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 
<QuestionnaireResponse xmlns="http://hl7.org/fhir"> <id value="questionnaireresponse-sdc-example-ussg-fht-answers"/> <text> <status value="generated"/> <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> </text> <questionnaire value="http://hl7.org/fhir/uv/sdc/Questionnaire/54127-6"/> <status value="in-progress"/> <subject> <reference value="http://hl7.org/fhir/2018Sep/Patient/proband"/> </subject> <authored value="2008-01-17"/> <item> <linkId value="0"/> <item> <linkId value="0.1"/> <text value="Date Done"/> <answer> <valueDate value="2008-01-17"/> </answer> </item> </item> <item> <linkId value="1"/> <definition value="http://loinc.org/fhir/DataElement/54126-8"/> <text value="Your health information"/> <item> <linkId value="1.1"/> <item> <linkId value="1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54125-0"/> <text value="Name"/> <answer> <valueString value="Annie Proband"/> </answer> </item> <item> <linkId value="1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54131-8"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/21112-8"/> <text value="Date of Birth"/> <answer> <valueDate value="1966-04-04"/> </answer> </item> <item> <linkId value="1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54132-6"/> <text value="Were you born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54128-4"/> <text value="Were you adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54135-9"/> <text value="Are your parents related to each other in any way other than marriage?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="1.1.7"/> <definition value="http://loinc.org/fhir/DataElement/8302-2"/> <text value="Height"/> <answer> <valueDecimal value="63"/> <item> <linkId value="1.1.7.1.1"/> <text value="Units"/> <answer> <valueCoding> <system value="http://unitsofmeasure.org"/> <code value="[in_i]"/> <display value="inches"/> </valueCoding> </answer> </item> </answer> </item> <item> <linkId value="1.1.8"/> <definition value="http://loinc.org/fhir/DataElement/29463-7"/> <text value="Weight"/> <answer> <valueDecimal value="127"/> <item> <linkId value="1.1.8.1.1"/> <text value="Units"/> <answer> <valueCoding> <system value="http://unitsofmeasure.org"/> <code value="[lb_i]"/> <display value="pounds"/> </valueCoding> </answer> </item> </answer> </item> <item> <linkId value="1.1.9"/> <definition value="http://loinc.org/fhir/DataElement/39156-5"/> <text value="Body mass index (BMI) [Ratio]"/> <answer> <valueDecimal value="22.5"/> </answer> </item> <item> <linkId value="1.1.10"/> <definition value="http://loinc.org/fhir/DataElement/54134-2"/> <text value="Race"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA4457-3"/> <display value="White"/> </valueCoding> </answer> </item> <item> <linkId value="1.1.11"/> <definition value="http://loinc.org/fhir/DataElement/54133-4"/> <text value="Ethnicity"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10602-3"/> <display value="-- Mexican"/> </valueCoding> </answer> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10606-4"/> <display value="-- South American"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10405-1"/> <display value="Daughter"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Susan"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="17"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10415-0"/> <display value="Brother"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Brian"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA2-8"/> <display value="Male"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="32"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> <item> <linkId value="2.1.2"/> <text value="This family member's history of disease"/> <item> <linkId value="2.1.2.1"/> <text value="Disease or Condition"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10550-4"/> <display value="-- Other Cancer"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.2.2"/> <text value="Age at Diagnosis"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10397-0"/> <display value="30-39"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10418-4"/> <display value="Sister"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Janet"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="36"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> <item> <linkId value="2.1.2"/> <text value="This family member's history of disease"/> <item> <linkId value="2.1.2.1"/> <text value="Disease or Condition"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10536-3"/> <display value="-- Breast Cancer"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.2.2"/> <text value="Age at Diagnosis"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10397-0"/> <display value="30-39"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10419-2"/> <display value="Nephew"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Ian"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA2-8"/> <display value="Male"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="16"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10420-0"/> <display value="Niece"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Helen"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="15"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10416-8"/> <display value="Father"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Donald"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA2-8"/> <display value="Male"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="52"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10425-9"/> <display value="Paternal Uncle"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Eric"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA2-8"/> <display value="Male"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="56"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10421-8"/> <display value="Paternal Aunt"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Fiona"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="57"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> <item> <linkId value="2.1.2"/> <text value="This family member's history of disease"/> <item> <linkId value="2.1.2.1"/> <text value="Disease or Condition"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10543-9"/> <display value="-- Skin Cancer"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10423-4"/> <display value="Paternal Grandfather"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Bob"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA2-8"/> <display value="Male"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> <item> <linkId value="2.1.1.4.1"/> <item> <linkId value="2.1.1.4.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54112-8"/> <text value="Cause of Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10537-1"/> <display value="-- Colon Cancer"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54113-6"/> <text value="Age at Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10400-2"/> <display value="OVER 60"/> </valueCoding> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> <item> <linkId value="2.1.2"/> <text value="This family member's history of disease"/> <item> <linkId value="2.1.2.1"/> <text value="Disease or Condition"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10537-1"/> <display value="-- Colon Cancer"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.2.2"/> <text value="Age at Diagnosis"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10400-2"/> <display value="OVER 60"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10424-2"/> <display value="Paternal Grandmother"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Claire"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> <item> <linkId value="2.1.1.4.1"/> <item> <linkId value="2.1.1.4.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54112-8"/> <text value="Cause of Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10589-2"/> <display value="-- Other/Unexpected"/> </valueCoding> <item> <linkId value="2.1.1.4.1.1.1"/> <text value="Please specify"/> <answer> <valueString value="Lou Gehrigs"/> </answer> </item> </answer> </item> <item> <linkId value="2.1.1.4.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54113-6"/> <text value="Age at Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10400-2"/> <display value="OVER 60"/> </valueCoding> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10417-6"/> <display value="Mother"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Harriet"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> <item> <linkId value="2.1.1.4.1"/> <item> <linkId value="2.1.1.4.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54112-8"/> <text value="Cause of Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10539-7"/> <display value="-- Ovarian Cancer"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54113-6"/> <text value="Age at Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10399-6"/> <display value="50-59"/> </valueCoding> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> <item> <linkId value="2.1.2"/> <text value="This family member's history of disease"/> <item> <linkId value="2.1.2.1"/> <text value="Disease or Condition"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10539-7"/> <display value="-- Ovarian Cancer"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.2.2"/> <text value="Age at Diagnosis"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10398-8"/> <display value="40-49"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10414-3"/> <display value="Maternal Uncle"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Rudy"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA2-8"/> <display value="Male"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="60"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10410-1"/> <display value="Maternal Aunt"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Julie"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="57"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10412-7"/> <display value="Maternal Grandfather"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Ian"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA2-8"/> <display value="Male"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> <item> <linkId value="2.1.1.4.1"/> <item> <linkId value="2.1.1.4.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54112-8"/> <text value="Cause of Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10558-7"/> <display value="-- Heart Attack"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54113-6"/> <text value="Age at Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10400-2"/> <display value="OVER 60"/> </valueCoding> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10413-5"/> <display value="Maternal Grandmother"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Gladys"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> <item> <linkId value="2.1.1.4.1"/> <item> <linkId value="2.1.1.4.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54112-8"/> <text value="Cause of Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10571-0"/> <display value="-- Other/Unknown"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54113-6"/> <text value="Age at Death"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10400-2"/> <display value="OVER 60"/> </valueCoding> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> <item> <linkId value="2.1.2"/> <text value="This family member's history of disease"/> <item> <linkId value="2.1.2.1"/> <text value="Disease or Condition"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10536-3"/> <display value="-- Breast Cancer"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.2.2"/> <text value="Age at Diagnosis"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10399-6"/> <display value="50-59"/> </valueCoding> </answer> </item> </item> <item> <linkId value="2.1.2"/> <text value="This family member's history of disease"/> <item> <linkId value="2.1.2.1"/> <text value="Disease or Condition"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10564-5"/> <display value="-- Asthma"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.2.2"/> <text value="Age at Diagnosis"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10395-4"/> <display value="Childhood"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10411-9"/> <display value="Maternal Cousin"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Karren"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="30"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> <item> <linkId value="2.1.2"/> <text value="This family member's history of disease"/> <item> <linkId value="2.1.2.1"/> <text value="Disease or Condition"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10536-3"/> <display value="-- Breast Cancer"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.2.2"/> <text value="Age at Diagnosis"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10397-0"/> <display value="30-39"/> </valueCoding> </answer> </item> </item> </item> <item> <linkId value="2"/> <definition value="http://loinc.org/fhir/DataElement/54114-4"/> <text value="Family member health information"/> <item> <linkId value="2.1.1"/> <item> <linkId value="2.1.1.1"/> <definition value="http://loinc.org/fhir/DataElement/54136-7"/> <text value="Relationship to you"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA10411-9"/> <display value="Maternal Cousin"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.2"/> <definition value="http://loinc.org/fhir/DataElement/54138-3"/> <text value="Name"/> <answer> <valueString value="Mary"/> </answer> </item> <item> <linkId value="2.1.1.3"/> <definition value="http://loinc.org/fhir/DataElement/54123-5"/> <text value="Gender"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.4"/> <definition value="http://loinc.org/fhir/DataElement/54139-1"/> <text value="Living?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> <item> <linkId value="2.1.1.4.2"/> <item> <linkId value="2.1.1.4.2.2"/> <definition value="http://loinc.org/fhir/DataElement/54141-7"/> <text value="Age"/> <answer> <valueDecimal value="31"/> </answer> </item> </item> </answer> </item> <item> <linkId value="2.1.1.5"/> <definition value="http://loinc.org/fhir/DataElement/54121-9"/> <text value="Was this person born a twin?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> <item> <linkId value="2.1.1.6"/> <definition value="http://loinc.org/fhir/DataElement/54122-7"/> <text value="Was this person adopted?"/> <answer> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answer> </item> </item> </item> </QuestionnaireResponse>
© 2015+ HL7 International (OO work group). Based on FHIR version (3.5.0-14923). IG generated on Fri, Aug 31, 2018 16:04+1000.
Links: Version History |
Table of Contents |
|
Propose a change