Questionnaire-example.json

General questionnaire example

{
  "resourceType": "Questionnaire",
  "text": {
    "status": "generated",
    "div": "<div>\n      <pre>\n            Comorbidity? YES\n              Cardial Comorbidity? YES\n                Angina? YES\n                MI? NO\n              Vascular Comorbidity?\n                (no answers)\n              ...\n            Histopathology\n              Abdominal\n                pT category: 1a\n              ...\n          </pre>\n    </div>"
  },
  "contained": [
    {
      "resourceType": "Patient",
      "id": "patsub",
      "identifier": [
        {
          "system": "http://cancer.questionnaire.org/systems/id/patientnr",
          "value": "A34442332"
        },
        {
          "label": "Dutch BSN",
          "system": "urn:oid:2.16.840.1.113883.2.4.6.3",
          "value": "188912345"
        }
      ],
      "gender": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/AdministrativeGender",
            "code": "M"
          }
        ]
      },
      "birthDate": "1972-11-30"
    },
    {
      "resourceType": "Practitioner",
      "id": "questauth",
      "identifier": [
        {
          "label": "AUMC, Den Helder",
          "system": "http://cancer.questionnaire.org/systems/id/org",
          "value": "AUMC"
        }
      ]
    },
    {
      "resourceType": "Observation",
      "id": "obs.pt-category",
      "name": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "53786006",
            "display": "pT1 category"
          }
        ]
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "443357004",
            "display": "pT1a category"
          }
        ]
      },
      "status": "final",
      "reliability": "unknown"
    }
  ],
  "status": "completed",
  "authored": "2013-02-19T14:15:00",
  "subject": {
    "reference": "#patsub"
  },
  "author": {
    "reference": "#questauth"
  },
  "name": {
    "text": "Cancer Quality Forum Questionnaire 2012"
  },
  "group": {
    "group": [
      {
        "name": {
          "coding": [
            {
              "system": "http://cancer.questionnaire.org/system/code/sections",
              "code": "COMORBIDITY"
            }
          ]
        },
        "question": [
          {
            "name": {
              "coding": [
                {
                  "system": "http://cancer.questionnaire.org/system/code/questions",
                  "code": "COMORB"
                }
              ]
            },
            "choice": [
              {
                "system": "http://cancer.questionnaire.org/system/code/yesno",
                "code": "1",
                "display": "Yes"
              }
            ],
            "group": [
              {
                "name": {
                  "coding": [
                    {
                      "system": "http://cancer.questionnaire.org/system/code/sections",
                      "code": "CARDIAL"
                    }
                  ]
                },
                "question": [
                  {
                    "name": {
                      "coding": [
                        {
                          "system": "http://cancer.questionnaire.org/system/code/questions",
                          "code": "COMORBCAR"
                        }
                      ]
                    },
                    "choice": [
                      {
                        "system": "http://cancer.questionnaire.org/system/code/yesno",
                        "code": "1"
                      }
                    ]
                  },
                  {
                    "name": {
                      "coding": [
                        {
                          "system": "http://cancer.questionnaire.org/system/code/questions",
                          "code": "COMCAR00",
                          "display": "Angina Pectoris"
                        },
                        {
                          "system": "http://snomed.info/sct",
                          "code": "194828000",
                          "display": "Angina (disorder)"
                        }
                      ]
                    },
                    "choice": [
                      {
                        "system": "http://cancer.questionnaire.org/system/code/yesno",
                        "code": "1"
                      }
                    ]
                  },
                  {
                    "name": {
                      "coding": [
                        {
                          "system": "http://snomed.info/sct",
                          "code": "22298006",
                          "display": "Myocardial infarction (disorder)"
                        }
                      ]
                    },
                    "choice": [
                      {
                        "system": "http://cancer.questionnaire.org/system/code/yesno",
                        "code": "0"
                      }
                    ]
                  }
                ]
              },
              {
                "name": {
                  "coding": [
                    {
                      "system": "http://cancer.questionnaire.org/system/code/sections",
                      "code": "VASCULAR"
                    }
                  ]
                }
              }
            ]
          }
        ]
      },
      {
        "name": {
          "coding": [
            {
              "system": "http://cancer.questionnaire.org/system/code/sections",
              "code": "HISTOPATHOLOGY"
            }
          ]
        },
        "group": [
          {
            "name": {
              "coding": [
                {
                  "system": "http://cancer.questionnaire.org/system/code/sections",
                  "code": "ABDOMINAL"
                }
              ]
            },
            "question": [
              {
                "name": {
                  "coding": [
                    {
                      "system": "http://cancer.questionnaire.org/system/code/questions",
                      "code": "STADPT",
                      "display": "pT category"
                    }
                  ]
                },
                "dataResource": {
                  "reference": "#obs.pt-category"
                }
              }
            ]
          }
        ]
      }
    ]
  }
}