Questionnaire Example: questionnaire-example

Narrative

1.Comorbidity? 1.1 Cardial Comorbidity 1.1.1 Angina? 1.1.2 MI? 1.2 Vascular Comorbidity? ... Histopathology Abdominal pT category? ...

Example XML

<?xml version="1.0" encoding="UTF-8"?>

<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="3141"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">

      <pre>
            1.Comorbidity?
              1.1 Cardial Comorbidity
                1.1.1 Angina?
                1.1.2 MI?
              1.2 Vascular Comorbidity?
              ...
            Histopathology
              Abdominal
                pT category?
              ...
          </pre>

    </div>
  </text>
  <url value="http://hl7.org/fhir/Questionnaire/3141"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.20.2"/>
  </identifier>
  <name value="CancerQualityForumQuestionnaire2012"/>
  <title value="Cancer Quality Forum Questionnaire 2012"/>
  <status value="draft"/>
  <subjectType value="Patient"/>
  <date value="2012-01"/>
  <description value="Cancer Quality Forum Questionnaire 2012"/>
  <item>
    <linkId value="1"/>
    <code>
      <system value="http://example.org/system/code/sections"/>
      <code value="COMORBIDITY"/>
    </code>
    <type value="group"/>
    <item>
      <linkId value="1.1"/>
      <code>
        <system value="http://example.org/system/code/questions"/>
        <code value="COMORB"/>
      </code>
      <prefix value="1"/>
      <type value="coding"/>
      <answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
      <item>
        <linkId value="1.1.1"/>
        <code>
          <system value="http://example.org/system/code/sections"/>
          <code value="CARDIAL"/>
        </code>
        <type value="group"/>
        <enableWhen>
          <question value="1.1"/>
          <operator value="="/>
          <answerCoding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0136"/>
            <code value="Y"/>
          </answerCoding>
        </enableWhen>
        <item>
          <linkId value="1.1.1.1"/>
          <code>
            <system value="http://example.org/system/code/questions"/>
            <code value="COMORBCAR"/>
          </code>
          <prefix value="1.1"/>
          <type value="coding"/>
          <answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
          <item>
            <linkId value="1.1.1.1.1"/>
            <code>
              <system value="http://example.org/system/code/questions"/>
              <code value="COMCAR00"/>
              <display value="Angina Pectoris"/>
            </code>
            <code>
              <system value="http://snomed.info/sct"/>
              <code value="194828000"/>
              <display value="Angina (disorder)"/>
            </code>
            <prefix value="1.1.1"/>
            <type value="coding"/>
            <answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
          </item>
          <item>
            <linkId value="1.1.1.1.2"/>
            <code>
              <system value="http://snomed.info/sct"/>
              <code value="22298006"/>
              <display value="Myocardial infarction (disorder)"/>
            </code>
            <prefix value="1.1.2"/>
            <type value="coding"/>
            <answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
          </item>
        </item>
        <item>
          <linkId value="1.1.1.2"/>
          <code>
            <system value="http://example.org/system/code/questions"/>
            <code value="COMORBVAS"/>
          </code>
          <prefix value="1.2"/>
          <type value="coding"/>
          <answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
        </item>
      </item>
    </item>
  </item>
  <item>
    <linkId value="2"/>
    <code>
      <system value="http://example.org/system/code/sections"/>
      <code value="HISTOPATHOLOGY"/>
    </code>
    <type value="group"/>
    <item>
      <linkId value="2.1"/>
      <code>
        <system value="http://example.org/system/code/sections"/>
        <code value="ABDOMINAL"/>
      </code>
      <type value="group"/>
      <item>
        <linkId value="2.1.2"/>
        <code>
          <system value="http://example.org/system/code/questions"/>
          <code value="STADPT"/>
          <display value="pT category"/>
        </code>
        <type value="coding"/>
      </item>
    </item>
  </item>
</Questionnaire>