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FHIR Infrastructure Work Group Maturity Level: 1Trial Use Use Context: Any

Definitions for the cqf-questionnaire Profile.

Questionnaire
Element IdQuestionnaire
Definition

A CR (Clinical Reasoning) questionnaire is a questionnaire with the added ability to describe behavior associated with questions. For example, whether or not to display a particular question or group of questions, or automatically calculating the value of an answer based on the answers to previous questions.

Cardinality0..*
Alternate NamesForm, CRF, Survey
Invariants
Inherited by this element
que-0WarningName should be usable as an identifier for the module by machine processing applications such as code generationname.matches('[A-Z]([A-Za-z0-9_]){0,254}')
dom-2RuleIf the resource is contained in another resource, it SHALL NOT contain nested Resourcescontained.contained.empty()
que-2RuleThe link ids for groups and questions must be unique within the questionnairedescendants().linkId.isDistinct()
dom-3RuleIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resourcecontained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4RuleIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdatedcontained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5RuleIf a resource is contained in another resource, it SHALL NOT have a security labelcontained.meta.security.empty()
dom-6GuidelineA resource should have narrative for robust managementtext.div.exists()
This is (only) a best practice guideline because:

When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

Questionnaire.id
Element IdQuestionnaire.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Cardinality0..1
Typeid
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Questionnaire.meta
Element IdQuestionnaire.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Cardinality0..1
TypeMeta
Questionnaire.implicitRules
Element IdQuestionnaire.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Cardinality0..1
Typeuri
Is Modifiertrue (Reason: This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation)
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Questionnaire.language
Element IdQuestionnaire.language
Definition

The base language in which the resource is written.

Cardinality0..1
Terminology BindingA human language.
The codes SHOULD be taken from Common Languages
Typecode
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Questionnaire.text
Element IdQuestionnaire.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Cardinality0..1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Questionnaire.contained
Element IdQuestionnaire.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Cardinality0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Questionnaire.extension
Element IdQuestionnaire.extension
Definition

An Extension

Cardinality0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: value:url
Questionnaire.extension(library)
Element IdQuestionnaire.extension:library
Definition

A CQL or ELM library containing any logic referenced by the questionnaire.

Cardinality0..* This element is affected by the following invariants: ele-1
TypeExtension(library)
Alternate Nameslibrary
Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
ext-1RuleMust have either extensions or value[x], not bothextension.exists() != value.exists()
Questionnaire.modifierExtension
Element IdQuestionnaire.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
Is Modifiertrue (Reason: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them)
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Questionnaire.url
Element IdQuestionnaire.url
Definition

An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.

Cardinality0..1
Typeuri
Requirements

… This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.

Comments

The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension.

Questionnaire.identifier
Element IdQuestionnaire.identifier
Definition

A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance.

Cardinality0..*
TypeIdentifier
Requirements

Allows externally provided and/or usable business identifiers to be easily associated with the module.

Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this questionnaire outside of FHIR, where it is not possible to use the logical URI.

Questionnaire.version
Element IdQuestionnaire.version
Definition

The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

Cardinality0..1
Typestring
Comments

There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version].

Questionnaire.name
Element IdQuestionnaire.name
Definition

A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation.

Cardinality0..1 This element is affected by the following invariants: inv-0
Typestring
Requirements

Support human navigation and code generation.

Comments

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Questionnaire.title
Element IdQuestionnaire.title
Definition

A short, descriptive, user-friendly title for the questionnaire.

Cardinality0..1
Typestring
Comments

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

Questionnaire.derivedFrom
Element IdQuestionnaire.derivedFrom
Definition

The URL of a Questionnaire that this Questionnaire is based on.

Cardinality0..*
Typecanonical(Questionnaire)
Requirements

Allows a Questionnaire to be created based on another Questionnaire.

Questionnaire.status
Element IdQuestionnaire.status
Definition

The status of this questionnaire. Enables tracking the life-cycle of the content.

Cardinality1..1
Terminology BindingThe lifecycle status of an artifact.
The codes SHALL be taken from PublicationStatus
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration)
Comments

Allows filtering of questionnaires that are appropriate for use versus not.

Questionnaire.experimental
Element IdQuestionnaire.experimental
Definition

A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Cardinality0..1
Typeboolean
Requirements

Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire.

Comments

Allows filtering of questionnaires that are appropriate for use versus not.

Questionnaire.subjectType
Element IdQuestionnaire.subjectType
Definition

The types of subjects that can be the subject of responses created for the questionnaire.

Cardinality0..*
Terminology BindingOne of the resource types defined as part of this version of FHIR.
The codes SHALL be taken from ResourceType
Typecode
Comments

If none are specified, then the subject is unlimited.

Questionnaire.date
Element IdQuestionnaire.date
Definition

The date (and optionally time) when the questionnaire was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes.

Cardinality0..1
TypedateTime
Alternate NamesRevision Date
Comments

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

Questionnaire.publisher
Element IdQuestionnaire.publisher
Definition

The name of the organization or individual that published the questionnaire.

Cardinality0..1
Typestring
Requirements

Helps establish the "authority/credibility" of the questionnaire. May also allow for contact.

Comments

Usually an organization but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context.

Questionnaire.contact
Element IdQuestionnaire.contact
Definition

Contact details to assist a user in finding and communicating with the publisher.

Cardinality0..*
TypeContactDetail
Comments

May be a web site, an email address, a telephone number, etc.

Questionnaire.description
Element IdQuestionnaire.description
Definition

A free text natural language description of the questionnaire from a consumer's perspective.

Cardinality0..1
Typemarkdown
Comments

This description can be used to capture details such as why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created).

Questionnaire.useContext
Element IdQuestionnaire.useContext
Definition

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate questionnaire instances.

Cardinality0..*
TypeUsageContext
Requirements

Assist in searching for appropriate content.

Comments

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

Questionnaire.jurisdiction
Element IdQuestionnaire.jurisdiction
Definition

A legal or geographic region in which the questionnaire is intended to be used.

Cardinality0..*
Terminology BindingCountries and regions within which this artifact is targeted for use.
The codes SHALL be taken from Jurisdiction; other codes may be used where these codes are not suitable
TypeCodeableConcept
Comments

It may be possible for the questionnaire to be used in jurisdictions other than those for which it was originally designed or intended.

Questionnaire.purpose
Element IdQuestionnaire.purpose
Definition

Explanation of why this questionnaire is needed and why it has been designed as it has.

Cardinality0..1
Typemarkdown
Comments

This element does not describe the usage of the questionnaire. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this questionnaire.

Questionnaire.copyright
Element IdQuestionnaire.copyright
Definition

A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire.

Cardinality0..1
Typemarkdown
Requirements

Consumers must be able to determine any legal restrictions on the use of the questionnaire and/or its content.

Alternate NamesLicense, Restrictions
Questionnaire.approvalDate
Element IdQuestionnaire.approvalDate
Definition

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

Cardinality0..1
Typedate
Comments

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

Questionnaire.lastReviewDate
Element IdQuestionnaire.lastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

Cardinality0..1
Typedate
Requirements

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

Comments

If specified, this date follows the original approval date.

Questionnaire.effectivePeriod
Element IdQuestionnaire.effectivePeriod
Definition

The period during which the questionnaire content was or is planned to be in active use.

Cardinality0..1
TypePeriod
Requirements

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the questionnaire are or are expected to be used instead.

Comments

The effective period for a questionnaire determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

Questionnaire.code
Element IdQuestionnaire.code
Definition

An identifier for this question or group of questions in a particular terminology such as LOINC.

Cardinality0..*
Terminology BindingCodes for questionnaires, groups and individual questions.
For example codes, see Questionnaire Question Codes
TypeCoding
Requirements

Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code.

Questionnaire.item
Element IdQuestionnaire.item
Definition

A particular question, question grouping or display text that is part of the questionnaire.

Cardinality0..* This element is affected by the following invariants: que-3
TypeBackboneElement
Comments

The content of the questionnaire is constructed from an ordered, hierarchical collection of items.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
que-1RuleGroup items must have nested items, display items cannot have nested items(type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty())
que-3RuleDisplay items cannot have a "code" assertedtype!='display' or code.empty()
que-4RuleA question cannot have both answerOption and answerValueSetanswerOption.empty() or answerValueSet.empty()
que-5RuleOnly 'choice' and 'open-choice' items can have answerValueSet(type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty())
que-6RuleRequired and repeat aren't permitted for display itemstype!='display' or (required.empty() and repeats.empty())
que-8RuleInitial values can't be specified for groups or display items(type!='group' and type!='display') or initial.empty()
que-9RuleRead-only can't be specified for "display" itemstype!='display' or readOnly.empty()
que-10RuleMaximum length can only be declared for simple question types(type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty()
que-11RuleIf one or more answerOption is present, initial[x] must be missinganswerOption.empty() or initial.empty()
que-12RuleIf there are more than one enableWhen, enableBehavior must be specifiedenableWhen.count() > 2 implies enableBehavior.exists()
que-13RuleCan only have multiple initial values for repeating itemsrepeats=true or initial.count() <= 1
Questionnaire.item.id
Element IdQuestionnaire.item.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Questionnaire.item.extension
Element IdQuestionnaire.item.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Questionnaire.item.modifierExtension
Element IdQuestionnaire.item.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
Is Modifiertrue (Reason: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them)
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Questionnaire.item.linkId
Element IdQuestionnaire.item.linkId
Definition

An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.

Cardinality1..1
Typestring
Requirements

QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.

Comments

This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

Questionnaire.item.definition
Element IdQuestionnaire.item.definition
Definition

This element is a URI that refers to an ElementDefinition that provides information about this item, including information that might otherwise be included in the instance of the Questionnaire resource. A detailed description of the construction of the URI is shown in Comments, below. If this element is present then the following element values MAY be derived from the Element Definition if the corresponding elements of this Questionnaire resource instance have no value:

  • code (ElementDefinition.code)
  • type (ElementDefinition.type)
  • required (ElementDefinition.min)
  • repeats (ElementDefinition.max)
  • maxLength (ElementDefinition.maxLength)
  • answerValueSet (ElementDefinition.binding)
  • options (ElementDefinition.binding).
Cardinality0..1
Typeuri
Requirements

A common pattern is to define a set of data elements and then build multiple questionnaires for different circumstances to gather the data. This element provides traceability to the common definition and allows the content for the question to come from the underlying definition.

Comments

The uri refers to an ElementDefinition in a StructureDefinition and always starts with the canonical URL for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id Element.id. E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment identifier, the first/root element definition in the target is the matching element definition.

Questionnaire.item.code
Element IdQuestionnaire.item.code
Definition

A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers).

Cardinality0..* This element is affected by the following invariants: que-3
Terminology BindingCodes for questionnaires, groups and individual questions.
For example codes, see Questionnaire Question Codes
TypeCoding
Requirements

Allows linking of groups of questions to formal terminologies.

Comments

The value may come from the ElementDefinition referred to by .definition.

Questionnaire.item.prefix
Element IdQuestionnaire.item.prefix
Definition

A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire.

Cardinality0..1
Typestring
Requirements

Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used.

Alternate Nameslabel
Comments

These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically, these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire.

Questionnaire.item.text
Element IdQuestionnaire.item.text
Definition

The name of a section, the text of a question or text content for a display item.

Cardinality0..1
Typestring
Comments

When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading. Group item instructions should be included as a display type item within the group.

Questionnaire.item.type
Element IdQuestionnaire.item.type
Definition

The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.).

Cardinality1..1
Terminology BindingDistinguishes groups from questions and display text and indicates data type for questions.
The codes SHALL be taken from QuestionnaireItemType
Typecode
Requirements

Defines the format in which the user is to be prompted for the answer.

Comments

Additional constraints on the type of answer can be conveyed by extensions. The value may come from the ElementDefinition referred to by .definition.

Questionnaire.item.enableWhen
Element IdQuestionnaire.item.enableWhen
Definition

A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true.

Cardinality0..*
TypeBackboneElement
Is Modifiertrue (Reason: If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present)
Requirements

Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions.

Comments

If multiple repetitions of this extension are present, the item should be enabled when the condition for any of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
que-7RuleIf the operator is 'exists', the value must be a booleanoperator = 'exists' implies (answer is Boolean)
Questionnaire.item.enableWhen.id
Element IdQuestionnaire.item.enableWhen.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Questionnaire.item.enableWhen.extension
Element IdQuestionnaire.item.enableWhen.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Questionnaire.item.enableWhen.modifierExtension
Element IdQuestionnaire.item.enableWhen.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
Is Modifiertrue (Reason: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them)
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Questionnaire.item.enableWhen.question
Element IdQuestionnaire.item.enableWhen.question
Definition

The linkId for the question whose answer (or lack of answer) governs whether this item is enabled.

Cardinality1..1
Typestring
Comments

If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the "ancestor" axis and then the "preceding" axis and then the "following" axis.

Questionnaire.item.enableWhen.operator
Element IdQuestionnaire.item.enableWhen.operator
Definition

Specifies the criteria by which the question is enabled.

Cardinality1..1
Terminology BindingThe criteria by which a question is enabled.
The codes SHALL be taken from QuestionnaireItemOperator
Typecode
Questionnaire.item.enableWhen.answer[x]
Element IdQuestionnaire.item.enableWhen.answer[x]
Definition

A value that the referenced question is tested using the specified operator in order for the item to be enabled.

Cardinality1..1 This element is affected by the following invariants: que-7
Terminology BindingAllowed values to answer questions.
For example codes, see Questionnaire Answer Codes
TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, Coding, Quantity, Reference(Resource)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Questionnaire.item.enableBehavior
Element IdQuestionnaire.item.enableBehavior
Definition

Controls how multiple enableWhen values are interpreted - whether all or any must be true.

Cardinality0..1 This element is affected by the following invariants: que-12
Terminology BindingControls how multiple enableWhen values are interpreted - whether all or any must be true.
The codes SHALL be taken from EnableWhenBehavior
Typecode
Comments

This element must be specified if more than one enableWhen value is provided.

Questionnaire.item.required
Element IdQuestionnaire.item.required
Definition

An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire.

Cardinality0..1 This element is affected by the following invariants: que-6
Typeboolean
Comments

Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition.

Meaning if MissingItems are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
Questionnaire.item.repeats
Element IdQuestionnaire.item.repeats
Definition

An indication, if true, that the item may occur multiple times in the response, collecting multiple answers for questions or multiple sets of answers for groups.

Cardinality0..1 This element is affected by the following invariants: que-6
Typeboolean
Requirements

Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set.

Comments

If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items.

The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values.

The value may come from the ElementDefinition referred to by .definition.

Meaning if MissingItems are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
Questionnaire.item.readOnly
Element IdQuestionnaire.item.readOnly
Definition

An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.

Cardinality0..1 This element is affected by the following invariants: que-9
Typeboolean
Requirements

Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc.

Comments

The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers.

Questionnaire.item.maxLength
Element IdQuestionnaire.item.maxLength
Definition

The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse.

Cardinality0..1 This element is affected by the following invariants: que-10
Typeinteger
Comments

For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition.

Questionnaire.item.answerValueSet
Element IdQuestionnaire.item.answerValueSet
Definition

A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" question.

Cardinality0..1 This element is affected by the following invariants: que-4, que-5
Typecanonical(ValueSet)
Comments

LOINC defines many useful value sets for questionnaire responses. See LOINC Answer Lists. The value may come from the ElementDefinition referred to by .definition.

Questionnaire.item.answerOption
Element IdQuestionnaire.item.answerOption
Definition

One of the permitted answers for a "choice" or "open-choice" question.

Cardinality0..* This element is affected by the following invariants: que-4, que-5
TypeBackboneElement
Comments

This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Questionnaire.item.answerOption.id
Element IdQuestionnaire.item.answerOption.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Questionnaire.item.answerOption.extension
Element IdQuestionnaire.item.answerOption.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Questionnaire.item.answerOption.modifierExtension
Element IdQuestionnaire.item.answerOption.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
Is Modifiertrue (Reason: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them)
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Questionnaire.item.answerOption.value[x]
Element IdQuestionnaire.item.answerOption.value[x]
Definition

A potential answer that's allowed as the answer to this question.

Cardinality1..1
Terminology BindingAllowed values to answer questions.
For example codes, see Questionnaire Answer Codes
TypeChoice of: integer, date, time, string, Coding, Reference(Resource)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

The data type of the value must agree with the item.type.

Questionnaire.item.answerOption.initialSelected
Element IdQuestionnaire.item.answerOption.initialSelected
Definition

Indicates whether the answer value is selected when the list of possible answers is initially shown.

Cardinality0..1
Typeboolean
Comments

Use this instead of initial[v] if answerValueSet is present.

Meaning if MissingOnly selected items explicitly marked to be selected
Questionnaire.item.initial
Element IdQuestionnaire.item.initial
Definition

One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.

Cardinality0..* This element is affected by the following invariants: que-8, que-13
TypeBackboneElement
Requirements

In some workflows, having defaults saves time.

Comments

The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial[x] must agree with the item.type, and only repeating items can have more then one initial value.

Invariants
Inherited by this element
ele-1RuleAll FHIR elements must have a @value or childrenhasValue() or (children().count() > id.count())
Questionnaire.item.initial.id
Element IdQuestionnaire.item.initial.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality0..1
Typestring
Questionnaire.item.initial.extension
Element IdQuestionnaire.item.initial.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Questionnaire.item.initial.modifierExtension
Element IdQuestionnaire.item.initial.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
Is Modifiertrue (Reason: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them)
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Questionnaire.item.initial.value[x]
Element IdQuestionnaire.item.initial.value[x]
Definition

The actual value to for an initial answer.

Cardinality1..1
Terminology BindingAllowed values to answer questions.
For example codes, see Questionnaire Answer Codes
TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

The type of the initial value must be consistent with the type of the item.

Questionnaire.item.item
Element IdQuestionnaire.item.item
Definition

Text, questions and other groups to be nested beneath a question or group.

Cardinality0..* This element is affected by the following invariants: que-1
TypeSee Questionnaire.item
Requirements

Reports can consist of complex nested groups.

Comments

There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting.