This page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions
General questionnaire example
{
"resourceType" : "Questionnaire",
"id" : "3141",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n \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 \n </div>"
},
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "fhir"
}],
"url" : "http://hl7.org/fhir/Questionnaire/3141",
"identifier" : [{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.4.642.20.2"
}],
"name" : "CancerQualityForumQuestionnaire2012",
"title" : "Cancer Quality Forum Questionnaire 2012",
"status" : "draft",
"subjectType" : ["Patient"],
"date" : "2012-01",
"publisher" : "HL7 International / FHIR Infrastructure",
"contact" : [{
"telecom" : [{
"system" : "url"
}]
}],
"description" : "Cancer Quality Forum Questionnaire 2012",
"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" : "coding",
"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" : "coding",
"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" : "coding",
"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" : "coding",
"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" : "coding",
"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" : "coding"
}]
}]
}]
}
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.