MII IG PRO
2027.0.0-ballot.1 - Germany

This page is part of the MII Implementation Guide PRO (v2027.0.0-ballot.1: 2027 Ballot 5) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

PHQ-15

Clinical Context

The PHQ-15 is a validated screening instrument for the severity of somatic symptoms. It captures the interference caused by 15 bodily complaints over a four-week period on a three-point scale (0 = not bothered, 1 = bothered a little, 2 = bothered a lot).

Scoring and interpretation (sum score 0–30, Kroenke et al. 2002):

  • 0–4: minimal somatic symptom burden
  • 5–9: low somatic symptom burden
  • 10–14: medium somatic symptom burden
  • 15 and above: high somatic symptom burden

Relationship to the PHQ family: two of the 15 items (fatigue, sleep) originate in the depression module (PHQ-9). In the MII PRO module they are identified through the shared PHQ-D item bank namespace (phq-phq2d fatigue, phq-phq2c sleep) — the same linkIds as in the PHQ-9 (instrument-specific LOINC code because of the differing scale and recall period).

FHIR Implementation

Language strategy: English as the primary language (the original instrument), German texts as translations (PHQ-D, Löwe et al. 2002). This ensures correct validation against LOINC.

Questionnaire

Canonical URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-phq-15

Capabilities: Displayable, Collectable, Calculatable, Extractable, Domain-aligned

Implementation notes:

  • linkIds in the PHQ-D block namespace: somatic phq-phq1a…phq-phq1m, plus the shared phq-phq2c (sleep) / phq-phq2d (fatigue).
  • Answer scale via answerValueSet (mii-vs-pro-phq-15-answers); ordinal weights (0/1/2) as a property on the CodeSystem concepts (mii-cs-pro-phq-15-answers).
  • Automatic score calculation via FHIRPath: %resource.item.where(linkId.matches('^phq-phq(1[a-m]|2[cd])$')).answer.value.weight().sum(). Note: resolving .weight() from an answerValueSet is engine-dependent; robust scoring via CQL/server.
  • LOINC panel 69728-4, items LOINC-coded.

The complete resource: Questionnaire definition.

Score Representation

  1. Calculated item in the QuestionnaireResponse (linkId: phq-phq15-score-total)
  2. Observation carrying the LOINC code 70273-8 "Patient Health Questionnaire 15 item (PHQ-15) total score"
  3. ObservationDefinition: mii-obsdef-pro-score-phq-15 — value range 0–30 {score}, higher = greater somatic symptom burden

License

PHQ / PHQ-15 © Pfizer Inc. — freely available (public domain); no permission required for reproduction, translation or use. German version: PHQ-D (Löwe, Spitzer, Zipfel & Herzog 2002).

Sources

  • Kroenke K, Spitzer RL, Williams JBW. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine 2002;64(2):258–266.
  • Gräfe K, Zipfel S, Herzog W, Löwe B. Screening psychischer Störungen mit dem „Gesundheitsfragebogen für Patienten (PHQ-D)". Diagnostica 2004;50(4):171–181. doi:10.1026/0012-1924.50.4.171

Example response: PHQ-15 QuestionnaireResponse