Release 4B Ballot #1

This page is part of the FHIR Specification (v4.1.0: Release 4B Ballot #1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Questionnaire-example.json

FHIR Infrastructure Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Not linked to any defined compartments

Raw JSON (canonical form + also see JSON Format Specification)

General questionnaire example

{
  "resourceType": "Questionnaire",
  "id": "3141",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      <pre>\n            1.Comorbidity?\n              1.1 Cardial Comorbidity\n                1.1.1 Angina?\n                1.1.2 MI?\n              1.2 Vascular Comorbidity?\n              ...\n            Histopathology\n              Abdominal\n                pT category?\n              ...\n          </pre>\n    </div>"
  },
  "url": "http://hl7.org/fhir/Questionnaire/3141",
  "title": "Cancer Quality Forum Questionnaire 2012",
  "status": "draft",
  "subjectType": [
    "Patient"
  ],
  "date": "2012-01",
  "item": [
    {
      "linkId": "1",
      "code": [
        {
          "system": "http://example.org/system/code/sections",
          "code": "COMORBIDITY"
        }
      ],
      "type": "group",
      "item": [
        {
          "linkId": "1.1",
          "code": [
            {
              "system": "http://example.org/system/code/questions",
              "code": "COMORB"
            }
          ],
          "prefix": "1",
          "type": "choice",
          "answerValueSet": "http://hl7.org/fhir/ValueSet/yesnodontknow",
          "item": [
            {
              "linkId": "1.1.1",
              "code": [
                {
                  "system": "http://example.org/system/code/sections",
                  "code": "CARDIAL"
                }
              ],
              "type": "group",
              "enableWhen": [
                {
                  "question": "1.1",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
                    "code": "Y"
                  }
                }
              ],
              "item": [
                {
                  "linkId": "1.1.1.1",
                  "code": [
                    {
                      "system": "http://example.org/system/code/questions",
                      "code": "COMORBCAR"
                    }
                  ],
                  "prefix": "1.1",
                  "type": "choice",
                  "answerValueSet": "http://hl7.org/fhir/ValueSet/yesnodontknow",
                  "item": [
                    {
                      "linkId": "1.1.1.1.1",
                      "code": [
                        {
                          "system": "http://example.org/system/code/questions",
                          "code": "COMCAR00",
                          "display": "Angina Pectoris"
                        },
                        {
                          "system": "http://snomed.info/sct",
                          "code": "194828000",
                          "display": "Angina (disorder)"
                        }
                      ],
                      "prefix": "1.1.1",
                      "type": "choice",
                      "answerValueSet": "http://hl7.org/fhir/ValueSet/yesnodontknow"
                    },
                    {
                      "linkId": "1.1.1.1.2",
                      "code": [
                        {
                          "system": "http://snomed.info/sct",
                          "code": "22298006",
                          "display": "Myocardial infarction (disorder)"
                        }
                      ],
                      "prefix": "1.1.2",
                      "type": "choice",
                      "answerValueSet": "http://hl7.org/fhir/ValueSet/yesnodontknow"
                    }
                  ]
                },
                {
                  "linkId": "1.1.1.2",
                  "code": [
                    {
                      "system": "http://example.org/system/code/questions",
                      "code": "COMORBVAS"
                    }
                  ],
                  "prefix": "1.2",
                  "type": "choice",
                  "answerValueSet": "http://hl7.org/fhir/ValueSet/yesnodontknow"
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId": "2",
      "code": [
        {
          "system": "http://example.org/system/code/sections",
          "code": "HISTOPATHOLOGY"
        }
      ],
      "type": "group",
      "item": [
        {
          "linkId": "2.1",
          "code": [
            {
              "system": "http://example.org/system/code/sections",
              "code": "ABDOMINAL"
            }
          ],
          "type": "group",
          "item": [
            {
              "linkId": "2.1.2",
              "code": [
                {
                  "system": "http://example.org/system/code/questions",
                  "code": "STADPT",
                  "display": "pT category"
                }
              ],
              "type": "choice"
            }
          ]
        }
      ]
    }
  ]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.