Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: FHIR R5 Ballot Preview). 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

Example Questionnaire/zika-virus-exposure-assessment (Turtle)

FHIR Infrastructure Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Not linked to any defined compartments

Raw Turtle (+ also see Turtle/RDF Format Specification)

Example instrument for assessing Zika virus exposure potential

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

[a fhir:Questionnaire;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "zika-virus-exposure-assessment"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Questionnaire</b><a name=\"zika-virus-exposure-assessment\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Questionnaire &quot;zika-virus-exposure-assessment&quot; </p></div><p><b>url</b>: <code>http://example.org/Questionnaire/zika-virus-exposure-assessment</code></p><p><b>identifier</b>: id: urn:oid:2.16.840.1.113883.4.642.20.1</p><p><b>name</b>: ExampleZikaVirusExposureAssessment</p><p><b>title</b>: Example Zika Virus Exposure Assessment</p><p><b>status</b>: draft</p><p><b>subjectType</b>: Patient</p><p><b>date</b>: 2016-11-14</p><p><b>description</b>: Example questionnaire to assess Zika virus exposure potential.</p><p><b>effectivePeriod</b>: 2016-11-14 --&gt; (ongoing)</p><blockquote><p><b>item</b></p><p><b>linkId</b>: 1</p><p><b>code</b>: CDE: Resident of or Frequent Traveler to Zika Area (Details: http://example.org/questionnaires code CDE: Resident of or Frequent Traveler to Zika Area = 'CDE: Resident of or Frequent Traveler to Zika Area', stated as 'null')</p><p><b>text</b>: Are you a resident of, or do you travel frequently to, an area with active Zika transmission?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>code</b>: CDE: Recent Travel to Zika Area (Details: http://example.org/questionnaires code CDE: Recent Travel to Zika Area = 'CDE: Recent Travel to Zika Area', stated as 'null')</p><p><b>text</b>: Have you recently traveled to an area with active Zika transmission?</p><p><b>type</b>: boolean</p><h3>EnableWhens</h3><table class=\"grid\"><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>1</td><td>=</td><td>false</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 3</p><p><b>code</b>: CDE: Time Since Returned From Travel (Details: http://example.org/questionnaires code CDE: Time Since Returned From Travel = 'CDE: Time Since Returned From Travel', stated as 'null')</p><p><b>text</b>: How long has it been since you returned?</p><p><b>type</b>: quantity</p><h3>EnableWhens</h3><table class=\"grid\"><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>2</td><td>=</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 4</p><p><b>code</b>: CDE: Recent Sexual Encounter with Traveler to Zika Area (Details: http://example.org/questionnaires code CDE: Recent Sexual Encounter with Traveler to Zika Area = 'CDE: Recent Sexual Encounter with Traveler to Zika Area', stated as 'null')</p><p><b>text</b>: Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?</p><p><b>type</b>: boolean</p><h3>EnableWhens</h3><table class=\"grid\"><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>2</td><td>=</td><td>false</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 5</p><p><b>code</b>: CDE: Time Since Sexual Encounter (Details: http://example.org/questionnaires code CDE: Time Since Sexual Encounter = 'CDE: Time Since Sexual Encounter', stated as 'null')</p><p><b>text</b>: How long has it been since your last condomless sexual encounter?</p><p><b>type</b>: quantity</p><h3>EnableWhens</h3><table class=\"grid\"><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>4</td><td>=</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 6</p><p><b>code</b>: CDE: Planned Travel to Zika Area (Details: http://example.org/questionnaires code CDE: Planned Travel to Zika Area = 'CDE: Planned Travel to Zika Area', stated as 'null')</p><p><b>text</b>: Do you plan to travel to an area with active Zika transmission?</p><p><b>type</b>: boolean</p><h3>EnableWhens</h3><table class=\"grid\"><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>4</td><td>=</td><td>false</td></tr></table></blockquote></div>"
  ];
  fhir:Questionnaire.url [ fhir:value "http://example.org/Questionnaire/zika-virus-exposure-assessment"];
  fhir:Questionnaire.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ];
     fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.4.642.20.1" ]
  ];
  fhir:Questionnaire.name [ fhir:value "ExampleZikaVirusExposureAssessment"];
  fhir:Questionnaire.title [ fhir:value "Example Zika Virus Exposure Assessment"];
  fhir:Questionnaire.status [ fhir:value "draft"];
  fhir:Questionnaire.subjectType [
     fhir:value "Patient";
     fhir:index 0
  ];
  fhir:Questionnaire.date [ fhir:value "2016-11-14"^^xsd:date];
  fhir:Questionnaire.description [ fhir:value "Example questionnaire to assess Zika virus exposure potential."];
  fhir:Questionnaire.effectivePeriod [
     fhir:Period.start [ fhir:value "2016-11-14"^^xsd:date ]
  ];
  fhir:Questionnaire.item [
     fhir:index 0;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://example.org/additional-information" ];
       fhir:Extension.valueAttachment [
         fhir:Attachment.url [ fhir:value "http://www.cdc.gov/zika/geo/index.html" ];
         fhir:Attachment.title [ fhir:value "Areas with active Zika virus transmission/exposure risk" ]
       ]
     ];
     fhir:Questionnaire.item.linkId [ fhir:value "1" ];
     fhir:Questionnaire.item.code [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://example.org/questionnaires" ];
       fhir:Coding.code [ fhir:value "CDE: Resident of or Frequent Traveler to Zika Area" ]
     ];
     fhir:Questionnaire.item.text [ fhir:value "Are you a resident of, or do you travel frequently to, an area with active Zika transmission?" ];
     fhir:Questionnaire.item.type [ fhir:value "boolean" ]
  ], [
     fhir:index 1;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://example.org/additional-information" ];
       fhir:Extension.valueAttachment [
         fhir:Attachment.url [ fhir:value "http://www.cdc.gov/zika/geo/index.html" ];
         fhir:Attachment.title [ fhir:value "Areas with active Zika virus transmission/exposure risk" ]
       ]
     ];
     fhir:Questionnaire.item.linkId [ fhir:value "2" ];
     fhir:Questionnaire.item.code [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://example.org/questionnaires" ];
       fhir:Coding.code [ fhir:value "CDE: Recent Travel to Zika Area" ]
     ];
     fhir:Questionnaire.item.text [ fhir:value "Have you recently traveled to an area with active Zika transmission?" ];
     fhir:Questionnaire.item.type [ fhir:value "boolean" ];
     fhir:Questionnaire.item.enableWhen [
       fhir:index 0;
       fhir:Questionnaire.item.enableWhen.question [ fhir:value "1" ];
       fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ];
       fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "false"^^xsd:boolean ]
     ]
  ], [
     fhir:index 2;
     fhir:Questionnaire.item.linkId [ fhir:value "3" ];
     fhir:Questionnaire.item.code [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://example.org/questionnaires" ];
       fhir:Coding.code [ fhir:value "CDE: Time Since Returned From Travel" ]
     ];
     fhir:Questionnaire.item.text [ fhir:value "How long has it been since you returned?" ];
     fhir:Questionnaire.item.type [ fhir:value "quantity" ];
     fhir:Questionnaire.item.enableWhen [
       fhir:index 0;
       fhir:Questionnaire.item.enableWhen.question [ fhir:value "2" ];
       fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ];
       fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "true"^^xsd:boolean ]
     ]
  ], [
     fhir:index 3;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://example.org/additional-information" ];
       fhir:Extension.valueAttachment [
         fhir:Attachment.url [ fhir:value "http://www.cdc.gov/zika/geo/index.html" ];
         fhir:Attachment.title [ fhir:value "Areas with active Zika virus transmission/exposure risk" ]
       ]
     ];
     fhir:Questionnaire.item.linkId [ fhir:value "4" ];
     fhir:Questionnaire.item.code [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://example.org/questionnaires" ];
       fhir:Coding.code [ fhir:value "CDE: Recent Sexual Encounter with Traveler to Zika Area" ]
     ];
     fhir:Questionnaire.item.text [ fhir:value "Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?" ];
     fhir:Questionnaire.item.type [ fhir:value "boolean" ];
     fhir:Questionnaire.item.enableWhen [
       fhir:index 0;
       fhir:Questionnaire.item.enableWhen.question [ fhir:value "2" ];
       fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ];
       fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "false"^^xsd:boolean ]
     ]
  ], [
     fhir:index 4;
     fhir:Questionnaire.item.linkId [ fhir:value "5" ];
     fhir:Questionnaire.item.code [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://example.org/questionnaires" ];
       fhir:Coding.code [ fhir:value "CDE: Time Since Sexual Encounter" ]
     ];
     fhir:Questionnaire.item.text [ fhir:value "How long has it been since your last condomless sexual encounter?" ];
     fhir:Questionnaire.item.type [ fhir:value "quantity" ];
     fhir:Questionnaire.item.enableWhen [
       fhir:index 0;
       fhir:Questionnaire.item.enableWhen.question [ fhir:value "4" ];
       fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ];
       fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "true"^^xsd:boolean ]
     ]
  ], [
     fhir:index 5;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://example.org/additional-information" ];
       fhir:Extension.valueAttachment [
         fhir:Attachment.url [ fhir:value "http://www.cdc.gov/zika/geo/index.html" ];
         fhir:Attachment.title [ fhir:value "Areas with active Zika virus transmission/exposure risk" ]
       ]
     ];
     fhir:Questionnaire.item.linkId [ fhir:value "6" ];
     fhir:Questionnaire.item.code [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://example.org/questionnaires" ];
       fhir:Coding.code [ fhir:value "CDE: Planned Travel to Zika Area" ]
     ];
     fhir:Questionnaire.item.text [ fhir:value "Do you plan to travel to an area with active Zika transmission?" ];
     fhir:Questionnaire.item.type [ fhir:value "boolean" ];
     fhir:Questionnaire.item.enableWhen [
       fhir:index 0;
       fhir:Questionnaire.item.enableWhen.question [ fhir:value "4" ];
       fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ];
       fhir:Questionnaire.item.enableWhen.answerBoolean [ fhir:value "false"^^xsd:boolean ]
     ]
  ]] .

# - ontology header ------------------------------------------------------------

[a owl:Ontology;
  owl:imports fhir:fhir.ttl] .

# -------------------------------------------------------------------------------------


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.