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General questionnaire example (id = "3141")
<Questionnaire xmlns="http://hl7.org/fhir"> <id value="3141"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div> </text> <contained> <ValueSet> <id value="yesno"/><!-- In practice you could (should?) use boolean for this sort of circumstance. However, the reality is that many systems treat booleans as coded data --> <name value="Example YesNo"/> <description value="Captures simple yes-no"/> <status value="active"/> <define> <system value="http://example.org/system/code/yesno"/> <caseSensitive value="true"/> <concept> <code value="1"/> <display value="Yes"/> </concept> <concept> <code value="2"/> <display value="No"/> </concept> </define> </ValueSet> </contained> <status value="draft"/> <date value="2012-01"/> <group> <title value="Cancer Quality Forum Questionnaire 2012"/> <group><!-- COMORBIDITY --><!-- First main section of the form, questions about comorbidity --> <concept> <system value="http://example.org/system/code/sections"/> <code value="COMORBIDITY"/> </concept><!-- section contains one question: whether there is comorbidity --> <question> <concept> <system value="http://example.org/system/code/questions"/> <code value="COMORB"/> </concept> <type value="choice"/> <options> <reference value="#yesno"/> </options> <group><!-- COMORBIDITY/CARDIAL --><!-- Subsection about specific comorbidity: cardial --> <concept> <system value="http://example.org/system/code/sections"/> <code value="CARDIAL"/> </concept> <question> <concept> <system value="http://example.org/system/code/questions"/> <code value="COMORBCAR"/> </concept> <type value="choice"/> <options> <reference value="#yesno"/> </options> </question> <question><!-- This answer carries both the questionnaire-specific name and an equivalent SNOMED CT code --> <concept> <system value="http://example.org/system/code/questions"/> <code value="COMCAR00"/> <display value="Angina Pectoris"/> </concept> <concept> <system value="http://snomed.info/sct"/> <code value="194828000"/> <display value="Angina (disorder)"/> </concept> <type value="choice"/> <options> <reference value="#yesno"/> </options> </question> <question> <concept> <system value="http://snomed.info/sct"/> <code value="22298006"/> <display value="Myocardial infarction (disorder)"/> </concept> <type value="choice"/> <options> <reference value="#yesno"/> </options> </question> </group> <group><!-- COMORBIDITY/VASCULAR --> <concept> <system value="http://example.org/system/code/sections"/> <code value="VASCULAR"/> </concept> </group> </question> </group><!-- Todo: What's supposed to go here? --> <group><!-- HISTOPATHOLOGY --> <concept> <system value="http://example.org/system/code/sections"/> <code value="HISTOPATHOLOGY"/> </concept> <group> <concept> <system value="http://example.org/system/code/sections"/> <code value="ABDOMINAL"/> </concept> <question> <concept> <system value="http://example.org/system/code/questions"/> <code value="STADPT"/> <display value="pT category"/> </concept> </question> </group> </group> </group> </Questionnaire>
JSON
General questionnaire example
{ "resourceType": "Questionnaire", "id": "3141", "text": { "status": "generated", "div": "<div>!-- Snipped for Brevity --></div>" }, "contained": [ { "resourceType": "ValueSet", "id": "yesno", "name": "Example YesNo", "description": "Captures simple yes-no", "status": "active", "define": { "system": "http://example.org/system/code/yesno", "caseSensitive": true, "concept": [ { "code": "1", "display": "Yes" }, { "code": "2", "display": "No" } ] } } ], "status": "draft", "date": "2012-01", "group": { "title": "Cancer Quality Forum Questionnaire 2012", "group": [ { "concept": [ { "system": "http://example.org/system/code/sections", "code": "COMORBIDITY" } ], "question": [ { "concept": [ { "system": "http://example.org/system/code/questions", "code": "COMORB" } ], "type": "choice", "options": { "reference": "#yesno" }, "group": [ { "concept": [ { "system": "http://example.org/system/code/sections", "code": "CARDIAL" } ], "question": [ { "concept": [ { "system": "http://example.org/system/code/questions", "code": "COMORBCAR" } ], "type": "choice", "options": { "reference": "#yesno" } }, { "concept": [ { "system": "http://example.org/system/code/questions", "code": "COMCAR00", "display": "Angina Pectoris" }, { "system": "http://snomed.info/sct", "code": "194828000", "display": "Angina (disorder)" } ], "type": "choice", "options": { "reference": "#yesno" } }, { "concept": [ { "system": "http://snomed.info/sct", "code": "22298006", "display": "Myocardial infarction (disorder)" } ], "type": "choice", "options": { "reference": "#yesno" } } ] }, { "concept": [ { "system": "http://example.org/system/code/sections", "code": "VASCULAR" } ] } ] } ] }, { "concept": [ { "system": "http://example.org/system/code/sections", "code": "HISTOPATHOLOGY" } ], "group": [ { "concept": [ { "system": "http://example.org/system/code/sections", "code": "ABDOMINAL" } ], "question": [ { "concept": [ { "system": "http://example.org/system/code/questions", "code": "STADPT", "display": "pT category" } ] } ] } ] } ] } }
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.