.. _data-model-and-specifications: Data model and specifications ============================= .. _data-model: Data model ---------- There are three contexts where data can be submitted using the version 4 specification: 1. Intake teams 2. Treatment organisations 3. Combined Intake/Treatment organisations Different records in the specification are intended to be used in each of these contexts. Within the PMHC-MDS system a single intake team and individual service providers/treatment organisations will each have their own organisation path and report data against those organisations. Below is the combined Intake/Treatment data model. If an Intake only or Treatment only organisation is submitting data, a sub set of this data model may be submitted. Please refer to :ref:`introduction-contexts` for data models of the different contexts that may be submitted. .. _data-model-diagram: .. figure:: figures/data-model-v4.0-combined.svg :alt: PMHC MDS Version 4.0 combined data model PMHC MDS Version 4.0 combined data model .. note:: * The above data model diagram is in the SVG format and can be enlarged or zoomed by opening in a new tab or window or by downloading it. .. _collection-occasion-diagram: .. figure:: figures/collection-occasion-data-model-v4.0.svg :alt: PMHC MDS Version 4.0 Collection Occasion data model PMHC MDS Version 4.0 Collection Occasion data model .. note:: See :ref:`data-model-diagram` for more details about how Collection Occasion records fit into the overall structure. .. _key-concepts: Key concepts ------------ .. _key-concepts-primary-health-network: Primary Health Network ^^^^^^^^^^^^^^^^^^^^^^ Primary Health Networks (PHNs) have been established by the Australian Government with the key objectives of increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time. .. _key-concepts-provider-organisation: Provider Organisation ^^^^^^^^^^^^^^^^^^^^^ The Provider Organisation is the business entity that the PHN has commissioned to provide the service. See :ref:`provider-organisation-data-elements` for the data elements for a provider organisation. .. _key-concepts-practitioner: Practitioner ^^^^^^^^^^^^ The Practitioner is the person who is delivering the service. Multiple practitioners can deliver a service. See :ref:`practitioner-data-elements` for the data elements for a practitioner. .. _key-concepts-client: Client ^^^^^^ The Client is the person who is receiving the service. See :ref:`client-data-elements` for the data elements for a client. .. _active-client: Active Client """"""""""""" An **active client** is a client who has had one or more Service Contacts in a reference reporting period. .. _key-concepts-intake: Intake ^^^^^^ For the purpose of the PMHC MDS, an *Intake* is defined as a point of contact between a client and a PHN-commissioned organisation where the client is assessed to determine the appropriate level of care and referred to a service provider to provide clinical care. An Intake may include the collection of an IAR-DST measure. The collection of Intake and IAR data may not be required for all programs. Please see :ref:`intake-data-elements`. .. _concluded-intake: Concluded Intake """"""""""""""""" Concluded intakes are intakes where :ref:`dfn-organisation_type_referred_to_at_intake_conclusion` is **not** blank. .. _key-concepts-intake-episode: Intake Episode ^^^^^^^^^^^^^^ The Intake Episode record links an Intake record and an Episode record. It must be provided by the organisation that delivers the episode, not the intake. .. _key-concepts-episode: Episode ^^^^^^^ For the purposes of the PMHC MDS, an *Episode of Care* is defined as a more or less continuous period of contact between a client and a PHN-commissioned provider organisation/clinician that starts at the point of first contact, and concludes at discharge. Episodes comprise a series of one or more Service Contacts. This structure allows for a logical data collection protocol that specifies what data are collected when, and by whom. Different sets of PMHC MDS items are collected at various points in the client’s engagement with the provider organisation. Some items are only collected once at the episode level, while others are collected at each *Service Contact*. Four business rules apply to how the *Episode of Care* concept is implemented across PHN-commissioned services: - **One Intake may be associated with each episode.** An episode is not required to be associated with an Intake. - **One episode at a time for each client, defined at the level of the provider organisation.** While an individual may have multiple *Episodes of Care* over the course of their illness, they may be considered as being in only one episode at any given point of time for **any particular PHN-commissioned provider organisation**. The implication is that the care provided by the organisation to an individual client at any point in time is subject to only one set of reporting requirements. - **Episodes commence at the point of first contact.** The episode start date will be derived from the first service contact regardless of no show state as long as there is a service contact that isn't a no show. Therefore, if there is no attended service contact the episode is uncommenced. Some examples: * If a service contact occurs on the 1/1/2018 that is recorded as a no show then the episode is uncommenced. * If a service contact occurs on the 1/1/2018 that is recorded as a no show and another service contact occurs on the 2/1/2018 that is attended then the episode start date is derived as 1/1/2018. - **Discharge from care concludes the episode** Discharge may occur clinically or administratively in instances where contact has been lost with the client. A new episode is deemed to commence if the person re-presents to the organisation. See :ref:`episode-data-elements` for the data elements for a episode. .. _open-episode: Open Episode """""""""""" Open episodes are those with :ref:`dfn-episode_completion_status` recorded as open (Response item 0). .. _closed-episode: Closed Episode """""""""""""" Closed episodes are those with :ref:`dfn-episode_completion_status` recorded using one of the 'Episode closed' responses (Response items 1-6). .. _active-episode: Active Episode """""""""""""" An **active episode** is an episode with one or more :ref:`Attended Service Contacts ` recorded in a reference reporting period. .. _key-concepts-service-contact: Service Contact ^^^^^^^^^^^^^^^ - Service contacts are defined as the provision of a service by one or more PHN commissioned mental health service provider(s) for a client where the nature of the service would normally warrant a dated entry in the clinical record of the client. - A service contact must involve at least two persons, one of whom must be a mental health service provider. - Service contacts can be either with the client or with a third party, such as a carer or family member, and/or other professional or mental health worker, or other service provider. - Service contacts are not restricted to face‑to‑face communication but can include telephone, internet, video link or other forms of direct communication. - Service provision is only regarded as a service contact if it is relevant to the clinical condition of the client. This means that it does not include services of an administrative nature (e.g. telephone contact to schedule an appointment). Definition based on METeOR: `493304 `_ with modification. .. _attended-contact: Attended Service Contact """""""""""""""""""""""" An attended service contact is one that is not marked as 'No show'. See :ref:`service-contact-data-elements` for the data elements for a service contact. .. _key-concepts-service-contact-practitioner: Service Contact Practitioner ^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Service Contacts can have more than one practitioner. Practitioners are linked to Service Contacts through Service Contact Practitioner. One (and only one) practitioner must be specified as the Primary Practitioner for each Service Contact. See :ref:`service-contact-practitioner-data-elements` for the data elements for a service contact practitioner. .. _key-concepts-collection-occasion: Collection Occasion ^^^^^^^^^^^^^^^^^^^ A Collection Occasion is defined as an occasion during an Episode of Care when specific Service Activities are required to be collected. At a minimum, collection is required at both Episode Start and Episode End, but may be more frequent if clinically indicated and agreed by the client. Measures will be the Kessler Psychological Distress Scale K10+ (in the case of Aboriginal and Torres Strait Islander clients, the K5) as well as the Strengths & Difficulties Questionnaires. See :ref:`collection-occasion-data-elements` for the data elements for a collection occasion. .. _record-formats: Record formats -------------- .. _metadata-data-elements: Metadata ^^^^^^^^ The Metadata table must be included in file uploads in order to identify the type and version of the uploaded data. .. csv-table:: Metadata record layout :file: record/metadata.csv :header-rows: 1 For this version of the specification the required content is shown in the following table: .. include:: shared/metadata-content.rst ---------- .. _provider-organisation-data-elements: Provider Organisation ^^^^^^^^^^^^^^^^^^^^^ See :ref:`key-concepts-provider-organisation` for the definition of a provider organisation. Provider Organisation data is for administrative use within the PMHC MDS system. It is managed by the PHN's via the PMHC MDS administrative interface, it cannot be uploaded. .. csv-table:: Provider Organisation record layout :file: record/organisation.csv :header-rows: 1 ---------- .. _practitioner-data-elements: Practitioner ^^^^^^^^^^^^ See :ref:`key-concepts-practitioner` for the definition of a practitioner. Practitioner data is intended to provide workforce planning data for use regionally by the PHN and nationally by the Department. It is managed by the provider organisations via either the PMHC MDS administrative interface or upload. .. csv-table:: Practitioner record layout :file: record/practitioner.csv :header-rows: 1 ---------- .. _client-data-elements: Client ^^^^^^ See :ref:`key-concepts-client` for definition of a client. Clients are managed by the provider organisations via either the PMHC MDS administrative interface or upload. .. csv-table:: Client record layout :file: record/client.csv :header-rows: 1 ---------- .. _intake-data-elements: Intake ^^^^^^^ See :ref:`key-concepts-intake` for definition of an intake. The collection of Intake and IAR data is a requirement for Head to Health programs. This includes the Head to Health Phone Service, centres, satellites and Pop-Up clinics. PHNs may choose to collect Intake and IAR data for other non-Head to Health programs using the PMHC-MDS v4 specification, however reporting of this data remains optional subject to further guidance from the department. Intakes are managed by the provider organisations via either the PMHC MDS administrative interface or upload. .. csv-table:: Intake record layout :file: record/intake.csv :header-rows: 1 ---------- .. _intake-episode-data-elements: Intake Episode ^^^^^^^^^^^^^^ See :ref:`key-concepts-intake-episode` for definition of an intake episode. Intake Episodes are managed by the provider organisations via either the PMHC MDS administrative interface or upload. .. csv-table:: Intake Episode record layout :file: record/intake-episode.csv :header-rows: 1 ---------- .. _episode-data-elements: Episode ^^^^^^^ See :ref:`key-concepts-episode` for definition of an episode. Episodes are managed by the provider organisations via either the PMHC MDS administrative interface or upload. .. csv-table:: Episode record layout :file: record/episode.csv :header-rows: 1 ---------- .. _service-contact-data-elements: Service Contact ^^^^^^^^^^^^^^^ See :ref:`key-concepts-service-contact` for definition of a service contact. Service contacts are managed by the provider organisations via either the PMHC MDS administrative interface or upload. .. csv-table:: Service contact record layout :file: record/service-contact.csv :header-rows: 1 ---------- .. _service-contact-practitioner-data-elements: Service Contact Practitioner ^^^^^^^^^^^^^^^^^^^^^^^^^^^^ See :ref:`key-concepts-service-contact-practitioner` for definition of a service contact practitioner. Service contacts practitioners are managed by the provider organisations via either the PMHC MDS administrative interface or upload. .. csv-table:: Service contact practitioner record layout :file: record/service-contact-practitioner.csv :header-rows: 1 ---------- .. _collection-occasion-data-elements: Collection Occasion ^^^^^^^^^^^^^^^^^^^ See :ref:`key-concepts-collection-occasion` for definition of a collection occasion. Individual item scores will eventually be required, however, it is noted that in the short term there are issues with collecting individual item scores. Therefore, as a transitional phase, reporting overall scores/subscales will be allowed. Collection occasions are managed by the provider organisations via either the PMHC MDS administrative interface or upload. .. csv-table:: Collection Occasion record layout :file: record/collection-occasion.csv :header-rows: 1 .. _measure-data-elements: Measures ^^^^^^^^ .. _intake_measures: Measures at Intake """""""""""""""""" .. _iar-dst-data-elements: IAR-DST ''''''' The collection of Intake and IAR DST data may not be required for all programs. Please see :ref:`intake-data-elements`. Where an Intake is recorded, an associated :ref:`iar-dst-data-elements` should also be recorded. However, this is not enforced by the PMHC MDS as Intake data could be collected separately from IAR DST data. .. note:: Versions 4.0.0 through 4.0.2 of the PMHC MDS specifiction only described version 1 of the IAR DST. This version was to be used only for adults. As of PMHC-MDS specification v4.0.4 you may supply either v1 or v2 IAR-DST versions. Version 2 adds child, adolescent, and older adult adaptions. The PMHC-MDS implementation of this change is backward compatible with the existing v1 format as the only difference is the extension of the `IAR-DST - Version`_ domain with v2 specific values. For more information regarding IAR-DST v2 see the `official IAR-DST v2 specification documentation `_. .. note:: **Technical implementation guidance** The version data element now contains both the version (``1`` or ``2``) and, in the case of version 2, a sub-version indicating the age-group specific form of the IAR-DST used. i.e. ``child``, ``adolescent``, ``adult``, and ``older-adult``. For example a rating generated using the child form must have the version set to ``2.child``. This approach has been taken for backwards compatibility with v1 to minimise the changes required by data providers to extract and supply v2 data to the PMHC-MDS for reporting. Carefully consider how these two related but separate data items are stored within local systems. Analysis and reporting of future IAR-DST data may be simplified if they are recorded separately in local systems and only combined for use during data supply. .. csv-table:: IAR-DST record layout :file: record/iar-dst-measure.csv :header-rows: 1 .. _episode_measures: Measures during an Episode """""""""""""""""""""""""" PMHC MDS requires the use of one of the following three required measures, as follows: * **For adults (18+ years)** - :ref:`Kessler Psychological Distress Scale (K10+) ` is the prescribed measure, with the option to use the :ref:`k5-data-elements` for Aboriginal and Torres Strait Islander people if that is considered more appropriate. * **For children and young people (up to and including 17 years)** - the :ref:`Strengths & Difficulties Questionnaires (SDQ) ` is the prescribed tool. The specified versions include the parent-report for 4-10 years and 11-17 years; and the self-report for 11-17 years. *Please note: For adolescents, clinician-discretion is allowed, and that the K10+ or K5 may be used, even though the person is under 18 years* .. _k10p-data-elements: K10+ '''' As noted above, reporting individual item scores will eventually be required. In the short term, respondents can either report all 14 item scores or report the K10 total score as well as item scores for the 4 extra items in the K10+. .. csv-table:: K10+ record layout :file: record/k10p-measure.csv :header-rows: 1 When the client’s responses to Q1-10 are all recorded as 1 'None of the time', they are not required to answer questions 11-14. Where a question has not been answered please select a response of 'Not stated / missing'. .. _k5-data-elements: K5 '' As noted above, reporting individual item scores will eventually be required. In the short term, respondents can either report all 5 item scores or report the K5 total score. .. csv-table:: K5 record layout :file: record/k5-measure.csv :header-rows: 1 .. _sdq-data-elements: SDQ ''' Extensive support materials are available on the SDQ developers' website, including copies of the various versions of the instrument, background information and scoring instructions. See https://www.sdqinfo.org/. There are six versions (parent-report and youth-self report) currently specified format PMHC MDS reporting. The "1" versions are administered on admission and are rated on the basis of the proceeding 6 months. The "2" follow up versions are administered on review and discharge and are rated on the basis of the previous 1 month period. The versions specified for PMHC MDS reporting are: - PC1 - SDQ Parent Report: 4-10 years (Baseline version); - PC2 - SDQ Parent Report: 4-10 years (Follow up version); - PY1 - SDQ Parent Report: 11-17 years (Baseline version); - PY2 - SDQ Parent Report: 11-17 years (Follow up version); - YR1 - SDQ Youth Report: 11-17 years (Baseline version); and - YR2 - SDQ Youth Report: 11-17 years (Follow up version). *We acknowledge that there is also a parent-report for 2-4 years; and teacher versions for all the years (2-4; 4-10 and 11-17) but that these are not to be reported the PMHC-MDS.* Please note that the item numbering in the SDQ versions is deliberately non sequential because it covers all items in all versions, both to indicate item equivalence across versions and to assist data entry, especially of translated versions. The table below indicates the items that are included in each version, the rating periods used and the broad content covered by each item. +-------+-----------------------------+-------------------------------------------+---------------------+ | | Informant | Parent | Young Person | + +-----------------------------+---------------------+----------+----------+---------------------+ | | Age range | 4-10 | 11-17 | 11 - 17 | + +-----------------------------+----------+----------+----------+----------+----------+----------+ | | Application | Baseline | Followup | Baseline | Followup | Baseline | Followup | + +-----------------------------+----------+----------+----------+----------+----------+----------+ | | Rating period | 6 months | 1 month | 6 months | 1 month | 6 months | 1 month | +-------+-----------------------------+----------+----------+----------+----------+----------+----------+ | Items | Item Content | Version | | | +----------+----------+----------+----------+----------+----------+ | | | PC1 | PC2 | PY1 | PY2 | YR1 | YR2 | +=======+=============================+==========+==========+==========+==========+==========+==========+ | 1-25 | Symptoms | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | +-------+-----------------------------+----------+----------+----------+----------+----------+----------+ | 26 | Overall | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | +-------+-----------------------------+----------+----------+----------+----------+----------+----------+ | 27 | Duration | ✓ | X | ✓ | X | ✓ | | +-------+-----------------------------+----------+----------+----------+----------+----------+----------+ | 28-33 | Impact | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | +-------+-----------------------------+----------+----------+----------+----------+----------+----------+ | 34-35 | Follow up progress | X | ✓ | X | ✓ | X | ✓ | +-------+-----------------------------+----------+----------+----------+----------+----------+----------+ | 36-38 | Cross-Informant information | ✓ | X | ✓ | X | X | X | +-------+-----------------------------+----------+----------+----------+----------+----------+----------+ | 39-42 | Cross-Informant information | X | X | X | X | ✓ | X | +-------+-----------------------------+----------+----------+----------+----------+----------+----------+ As noted above, reporting individual item scores will eventually be required. In the short term, respondents can either report all 42 item scores or report the SDQ subscale scores. .. _scoring-the-sdq: SDQ items and Scale Summary scores :::::::::::::::::::::::::::::::::: The first 25 items in the SDQ comprise 5 scales of 5 items each. It is usually easiest to score all 5 scales before working out the Total Difficulties score. For data entry, the responses to items should always be entered the same way (see below), but they are not all scored the same way. Somewhat True is always scored as 1, but the scoring of Not True and Certainly True varies with each item (see Table 5). For each of the 5 scales the score can range from 0-10 if all 5 items were completed. Scale scores can be prorated if at least 3 items were completed. +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | | Not True | Some-what True | Certainly True | | +-------------------------------------------------------------------+----------------+----------------------+-----------------------+ | | Standard Values for Data Entry | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+ | | Data element | SDQ Item number and description | Item Score | Summary Score | +==================+================================================+===============================================================+=================+ | *Emotional Symptoms Scale* | 0-10 | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 03 | Often complains of headaches … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 08 | Many worries or often seems worried | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 13 | Often unhappy, depressed or tearful | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 16 | Nervous or clingy in new situations … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 24 | Many fears, easily scared | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | *Conduct Problem Scale* | 0-10 | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 05 | Often loses temper … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | **Item 07** | **Generally well behaved** … | **2** | **1** | **0** | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 12 | Often fights with other children … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 18 | Often lies or cheats | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 22 | Steals from home, school … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | *Hyperactivity Scale* | 0-10 | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 02 | Restless, overactive … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 10 | Constantly fidgeting … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 15 | Easily distracted … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | **Item 21** | **Thinks things out before acting** | **2** | **1** | **0** | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | **Item 25** | **Good attention span** … | **2** | **1** | **0** | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | *Peer Problem Scale* | 0-10 | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 06 | Rather solitary, prefers to play alone | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | **Item 11** | **Has at least one good friend** | **2** | **1** | **0** | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | **Item 14** | **Generally liked by other children** | **2** | **1** | **0** | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 19 | Picked on or bullied … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 23 | Gets along better with adults … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | *Prosocial Scale* | 0-10 | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 01 | Considerate of other people’s feelings | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 04 | Shares readily with other children … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 09 | Helpful if someone is hurt … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 17 | Kind to younger children | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | Item 20 | Often volunteers to help others … | 0 | 1 | 2 | | +------------------+------------------------------------------------+----------------+----------------------+-----------------------+-----------------+ | *SDQ Total Difficulties Score = Sum of Scales below* | 0-40 | +------------------+------------------------------------------------+---------------------------------------------------------------+-----------------+ | | *Emotional Symptoms Scale* | 0-10 | | +------------------+------------------------------------------------+---------------------------------------------------------------+-----------------+ | | *Conduct Problem Scale* | 0-10 | | +------------------+------------------------------------------------+---------------------------------------------------------------+-----------------+ | | *Hyperactivity Scale* | 0-10 | | +------------------+------------------------------------------------+---------------------------------------------------------------+-----------------+ | | *Peer Problem Scale* | 0-10 | | +------------------+------------------------------------------------+---------------------------------------------------------------+-----------------+ - *NB. Bold items indicate reverse scoring* Scoring the SDQ ::::::::::::::: The standard values for coding individual Item responses are 0 (Not True), 1 (Somewhat True), 2 (Certainly True) and 9 (Missing data). For completed items (response coded 0,1,2) the Item scores are usually the same as the standard values. Them exceptions are item 07, 11, 14, 21 and 25. These items are "reverse-scored", that is, the standard value is mapped to Item scores as follows: 0->2, 1->1, 2->0. Summary scores are only calculated if at least three of the five items have been completed (that is, coded 0, 1 or 2). Otherwise the summary score is set to missing. For the Summary scores, the missing value used should be 99. The Summary scores are computed using the equation shown below, with the result being rounded to the nearest whole number. In the first 25 SDQ questions, each summary scale is composed of five items. Summary score = (sum of item scores/number of valid completed items) x number of items The simplest way to calculate the total difficulties score is to add up the following summary scores with the result being rounded to the nearest whole number. Total score = Emotional Scale + Conduct Scale + Hyperactivity Scale + Peer Problem Scale However, some of the summary scores may be missing. The rule is if more than one summary score is missing the Total Score is set to missing, value 99. Items 28-32 are not completed if respondents have answered "No" to Item 26, which asks for an overall opinion about difficulties being present. In this case, all Item responses for Items 27 through 33 should be coded "8" for "not applicable", and the impact score should be coded to zero. Item 27 is not included in the Impact Score since it assesses the chronicity of the difficulties- the length of time they have been present. Item 33 is not included in the Impact Score, since it assess the burden on others rather than on the child/youth. The coded Item Responses for the remaining Items 28 through 32 have to be mapped to their Item Scores before adding up. This mapping is the same for all, namely: 0->0, 1->0, 2->1, 3->2. .. csv-table:: SDQ record layout :file: record/sdq-measure.csv :header-rows: 1 ----- .. _definitions: .. include:: include/definitions.rst .. _data-specifications-download: Download Specification Files ---------------------------- Available for software developers designing extracts for the PMHC MDS, please click the link below to download the PMHC MDS Specification files: * `Specification zip <_static/pmhcmds-spec-meta.zip>`_ These files conform to the CSV on the Web (CSVW) standard that is defined at https://csvw.org/. They are used: * to generate the :ref:`record-formats` and :ref:`definitions` sections of the data specification documentation * in the first pass of upload validations