DSTU2 Ballot Source

This page is part of the FHIR Specification (v0.5.0: DSTU 2 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Questionnaire-example.xml

Raw XML (canonical form)

General questionnaire example (id = "3141")

Raw XML

<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="3141"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <contained>
    <ValueSet>
      <id value="yesno"/><!--    In practice you could (should?) use boolean for this sort of circumstance.  However,
       the reality is
        that many systems treat booleans as coded data    -->
      <name value="Example YesNo"/>
      <description value="Captures simple yes-no"/>
      <status value="active"/>
      <define>
        <system value="http://example.org/system/code/yesno"/>
        <caseSensitive value="true"/>
        <concept>
          <code value="1"/>
          <display value="Yes"/>
        </concept>
        <concept>
          <code value="2"/>
          <display value="No"/>
        </concept>
      </define>
    </ValueSet>
  </contained>
  <status value="draft"/>
  <date value="2012-01"/>
  <group>
    <title value="Cancer Quality Forum Questionnaire 2012"/>
    <group><!--    COMORBIDITY    --><!--    First main section of the form, questions about comorbidity    -->
      <concept>
        <system value="http://example.org/system/code/sections"/>
        <code value="COMORBIDITY"/>
      </concept><!--    section contains one question: whether there is comorbidity    -->
      <question>
        <concept>
          <system value="http://example.org/system/code/questions"/>
          <code value="COMORB"/>
        </concept>
        <type value="choice"/>
        <options>
          <reference value="#yesno"/>
        </options>
        <group><!--    COMORBIDITY/CARDIAL    --><!--    Subsection about specific comorbidity: cardial    -->
          <concept>
            <system value="http://example.org/system/code/sections"/>
            <code value="CARDIAL"/>
          </concept>
          <question>
            <concept>
              <system value="http://example.org/system/code/questions"/>
              <code value="COMORBCAR"/>
            </concept>
            <type value="choice"/>
            <options>
              <reference value="#yesno"/>
            </options>
          </question>
          <question><!--    This answer carries both the questionnaire-specific name and an equivalent SNOMED CT
             code    -->
            <concept>
              <system value="http://example.org/system/code/questions"/>
              <code value="COMCAR00"/>
              <display value="Angina Pectoris"/>
            </concept>
            <concept>
              <system value="http://snomed.info/sct"/>
              <code value="194828000"/>
              <display value="Angina (disorder)"/>
            </concept>
            <type value="choice"/>
            <options>
              <reference value="#yesno"/>
            </options>
          </question>
          <question>
            <concept>
              <system value="http://snomed.info/sct"/>
              <code value="22298006"/>
              <display value="Myocardial infarction (disorder)"/>
            </concept>
            <type value="choice"/>
            <options>
              <reference value="#yesno"/>
            </options>
          </question>
        </group>
        <group><!--    COMORBIDITY/VASCULAR    -->
          <concept>
            <system value="http://example.org/system/code/sections"/>
            <code value="VASCULAR"/>
          </concept>
        </group>
      </question>
    </group><!--    Todo: What's supposed to go here?    -->
    <group><!--    HISTOPATHOLOGY    -->
      <concept>
        <system value="http://example.org/system/code/sections"/>
        <code value="HISTOPATHOLOGY"/>
      </concept>
      <group>
        <concept>
          <system value="http://example.org/system/code/sections"/>
          <code value="ABDOMINAL"/>
        </concept>
        <question>
          <concept>
            <system value="http://example.org/system/code/questions"/>
            <code value="STADPT"/>
            <display value="pT category"/>
          </concept>
        </question>
      </group>
    </group>
  </group>
</Questionnaire>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.