PACIO Sample Data Depot
0.1.0 - draft

PACIO Sample Data Depot, published by MITRE. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/paciowg/sample-data-fsh/ and changes regularly. See the Directory of published versions

## Questionnaire: Brief Interview for Mental Status (BIMS)

Official URL: http://mitre.org/paciowg/Questionnaire/Questionnaire-Brief-Interview-for-Mental-Status | Version: 0.1.0
Draft as of 2025-12-02 | Computable Name: Brief_Interview_for_Mental_Status_BIMS
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Structure

LinkID | Text | Cardinality | Type | Description & Constraints
--- | --- | --- | --- | ---
Brief_Interview_for_Mental_Status_BIMS |  |  | Questionnaire | http://mitre.org/paciowg/Questionnaire/Questionnaire-Brief-Interview-for-Mental-Status#0.1.0
97479 | C0200. Repetition of Three Words. Number of words repeated after first attempt | 0..1 | choice | Options: 4 options
97480 | C0300. Temporal Orientation (orientation to year, month, and day) | 1..1 | group |
97481 | C0300A. Able to report correct year | 0..1 | choice | Options: 4 options
97482 | C0300B. Able to report correct month | 0..1 | choice | Options: 3 options
97483 | C0300C. Able to report correct day of the week | 0..1 | choice | Options: 2 options
97484 | C0400. Recall | 1..1 | group |
97485 | C0400A. Able to recall "sock" | 0..1 | choice | Options: 3 options
97486 | C0400B. Able to recall "blue" | 0..1 | choice | Options: 3 options
97487 | C0400C. Able to recall "bed" | 0..1 | choice | Options: 3 options
97488 | C0500. BIMS Summary Score | 0..1 | decimal |
Documentation for this format

Options Sets

Answer options for 97479

- http://loinc.org#LA137-2 ("None")
- http://loinc.org#LA6306-0 ("One")
- http://loinc.org#LA6404-3 ("Two")
- http://loinc.org#LA6395-3 ("Three")

Answer options for 97481

- http://loinc.org#LA10965-4 ("Missed by > 5 years or no answer")
- http://loinc.org#LA10966-2 ("Missed by 2-5 years")
- http://loinc.org#LA10008-3 ("Missed by 1 year")
- http://loinc.org#LA9960-1 ("Correct")

Answer options for 97482

- http://loinc.org#LA10969-6 ("Missed by > 1 month or no answer")
- http://loinc.org#LA10010-9 ("Missed by 6 days to 1 month")
- http://loinc.org#LA9927-0 ("Accurate within 5 days")

Answer options for 97483

- http://loinc.org#LA9981-7 ("Incorrect or no answer")
- http://loinc.org#LA9960-1 ("Correct")

Answer options for 97485

- http://loinc.org#LA10974-6 ("No - could not recall")
- http://loinc.org#LA10126-3 ("Yes, after cueing ("something to wear")")
- http://loinc.org#LA10134-7 ("Yes, no cue required")

Answer options for 97486

- http://loinc.org#LA10974-6 ("No - could not recall")
- http://loinc.org#LA10978-7 ("Yes, after cueing ("a color")")
- http://loinc.org#LA10134-7 ("Yes, no cue required")

Answer options for 97487

- http://loinc.org#LA10974-6 ("No - could not recall")
- http://loinc.org#LA10125-5 ("Yes, after cueing ("a piece of furniture")")
- http://loinc.org#LA10134-7 ("Yes, no cue required")