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FHIR Infrastructure Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Not linked to any defined compartments |
Raw XML (canonical form + also see XML Format Specification)
Glasgow Coma Score example form (id = "gcs")
<?xml version="1.0" encoding="UTF-8"?> <Questionnaire xmlns="http://hl7.org/fhir"> <id value="gcs"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : gcs</p> <p> <b> contained</b> : , , </p> <p> <b> url</b> : <a> http://hl7.org/fhir/Questionnaire/gcs</a> </p> <p> <b> title</b> : Glasgow Coma Score</p> <p> <b> status</b> : draft</p> <p> <b> subjectType</b> : Patient</p> <p> <b> date</b> : 2015-08-03</p> <p> <b> publisher</b> : FHIR Project team</p> <p> <b> code</b> : Glasgow coma score total (Details: LOINC code 9269-2 = 'Glasgow coma score total', stated as 'null')</p> <blockquote> <p> <b> item</b> </p> <p> <b> linkId</b> : 1.1</p> <p> <b> code</b> : Glasgow coma score verbal (Details: LOINC code 9270-0 = 'Glasgow coma score verbal', stated as 'null')</p> <p> <b> type</b> : choice</p> <p> <b> answerValueSet</b> : <a> #verbal</a> </p> </blockquote> <blockquote> <p> <b> item</b> </p> <p> <b> linkId</b> : 1.2</p> <p> <b> code</b> : Glasgow coma score motor (Details: LOINC code 9268-4 = 'Glasgow coma score motor', stated as 'null')</p> <p> <b> type</b> : choice</p> <p> <b> answerValueSet</b> : <a> #motor</a> </p> </blockquote> <blockquote> <p> <b> item</b> </p> <p> <b> linkId</b> : 1.3</p> <p> <b> code</b> : Glasgow coma score eye opening (Details: LOINC code 9267-6 = 'Glasgow coma score eye opening', stated as 'null')</p> <p> <b> type</b> : choice</p> <p> <b> answerValueSet</b> : <a> #eye</a> </p> </blockquote> </div> </text> <contained> <ValueSet> <id value="motor"/> <identifier> <system value="http://loinc.org"/> <value value="http://loinc.org/ValueSet/LL357-5"/> </identifier> <name value="GCS Motor Value Set"/> <status value="active"/> <description value="LOINC ANSWER LIST (LL357-5)"/> <compose> <include> <system value="http://loinc.org"/> <concept> <code value="LA6562-8"/> <display value="No motor response"/> </concept> <concept> <code value="LA6563-6"/> <display value="Extension to pain"/> </concept> <concept> <code value="LA6564-4"/> <display value="Flexion to pain"/> </concept> <concept> <code value="LA6565-1"/> <display value="Withdrawl from pain"/> </concept> <concept> <code value="LA6566-9"/> <display value="Localizing pain"/> </concept> <concept> <code value="LA6567-7"/> <display value="Obeys commands"/> </concept> </include> </compose> </ValueSet> </contained> <contained> <ValueSet> <id value="verbal"/> <identifier> <system value="http://loinc.org"/> <value value="http://loinc.org/ValueSet/LL356-7"/> </identifier> <name value="GCS Verbal Value Set"/> <status value="active"/> <description value="LOINC ANSWER LIST (LL356-7)"/> <compose> <include> <system value="http://loinc.org"/> <concept> <code value="LA6557-8"/> <display value="No verbal response (>2yrs); no vocal response (<=2yrs)"/> </concept> <concept> <code value="LA6558-6"/> <display value="Incomprehensible sounds"/> </concept> <concept> <code value="LA6559-4"/> <display value="Inappropriate words"/> </concept> <concept> <code value="LA6560-2"/> <display value="Confused"/> </concept> <concept> <code value="LA6561-0"/> <display value="Oriented"/> </concept> </include> </compose> </ValueSet> </contained> <contained> <ValueSet> <id value="eye"/> <identifier> <system value="http://loinc.org"/> <value value="http://loinc.org/ValueSet/LL355-9"/> </identifier> <name value="GCS Eye Value Set"/> <status value="active"/> <description value="LOINC ANSWER LIST (LL355-9)"/> <compose> <include> <system value="http://loinc.org"/> <concept> <code value="LA6553-7"/> <display value="No eye opening"/> </concept> <concept> <code value="LA6554-5"/> <display value="Eye opening to pain"/> </concept> <concept> <code value="LA6555-2"/> <display value="Eye opening to verbal command"/> </concept> <concept> <code value="LA6556-0"/> <display value="Eyes open spontaneously"/> </concept> </include> </compose> </ValueSet> </contained> <url value="http://hl7.org/fhir/Questionnaire/gcs"/> <title value="Glasgow Coma Score"/> <status value="draft"/> <subjectType value="Patient"/> <date value="2015-08-03"/> <publisher value="FHIR Project team"/> <code> <system value="http://loinc.org"/> <code value="9269-2"/> </code> <item> <linkId value="1.1"/> <code> <system value="http://loinc.org"/> <code value="9270-0"/> </code> <type value="choice"/> <answerValueSet value="#verbal"/> </item> <item> <linkId value="1.2"/> <code> <system value="http://loinc.org"/> <code value="9268-4"/> </code> <type value="choice"/> <answerValueSet value="#motor"/> </item> <item> <linkId value="1.3"/> <code> <system value="http://loinc.org"/> <code value="9267-6"/> </code> <type value="choice"/> <answerValueSet value="#eye"/> </item> </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.