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Assessment Questionnaire Algorithms

ASSESSMENT QUESTIONAIRE ALGORITHMS

SECTION 1: SCORING CATEGORISATION OF RISK STATUS

Morbity Triage questionaires and related scoring system will categorise each morbidity risk (likelihood) as either:

  • Low risk (green icon)
  • Elevated risk (orange icon)
  • High risk (pink icon)
  • Severe risk (red icon)

Each of these risk categories has its own symbol/icon with color as shown in brackets.

Section 2: TRIAGE: Morbidity Risk Scoring System

BMI Ranges

  • If BMI Score Less Than “19” = HEALTHY (wrong)
  • If BMI Score Less Than “25” If BMI Score Greater Than “18.9” = HEALTHY
  • If BMI Score Less Than “30” If BMI Score Greater Than “24.9” = ELEVATED
  • If BMI Score Greater Than “29.9” If BMI Score Less Than “40” = HIGH
  • If BMI Score Greater Than “39.9” : SEVERE

VFI Ranges

  • If VFA Score Less Than “131” = LOW RISK
  • If VFA Score Less Than “151” If VFA Score Greater Than “130” = ELEVATED RISK
  • If VFA Score Less Than “181” If VFA Score Greater Than “150” = HIGH RISK
  • If VFA Score Greater Than “180” = SEVERE RISK

DIABETES Ranges

  • If Diabetes Score Less Than “7” = LOW RISK
  • If Diabetes Score Greater Than “6” If Diabetes Score Less Than “16” = ELEVATED RISK
  • If Diabetes Score Greater Than “15” If Diabetes Score Less Than “25” = HIGH RISK
  • If Diabetes Score Greater Than “24” = SEVERE RISK

GAD Ranges

  • If GAD Score Less Than “5” = LOW RISK
  • If GAD Score Greater Than “4” If GAD Score Less Than “10” = ELEVATED RISK
  • If GAD Score Greater Than “9” If GAD Score Less Than “15” = HIGH RISK
  • If GAD Score Greater Than “14” = SEVERE RISK

OSA Ranges

  • If OSA Score Less Than “3” = LOW RISK
  • If OSA Score Greater Than “2” If OSA Score Less Than “5” = ELEVATED RISK
  • If OSA Score Greater Than “4” If OSA Score Less Than “7” = HIGH RISK
  • If OSA Score Greater Than “7” = SEVERE RISK

Insomnia Ranges

  • If Insomnia Index Score Less Than “9” = LOW RISK
  • If Insomnia Index Score Greater Than “8” If Insomnia Index Score Less Than “15” = ELEVATED RISK
  • If Insomnia Index Score Greater Than “14” If Insomnia Index Score Less Than “22” = HIGH RISK
  • If Insomnia Index Score Greater Than “21” = SEVERE RISK

Sleep Efficiency Ranges – INVERSE STATUSES

  • If Sleep Efficiency Score Less Than “7.6” = SEVERE RISK
  • If Sleep Efficiency Score Greater Than “7.5” If Sleep Efficiency Score Less Than “8.2” = HIGH RISK
  • If Sleep Efficiency Score Greater Than “8.1” If Sleep Efficiency Score Less Than “9.5” = ELEVATED RISK
  • If Sleep Efficiency Score Greater Than “9.4” = LOW RISK

Adjunct to Sleep Efficiency Result

Hours Asleep Ranges

  • If Hours Asleep Score Greater Than “7” – Insert Adequate Sleep Hours Into Hours Asleep Status (needs adding to results along…)
  • If Hours Asleep Score Less Than “8” – Insert Inadequate Sleep Hours Into Hours Asleep Status (needs adding to results along…)

Circadian Ranges

  • If Circadian Rhythm Score Less Than “6” = LOW RISK
  • If Circadian Rhythm Score Greater Than “5” If Circadian Rhythm Score Less Than “13” = ELEVATED RISK
  • If Circadian Rhythm Score Greater Than “12” If Circadian Rhythm Score Less Than “19” = HIGH RISK
  • If Circadian Rhythm Score Greater Than “18” = SEVERE RISK

IBS Ranges

  • If IBS Score Less Than “31” = LOW RISK
  • If IBS Score Greater Than “30” and Less Than “51” = ELEVATED RISK
  • If IBS Score Greater Than “50” and Less Than “71” = HIGH RISK
  • If IBS Score Greater Than “70” and Less Than “91” = SEVERE RISK

SIBO Ranges

  • If SIBO Score is Less Than “31” = LOW RISK
  • If SIBO Score is Greater Than “30” and Less Than “51” = ELEVATED RISK
  • If SIBO Score is Greater Than “50” and Less Than “71” = HIGH RISK
  • If SIBO Score is Greater Than “70” and Less Than “96” = SEVERE RISK

Celiac Ranges

  • If Celiac Score is Less Than “31” = LOW RISK
  • If Celiac Score is Greater Than “30” and Less Than “51” = ELEVATED RISK
  • If Celiac Score is Greater Than “50” and Less Than “71” = HIGH RISK
  • If Celiac Score is Greater Than “70” and Less Than “101” = SEVERE RISK

Lactose Ranges

  • If Lactose Score Less Than “31” = LOW RISK
  • If Lactose Score Greater Than “30” and Less Than “51” = ELEVATED RISK
  • If Lactose Score Greater Than “50” and Less Than “71” = HIGH RISK
  • If Lactose Score Greater Than “70” and Less Than “76” = SEVERE RISK

IBD Alert

Have you noticed blood or blood and mucous in your stools? This could be a marker for IBD which requires early medical intervention.

SECTION 3: TRIAGE QUESTIONS AND SCORING

1. BMI

SCORE = WEIGHT / HEIGHT SQUARED (metric)

2. VISCERAL FAT (VAT)

SCORE (Women) = 2.15 × Waist C − 3.63 × Proximal Thigh C + 1.46 × Age + 6.22 × BMI − 92.713; [R2 = 0.836]

SCORE (Men) = 6 × Waist C − 4.41 × proximal thigh C + 1.19 × Age − 213.65; [R2 = 0.803]

Sources:

3. DIABETES

SCORE = Age score + gender score + ethnicity score + family score + waist score + bmi score + bp score

Age Score

  • Under 50: 0
  • 60-70: 5
  • 0-69: 9
  • 70 plus: 13

Gender Score

  • Male: 1
  • Female: 0

Ethnicity Score

  • White: 0
  • Other: 6

Family Score

  • Yes: 5
  • No: 0

Waist Score

  • Under 90: 0
  • 90-99: 4
  • 100-110: 6
  • 110+: 9

BMI Score

  • Under 25: 0
  • 25-30: 3
  • 30-35: 5
  • 35+: 8

BP Score

  • High: 5
  • Normal: 0

Sources:

4. ANXIETY (GAD7)

SCORE = Sum of scores for each question:

Over the last two weeks, how often have you been bothered by any of the following problems:

  • Feeling nervous, anxious or on edge?
    • Not at all = 0
    • Several days = 1
    • More than half the days = 2
    • Nearly every day = 3
  • Not being able to stop or control worrying?
    • Not at all = 0
    • Several days = 1
    • More than half the days = 2
    • Nearly every day = 3
  • Worrying too much about different things?
    • Not at all = 0
    • Several days = 1
    • More than half the days = 2
    • Nearly every day = 3
  • Trouble relaxing?
    • Not at all = 0
    • Several days = 1
    • More than half the days = 2
    • Nearly every day = 3
  • Being so restless that it is hard to sit still?
    • Not at all = 0
    • Several days = 1
    • More than half the days = 2
    • Nearly every day = 3
  • Becoming easily annoyed or irritable?
    • Not at all = 0
    • Several days = 1
    • More than half the days = 2
    • Nearly every day = 3
  • Feeling afraid as if something awful might happen?
    • Not at all = 0
    • Several days = 1
    • More than half the days = 2
    • Nearly every day = 3

Sources:

  • GAD (formerly owned by pfizer who have released all rights for anyone to use it)

5. OSA STOP BANG

SCORE = Sum of scores for each question:

  • Do you snore loudly?
    • Yes: 1
    • No: 0
  • Do you often feel tired?
    • Yes: 1
    • No: 0
  • Have you stopped breathing during sleep?
    • Yes: 1
    • No: 0
  • OSA Neck Score is over 40 cms)
    • Yes: 1
    • No: 0
  • OSA Gender Score (is male?)
    • Yes: 1
    • No: 0
  • OSA Age Score (is over 50?)
    • Yes: 1
    • No: 0
  • OSA BMI Score (is over 35)
    • Yes: 1
    • No: 0

Sources:

6. INSOMNIA ISI

SCORE = Sum of all question scores:

  • Difficulty Falling Asleep
    • No Problem: 0
    • Mild Problem: 1
    • Moderate Problem: 2
    • Severe Problem: 3
    • Very Severe Problem: 4
  • Difficulty Staying Asleep?
    • No Problem: 0
    • Mild Problem: 1
    • Moderate Problem: 2
    • Severe Problem: 3
    • Very Severe Problem: 4
  • Problems Waking Up Too early?
    • Not at all: 0
    • Noticeable A Little: 1
    • Somewhat Noticeable: 2
    • Much Noticeable: 3
    • Very Much Noticeable: 4
  • How Satisfied Are You With Your Current Sleep Pattern?
    • Very Satisfied: 0
    • Satisfied: 1
    • Neutral: 2
    • Dissatisfied: 3
    • Very Dissatisfied: 4
  • How Noticeable to Others Do You Think Your Sleep Problem Is?
    • Not at all: 0
    • Noticeable A Little: 1
    • Somewhat Noticeable: 2
    • Much Noticeable: 3
    • Very Much Noticeable: 4
  • How Worried Are You About Your Current Sleep Problem?
    • Not at all: 0
    • A Little Worried: 1
    • Somewhat Worried: 2
    • Much Worried: 3
    • Very Much Worried: 4
  • How Much Does Your Sleep Problem Interfere With Daily Functioning?
    • Not at all: 0
    • Interferes A Little: 1
    • Interferes Somewhat: 2
    • Much Interference: 3
    • Very Much Worried: 4

7. SLEEP Efficiency (AND HOURS ASLEEP)

SCORE : Sleep Efficiency = hours asleep/hours in bed

8. CIRCADIAN RYTHM

SCORE = Sum of all question scores:

  • Difficulty Falling Asleep at Desired Bedtime?
    • Rarely or never have trouble falling asleep at my desired bedtime.: 0
    • Occasionally have trouble (1-2 times per week).: 1
    • Frequently have trouble (3-5 times per week).: 2
    • Almost always have trouble (6-7 times per week).: 3
  • Rarely or never have trouble waking up at my desired time.?
    • Rarely or never have trouble waking up at my desired time.: 0
    • Occasionally have trouble (1-2 times per week).: 1
    • Frequently have trouble (3-5 times per week).: 2
    • Almost always have trouble (6-7 times per week): 3
    • Occasionally have trouble (1-2 times per week)?: 4
  • Feeling Alert/Energetic at Inconvenient Times?
    • Rarely or never feel most alert at inconvenient times.: 1
    • Occasionally feel more alert at inconvenient times (1-2 times per week).: 2
    • Frequently feel more alert at inconvenient times (3-5 times per week).: 3
    • Almost always feel more alert at inconvenient times (6-7 times per week): 4
  • Night Owl or Early Bird?
    • Strongly identify as an early bird and it aligns with my schedule.: 1
    • Mildly identify as an early bird but struggle to maintain this on weekends.: 2
    • Mildly identify as a night owl but can function reasonably well on a daytime schedule.: 3
    • Strongly identify as a night owl and struggle significantly with daytime schedules.: 4
  • Social Jetlag (Difference in Sleep Schedule Weekdays vs. Weekends)?
    • Less than 1 hour difference in sleep times between weekdays and weekends.: 1
    • 1-2 hours difference.: 2
    • 2-3 hours difference.: 3
    • More than 3 hours difference.: 4
  • Screen Use Before Bed (Within 1 Hour of Sleep Time)?
    • Rarely or never use screens before bed.: 1
    • Sometimes use screens (1-3 times per week).: 2
    • Frequently use screens (4-6 times per week).: 3
    • Almost always use screens before bed (7 times per week).: 4
  • Amount of Daytime Light Exposure?
    • Spend a significant amount of time outdoors in natural light daily.: 1
    • Spend some time outdoors in natural light most days.: 2
    • Mostly indoors, limited exposure to natural light.: 3
    • Almost entirely indoors, very little to no natural light exposure: 4
  • Daylight Savings Time Impact?
    • Not significantly affected by daylight savings time.: 1
    • Mildly affected, adjust within a few days.: 2
    • Moderately affected, takes a week or two to adjust.: 3
    • Severely affected, struggle to adjust for several weeks or months: 4

Souces : AI Derived with sources including…

Gastro Risk Assessment and Triage

Gastro Risk Assessment and Sources:

  • Adapts the Rome IV (SSS1 to SSS5) question framework for general gastro symptom impact
    • .
    1. abdominal pain severity,
    2. frequency of abdominal pain,
    3. severity of abdominal distension/bloating,
    4. satisfaction with bowel habits, and i
    5. interference with daily life
    6. The max score from these five question is 50 (which is equiv to 500 max on the SSS scale)
      1. Risk specific questions overlay the core 5 questions so giving a risk specific assessment
nt

General Gastro Rome: SSS1 to SSS5 (applied to all gastro risk assessment)

These questions apply to all gastrointestinal (GI) conditions.

  • Rate the severity of any abdominal pain you maybe experiencing (SSS1)?
    • 0 (none)
    • 3 (mild)
    • 6 (moderate)
    • 10 (severe)
    • 0 (Don’t Know)
  • Rate the frequency of any abdominal pain you maybe experiencing? (SSS2)
    • 0 (rarely or never)
    • 3 (occasionally)
    • 6 (often)
    • 10 (most or all days)
    • 0 (Don’t Know)
  • Do you experience bloating or gas in your abdomen (SSS3)?
    • 0 (no)
    • 3 (mild or occasional)
    • 6 (moderate or frequent)
    • 10 (severe or almost constant)
    • 0 (Don’t Know)
  • How often do you experience diarrhea or constipation or a cycle of both (SSS4)?
    • 0 (never or rarely)
    • 3 (occasionally, 1-3 days a week)
    • 6 (often, 4-6 days a week)
    • 10 (almost always or always)
    • 0 (Don’t Know)
  • Do bowel and abdomin problems affect your daily life? (SSS5)
    • 0 (no)
    • 3 (mild impact)
    • 6 (moderate impact)
    • 10 (severe impact)
    • 0 (Don’t Know)

    10. IBS Triage Questions

    These questions help identify if you’re more likely to have Irritable Bowel Syndrome (IBS).

  • Does any stomach pain get better after a bowel movement?
    • 0 (No)
    • 5 (Sometimes)
    • 10 (Yes)
    • 0 (Don’t Know)
  • Do you have changes in stool form (hard/lumpy or loose/watery) when you have stomach pain?
    • 0 (No)
    • 5 (Yes, harder/lumpier)
    • 5 (Yes, looser/watery)
    • 10 (Yes, alternating)
    • 0 (Don’t Know)
  • How often do you feel like you still need to go after a bowel movement?
    • 0 (Rarely or Never)
    • 3 (Occasionally)
    • 6 (Often)
    • 10 (Almost Always)
    • 0 (Don’t Know)
  • Do you have a family history of IBS or gastrointestinal disorders?
    • 0 (No)
    • 5 (Yes)
    • 0 (Don’t Know)
  • Your level of Anxiety (auto-based on GAD Status)?
    • If GAD-7 is Severe (15-21): Add 5 points
    • If GAD-7 is High (10-14): Add 3 points
    • If GAD-7 is Elevated (5-9): Add 1 point
    • If GAD-7 is Low (0-4): Add 0 points

    11.SIBO Triage Questions

    These questions help identify if you’re more likely to have Small Intestinal Bacterial Overgrowth (SIBO).

  • Does bloating get worse after eating carbohydrates?
    • 0 (No)
    • 5 (Sometimes)
    • 10 (Yes, significantly worse)
    • 0 (Don’t Know)
  • Do you have a history of chronic antibiotic use?
    • 0 (No)
    • 5 (Yes, once in past year)
    • 10 (Yes, multiple times/chronic)
    • 0 (Don’t Know)
  • Do you frequently experience motality issues such as indigestion, bloating, feeling full quickly, nausea, constipation, ?
    • 0 (No)
    • 5 (Yes, suspected)
    • 10 (Yes, diagnosed)
    • 0 (Don’t Know)
  • Have you taken PPI for an extended period (more than 1 month)?
    • 0 (No)
    • 5 (Yes, in the past)
    • 10 (Yes, currently)
    • 0 (Don’t Know)
  • What has been the impact of Antibiotics on your motality issues?
    • 0 (Not taken antibiotics)
    • -5 (Symptoms worsened)
    • 0 (Symptoms stayed the same)
    • 5 (Symptoms improved)
    • 0 (Don’t Know)

    12: Celiac Triage Questions

    These questions help identify if you’re more likely to have Celiac Disease.

  • Do you have iron-deficiency anemia, even though you get enough iron?”
    • 0 (No)
    • 5 (Yes, in the past)
    • 10 (Yes, currently)
    • 0 (Don’t Know)
  • Have you been diagnosed with osteoporosis or osteopenia before age 50?
    • 0 (No)
    • 5 (Yes, suspected)
    • 10 (Yes, diagnosed)
    • 0 (Don’t Know)
  • Family history of celiac disease, autoimmune disorders, or other digestive conditions?
    • 0 (No)
    • 5 (Yes, one 1st-degree relative)
    • 10 (Yes, multiple 1st-degree relatives)
    • 0 (Don’t Know)
  • Do you have or ever had, an itchy rash with blistering on your joints or torso for more than a few weeks?”
    • 0 (No)
    • 5 (Yes, suspected)
    • 10 (Yes, diagnosed)
    • 0 (Don’t Know)
  • Have you tried a gluten-free diet that improved stomach problems
    • 0 (Not tried GFD)
    • 0 (No improvement)
    • 5 (Slight improvement)
    • 10 (Significant improvement)
    • 0 (Don’t Know)

    13 Lactose Triage

    These questions help differentiate Lactose risk.

  • Do you regularly experience gas, bloating or diarrhea after consuming dairy products (like milk, cheese, and yogurt)?
    • 0 (No)
    • 5 (Sometimes)
    • 10 (Yes)
    • 0 (Don’t Know)
  • Have you tried a dairy-free diet and it improved gastro problems
    • 0 (Not tried LFD)
    • 0 (No improvement)
    • 5 (Slight improvement)
    • 10 (Significant improvement)
    • 0 (Don’t Know)
  • From the earlier ethnicity question
    • 5 (Black Afro-Caribbean)
    • 5 (Asian)
    • 0 (Other)
    • 0 (White Caucasian)