Extensions for Using Data Elements from FHIR R5 in FHIR R4
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Extensions for Using Data Elements from FHIR R5 in FHIR R4 - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R5_Questionnaire_R4 - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the profile-Questionnaire resource profile.

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

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())
dom-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())
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()))
ele-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())
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())
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

    R5: Questionnaire.versionAlgorithm[x] (new:Coding, string)

    ShortR5: How to compare versions (new)
    Comments

    Element Questionnaire.versionAlgorithm[x] has a context of Questionnaire based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.versionAlgorithm[x] has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Questionnaire.versionAlgorithm[x]: http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm. If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

    Control0..1
    TypeExtension(Artifact Version Algorithm) (Extension Type: Choice of: string, Coding)
    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())
    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())
    8. Questionnaire.extension:copyrightLabel
    Slice NamecopyrightLabel
    Definition

    R5: Questionnaire.copyrightLabel (new:string)

    ShortR5: Copyright holder and year(s) (new)
    Comments

    Element Questionnaire.copyrightLabel has a context of Questionnaire based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.copyrightLabel has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Questionnaire.copyrightLabel: http://hl7.org/fhir/StructureDefinition/artifact-copyrightLabel. The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

    Control0..1
    TypeExtension(Artifact Copyright Label) (Extension Type: string)
    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())
    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())
    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())
    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())
    12. 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
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-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 foundhere

    0. Questionnaire
    2. Questionnaire.extension
    Control0..*
    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
      Definition

      R5: Questionnaire.versionAlgorithm[x] (new:Coding, string)

      ShortR5: How to compare versions (new)
      Comments

      Element Questionnaire.versionAlgorithm[x] has a context of Questionnaire based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.versionAlgorithm[x] has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Questionnaire.versionAlgorithm[x]: http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm. If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

      Control0..1
      TypeExtension(Artifact Version Algorithm) (Extension Type: Choice of: string, Coding)
      6. Questionnaire.extension:copyrightLabel
      Slice NamecopyrightLabel
      Definition

      R5: Questionnaire.copyrightLabel (new:string)

      ShortR5: Copyright holder and year(s) (new)
      Comments

      Element Questionnaire.copyrightLabel has a context of Questionnaire based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.copyrightLabel has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Questionnaire.copyrightLabel: http://hl7.org/fhir/StructureDefinition/artifact-copyrightLabel. The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

      Control0..1
      TypeExtension(Artifact Copyright Label) (Extension Type: string)
      8. Questionnaire.subjectType
      10. Questionnaire.subjectType.extension
      Control0..*
      SlicingThis element introduces a set of slices on Questionnaire.subjectType.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 12. Questionnaire.subjectType.extension:subjectType
        Slice NamesubjectType
        Definition

        R5: Questionnaire.subjectType additional codes

        ShortR5: subjectType additional codes
        Comments

        Element Questionnaire.subjectType is mapped to FHIR R4 element Questionnaire.subjectType as RelatedTo. The mappings for Questionnaire.subjectType do not allow expression of the necessary codes, per the bindings on the source and target. If none are specified, then the subject is unlimited.

        Control0..*
        TypeExtension(R5: subjectType additional codes) (Extension Type: code)
        14. Questionnaire.item
        16. Questionnaire.item.extension
        Control0..*
        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
        • 18. Questionnaire.item.extension:disabledDisplay
          Slice NamedisabledDisplay
          Definition

          R5: Questionnaire.item.disabledDisplay (new:code)

          ShortR5: hidden | protected (new)
          Comments

          Element Questionnaire.item.disabledDisplay has a context of Questionnaire.item based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.item.disabledDisplay has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If not specified, rendering behavior is up to the client. This element is only meaningful if enableWhen or an equivalent extension is present

          Control0..1
          TypeExtension(R5: hidden | protected (new)) (Extension Type: code)
          20. Questionnaire.item.extension:answerConstraint
          Slice NameanswerConstraint
          Definition

          R5: Questionnaire.item.answerConstraint (new:code)

          ShortR5: optionsOnly | optionsOrType | optionsOrString (new)
          Comments

          Element Questionnaire.item.answerConstraint has a context of Questionnaire.item based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.item.answerConstraint has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

          Control0..1
          TypeExtension(R5: optionsOnly | optionsOrType | optionsOrString (new)) (Extension Type: code)

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

          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())
          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|4.0.1)

          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

            R5: Questionnaire.versionAlgorithm[x] (new:Coding, string)

            ShortR5: How to compare versions (new)
            Comments

            Element Questionnaire.versionAlgorithm[x] has a context of Questionnaire based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.versionAlgorithm[x] has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Questionnaire.versionAlgorithm[x]: http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm. If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

            Control0..1
            TypeExtension(Artifact Version Algorithm) (Extension Type: Choice of: string, Coding)
            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())
            18. Questionnaire.extension:copyrightLabel
            Slice NamecopyrightLabel
            Definition

            R5: Questionnaire.copyrightLabel (new:string)

            ShortR5: Copyright holder and year(s) (new)
            Comments

            Element Questionnaire.copyrightLabel has a context of Questionnaire based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.copyrightLabel has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element Questionnaire.copyrightLabel: http://hl7.org/fhir/StructureDefinition/artifact-copyrightLabel. The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

            Control0..1
            TypeExtension(Artifact Copyright Label) (Extension Type: string)
            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())
            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()))
            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
            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
            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.subjectType.id
            Definition

            unique id for the element within a resource (for internal references)

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            42. Questionnaire.subjectType.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.subjectType.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 44. Questionnaire.subjectType.extension:subjectType
              Slice NamesubjectType
              Definition

              R5: Questionnaire.subjectType additional codes

              ShortR5: subjectType additional codes
              Comments

              Element Questionnaire.subjectType is mapped to FHIR R4 element Questionnaire.subjectType as RelatedTo. The mappings for Questionnaire.subjectType do not allow expression of the necessary codes, per the bindings on the source and target. If none are specified, then the subject is unlimited.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: subjectType additional codes) (Extension Type: code)
              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())
              46. Questionnaire.subjectType.value
              Definition

              Primitive value for code

              ShortPrimitive value for code
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              48. 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()))
              50. 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()))
              52. 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()))
              54. 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()))
              56. 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()))
              58. 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|4.0.1)

              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()))
              60. 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()))
              62. 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()))
              64. 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()))
              66. 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()))
              68. 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()))
              70. 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|4.0.1)

              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()))
              72. 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)
              74. 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
              76. 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
              • 78. Questionnaire.item.extension:disabledDisplay
                Slice NamedisabledDisplay
                Definition

                R5: Questionnaire.item.disabledDisplay (new:code)

                ShortR5: hidden | protected (new)
                Comments

                Element Questionnaire.item.disabledDisplay has a context of Questionnaire.item based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.item.disabledDisplay has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If not specified, rendering behavior is up to the client. This element is only meaningful if enableWhen or an equivalent extension is present

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(R5: hidden | protected (new)) (Extension Type: code)
                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())
                80. Questionnaire.item.extension:answerConstraint
                Slice NameanswerConstraint
                Definition

                R5: Questionnaire.item.answerConstraint (new:code)

                ShortR5: optionsOnly | optionsOrType | optionsOrString (new)
                Comments

                Element Questionnaire.item.answerConstraint has a context of Questionnaire.item based on following the parent source element upwards and mapping to Questionnaire. Element Questionnaire.item.answerConstraint has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(R5: optionsOnly | optionsOrType | optionsOrString (new)) (Extension Type: code)
                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())
                82. 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())
                84. 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
                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()))
                86. 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()))
                88. 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|4.0.1)

                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()))
                90. 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
                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()))
                92. 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()))
                94. 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

                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 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
                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()))
                96. 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))
                98. 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
                100. 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())
                102. 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())
                104. 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()))
                106. 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()))
                108. 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|4.0.1)

                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()))
                110. 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()))
                112. 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
                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()))
                114. Questionnaire.item.repeats
                Definition

                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
                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()))
                116. 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
                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()))
                118. 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()))
                120. 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(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()))
                122. 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
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. 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
                126. 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())
                128. 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())
                130. 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|4.0.1)

                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
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                132. 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()))
                134. 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
                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()))
                136. 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
                138. 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())
                140. 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())
                142. 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|4.0.1)

                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
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                144. 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
                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()))