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Page standards status: Draft | Maturity Level: 0 |
{
"resourceType" : "Questionnaire",
"id" : "questionnaire-sdc-profile-example-hunger-vital-signs",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkId for the item\">LinkId</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the itemcan appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Other attributes of the item\">Flags</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description & Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> QuestionnaireSdcProfileExampleHungerVitalSigns</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A hunger vital signs form (showing calculatedExpression selecting a value from a list).</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-hunger-vital-signs#3.0.0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item./88122-7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /88122-7</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Within the past 12Mo we worried whether our food would run out before we got money to buy more</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./88122-7\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item./88123-5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /88123-5</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Within the past 12Mo the food we bought just didn't last and we didn't have money to get more [U.S. FSS]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./88123-5\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" id=\"item./88124-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> /88124-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Food insecurity risk</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/questionnaire-definitions.html#Questionnaire.item.readOnly\" title=\"Is Readonly\"><img src=\"icon-qi-readonly.png\"/></a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item./88124-3\">2 options</a><br/>Expressions: <ul><li style=\"font-size: 11px\"><a href=\"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression\">Calculated Value</a>: <code>iif(%answeredEitherQ, iif(%riskStatus, %atRiskCoding, %noRiskCoding), {})</code></li></ul></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" id=\"item./88124-3-help\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-display.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Display\" class=\"hierarchy\"/> /88124-3-help</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">An answer of "often true" or "sometimes true" to either or both of the Hunger Vital Sign™ questions identifies a patient as at risk for food insecurity (FI).</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display\">display</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr><td colspan=\"6\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Option Sets</b></p><a name=\"opt-item./88122-7\"> </a><p><b>Answer options for /88122-7</b></p><ul><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA28397-0 ("Often true")</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA6729-3 ("Sometimes true")</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA28398-8 ("Never true")</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA15775-2 ("Don't know/refused")</li></ul><a name=\"opt-item./88123-5\"> </a><p><b>Answer options for /88123-5</b></p><ul><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA28397-0 ("Often true")</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA6729-3 ("Sometimes true")</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA28398-8 ("Never true")</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA15775-2 ("Don't know/refused")</li></ul><a name=\"opt-item./88124-3\"> </a><p><b>Answer options for /88124-3</b></p><ul><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA19952-3 ("At risk")</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA19983-8 ("No risk")</li></ul></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression" : {
"name" : "worriedAnsCode",
"language" : "text/fhirpath",
"expression" : "%resource.item.where(linkId='/88122-7').answer.value.code"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression" : {
"name" : "ranOutAnsCode",
"language" : "text/fhirpath",
"expression" : "%resource.item.where(linkId='/88123-5').answer.value.code"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression" : {
"name" : "riskCodes",
"language" : "text/fhirpath",
"expression" : "'LA28397-0'.combine('LA6729-3')"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression" : {
"name" : "riskStatus",
"language" : "text/fhirpath",
"expression" : "%riskCodes contains %worriedAnsCode or %riskCodes contains %ranOutAnsCode"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression" : {
"name" : "answeredEitherQ",
"language" : "text/fhirpath",
"expression" : "%worriedAnsCode.exists() or %ranOutAnsCode.exists()"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "draft"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-hunger-vital-signs",
"version" : "3.0.0",
"name" : "QuestionnaireSdcProfileExampleHungerVitalSigns",
"title" : "Hunger Vital Sign [HVS]",
"status" : "draft",
"experimental" : true,
"subjectType" : [
"Patient"
],
"date" : "2022-03-08T18:33:14+00:00",
"publisher" : "HL7 International - FHIR Infrastructure Work Group",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://hl7.org/Special/committees/fiwg"
}
]
}
],
"description" : "A hunger vital signs form (showing calculatedExpression selecting a value from a list).",
"jurisdiction" : [
{
"coding" : [
{
"system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code" : "001"
}
]
}
],
"code" : [
{
"system" : "http://loinc.org",
"code" : "88121-9",
"display" : "Hunger Vital Sign [HVS]"
}
],
"item" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "drop-down",
"display" : "Drop down"
}
],
"text" : "Drop down"
}
}
],
"linkId" : "/88122-7",
"code" : [
{
"system" : "http://loinc.org",
"code" : "88122-7",
"display" : "Within the past 12 months we worried whether our food would run out before we got money to buy more [U.S. FSS]"
}
],
"text" : "Within the past 12Mo we worried whether our food would run out before we got money to buy more",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA28397-0",
"display" : "Often true"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA6729-3",
"display" : "Sometimes true"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA28398-8",
"display" : "Never true"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA15775-2",
"display" : "Don't know/refused"
}
}
]
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "drop-down",
"display" : "Drop down"
}
],
"text" : "Drop down"
}
}
],
"linkId" : "/88123-5",
"code" : [
{
"system" : "http://loinc.org",
"code" : "88123-5",
"display" : "Within the past 12 months the food we bought just didn't last and we didn't have money to get more [U.S. FSS]"
}
],
"text" : "Within the past 12Mo the food we bought just didn't last and we didn't have money to get more [U.S. FSS]",
"type" : "choice",
"required" : false,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA28397-0",
"display" : "Often true"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA6729-3",
"display" : "Sometimes true"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA28398-8",
"display" : "Never true"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA15775-2",
"display" : "Don't know/refused"
}
}
]
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "drop-down",
"display" : "Drop down"
}
],
"text" : "Drop down"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression" : {
"name" : "thisItem",
"language" : "text/fhirpath",
"expression" : "%questionnaire.item.where(linkId = '/88124-3')"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression" : {
"name" : "atRiskCoding",
"language" : "text/fhirpath",
"expression" : "%thisItem.answerOption.valueCoding.where(code='LA19952-3')"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression" : {
"name" : "noRiskCoding",
"language" : "text/fhirpath",
"expression" : "%thisItem.answerOption.valueCoding.where(code='LA19983-8')"
}
},
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression",
"valueExpression" : {
"description" : "risk determination",
"language" : "text/fhirpath",
"expression" : "iif(%answeredEitherQ, iif(%riskStatus, %atRiskCoding, %noRiskCoding), {})"
}
}
],
"linkId" : "/88124-3",
"code" : [
{
"system" : "http://loinc.org",
"code" : "88124-3",
"display" : "Food insecurity risk [HVS]"
}
],
"text" : "Food insecurity risk",
"type" : "choice",
"required" : false,
"readOnly" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA19952-3",
"display" : "At risk"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA19983-8",
"display" : "No risk"
}
}
],
"item" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "help",
"display" : "Help-Button"
}
],
"text" : "Help-Button"
}
}
],
"linkId" : "/88124-3-help",
"text" : "An answer of \"often true\" or \"sometimes true\" to either or both of the Hunger Vital Sign™ questions identifies a patient as at risk for food insecurity (FI).",
"type" : "display"
}
]
}
]
}