Release 4B

This page is part of the FHIR Specification (v4.3.0: R4B - STU). 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",
  "experimental" : true,
  "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.