Questionnaire-example.xml

General questionnaire example (id = "3141")

<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="3141"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <pre>
            Comorbidity? YES
              Cardial Comorbidity? YES
                Angina? YES
                MI? NO
              Vascular Comorbidity?
                (no answers)
              ...
            Histopathology
              Abdominal
                pT category: 1a
              ...
          </pre>
    </div>
  </text>
  <url value="http://hl7.org/fhir/Questionnaire/3141"/>
  <status value="draft"/>
  <date value="2012-01"/>
  <title value="Cancer Quality Forum Questionnaire 2012"/>
  <subjectType value="Patient"/>
  <item>
    <linkId value="1"/>
    <concept>
      <system value="http://example.org/system/code/sections"/>
      <code value="COMORBIDITY"/>
    </concept>
    <type value="group"/>
    <item>
      <linkId value="1.1"/>
      <concept>
        <system value="http://example.org/system/code/questions"/>
        <code value="COMORB"/>
      </concept>
      <type value="choice"/>
      <options>
        <reference value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
      </options>
      <item>
        <linkId value="1.1.1"/>
        <concept>
          <system value="http://example.org/system/code/sections"/>
          <code value="CARDIAL"/>
        </concept>
        <type value="group"/>
        <item>
          <linkId value="1.1.1.1"/>
          <concept>
            <system value="http://example.org/system/code/questions"/>
            <code value="COMORBCAR"/>
          </concept>
          <type value="choice"/>
          <options>
            <reference value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
          </options>
        </item>
        <item>
          <linkId value="1.1.1.2"/>
          <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="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
          </options>
        </item>
        <item>
          <linkId value="1.1.1.3"/>
          <concept>
            <system value="http://snomed.info/sct"/>
            <code value="22298006"/>
            <display value="Myocardial infarction (disorder)"/>
          </concept>
          <type value="choice"/>
          <options>
            <reference value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
          </options>
        </item>
      </item>
    </item>
  </item>
  <item>
    <linkId value="2"/>
    <concept>
      <system value="http://example.org/system/code/sections"/>
      <code value="HISTOPATHOLOGY"/>
    </concept>
    <type value="group"/>
    <item>
      <linkId value="2.1"/>
      <concept>
        <system value="http://example.org/system/code/sections"/>
        <code value="ABDOMINAL"/>
      </concept>
      <type value="group"/>
      <item>
        <linkId value="2.1.2"/>
        <concept>
          <system value="http://example.org/system/code/questions"/>
          <code value="STADPT"/>
          <display value="pT category"/>
        </concept>
        <type value="choice"/>
      </item>
    </item>
  </item>
</Questionnaire>