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Questionnaireresponse-sdc-example-ussg-fht-answers.xml

Raw XML (canonical form)
Example response to the SDC-LOINC USSG Family History questionnaire (id = "questionnaireresponse-sdc-example-ussg-fht-answers")
Raw XML
<QuestionnaireResponse xmlns="http://hl7.org/fhir">
  <id value="questionnaireresponse-sdc-example-ussg-fht-answers"/>
  <text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: questionnaireresponse-sdc-example-ussg-fht-answers</p><p><b>questionnaire</b>: <a>Questionnaire/43127-6</a></p><p><b>status</b>: in-progress</p><p><b>subject</b>: <a>Patient/proband</a></p><p><b>authored</b>: 17/01/2008</p><blockquote><p><b>group</b></p><p><b>linkId</b>: root</p><p><b>title</b>: US Surgeon General - Family Health Portrait</p><h3>Groups</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div></text><questionnaire>
    <reference value="Questionnaire/43127-6"/>
  </questionnaire>
  <status value="in-progress"/>
  <subject>
    <reference value="Patient/proband"/>
  </subject>
  <authored value="2008-01-17"/>
  <group>
    <linkId value="root"/>
    <title value="US Surgeon General - Family Health Portrait"/>
    <group>
      <linkId value="0"/>
      <question>
        <linkId value="0.1"/>
        <text value="Date Done"/>
        <answer>
          <valueDate value="2008-01-17"/>
        </answer>
      </question>
    </group>
    <group>
      <linkId value="1"/>
      <title value="Your health information"/>
      <group>
        <linkId value="1.1"/>
        <question>
          <linkId value="1.1.1"/>
          <text value="Name"/>
          <answer>
            <valueString value="Annie Proband"/>
          </answer>
        </question>
        <question>
          <linkId value="1.1.2"/>
          <text value="Gender"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA3-6"/>
              <display value="Female"/>
            </valueCoding>
          </answer>
        </question>
        <question>
          <linkId value="1.1.3"/>
          <text value="Date of Birth"/>
          <answer>
            <valueDate value="1966-04-04"/>
          </answer>
        </question>
        <question>
          <linkId value="1.1.4"/>
          <text value="Were you born a twin?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </question>
        <question>
          <linkId value="1.1.5"/>
          <text value="Were you adopted?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </question>
        <question>
          <linkId value="1.1.6"/>
          <text value="Are your parents related to each other in any way other than marriage?"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA32-8"/>
              <display value="No"/>
            </valueCoding>
          </answer>
        </question>
        <question>
          <linkId value="1.1.7"/>
          <text value="Height"/>
          <answer>
            <valueDecimal value="63"/>
            <group>
              <linkId value="1.1.7.1"/>
              <question>
                <linkId value="1.1.7.1.1"/>
                <text value="Units"/>
                <answer>
                  <valueCoding>
                    <system value="http://unitsofmeasure.org"/>
                    <code value="[in_i]"/>
                    <display value="inches"/>
                  </valueCoding>
                </answer>
              </question>
            </group>
          </answer>
        </question>
        <question>
          <linkId value="1.1.8"/>
          <text value="Weight"/>
          <answer>
            <valueDecimal value="127"/>
            <group>
              <linkId value="1.1.8.1"/>
              <question>
                <linkId value="1.1.8.1.1"/>
                <text value="Units"/>
                <answer>
                  <valueCoding>
                    <system value="http://unitsofmeasure.org"/>
                    <code value="lb"/>
                    <display value="pounds"/>
                  </valueCoding>
                </answer>
              </question>
            </group>
          </answer>
        </question>
        <question>
          <linkId value="1.1.9"/>
          <text value="Body mass index (BMI) [Ratio]"/>
          <answer>
            <valueDecimal value="22.5"/>
          </answer>
        </question>
        <question>
          <linkId value="1.1.10"/>
          <text value="Race"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA4457-3"/>
              <display value="White"/>
            </valueCoding>
          </answer>
        </question>
        <question>
          <linkId value="1.1.11"/>
          <text value="Ethnicity"/>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10602-3"/>
              <display value="-- Mexican"/>
            </valueCoding>
          </answer>
          <answer>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA10606-4"/>
              <display value="-- South American"/>
            </valueCoding>
          </answer>
        </question>
      </group>
    </group>
    <group>
      <linkId value="2"/>
      <title value="Family member health information"/>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10405-1"/>
                <display value="Daughter"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Susan"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="17"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10415-0"/>
                <display value="Brother"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Brian"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA2-8"/>
                <display value="Male"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="32"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
        <group>
          <linkId value="2.1.2"/>
          <title value="This family member's history of disease"/>
          <question>
            <linkId value="2.1.2.1"/>
            <text value="Disease or Condition"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10550-4"/>
                <display value="-- Other Cancer"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.2.2"/>
            <text value="Age at Diagnosis"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10397-0"/>
                <display value="30-39"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10418-4"/>
                <display value="Sister"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Janet"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="36"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
        <group>
          <linkId value="2.1.2"/>
          <title value="This family member's history of disease"/>
          <question>
            <linkId value="2.1.2.1"/>
            <text value="Disease or Condition"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10536-3"/>
                <display value="-- Breast Cancer"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.2.2"/>
            <text value="Age at Diagnosis"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10397-0"/>
                <display value="30-39"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10419-2"/>
                <display value="Nephew"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Ian"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA2-8"/>
                <display value="Male"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="16"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10420-0"/>
                <display value="Niece"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Helen"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="15"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10416-8"/>
                <display value="Father"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Donald"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA2-8"/>
                <display value="Male"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="52"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10425-9"/>
                <display value="Paternal Uncle"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Eric"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA2-8"/>
                <display value="Male"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="56"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10421-8"/>
                <display value="Paternal Aunt"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Fiona"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="57"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
        <group>
          <linkId value="2.1.2"/>
          <title value="This family member's history of disease"/>
          <question>
            <linkId value="2.1.2.1"/>
            <text value="Disease or Condition"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10543-9"/>
                <display value="-- Skin Cancer"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10423-4"/>
                <display value="Paternal Grandfather"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Bob"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA2-8"/>
                <display value="Male"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.1"/>
                <question>
                  <linkId value="2.1.1.4.1.1"/>
                  <text value="Cause of Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10537-1"/>
                      <display value="-- Colon Cancer"/>
                    </valueCoding>
                  </answer>
                </question>
                <question>
                  <linkId value="2.1.1.4.1.2"/>
                  <text value="Age at Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10400-2"/>
                      <display value="OVER 60"/>
                    </valueCoding>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
        <group>
          <linkId value="2.1.2"/>
          <title value="This family member's history of disease"/>
          <question>
            <linkId value="2.1.2.1"/>
            <text value="Disease or Condition"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10537-1"/>
                <display value="-- Colon Cancer"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.2.2"/>
            <text value="Age at Diagnosis"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10400-2"/>
                <display value="OVER 60"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10424-2"/>
                <display value="Paternal Grandmother"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Claire"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.1"/>
                <question>
                  <linkId value="2.1.1.4.1.1"/>
                  <text value="Cause of Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10589-2"/>
                      <display value="-- Other/Unexpected"/>
                    </valueCoding>
                    <group>
                      <linkId value="2.1.1.4.1.1.1"/>
                      <question>
                        <text value="Please specify"/>
                        <answer>
                          <valueString value="Lou Gehrigs"/>
                        </answer>
                      </question>
                    </group>
                  </answer>
                </question>
                <question>
                  <linkId value="2.1.1.4.1.2"/>
                  <text value="Age at Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10400-2"/>
                      <display value="OVER 60"/>
                    </valueCoding>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10417-6"/>
                <display value="Mother"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Harriet"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.1"/>
                <question>
                  <linkId value="2.1.1.4.1.1"/>
                  <text value="Cause of Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10539-7"/>
                      <display value="-- Ovarian Cancer"/>
                    </valueCoding>
                  </answer>
                </question>
                <question>
                  <linkId value="2.1.1.4.1.2"/>
                  <text value="Age at Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10399-6"/>
                      <display value="50-59"/>
                    </valueCoding>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
        <group>
          <linkId value="2.1.2"/>
          <title value="This family member's history of disease"/>
          <question>
            <linkId value="2.1.2.1"/>
            <text value="Disease or Condition"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10539-7"/>
                <display value="-- Ovarian Cancer"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.2.2"/>
            <text value="Age at Diagnosis"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10398-8"/>
                <display value="40-49"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10414-3"/>
                <display value="Maternal Uncle"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Rudy"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA2-8"/>
                <display value="Male"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="60"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10410-1"/>
                <display value="Maternal Aunt"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Julie"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="57"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10412-7"/>
                <display value="Maternal Grandfather"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Ian"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA2-8"/>
                <display value="Male"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.1"/>
                <question>
                  <linkId value="2.1.1.4.1.1"/>
                  <text value="Cause of Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10558-7"/>
                      <display value="-- Heart Attack"/>
                    </valueCoding>
                  </answer>
                </question>
                <question>
                  <linkId value="2.1.1.4.1.2"/>
                  <text value="Age at Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10400-2"/>
                      <display value="OVER 60"/>
                    </valueCoding>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10413-5"/>
                <display value="Maternal Grandmother"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Gladys"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.1"/>
                <question>
                  <linkId value="2.1.1.4.1.1"/>
                  <text value="Cause of Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10571-0"/>
                      <display value="-- Other/Unknown"/>
                    </valueCoding>
                  </answer>
                </question>
                <question>
                  <linkId value="2.1.1.4.1.2"/>
                  <text value="Age at Death"/>
                  <answer>
                    <valueCoding>
                      <system value="http://loinc.org"/>
                      <code value="LA10400-2"/>
                      <display value="OVER 60"/>
                    </valueCoding>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
        <group>
          <linkId value="2.1.2"/>
          <title value="This family member's history of disease"/>
          <question>
            <linkId value="2.1.2.1"/>
            <text value="Disease or Condition"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10536-3"/>
                <display value="-- Breast Cancer"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.2.2"/>
            <text value="Age at Diagnosis"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10399-6"/>
                <display value="50-59"/>
              </valueCoding>
            </answer>
          </question>
        </group>
        <group>
          <linkId value="2.1.2"/>
          <title value="This family member's history of disease"/>
          <question>
            <linkId value="2.1.2.1"/>
            <text value="Disease or Condition"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10564-5"/>
                <display value="-- Asthma"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.2.2"/>
            <text value="Age at Diagnosis"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10395-4"/>
                <display value="Childhood"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10411-9"/>
                <display value="Maternal Cousin"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Karren"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="30"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
        <group>
          <linkId value="2.1.2"/>
          <title value="This family member's history of disease"/>
          <question>
            <linkId value="2.1.2.1"/>
            <text value="Disease or Condition"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10536-3"/>
                <display value="-- Breast Cancer"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.2.2"/>
            <text value="Age at Diagnosis"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10397-0"/>
                <display value="30-39"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
      <group>
        <linkId value="2.1"/>
        <group>
          <linkId value="2.1.1"/>
          <question>
            <linkId value="2.1.1.1"/>
            <text value="Relationship to you"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA10411-9"/>
                <display value="Maternal Cousin"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.2"/>
            <text value="Name"/>
            <answer>
              <valueString value="Mary"/>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.3"/>
            <text value="Gender"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA3-6"/>
                <display value="Female"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.4"/>
            <text value="Living?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA33-6"/>
                <display value="Yes"/>
              </valueCoding>
              <group>
                <linkId value="2.1.1.4.2"/>
                <question>
                  <linkId value="2.1.1.4.2.2"/>
                  <text value="Age"/>
                  <answer>
                    <valueDecimal value="31"/>
                  </answer>
                </question>
              </group>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.5"/>
            <text value="Was this person born a twin?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
          <question>
            <linkId value="2.1.1.6"/>
            <text value="Was this person adopted?"/>
            <answer>
              <valueCoding>
                <system value="http://loinc.org"/>
                <code value="LA32-8"/>
                <display value="No"/>
              </valueCoding>
            </answer>
          </question>
        </group>
      </group>
    </group>
  </group>
</QuestionnaireResponse>
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.