Release 5 Draft Ballot
FoundationThis page is part of the FHIR Specification (v4.6.0: R5 Draft Ballot). 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
| FHIR Infrastructure Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson |
Raw JSON (canonical form + also see JSON Format Specification)
Example response to the SDC-LOINC USSG Family History questionnaire
{
"resourceType": "QuestionnaireResponse",
"id": "ussg-fht-answers",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><div>todo</div></div>"
},
"questionnaire": "http://hl7.org/fhir/Questionnaire/ussg-fht",
"status": "in-progress",
"subject": {
"reference": "http://hl7.org/fhir/Patient/proband",
"type": "Patient"
},
"authored": "2008-01-17",
"item": [
{
"linkId": "0",
"item": [
{
"linkId": "0.1",
"text": "Date Done",
"answer": [
{
"valueDate": "2008-01-17"
}
]
}
]
},
{
"linkId": "1",
"definition": "http://loinc.org/fhir/DataElement/54126-8",
"text": "Your health information",
"item": [
{
"linkId": "1.1",
"item": [
{
"linkId": "1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54125-0",
"text": "Name",
"answer": [
{
"valueString": "Annie Proband"
}
]
},
{
"linkId": "1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54131-8",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "1.1.3",
"definition": "http://loinc.org/fhir/DataElement/21112-8",
"text": "Date of Birth",
"answer": [
{
"valueDate": "1966-04-04"
}
]
},
{
"linkId": "1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54132-6",
"text": "Were you born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54128-4",
"text": "Were you adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54135-9",
"text": "Are your parents related to each other in any way other than marriage?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "1.1.7",
"definition": "http://loinc.org/fhir/DataElement/8302-2",
"text": "Height",
"answer": [
{
"valueDecimal": 63,
"item": [
{
"linkId": "1.1.7.1",
"item": [
{
"linkId": "1.1.7.1.1",
"text": "Units",
"answer": [
{
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "[in_i]",
"display": "inches"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "1.1.8",
"definition": "http://loinc.org/fhir/DataElement/29463-7",
"text": "Weight",
"answer": [
{
"valueDecimal": 127,
"item": [
{
"linkId": "1.1.8.1",
"item": [
{
"linkId": "1.1.8.1.1",
"text": "Units",
"answer": [
{
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "[lb_av]",
"display": "pounds"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "1.1.9",
"definition": "http://loinc.org/fhir/DataElement/39156-5",
"text": "Body mass index (BMI) [Ratio]",
"answer": [
{
"valueDecimal": 22.5
}
]
},
{
"linkId": "1.1.10",
"definition": "http://loinc.org/fhir/DataElement/54134-2",
"text": "Race",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
}
}
]
},
{
"linkId": "1.1.11",
"definition": "http://loinc.org/fhir/DataElement/54133-4",
"text": "Ethnicity",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10602-3",
"display": "-- Mexican"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10606-4",
"display": "-- South American"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"definition": "http://loinc.org/fhir/DataElement/54114-4",
"text": "Family member health information",
"item": [
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10405-1",
"display": "Daughter"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Susan"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 17
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10415-0",
"display": "Brother"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Brian"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 32
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10550-4",
"display": "-- Other Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10397-0",
"display": "30-39"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10418-4",
"display": "Sister"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Janet"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 36
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10536-3",
"display": "-- Breast Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10397-0",
"display": "30-39"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10419-2",
"display": "Nephew"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Ian"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 16
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10420-0",
"display": "Niece"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Helen"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 15
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10416-8",
"display": "Father"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Donald"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 52
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10425-9",
"display": "Paternal Uncle"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Eric"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 56
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10421-8",
"display": "Paternal Aunt"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Fiona"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 57
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10543-9",
"display": "-- Skin Cancer"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10423-4",
"display": "Paternal Grandfather"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Bob"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"definition": "http://loinc.org/fhir/DataElement/54112-8",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10537-1",
"display": "-- Colon Cancer"
}
}
]
},
{
"linkId": "2.1.1.4.1.2",
"definition": "http://loinc.org/fhir/DataElement/54113-6",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10537-1",
"display": "-- Colon Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10424-2",
"display": "Paternal Grandmother"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Claire"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"definition": "http://loinc.org/fhir/DataElement/54112-8",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10589-2",
"display": "-- Other/Unexpected"
},
"item": [
{
"linkId": "2.1.1.4.1.1.1",
"text": "Please specify",
"answer": [
{
"valueString": "Lou Gehrigs"
}
]
}
]
}
]
},
{
"linkId": "2.1.1.4.1.2",
"definition": "http://loinc.org/fhir/DataElement/54113-6",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10417-6",
"display": "Mother"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Harriet"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"definition": "http://loinc.org/fhir/DataElement/54112-8",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10539-7",
"display": "-- Ovarian Cancer"
}
}
]
},
{
"linkId": "2.1.1.4.1.2",
"definition": "http://loinc.org/fhir/DataElement/54113-6",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10399-6",
"display": "50-59"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10539-7",
"display": "-- Ovarian Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10398-8",
"display": "40-49"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10414-3",
"display": "Maternal Uncle"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Rudy"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 60
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10410-1",
"display": "Maternal Aunt"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Julie"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 57
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10412-7",
"display": "Maternal Grandfather"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Ian"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"definition": "http://loinc.org/fhir/DataElement/54112-8",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10558-7",
"display": "-- Heart Attack"
}
}
]
},
{
"linkId": "2.1.1.4.1.2",
"definition": "http://loinc.org/fhir/DataElement/54113-6",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10413-5",
"display": "Maternal Grandmother"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Gladys"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"definition": "http://loinc.org/fhir/DataElement/54112-8",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10571-0",
"display": "-- Other/Unknown"
}
}
]
},
{
"linkId": "2.1.1.4.1.2",
"definition": "http://loinc.org/fhir/DataElement/54113-6",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10536-3",
"display": "-- Breast Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10399-6",
"display": "50-59"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10564-5",
"display": "-- Asthma"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10395-4",
"display": "Childhood"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10411-9",
"display": "Maternal Cousin"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Karren"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 30
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10536-3",
"display": "-- Breast Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10397-0",
"display": "30-39"
}
}
]
}
]
}
]
},
{
"linkId": "2.1",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10411-9",
"display": "Maternal Cousin"
}
}
]
},
{
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"text": "Name",
"answer": [
{
"valueString": "Mary"
}
]
},
{
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"text": "Age",
"answer": [
{
"valueDecimal": 31
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
}
]
}
]
}
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.
FHIR ®© HL7.org 2011+. FHIR R5 Draft Ballot hl7.fhir.core#4.6.0 generated on Thu, Apr 15, 2021 12:29+1000.
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