Structured Data Capture
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This page is part of the Structured Data Capture FHIR IG (v3.0.0: STU 3) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: SDC-Hunger Vital Sign - JSON Representation

Page standards status: Draft Maturity Level: 0

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{
  "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 &amp; 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 &quot;often true&quot; or &quot;sometimes true&quot; 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 (&quot;Often true&quot;)</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA6729-3 (&quot;Sometimes true&quot;)</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA28398-8 (&quot;Never true&quot;)</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA15775-2 (&quot;Don't know/refused&quot;)</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 (&quot;Often true&quot;)</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA6729-3 (&quot;Sometimes true&quot;)</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA28398-8 (&quot;Never true&quot;)</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA15775-2 (&quot;Don't know/refused&quot;)</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 (&quot;At risk&quot;)</li><li style=\"font-size: 11px\"><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html\">LOINC</a>: LA19983-8 (&quot;No risk&quot;)</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"
        }
      ]
    }
  ]
}