Structured Data Capture
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This page is part of the Structured Data Capture FHIR IG (v3.0.0: STU 3) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: SDOHCC Questionnaire Hunger Vital Sign - XML Representation

Page standards status: Informative

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<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="SDOHCC-QuestionnaireHungerVitalSign"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-defn"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkId for the item">LinkId</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the itemcan appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> SDOHCCQuestionnaireHungerVitalSign</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Example Questionnaire that shows both definition-based population and StructureMap-based extraction</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://hl7.org/fhir/uv/sdc/Questionnaire/SDOHCC-QuestionnaireHungerVitalSign#3.0.0</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./88122-7" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> /88122-7</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./88122-7">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./88123-5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> /88123-5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The food that (I/we) bought just didn't last, and (I/we) didn't have money to get more.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./88123-5">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" id="item./88124-3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> /88124-3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Food insecurity risk</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./88124-3">2 options</a><br/>Expressions: <ul><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">Calculated Value</a>: <code>iif(%answeredEitherQ, iif(%riskStatus, %atRiskCoding, %noRiskCoding), {})</code></li><li style="font-size: 11px"><a href="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">Calculated Value</a>: <code>iif(%answeredEitherQ, iif(%riskStatus, %atRiskCoding, %noRiskCoding), {})</code></li></ul></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" id="item./88124-3-help" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: white; background-color: inherit" title="Display" class="hierarchy"/> /88124-3-help</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">An answer of &quot;often true&quot; or &quot;sometimes true&quot; to either or both of the Hunger Vital Sign™ questions identifies a patient as at risk for food insecurity (FI).</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Option Sets</b></p><a name="opt-item./88122-7"> </a><p><b>Answer options for /88122-7</b></p><ul><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA28397-0 (&quot;Often true&quot;)</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA6729-3 (&quot;Sometimes true&quot;)</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA28398-8 (&quot;Never true&quot;)</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA15775-2 (&quot;Don't know/refused&quot;)</li></ul><a name="opt-item./88123-5"> </a><p><b>Answer options for /88123-5</b></p><ul><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA28397-0 (&quot;Often true&quot;)</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA6729-3 (&quot;Sometimes true&quot;)</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA28398-8 (&quot;Never true&quot;)</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA15775-2 (&quot;Don't know/refused&quot;)</li></ul><a name="opt-item./88124-3"> </a><p><b>Answer options for /88124-3</b></p><ul><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA19952-3 (&quot;At risk&quot;)</li><li style="font-size: 11px"><a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-loinc.html">LOINC</a>: LA19983-8 (&quot;No risk&quot;)</li></ul></div>
  </text>
  <extension url="http://hl7.org/fhir/StructureDefinition/variable">
    <valueExpression>
      <name value="worriedAnsCode"/>
      <language value="text/fhirpath"/>
      <expression
                  value="%resource.item.where(linkId=&#39;/88122-7&#39;).answer.value.code"/>
    </valueExpression>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/variable">
    <valueExpression>
      <name value="ranOutAnsCode"/>
      <language value="text/fhirpath"/>
      <expression
                  value="%resource.item.where(linkId=&#39;/88123-5&#39;).answer.value.code"/>
    </valueExpression>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/variable">
    <valueExpression>
      <name value="riskCodes"/>
      <language value="text/fhirpath"/>
      <expression value="&#39;LA28397-0&#39;.combine(&#39;LA6729-3&#39;)"/>
    </valueExpression>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/variable">
    <valueExpression>
      <name value="riskStatus"/>
      <language value="text/fhirpath"/>
      <expression
                  value="%riskCodes contains %worriedAnsCode or %riskCodes contains %ranOutAnsCode"/>
    </valueExpression>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/variable">
    <valueExpression>
      <name value="answeredEitherQ"/>
      <language value="text/fhirpath"/>
      <expression value="%worriedAnsCode.exists() or %ranOutAnsCode.exists()"/>
    </valueExpression>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap">
    <valueCanonical
                    value="http://hl7.org/fhir/uv/sdc/StructureMap/SDOHCC-StructureMapHungerVitalSign"/>
  </extension>
  <url
       value="http://hl7.org/fhir/uv/sdc/Questionnaire/SDOHCC-QuestionnaireHungerVitalSign"/>
  <version value="3.0.0"/>
  <name value="SDOHCCQuestionnaireHungerVitalSign"/>
  <title value="SDOHCC Questionnaire Hunger Vital Sign"/>
  <status value="draft"/>
  <subjectType value="Patient"/>
  <date value="2022-03-08T18:37:19+00:00"/>
  <publisher value="HL7 International - FHIR Infrastructure Work Group"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/Special/committees/fiwg"/>
    </telecom>
  </contact>
  <description
               value="Example Questionnaire that shows both definition-based population and StructureMap-based extraction"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Content is from the Hunger Vital Sign Survey with permission: © 2010 Dr. Erin Hager and Dr. Anna Quigg and the Children’s HealthWatch research team"/>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/questionnaire-item-control"/>
          <code value="drop-down"/>
          <display value="Drop down"/>
        </coding>
        <text value="Drop down"/>
      </valueCodeableConcept>
    </extension>
    <linkId value="/88122-7"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="88122-7"/>
      <display
               value="(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more."/>
    </code>
    <text
          value="(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more."/>
    <type value="choice"/>
    <required value="false"/>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA28397-0"/>
        <display value="Often true"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA6729-3"/>
        <display value="Sometimes true"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA28398-8"/>
        <display value="Never true"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA15775-2"/>
        <display value="Don&#39;t know/refused"/>
      </valueCoding>
    </answerOption>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/questionnaire-item-control"/>
          <code value="drop-down"/>
          <display value="Drop down"/>
        </coding>
        <text value="Drop down"/>
      </valueCodeableConcept>
    </extension>
    <linkId value="/88123-5"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="88123-5"/>
      <display
               value="The food that (I/we) bought just didn&#39;t last, and (I/we) didn&#39;t have money to get more."/>
    </code>
    <text
          value="The food that (I/we) bought just didn&#39;t last, and (I/we) didn&#39;t have money to get more."/>
    <type value="choice"/>
    <required value="false"/>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA28397-0"/>
        <display value="Often true"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA6729-3"/>
        <display value="Sometimes true"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA28398-8"/>
        <display value="Never true"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA15775-2"/>
        <display value="Don&#39;t know/refused"/>
      </valueCoding>
    </answerOption>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/questionnaire-item-control"/>
          <code value="drop-down"/>
          <display value="Drop down"/>
        </coding>
        <text value="Drop down"/>
      </valueCodeableConcept>
    </extension>
    <extension url="http://hl7.org/fhir/StructureDefinition/variable">
      <valueExpression>
        <name value="thisItem"/>
        <language value="text/fhirpath"/>
        <expression
                    value="%questionnaire.item.where(linkId = &#39;/88124-3&#39;)"/>
      </valueExpression>
    </extension>
    <extension url="http://hl7.org/fhir/StructureDefinition/variable">
      <valueExpression>
        <name value="atRiskCoding"/>
        <language value="text/fhirpath"/>
        <expression
                    value="%thisItem.answerOption.valueCoding.where(code=&#39;LA19952-3&#39;)"/>
      </valueExpression>
    </extension>
    <extension url="http://hl7.org/fhir/StructureDefinition/variable">
      <valueExpression>
        <name value="noRiskCoding"/>
        <language value="text/fhirpath"/>
        <expression
                    value="%thisItem.answerOption.valueCoding.where(code=&#39;LA19983-8&#39;)"/>
      </valueExpression>
    </extension>
    <extension
               url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">
      <valueExpression>
        <description value="risk determination"/>
        <language value="text/fhirpath"/>
        <expression
                    value="iif(%answeredEitherQ, iif(%riskStatus, %atRiskCoding, %noRiskCoding), {})"/>
      </valueExpression>
    </extension>
    <extension
               url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">
      <valueExpression>
        <description value="risk determination"/>
        <language value="text/fhirpath"/>
        <expression
                    value="iif(%answeredEitherQ, iif(%riskStatus, %atRiskCoding, %noRiskCoding), {})"/>
      </valueExpression>
    </extension>
    <linkId value="/88124-3"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="88124-3"/>
      <display value="Food insecurity risk [HVS]"/>
    </code>
    <text value="Food insecurity risk"/>
    <type value="choice"/>
    <required value="false"/>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA19952-3"/>
        <display value="At risk"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA19983-8"/>
        <display value="No risk"/>
      </valueCoding>
    </answerOption>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="help"/>
            <display value="Help-Button"/>
          </coding>
          <text value="Help-Button"/>
        </valueCodeableConcept>
      </extension>
      <linkId value="/88124-3-help"/>
      <text
            value="An answer of &quot;often true&quot; or &quot;sometimes true&quot; to either or both of the Hunger Vital Sign™ questions identifies a patient as at risk for food insecurity (FI)."/>
      <type value="display"/>
    </item>
  </item>
</Questionnaire>