Structured Data Capture
4.0.0-ballot - STU 4 ballot International flag

This page is part of the Structured Data Capture FHIR IG (v4.0.0-ballot: STU 4 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: SDCQuestionnaireCommon - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 4

Definitions for the sdc-questionnairecommon resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Questionnaire
Invariantscnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$'))
sdc-2: If version is present, versionAlgorithm must be present. (version.exists() implies extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]').exists())
sdc-3: Semver is the preferred version algorithm - package machinery doesn't work well with artifacts using alternate versioning schemes (extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]').all(value.ofType(Coding).where(system='http://hl7.org/fhir/version-algorithm' and code='semver').exists()))
2. Questionnaire.extension
SlicingThis element introduces a set of slices on Questionnaire.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Questionnaire.extension:versionAlgorithm
    Slice NameversionAlgorithm
    Control0..1
    TypeExtension(Extension Definition for Questionnaire.versionAlgorithm[x] for Version 5.0) (Extension Type: Choice of: string, Coding)
    Must Supporttrue
    6. Questionnaire.extension:copyrightLabel
    Slice NamecopyrightLabel
    Control0..1
    TypeExtension(Extension Definition for Questionnaire.copyrightLabel for Version 5.0) (Extension Type: string)
    8. Questionnaire.url
    Invariantscnl-1: Warning Questionnaire.url URL should not contain | or # - these characters make processing canonical references problematic (exists() implies matches('^[^|# ]+$'))
    10. Questionnaire.version
    NoteThis is a business version Id, not a resource version Id (see discussion)
    12. Questionnaire.title
    Must Supporttrue
    14. Questionnaire.status
    Must Supporttrue
    16. Questionnaire.item
    Invariantssdc-1: An item cannot have an answerExpression if answerOption or answerValueSet is already present. (extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').empty().not() implies (answerOption.empty() and answerValueSet.empty()))
    que-1a: Group items must have nested items when Questionanire is complete ((type='group' and %resource.status='complete') implies item.empty().not())
    que-1b: Groups should have items (type='group' implies item.empty().not())
    que-1c: Display items cannot have child items (type='display' implies item.empty())
    que-14: Can only have answerConstraint if answerOption, answerValueSet, or answerExpression are present. (This is a warning because other extensions may serve the same purpose) (extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.item.answerConstraint').exists() implies answerOption.exists() or answerValueSet.exists() or extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').exists())
    18. Questionnaire.item.extension
    SlicingThis element introduces a set of slices on Questionnaire.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 20. Questionnaire.item.extension:hidden
      Slice Namehidden
      Control0..1
      TypeExtension(Questionnaire Hidden) (Extension Type: boolean)
      Must Supporttrue
      22. Questionnaire.item.extension:answerConstraint
      Slice NameanswerConstraint
      Control0..1
      TypeExtension(Extension Definition for Questionnaire.item.answerConstraint for Version 5.0) (Extension Type: code)
      24. Questionnaire.item.linkId
      Must Supporttrue
      Invariantsque-15: Link ids must be 255 characters or less ($this.length() <= 255)
      26. Questionnaire.item.prefix
      Must Supporttrue
      28. Questionnaire.item.text
      30. Questionnaire.item.type
      Comments

      Time is handled using "string". File is handled using Attachment. (Content can be sent as a contained binary).

      Must Supporttrue
      32. Questionnaire.item.required
      Must Supporttrue
      34. Questionnaire.item.repeats
      Definition

      An indication, if true, that a QuestionnaireResponse for this item may include multiple answers associated with a single instance of this item (for question-type items) or multiple repetitions of the item (for group-type items)

      Must Supporttrue
      36. Questionnaire.item.readOnly
      Must Supporttrue
      38. Questionnaire.item.maxLength
      40. Questionnaire.item.answerValueSet
      Typecanonical(SDC Value Set)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      42. Questionnaire.item.answerOption
      Must Supporttrue
      44. Questionnaire.item.answerOption.value[x]
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Must Supporttrue
      46. Questionnaire.item.initial
      Must Supporttrue
      48. Questionnaire.item.initial.value[x]
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Must Supporttrue
      50. Questionnaire.item.item
      Must Supporttrue

      Guidance on how to interpret the contents of this table can be found here

      0. Questionnaire
      Definition

      A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection.

      ShortA structured set of questions
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Alternate NamesForm, CRF, Survey
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
      que-2: The link ids for groups and questions must be unique within the questionnaire (descendants().linkId.isDistinct())
      cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$'))
      sdc-2: If version is present, versionAlgorithm must be present. (version.exists() implies extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]').exists())
      sdc-3: Semver is the preferred version algorithm - package machinery doesn't work well with artifacts using alternate versioning schemes (extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]').all(value.ofType(Coding).where(system='http://hl7.org/fhir/version-algorithm' and code='semver').exists()))
      que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
      que-2: The link ids for groups and questions must be unique within the questionnaire (descendants().linkId.isDistinct())
      2. Questionnaire.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Questionnaire.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Questionnaire.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Questionnaire.extension:versionAlgorithm
        Slice NameversionAlgorithm
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension Definition for Questionnaire.versionAlgorithm[x] for Version 5.0) (Extension Type: Choice of: string, Coding)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        8. Questionnaire.extension:copyrightLabel
        Slice NamecopyrightLabel
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension Definition for Questionnaire.copyrightLabel for Version 5.0) (Extension Type: string)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        10. Questionnaire.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. Questionnaire.url
        Definition

        An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.

        ShortCanonical identifier for this questionnaire, represented as a URI (globally unique)
        Comments

        The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        … This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cnl-1: Warning Questionnaire.url URL should not contain | or # - these characters make processing canonical references problematic (exists() implies matches('^[^|# ]+$'))
        14. Questionnaire.version
        Definition

        The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

        ShortBusiness version of the questionnaire
        Comments

        There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version].

        NoteThis is a business version Id, not a resource version Id (see discussion)
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Questionnaire.title
        Definition

        A short, descriptive, user-friendly title for the questionnaire.

        ShortName for this questionnaire (human friendly)
        Comments

        This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Questionnaire.status
        Definition

        The status of this questionnaire. Enables tracking the life-cycle of the content.

        Shortdraft | active | retired | unknown
        Comments

        Allows filtering of questionnaires that are appropriate for use versus not.

        Control1..1
        BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

        The lifecycle status of an artifact.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. Questionnaire.item
        Definition

        A particular question, question grouping or display text that is part of the questionnaire.

        ShortQuestions and sections within the Questionnaire
        Comments

        The content of the questionnaire is constructed from an ordered, hierarchical collection of items.

        Control0..*
        This element is affected by the following invariants: que-3
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        que-1: Group items must have nested items, display items cannot have nested items ((type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty()))
        que-3: Display items cannot have a "code" asserted (type!='display' or code.empty())
        que-4: A question cannot have both answerOption and answerValueSet (answerOption.empty() or answerValueSet.empty())
        que-5: Only 'choice' and 'open-choice' items can have answerValueSet ((type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty()))
        que-6: Required and repeat aren't permitted for display items (type!='display' or (required.empty() and repeats.empty()))
        que-8: Initial values can't be specified for groups or display items ((type!='group' and type!='display') or initial.empty())
        que-9: Read-only can't be specified for "display" items (type!='display' or readOnly.empty())
        que-10: Maximum length can only be declared for simple question types ((type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty())
        que-11: If one or more answerOption is present, initial[x] must be missing (answerOption.empty() or initial.empty())
        que-12: If there are more than one enableWhen, enableBehavior must be specified (enableWhen.count() > 2 implies enableBehavior.exists())
        que-13: Can only have multiple initial values for repeating items (repeats=true or initial.count() <= 1)
        sdc-1: An item cannot have an answerExpression if answerOption or answerValueSet is already present. (extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').empty().not() implies (answerOption.empty() and answerValueSet.empty()))
        que-1a: Group items must have nested items when Questionanire is complete ((type='group' and %resource.status='complete') implies item.empty().not())
        que-1b: Groups should have items (type='group' implies item.empty().not())
        que-1c: Display items cannot have child items (type='display' implies item.empty())
        que-14: Can only have answerConstraint if answerOption, answerValueSet, or answerExpression are present. (This is a warning because other extensions may serve the same purpose) (extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.item.answerConstraint').exists() implies answerOption.exists() or answerValueSet.exists() or extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').exists())
        que-1: Group items must have nested items, display items cannot have nested items ((type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty()))
        que-3: Display items cannot have a "code" asserted (type!='display' or code.empty())
        que-4: A question cannot have both answerOption and answerValueSet (answerOption.empty() or answerValueSet.empty())
        que-5: Only 'choice' and 'open-choice' items can have answerValueSet ((type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty()))
        que-6: Required and repeat aren't permitted for display items (type!='display' or (required.empty() and repeats.empty()))
        que-8: Initial values can't be specified for groups or display items ((type!='group' and type!='display') or initial.empty())
        que-9: Read-only can't be specified for "display" items (type!='display' or readOnly.empty())
        que-10: Maximum length can only be declared for simple question types ((type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty())
        que-11: If one or more answerOption is present, initial[x] must be missing (answerOption.empty() or initial.empty())
        que-12: If there are more than one enableWhen, enableBehavior must be specified (enableWhen.count() > 2 implies enableBehavior.exists())
        que-13: Can only have multiple initial values for repeating items (repeats=true or initial.count() <= 1)
        22. Questionnaire.item.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Questionnaire.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 24. Questionnaire.item.extension:hidden
          Slice Namehidden
          Definition

          If true, indicates that the extended item should not be displayed to the user.

          ShortDon't display to user
          Comments

          If an item is hidden, all descendant items are hidden as well. See additional guidance and examples in the SDC implementation guide.

          Control0..1
          TypeExtension(Questionnaire Hidden) (Extension Type: boolean)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          26. Questionnaire.item.extension:answerConstraint
          Slice NameanswerConstraint
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension Definition for Questionnaire.item.answerConstraint for Version 5.0) (Extension Type: code)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          28. Questionnaire.item.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          30. Questionnaire.item.linkId
          Definition

          An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.

          ShortUnique id for item in questionnaire
          Comments

          This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.


          QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          que-15: Link ids must be 255 characters or less ($this.length() <= 255)
          32. Questionnaire.item.prefix
          Definition

          A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire.

          ShortE.g. "1(a)", "2.5.3"
          Comments

          These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically, these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used.

          Alternate Nameslabel
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Questionnaire.item.text
          Definition

          The name of a section, the text of a question or text content for a display item.

          ShortPrimary text for the item
          Comments

          When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading. Group item instructions should be included as a display type item within the group.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Questionnaire.item.type
          Definition

          The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.).

          Shortgroup | display | boolean | decimal | integer | date | dateTime +
          Comments

          Time is handled using "string". File is handled using Attachment. (Content can be sent as a contained binary).


          Additional constraints on the type of answer can be conveyed by extensions. The value may come from the ElementDefinition referred to by .definition.

          Control1..1
          BindingThe codes SHALL be taken from QuestionnaireItemTypehttp://hl7.org/fhir/ValueSet/item-type|4.0.1
          (required to http://hl7.org/fhir/ValueSet/item-type|4.0.1)

          Distinguishes groups from questions and display text and indicates data type for questions.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Defines the format in which the user is to be prompted for the answer.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. Questionnaire.item.enableWhen
          Definition

          A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true.

          ShortOnly allow data when
          Comments

          If multiple repetitions of this extension are present, the item should be enabled when the condition for any of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to.

          Control0..*
          TypeBackboneElement
          Is Modifiertrue because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
          Summaryfalse
          Requirements

          Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          que-7: If the operator is 'exists', the value must be a boolean (operator = 'exists' implies (answer is Boolean))
          que-7: If the operator is 'exists', the value must be a boolean (operator = 'exists' implies (answer is Boolean))
          40. Questionnaire.item.enableWhen.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          42. Questionnaire.item.enableWhen.question
          Definition

          The linkId for the question whose answer (or lack of answer) governs whether this item is enabled.

          ShortQuestion that determines whether item is enabled
          Comments

          If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the "ancestor" axis and then the "preceding" axis and then the "following" axis.

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Questionnaire.item.enableWhen.operator
          Definition

          Specifies the criteria by which the question is enabled.

          Shortexists | = | != | > | < | >= | <=
          Control1..1
          BindingThe codes SHALL be taken from QuestionnaireItemOperatorhttp://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1
          (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1)

          The criteria by which a question is enabled.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. Questionnaire.item.enableWhen.answer[x]
          Definition

          A value that the referenced question is tested using the specified operator in order for the item to be enabled.

          ShortValue for question comparison based on operator
          Control1..1
          This element is affected by the following invariants: que-7
          BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers
          (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

          Allowed values to answer questions.

          TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, Coding, Quantity, Reference(Resource)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. Questionnaire.item.required
          Definition

          An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire.

          ShortWhether the item must be included in data results
          Comments

          Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition.

          Control0..1
          This element is affected by the following invariants: que-6
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Meaning if MissingItems are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. Questionnaire.item.repeats
          Definition

          An indication, if true, that a QuestionnaireResponse for this item may include multiple answers associated with a single instance of this item (for question-type items) or multiple repetitions of the item (for group-type items)


          An indication, if true, that the item may occur multiple times in the response, collecting multiple answers for questions or multiple sets of answers for groups.

          ShortWhether the item may repeat
          Comments

          If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items.

          The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values.

          The value may come from the ElementDefinition referred to by .definition.

          Control0..1
          This element is affected by the following invariants: que-6
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set.

          Meaning if MissingItems are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. Questionnaire.item.readOnly
          Definition

          An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.

          ShortDon't allow human editing
          Comments

          The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers.

          Control0..1
          This element is affected by the following invariants: que-9
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. Questionnaire.item.maxLength
          Definition

          The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse.

          ShortNo more than this many characters
          Comments

          For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition.

          Control0..1
          This element is affected by the following invariants: que-10
          Typeinteger
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. Questionnaire.item.answerValueSet
          Definition

          A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" question.

          ShortValueset containing permitted answers
          Comments

          LOINC defines many useful value sets for questionnaire responses. See LOINC Answer Lists. The value may come from the ElementDefinition referred to by .definition.

          Control0..1
          This element is affected by the following invariants: que-4, que-5
          Typecanonical(SDC Value Set, ValueSet)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. Questionnaire.item.answerOption
          Definition

          One of the permitted answers for a "choice" or "open-choice" question.

          ShortPermitted answer
          Comments

          This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes.

          Control0..*
          This element is affected by the following invariants: que-4, que-5
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. Questionnaire.item.answerOption.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          62. Questionnaire.item.answerOption.value[x]
          Definition

          A potential answer that's allowed as the answer to this question.

          ShortAnswer value
          Comments

          The data type of the value must agree with the item.type.

          Control1..1
          BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers
          (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

          Allowed values to answer questions.

          TypeChoice of: integer, date, time, string, Coding, Reference(Resource)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. Questionnaire.item.initial
          Definition

          One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.

          ShortInitial value(s) when item is first rendered
          Comments

          The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial[x] must agree with the item.type, and only repeating items can have more then one initial value.

          Control0..*
          This element is affected by the following invariants: que-8, que-13
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          In some workflows, having defaults saves time.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. Questionnaire.item.initial.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          68. Questionnaire.item.initial.value[x]
          Definition

          The actual value to for an initial answer.

          ShortActual value for initializing the question
          Comments

          The type of the initial value must be consistent with the type of the item.

          Control1..1
          BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers
          (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

          Allowed values to answer questions.

          TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. Questionnaire.item.item
          Definition

          Text, questions and other groups to be nested beneath a question or group.

          ShortNested questionnaire items
          Comments

          There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting.

          Control0..*
          This element is affected by the following invariants: que-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Reports can consist of complex nested groups.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be found here

          0. Questionnaire
          Definition

          A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection.

          ShortA structured set of questions
          Control0..*
          Is Modifierfalse
          Summaryfalse
          Alternate NamesForm, CRF, Survey
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
          que-2: The link ids for groups and questions must be unique within the questionnaire (descendants().linkId.isDistinct())
          cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$'))
          sdc-2: If version is present, versionAlgorithm must be present. (version.exists() implies extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]').exists())
          sdc-3: Semver is the preferred version algorithm - package machinery doesn't work well with artifacts using alternate versioning schemes (extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]').all(value.ofType(Coding).where(system='http://hl7.org/fhir/version-algorithm' and code='semver').exists()))
          2. Questionnaire.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. Questionnaire.meta
          Definition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Questionnaire.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. Questionnaire.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

          Control0..1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. Questionnaire.text
          Definition

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          ShortText summary of the resource, for human interpretation
          Comments

          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Questionnaire.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          ShortContained, inline Resources
          Comments

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Control0..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. Questionnaire.extension
          Definition

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Questionnaire.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. Questionnaire.extension:versionAlgorithm
            Slice NameversionAlgorithm
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Extension Definition for Questionnaire.versionAlgorithm[x] for Version 5.0) (Extension Type: Choice of: string, Coding)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. Questionnaire.extension:copyrightLabel
            Slice NamecopyrightLabel
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Extension Definition for Questionnaire.copyrightLabel for Version 5.0) (Extension Type: string)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            20. Questionnaire.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            22. Questionnaire.url
            Definition

            An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.

            ShortCanonical identifier for this questionnaire, represented as a URI (globally unique)
            Comments

            The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension.

            Control0..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            … This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            cnl-1: Warning Questionnaire.url URL should not contain | or # - these characters make processing canonical references problematic (exists() implies matches('^[^|# ]+$'))
            24. Questionnaire.identifier
            Definition

            A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance.

            ShortAdditional identifier for the questionnaire
            Comments

            Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this questionnaire outside of FHIR, where it is not possible to use the logical URI.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows externally provided and/or usable business identifiers to be easily associated with the module.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. Questionnaire.version
            Definition

            The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

            ShortBusiness version of the questionnaire
            Comments

            There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version].

            NoteThis is a business version Id, not a resource version Id (see discussion)
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. Questionnaire.name
            Definition

            A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation.

            ShortName for this questionnaire (computer friendly)
            Comments

            The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

            Control0..1
            This element is affected by the following invariants: inv-0
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Support human navigation and code generation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. Questionnaire.title
            Definition

            A short, descriptive, user-friendly title for the questionnaire.

            ShortName for this questionnaire (human friendly)
            Comments

            This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. Questionnaire.derivedFrom
            Definition

            The URL of a Questionnaire that this Questionnaire is based on.

            ShortInstantiates protocol or definition
            Control0..*
            Typecanonical(Questionnaire)
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            Allows a Questionnaire to be created based on another Questionnaire.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. Questionnaire.status
            Definition

            The status of this questionnaire. Enables tracking the life-cycle of the content.

            Shortdraft | active | retired | unknown
            Comments

            Allows filtering of questionnaires that are appropriate for use versus not.

            Control1..1
            BindingThe codes SHALL be taken from PublicationStatus
            (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

            The lifecycle status of an artifact.

            Typecode
            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. Questionnaire.experimental
            Definition

            A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

            ShortFor testing purposes, not real usage
            Comments

            Allows filtering of questionnaires that are appropriate for use versus not.

            Control0..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. Questionnaire.subjectType
            Definition

            The types of subjects that can be the subject of responses created for the questionnaire.

            ShortResource that can be subject of QuestionnaireResponse
            Comments

            If none are specified, then the subject is unlimited.

            Control0..*
            BindingThe codes SHALL be taken from ResourceType
            (required to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

            One of the resource types defined as part of this version of FHIR.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. Questionnaire.date
            Definition

            The date (and optionally time) when the questionnaire was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes.

            ShortDate last changed
            Comments

            Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

            Control0..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate NamesRevision Date
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. Questionnaire.publisher
            Definition

            The name of the organization or individual that published the questionnaire.

            ShortName of the publisher (organization or individual)
            Comments

            Usually an organization but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Helps establish the "authority/credibility" of the questionnaire. May also allow for contact.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. Questionnaire.contact
            Definition

            Contact details to assist a user in finding and communicating with the publisher.

            ShortContact details for the publisher
            Comments

            May be a web site, an email address, a telephone number, etc.

            Control0..*
            TypeContactDetail
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. Questionnaire.description
            Definition

            A free text natural language description of the questionnaire from a consumer's perspective.

            ShortNatural language description of the questionnaire
            Comments

            This description can be used to capture details such as why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created).

            Control0..1
            Typemarkdown
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. Questionnaire.useContext
            Definition

            The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate questionnaire instances.

            ShortThe context that the content is intended to support
            Comments

            When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

            Control0..*
            TypeUsageContext
            Is Modifierfalse
            Summarytrue
            Requirements

            Assist in searching for appropriate content.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. Questionnaire.jurisdiction
            Definition

            A legal or geographic region in which the questionnaire is intended to be used.

            ShortIntended jurisdiction for questionnaire (if applicable)
            Comments

            It may be possible for the questionnaire to be used in jurisdictions other than those for which it was originally designed or intended.

            Control0..*
            BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSet
            (extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

            Countries and regions within which this artifact is targeted for use.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. Questionnaire.purpose
            Definition

            Explanation of why this questionnaire is needed and why it has been designed as it has.

            ShortWhy this questionnaire is defined
            Comments

            This element does not describe the usage of the questionnaire. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this questionnaire.

            Control0..1
            Typemarkdown
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. Questionnaire.copyright
            Definition

            A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire.

            ShortUse and/or publishing restrictions
            Control0..1
            Typemarkdown
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            Consumers must be able to determine any legal restrictions on the use of the questionnaire and/or its content.

            Alternate NamesLicense, Restrictions
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Questionnaire.approvalDate
            Definition

            The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

            ShortWhen the questionnaire was approved by publisher
            Comments

            The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

            Control0..1
            Typedate
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Questionnaire.lastReviewDate
            Definition

            The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

            ShortWhen the questionnaire was last reviewed
            Comments

            If specified, this date follows the original approval date.

            Control0..1
            Typedate
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. Questionnaire.effectivePeriod
            Definition

            The period during which the questionnaire content was or is planned to be in active use.

            ShortWhen the questionnaire is expected to be used
            Comments

            The effective period for a questionnaire determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

            Control0..1
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the questionnaire are or are expected to be used instead.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. Questionnaire.code
            Definition

            An identifier for this question or group of questions in a particular terminology such as LOINC.

            ShortConcept that represents the overall questionnaire
            Control0..*
            BindingFor example codes, see QuestionnaireQuestionCodes
            (example to http://hl7.org/fhir/ValueSet/questionnaire-questions)

            Codes for questionnaires, groups and individual questions.

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. Questionnaire.item
            Definition

            A particular question, question grouping or display text that is part of the questionnaire.

            ShortQuestions and sections within the Questionnaire
            Comments

            The content of the questionnaire is constructed from an ordered, hierarchical collection of items.

            Control0..*
            This element is affected by the following invariants: que-3
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            que-1: Group items must have nested items, display items cannot have nested items ((type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty()))
            que-3: Display items cannot have a "code" asserted (type!='display' or code.empty())
            que-4: A question cannot have both answerOption and answerValueSet (answerOption.empty() or answerValueSet.empty())
            que-5: Only 'choice' and 'open-choice' items can have answerValueSet ((type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty()))
            que-6: Required and repeat aren't permitted for display items (type!='display' or (required.empty() and repeats.empty()))
            que-8: Initial values can't be specified for groups or display items ((type!='group' and type!='display') or initial.empty())
            que-9: Read-only can't be specified for "display" items (type!='display' or readOnly.empty())
            que-10: Maximum length can only be declared for simple question types ((type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty())
            que-11: If one or more answerOption is present, initial[x] must be missing (answerOption.empty() or initial.empty())
            que-12: If there are more than one enableWhen, enableBehavior must be specified (enableWhen.count() > 2 implies enableBehavior.exists())
            que-13: Can only have multiple initial values for repeating items (repeats=true or initial.count() <= 1)
            sdc-1: An item cannot have an answerExpression if answerOption or answerValueSet is already present. (extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').empty().not() implies (answerOption.empty() and answerValueSet.empty()))
            que-1a: Group items must have nested items when Questionanire is complete ((type='group' and %resource.status='complete') implies item.empty().not())
            que-1b: Groups should have items (type='group' implies item.empty().not())
            que-1c: Display items cannot have child items (type='display' implies item.empty())
            que-14: Can only have answerConstraint if answerOption, answerValueSet, or answerExpression are present. (This is a warning because other extensions may serve the same purpose) (extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.item.answerConstraint').exists() implies answerOption.exists() or answerValueSet.exists() or extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').exists())
            66. Questionnaire.item.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            68. Questionnaire.item.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Questionnaire.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 70. Questionnaire.item.extension:hidden
              Slice Namehidden
              Definition

              If true, indicates that the extended item should not be displayed to the user.

              ShortDon't display to user
              Comments

              If an item is hidden, all descendant items are hidden as well. See additional guidance and examples in the SDC implementation guide.

              Control0..1
              TypeExtension(Questionnaire Hidden) (Extension Type: boolean)
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              72. Questionnaire.item.extension:answerConstraint
              Slice NameanswerConstraint
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Extension Definition for Questionnaire.item.answerConstraint for Version 5.0) (Extension Type: code)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              74. Questionnaire.item.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              76. Questionnaire.item.linkId
              Definition

              An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.

              ShortUnique id for item in questionnaire
              Comments

              This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

              Control1..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Requirements

              QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              que-15: Link ids must be 255 characters or less ($this.length() <= 255)
              78. Questionnaire.item.definition
              Definition

              This element is a URI that refers to an ElementDefinition that provides information about this item, including information that might otherwise be included in the instance of the Questionnaire resource. A detailed description of the construction of the URI is shown in Comments, below. If this element is present then the following element values MAY be derived from the Element Definition if the corresponding elements of this Questionnaire resource instance have no value:

              • code (ElementDefinition.code)
              • type (ElementDefinition.type)
              • required (ElementDefinition.min)
              • repeats (ElementDefinition.max)
              • maxLength (ElementDefinition.maxLength)
              • answerValueSet (ElementDefinition.binding)
              • options (ElementDefinition.binding).
              ShortElementDefinition - details for the item
              Comments

              The uri refers to an ElementDefinition in a StructureDefinition and always starts with the canonical URL for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id Element.id. E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment identifier, the first/root element definition in the target is the matching element definition.

              Control0..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Requirements

              A common pattern is to define a set of data elements and then build multiple questionnaires for different circumstances to gather the data. This element provides traceability to the common definition and allows the content for the question to come from the underlying definition.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. Questionnaire.item.code
              Definition

              A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers).

              ShortCorresponding concept for this item in a terminology
              Comments

              The value may come from the ElementDefinition referred to by .definition.

              Control0..*
              This element is affected by the following invariants: que-3
              BindingFor example codes, see QuestionnaireQuestionCodes
              (example to http://hl7.org/fhir/ValueSet/questionnaire-questions)

              Codes for questionnaires, groups and individual questions.

              TypeCoding
              Is Modifierfalse
              Summaryfalse
              Requirements

              Allows linking of groups of questions to formal terminologies.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              82. Questionnaire.item.prefix
              Definition

              A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire.

              ShortE.g. "1(a)", "2.5.3"
              Comments

              These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically, these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Requirements

              Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used.

              Alternate Nameslabel
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              84. Questionnaire.item.text
              Definition

              The name of a section, the text of a question or text content for a display item.

              ShortPrimary text for the item
              Comments

              When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading. Group item instructions should be included as a display type item within the group.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. Questionnaire.item.type
              Definition

              The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.).

              Shortgroup | display | boolean | decimal | integer | date | dateTime +
              Comments

              Time is handled using "string". File is handled using Attachment. (Content can be sent as a contained binary).

              Control1..1
              BindingThe codes SHALL be taken from QuestionnaireItemType
              (required to http://hl7.org/fhir/ValueSet/item-type|4.0.1)

              Distinguishes groups from questions and display text and indicates data type for questions.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Requirements

              Defines the format in which the user is to be prompted for the answer.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              88. Questionnaire.item.enableWhen
              Definition

              A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true.

              ShortOnly allow data when
              Comments

              If multiple repetitions of this extension are present, the item should be enabled when the condition for any of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to.

              Control0..*
              TypeBackboneElement
              Is Modifiertrue because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
              Summaryfalse
              Requirements

              Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              que-7: If the operator is 'exists', the value must be a boolean (operator = 'exists' implies (answer is Boolean))
              90. Questionnaire.item.enableWhen.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              92. Questionnaire.item.enableWhen.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              94. Questionnaire.item.enableWhen.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              96. Questionnaire.item.enableWhen.question
              Definition

              The linkId for the question whose answer (or lack of answer) governs whether this item is enabled.

              ShortQuestion that determines whether item is enabled
              Comments

              If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the "ancestor" axis and then the "preceding" axis and then the "following" axis.

              Control1..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              98. Questionnaire.item.enableWhen.operator
              Definition

              Specifies the criteria by which the question is enabled.

              Shortexists | = | != | > | < | >= | <=
              Control1..1
              BindingThe codes SHALL be taken from QuestionnaireItemOperator
              (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1)

              The criteria by which a question is enabled.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              100. Questionnaire.item.enableWhen.answer[x]
              Definition

              A value that the referenced question is tested using the specified operator in order for the item to be enabled.

              ShortValue for question comparison based on operator
              Control1..1
              This element is affected by the following invariants: que-7
              BindingFor example codes, see QuestionnaireAnswerCodes
              (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

              Allowed values to answer questions.

              TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, Coding, Quantity, Reference(Resource)
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              102. Questionnaire.item.enableBehavior
              Definition

              Controls how multiple enableWhen values are interpreted - whether all or any must be true.

              Shortall | any
              Comments

              This element must be specified if more than one enableWhen value is provided.

              Control0..1
              This element is affected by the following invariants: que-12
              BindingThe codes SHALL be taken from EnableWhenBehavior
              (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1)

              Controls how multiple enableWhen values are interpreted - whether all or any must be true.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              104. Questionnaire.item.required
              Definition

              An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire.

              ShortWhether the item must be included in data results
              Comments

              Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition.

              Control0..1
              This element is affected by the following invariants: que-6
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Meaning if MissingItems are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. Questionnaire.item.repeats
              Definition

              An indication, if true, that a QuestionnaireResponse for this item may include multiple answers associated with a single instance of this item (for question-type items) or multiple repetitions of the item (for group-type items)

              ShortWhether the item may repeat
              Comments

              If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items.

              The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values.

              The value may come from the ElementDefinition referred to by .definition.

              Control0..1
              This element is affected by the following invariants: que-6
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Requirements

              Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set.

              Meaning if MissingItems are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              108. Questionnaire.item.readOnly
              Definition

              An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.

              ShortDon't allow human editing
              Comments

              The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers.

              Control0..1
              This element is affected by the following invariants: que-9
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Requirements

              Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              110. Questionnaire.item.maxLength
              Definition

              The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse.

              ShortNo more than this many characters
              Comments

              For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition.

              Control0..1
              This element is affected by the following invariants: que-10
              Typeinteger
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              112. Questionnaire.item.answerValueSet
              Definition

              A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" question.

              ShortValueset containing permitted answers
              Comments

              LOINC defines many useful value sets for questionnaire responses. See LOINC Answer Lists. The value may come from the ElementDefinition referred to by .definition.

              Control0..1
              This element is affected by the following invariants: que-4, que-5
              Typecanonical(SDC Value Set)
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              114. Questionnaire.item.answerOption
              Definition

              One of the permitted answers for a "choice" or "open-choice" question.

              ShortPermitted answer
              Comments

              This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes.

              Control0..*
              This element is affected by the following invariants: que-4, que-5
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              116. Questionnaire.item.answerOption.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              118. Questionnaire.item.answerOption.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              120. Questionnaire.item.answerOption.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              122. Questionnaire.item.answerOption.value[x]
              Definition

              A potential answer that's allowed as the answer to this question.

              ShortAnswer value
              Comments

              The data type of the value must agree with the item.type.

              Control1..1
              BindingFor example codes, see QuestionnaireAnswerCodes
              (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

              Allowed values to answer questions.

              TypeChoice of: integer, date, time, string, Coding, Reference(Resource)
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              124. Questionnaire.item.answerOption.initialSelected
              Definition

              Indicates whether the answer value is selected when the list of possible answers is initially shown.

              ShortWhether option is selected by default
              Comments

              Use this instead of initial[v] if answerValueSet is present.

              Control0..1
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Meaning if MissingOnly selected items explicitly marked to be selected
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              126. Questionnaire.item.initial
              Definition

              One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.

              ShortInitial value(s) when item is first rendered
              Comments

              The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial[x] must agree with the item.type, and only repeating items can have more then one initial value.

              Control0..*
              This element is affected by the following invariants: que-8, que-13
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              In some workflows, having defaults saves time.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              128. Questionnaire.item.initial.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              130. Questionnaire.item.initial.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              132. Questionnaire.item.initial.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              134. Questionnaire.item.initial.value[x]
              Definition

              The actual value to for an initial answer.

              ShortActual value for initializing the question
              Comments

              The type of the initial value must be consistent with the type of the item.

              Control1..1
              BindingFor example codes, see QuestionnaireAnswerCodes
              (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

              Allowed values to answer questions.

              TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              136. Questionnaire.item.item
              Definition

              Text, questions and other groups to be nested beneath a question or group.

              ShortNested questionnaire items
              Comments

              There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting.

              Control0..*
              This element is affected by the following invariants: que-1
              TypeSeettp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Reports can consist of complex nested groups.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))