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
FHIR Infrastructure Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson |
Raw XML (canonical form + also see XML Format Specification)
General questionnaire response example (id = "3141")
<?xml version="1.0" encoding="UTF-8"?> <QuestionnaireResponse xmlns="http://hl7.org/fhir"> <id value="3141"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <pre> Comorbidity? YES Cardial Comorbidity? YES Angina? YES MI? NO Vascular Comorbidity? (no answers) ... Histopathology Abdominal pT category: 1a ... </pre> </div> </text> <contained> <Patient> <id value="patsub"/> <identifier> <system value="http://cancer.questionnaire.org/systems/id/patientnr"/> <value value="A34442332"/> </identifier> <identifier> <type> <text value="Dutch BSN"/> </type> <system value="urn:oid:2.16.840.1.113883.2.4.6.3"/> <value value="188912345"/> </identifier> <gender value="male"/> <birthDate value="1972-11-30"/> </Patient> </contained> <contained> <ServiceRequest> <id value="order"/> <status value="unknown"/> <intent value="order"/> <subject> <reference value="#patsub"/> </subject> <requester> <reference value="Practitioner/example"/> </requester> </ServiceRequest> </contained> <contained> <Practitioner> <id value="questauth"/> <identifier> <type> <text value="AUMC, Den Helder"/> </type> <system value="http://cancer.questionnaire.org/systems/id/org"/> <value value="AUMC"/> </identifier> </Practitioner> </contained> <!-- TODO: decide how to do this <contained> <Observation> <id value="obs.pt-category"/> <status value="final"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="53786006"/> <display value="pT1 category"/> </coding> </code> <subject> <reference value="#patsub"/> </subject> <performer> <reference value="#questauth"/> </performer> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="443357004"/> <display value="pT1a category"/> </coding> </valueCodeableConcept> </Observation> </contained> --> <identifier> <system value="http://example.org/fhir/NamingSystem/questionnaire-ids"/> <value value="Q12349876"/> </identifier> <basedOn> <reference value="#order"/> </basedOn> <partOf> <reference value="Procedure/f201"/> </partOf> <status value="completed"/> <subject> <reference value="#patsub"/> </subject> <encounter> <reference value="Encounter/example"/> </encounter> <authored value="2013-02-19T14:15:00-05:00"/> <author> <reference value="#questauth"/> </author> <item> <!-- COMORBIDITY --> <!-- First main section of the form, questions about comorbidity --> <!-- section contains one question: whether there is comorbidity --> <linkId value="1"/> <item> <linkId value="1.1"/> <answer> <valueCoding> <system value="http://cancer.questionnaire.org/system/code/yesno"/> <code value="1"/> <display value="Yes"/> </valueCoding> <item> <!-- COMORBIDITY/CARDIAL --> <!-- Subsection about specific comorbidity: cardial --> <linkId value="1.1.1"/> <item> <linkId value="1.1.1.1"/> <answer> <valueCoding> <system value="http://cancer.questionnaire.org/system/code/yesno"/> <code value="1"/> </valueCoding> </answer> </item> <item> <!-- This answer carries both the questionnaire-specific name and an equivalent SNOMED CT code --> <linkId value="1.1.1.2"/> <answer> <valueCoding> <system value="http://cancer.questionnaire.org/system/code/yesno"/> <code value="1"/> </valueCoding> </answer> </item> <item> <linkId value="1.1.1.3"/> <answer> <valueCoding> <system value="http://cancer.questionnaire.org/system/code/yesno"/> <code value="0"/> </valueCoding> </answer> </item> </item> </answer> </item> </item> <!-- HISTOPATHOLOGY --> <!-- TODO: decide how to do this <item> <item> <item> <dataResource> <reference value="#obs.pt-category"/> </dataResource> </item> </item> </item> --> </QuestionnaireResponse>
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.