Structured Data Capture 2.5.0 - Edition 3(STU), For Comment 2018Sep Ballot
This page is part of the Structured Data Capture FHIR IG (v2.5.0: STU 3 Ballot 1) based on FHIR v3.5.0. The current version which supercedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions 
{
"resourceType" : "QuestionnaireResponse",
"id" : "questionnaireresponse-sdc-example-ussg-fht-answers",
"text" : {
"status" : "generated",
"div" : "<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 href="http://hl7.org/fhir/uv/sdc/Questionnaire/54127-6">http://hl7.org/fhir/uv/sdc/Questionnaire/54127-6</a></p><p><b>status</b>: INPROGRESS</p><p><b>subject</b>: <a href="http://hl7.org/fhir/2018Sep/Patient/proband">http://hl7.org/fhir/2018Sep/Patient/proband</a></p><p><b>authored</b>: 17/01/2008</p><blockquote><p><b>item</b></p><p><b>linkId</b>: 0</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 1</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54126-8">http://loinc.org/fhir/DataElement/54126-8</a></p><p><b>text</b>: Your health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote><blockquote><p><b>item</b></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>definition</b>: <a href="http://loinc.org/fhir/DataElement/54114-4">http://loinc.org/fhir/DataElement/54114-4</a></p><p><b>text</b>: Family member health information</p><blockquote><p><b>item</b></p></blockquote></blockquote></div>"
},
"questionnaire" : "http://hl7.org/fhir/uv/sdc/Questionnaire/54127-6",
"status" : "in-progress",
"subject" : {
"reference" : "http://hl7.org/fhir/2018Sep/Patient/proband"
},
"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" : "1.1.7.1.1",
"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" : "1.1.8.1.1",
"text" : "Units",
"answer" : [
{
"valueCoding" : {
"system" : "http://unitsofmeasure.org",
"code" : "[lb_i]",
"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" : "2.1.1",
"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",
"definition" : "http://loinc.org/fhir/DataElement/54114-4",
"text" : "Family member health information",
"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",
"definition" : "http://loinc.org/fhir/DataElement/54114-4",
"text" : "Family member health information",
"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",
"definition" : "http://loinc.org/fhir/DataElement/54114-4",
"text" : "Family member health information",
"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?",
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"valueCoding" : {
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}
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}
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}
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}
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},
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}
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},
{
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"linkId" : "2.1.1.4.2.2",
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}
]
}
]
}
]
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{
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"valueCoding" : {
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{
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}
]
}
]
}
]
},
{
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}
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},
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},
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"valueCoding" : {
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}
]
},
{
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"linkId" : "2.1.1.4.2.2",
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]
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]
}
]
}
]
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"linkId" : "2.1.1.5",
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"valueCoding" : {
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}
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},
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}
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}
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}
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]
},
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}
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{
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{
"linkId" : "2.1.1.4.2.2",
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]
}
]
}
]
}
]
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{
"linkId" : "2.1.1.5",
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{
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"valueCoding" : {
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},
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]
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}
]
},
{
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{
"linkId" : "2.1.1.4.2.2",
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]
}
]
}
]
}
]
},
{
"linkId" : "2.1.1.5",
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]
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{
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}
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}
]
},
{
"linkId" : "2.1.2",
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"linkId" : "2.1.2.1",
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{
"valueCoding" : {
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}
]
}
]
},
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},
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]
},
{
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}
]
},
{
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{
"linkId" : "2.1.1.4.1.1",
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"valueCoding" : {
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}
]
},
{
"linkId" : "2.1.1.4.1.2",
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"valueCoding" : {
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]
}
]
}
]
}
]
},
{
"linkId" : "2.1.1.5",
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]
},
{
"linkId" : "2.1.1.6",
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}
]
}
]
},
{
"linkId" : "2.1.2",
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{
"valueCoding" : {
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]
},
{
"linkId" : "2.1.2.2",
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"valueCoding" : {
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]
}
]
}
]
},
{
"linkId" : "2",
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"linkId" : "2.1.1.1",
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]
},
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"valueString" : "Claire"
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]
},
{
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"valueCoding" : {
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}
]
},
{
"linkId" : "2.1.1.4",
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"valueCoding" : {
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"item" : [
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"linkId" : "2.1.1.4.1.1",
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{
"valueCoding" : {
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"item" : [
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"linkId" : "2.1.1.4.1.1.1",
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"valueString" : "Lou Gehrigs"
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]
}
]
}
]
},
{
"linkId" : "2.1.1.4.1.2",
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"valueCoding" : {
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]
}
]
}
]
}
]
},
{
"linkId" : "2.1.1.5",
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"valueCoding" : {
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}
]
},
{
"linkId" : "2.1.1.6",
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}
]
}
]
}
]
},
{
"linkId" : "2",
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"linkId" : "2.1.1",
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"linkId" : "2.1.1.1",
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"valueCoding" : {
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}
]
},
{
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"valueString" : "Harriet"
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]
},
{
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"valueCoding" : {
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}
]
},
{
"linkId" : "2.1.1.4",
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"valueCoding" : {
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"item" : [
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"linkId" : "2.1.1.4.1.1",
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"valueCoding" : {
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}
]
},
{
"linkId" : "2.1.1.4.1.2",
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"valueCoding" : {
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}
]
}
]
}
]
}
]
},
{
"linkId" : "2.1.1.5",
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"valueCoding" : {
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}
]
},
{
"linkId" : "2.1.1.6",
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"valueCoding" : {
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}
]
}
]
},
{
"linkId" : "2.1.2",
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"linkId" : "2.1.2.1",
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{
"valueCoding" : {
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}
]
},
{
"linkId" : "2.1.2.2",
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"valueCoding" : {
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}
]
}
]
}
]
},
{
"linkId" : "2",
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"linkId" : "2.1.1",
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"linkId" : "2.1.1.1",
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"valueCoding" : {
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}
]
},
{
"linkId" : "2.1.1.2",
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"text" : "Name",
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"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",
"definition" : "http://loinc.org/fhir/DataElement/54114-4",
"text" : "Family member health information",
"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",
"definition" : "http://loinc.org/fhir/DataElement/54114-4",
"text" : "Family member health information",
"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",
"definition" : "http://loinc.org/fhir/DataElement/54114-4",
"text" : "Family member health information",
"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",
"definition" : "http://loinc.org/fhir/DataElement/54114-4",
"text" : "Family member health information",
"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",
"definition" : "http://loinc.org/fhir/DataElement/54114-4",
"text" : "Family member health information",
"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"
}
}
]
}
]
}
]
}
]
}
© 2015+ HL7 International (OO work group). Based on FHIR version (3.5.0-14923). IG generated on Fri, Aug 31, 2018 16:04+1000.
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