|4. Feeling tired or hav
ing little energy| <*Answer_3377*>|5. Poor appetite or overeating| <*Answer_3378*>|6. Feeling bad about yourself or that you are a failure or
\r\nhave let yourself or your family down| <*Answer_3379*>|7. Trouble concentrating on things, such as reading the newspaper or watching television| <*Answer_3380*>|8. Moving or speaking so slowly \r\nthat other people could have noti
ced. Or the opposite being so fidgety or restless that you have been moving around a lot more than usual| <*Answer_3381*>|9. Thoughts that you would be better off \r\ndead or of hurting yourself in some way| <*Answer_3382*>|10. 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 \r\nalong with other people?| <*Answer_4019*>||Information contained in this note is based on a self report
assessment and is not sufficient to use alone for diagnostic purposes. Assessment results \r\nshould be verified for accuracy and used in conjunction with other diagnostic activities.||Copyright 2001 Pfizer Inc.|All rights reserved. Reprodu
ced with permission of Pfizer Inc.|PRIME-MD is a \r\ntrademark of Pfizer Inc"},"scaleGroup":[{"grid1":0,"grid2":5,"grid3":15,"id":86,"instrument":42,"name":"PHQ9 total","ordInc":1,"ordMax":27,"ordMin":0,"ordTitle":"Score","scale":[{"groupId
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Population":null,"version":null,"wasOperational":true},"report":{"id":56,"instrument":85,"template":".|.|Clinical Institute Withdrawal Assessment - Alcohol Revised||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Loca
tion.>||Veteran: <.Patient_Name_Last_First.>|SSN: \r\n<.Patient_SSN.>|DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)|Gender: <.Patient_Gender.>||CIWA-AR| Total Score: <-Total Score->||Scores of less than 8 to 10 indicate minimal to mild
withdrawal. \r\n|Scores of 8 to 15 indicate moderate withdrawal (marked autonomic arousal).|Scores of 15 or more indicate severe withdrawal (impending delirium tremens). ||Questions and Answers||1. Time (use 24 hour \r\nclock, midnight is
|
