---
title: "four_a_test"
description: "A screening tool used for rapid initial assessment of delirium and cognitive impairment."
---

A screening tool used for rapid initial assessment of delirium and cognitive impairment.

**Purpose.** To record the results for each component parameter and their sum for the 4AT test.

## Source

| Model | Leg | Role |
|---|---|---|
| `openEHR-EHR-OBSERVATION.four_a_test.v1` | openEHR | defines this table |

## Columns

| Column | Type | Null | Description | Source |
|---|---|---|---|---|
| `id` | `uuid primary key` | no | Primary key. | — |
| `form_id` | `uuid` → [`form`](/docs/tables/form) | no | The form this entry was recorded on. | — |
| `form_block_id` | `uuid` | yes | The block within the form, when the entry is bound to one. | — |
| `alertness`<br />`alertness_code`<br />`alertness_system`<br />`alertness_numeric`<br />`alertness_valueset_id` | coded text<br />`text`, `text`, `text`, `numeric`, `text` | yes | Alertness | `/data[at0001]/events[at0002]/data[at0003]/items[at0004]` |
| `abbreviated_mental_test_4_amt_4_score`<br />`abbreviated_mental_test_4_amt_4_score_code`<br />`abbreviated_mental_test_4_amt_4_score_system`<br />`abbreviated_mental_test_4_amt_4_score_numeric`<br />`abbreviated_mental_test_4_amt_4_score_valueset_id` | coded text<br />`text`, `text`, `text`, `numeric`, `text` | yes | Abbreviated Mental Test 4 (AMT-4) score | `/data[at0001]/events[at0002]/data[at0003]/items[at0008]` |
| `attention`<br />`attention_code`<br />`attention_system`<br />`attention_numeric`<br />`attention_valueset_id` | coded text<br />`text`, `text`, `text`, `numeric`, `text` | yes | Attention | `/data[at0001]/events[at0002]/data[at0003]/items[at0012]` |
| `acute_change_or_fluctuating_course`<br />`acute_change_or_fluctuating_course_code`<br />`acute_change_or_fluctuating_course_system`<br />`acute_change_or_fluctuating_course_numeric`<br />`acute_change_or_fluctuating_course_valueset_id` | coded text<br />`text`, `text`, `text`, `numeric`, `text` | yes | Acute change or fluctuating course | `/data[at0001]/events[at0002]/data[at0003]/items[at0016]` |
| `total_score` | `integer` | yes | Total score | `/data[at0001]/events[at0002]/data[at0003]/items[at0019]` |

## Constraints

```sql
check ((alertness_code is null and alertness_system is null and alertness_numeric is null and alertness is null) or (alertness_valueset_id is not null and alertness_code is not null and alertness_system is not null and alertness_numeric is not null and alertness is not null))
check ((abbreviated_mental_test_4_amt_4_score_code is null and abbreviated_mental_test_4_amt_4_score_system is null and abbreviated_mental_test_4_amt_4_score_numeric is null and abbreviated_mental_test_4_amt_4_score is null) or (abbreviated_mental_test_4_amt_4_score_valueset_id is not null and abbreviated_mental_test_4_amt_4_score_code is not null and abbreviated_mental_test_4_amt_4_score_system is not null and abbreviated_mental_test_4_amt_4_score_numeric is not null and abbreviated_mental_test_4_amt_4_score is not null))
check ((attention_code is null and attention_system is null and attention_numeric is null and attention is null) or (attention_valueset_id is not null and attention_code is not null and attention_system is not null and attention_numeric is not null and attention is not null))
check ((acute_change_or_fluctuating_course_code is null and acute_change_or_fluctuating_course_system is null and acute_change_or_fluctuating_course_numeric is null and acute_change_or_fluctuating_course is null) or (acute_change_or_fluctuating_course_valueset_id is not null and acute_change_or_fluctuating_course_code is not null and acute_change_or_fluctuating_course_system is not null and acute_change_or_fluctuating_course_numeric is not null and acute_change_or_fluctuating_course is not null))
check (total_score is null or total_score between 0 and 12)
```

## Unique

- `form_block_id`

## References

| Columns | Target | On delete |
|---|---|---|
| `form_id` | [`form`](/docs/tables/form) | cascade |
| `form_id, form_block_id` | [`form_block`](/docs/tables/form_block) | cascade |
| `alertness_valueset_id, alertness_code, alertness_system, alertness, alertness_numeric` | [`valueset_code`](/docs/tables/valueset_code) | restrict |
| `abbreviated_mental_test_4_amt_4_score_valueset_id, abbreviated_mental_test_4_amt_4_score_code, abbreviated_mental_test_4_amt_4_score_system, abbreviated_mental_test_4_amt_4_score, abbreviated_mental_test_4_amt_4_score_numeric` | [`valueset_code`](/docs/tables/valueset_code) | restrict |
| `attention_valueset_id, attention_code, attention_system, attention, attention_numeric` | [`valueset_code`](/docs/tables/valueset_code) | restrict |
| `acute_change_or_fluctuating_course_valueset_id, acute_change_or_fluctuating_course_code, acute_change_or_fluctuating_course_system, acute_change_or_fluctuating_course, acute_change_or_fluctuating_course_numeric` | [`valueset_code`](/docs/tables/valueset_code) | restrict |

## Indexes

- `four_a_test_form_id_idx` on `form_id`

## Value sets

| Value set | Codes |
|---|---|
| `org.openehr::openEHR-EHR-OBSERVATION.four_a_test.v1/abbreviated_mental_test_4_amt_4_score` | 3 |
| `org.openehr::openEHR-EHR-OBSERVATION.four_a_test.v1/acute_change_or_fluctuating_course` | 2 |
| `org.openehr::openEHR-EHR-OBSERVATION.four_a_test.v1/alertness` | 3 |
| `org.openehr::openEHR-EHR-OBSERVATION.four_a_test.v1/attention` | 3 |