Da Vinci - Documentation Templates and Rules
2.1.0-preview - STU 2 United States of America flag

Da Vinci - Documentation Templates and Rules, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.1.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-dtr/ and changes regularly. See the Directory of published versions

Resource Profile: DTRQuestionnaireAdapt - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the dtr-questionnaire-adapt resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Questionnaire
2. Questionnaire.text
Control1..?
4. Questionnaire.text.div
Comments

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, 'anchor' elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

6. Questionnaire.extension
Control1..?
8. Questionnaire.extension:styleSensitive
Slice NamestyleSensitive
Comments

If set to true, all systems that claim to support this extension and that render elements from the resource SHALL either render the content as required by the style extensions (style, xhtml and markdown or shall indicate to the user that the resource (or specific elements in the resource) cannot be appropriately rendered by the system.

Control0..1
TypeExtension(Style sensitive) (Extension Type: boolean)
10. Questionnaire.extension:styleSensitive.value[x]
[x] NoteSee Choice of Data Types for further information about how to use [x]
Pattern Valuefalse
12. Questionnaire.extension:cqf-library
Slice Namecqf-library
ShortThe library can contain CQL, FHIRPath or x-fhir-query. The implementers must handle any of the above.
Control0..*
TypeExtension(CQF Library) (Extension Type: canonical(Library))
Must Supporttrue
14. Questionnaire.extension:cqf-library.value[x]
Typecanonical(SDCLibrary)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
16. Questionnaire.extension:itemPopulationContext
Slice NameitemPopulationContext
Control0..*
TypeExtension(Item population context) (Extension Type: Expression)
Must Supporttrue
18. Questionnaire.title
20. Questionnaire.title.extension
SlicingThis element introduces a set of slices on Questionnaire.title.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 22. Questionnaire.title.extension:titleRenderingStyle
    Slice NametitleRenderingStyle
    Control0..1
    TypeExtension(Rendering Style) (Extension Type: string)
    24. Questionnaire.title.extension:titleRenderingXhtml
    Slice NametitleRenderingXhtml
    Control0..1
    TypeExtension(XHTML Representation) (Extension Type: string)
    26. Questionnaire.effectivePeriod
    ShortValidity period for the Questionnaire
    Must Supporttrue
    28. Questionnaire.item
    30. Questionnaire.item.extension:itemMedia
    Slice NameitemMedia
    Control0..1
    TypeExtension(Item Media) (Extension Type: Attachment)
    32. Questionnaire.item.extension:itemOptionalDisplay
    Slice NameitemOptionalDisplay
    Control0..0
    TypeExtension(Optional Display?) (Extension Type: boolean)
    34. Questionnaire.item.extension:shortText
    Slice NameshortText
    Control0..1
    TypeExtension(Short text) (Extension Type: string)
    36. Questionnaire.item.extension:openLabel
    Slice NameopenLabel
    Control0..1
    TypeExtension(Label for 'open' items) (Extension Type: string)
    38. Questionnaire.item.extension:itemControl
    Slice NameitemControl
    Control0..1
    TypeExtension(Questionnaire Item Control) (Extension Type: CodeableConcept)
    Must Supporttrue
    40. Questionnaire.item.extension:choiceOrientation
    Slice NamechoiceOrientation
    Control0..1
    TypeExtension(Questionnaire ChoiceOrientation) (Extension Type: code)
    42. Questionnaire.item.extension:displayCategory
    Slice NamedisplayCategory
    Control0..1
    TypeExtension(Questionnaire Display Category) (Extension Type: CodeableConcept)
    44. Questionnaire.item.extension:supportLink
    Slice NamesupportLink
    Control0..*
    TypeExtension(Questionnaire Support Link) (Extension Type: uri)
    Must Supporttrue
    46. Questionnaire.item.extension:choiceColumn
    Slice NamechoiceColumn
    Control0..*
    TypeExtension(Choice column) (Complex Extension)
    48. Questionnaire.item.extension:width
    Slice Namewidth
    Control0..1
    TypeExtension(Width of column) (Extension Type: Quantity)
    50. Questionnaire.item.extension:sliderStepValue
    Slice NamesliderStepValue
    Control0..1
    TypeExtension(Questionnaire Slider Step Value) (Extension Type: integer)
    52. Questionnaire.item.extension:entryFormat
    Slice NameentryFormat
    Control0..1
    TypeExtension(Entry format) (Extension Type: string)
    54. Questionnaire.item.extension:collapsible
    Slice Namecollapsible
    Control0..1
    TypeExtension(Collapsible) (Extension Type: code)
    56. Questionnaire.item.extension:initialExpression
    Slice NameinitialExpression
    Control0..1
    TypeExtension(initial.exists().not()) (Extension Type: Expression)
    Must Supporttrue
    58. Questionnaire.item.extension:unit
    Slice Nameunit
    Control0..1
    TypeExtension(Questionnaire Unit) (Extension Type: Coding)
    60. Questionnaire.item.extension:candidateExpression
    Slice NamecandidateExpression
    Control0..1
    TypeExtension(Candidate Answers Expression) (Extension Type: Expression)
    Must Supporttrue
    62. Questionnaire.item.extension:contextExpression
    Slice NamecontextExpression
    Control0..*
    TypeExtension(Answer Context Expression) (Complex Extension)
    Must Supporttrue
    64. Questionnaire.item.prefix
    66. Questionnaire.item.prefix.extension
    SlicingThis element introduces a set of slices on Questionnaire.item.prefix.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 68. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
      Slice NameitemPrefixRenderingStyle
      Control0..1
      TypeExtension(Rendering Style) (Extension Type: string)
      70. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
      Slice NameitemPrefixRenderingXhtml
      Control0..1
      TypeExtension(XHTML Representation) (Extension Type: string)
      72. Questionnaire.item.text
      74. Questionnaire.item.text.extension
      SlicingThis element introduces a set of slices on Questionnaire.item.text.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 76. Questionnaire.item.text.extension:itemTextRenderingStyle
        Slice NameitemTextRenderingStyle
        Control0..1
        TypeExtension(Rendering Style) (Extension Type: string)
        78. Questionnaire.item.text.extension:itemTextRenderingXhtml
        Slice NameitemTextRenderingXhtml
        Control0..1
        TypeExtension(XHTML Representation) (Extension Type: string)
        Must Supporttrue
        80. Questionnaire.item.enableWhen
        Control0..0
        82. Questionnaire.item.enableBehavior
        Control0..0
        84. Questionnaire.item.answerOption
        86. Questionnaire.item.answerOption.extension
        SlicingThis element introduces a set of slices on Questionnaire.item.answerOption.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 88. Questionnaire.item.answerOption.extension:itemAnswerMedia
          Slice NameitemAnswerMedia
          Control0..1
          TypeExtension(Item Answer Media) (Extension Type: Attachment)

          Guidance on how to interpret the contents of this table can be found here

          0. Questionnaire
          Definition

          Defines the metadata that should be present when embedding a adaptive Questionnaire as part of a QuestionnaireResponse.


          A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection.

          ShortAdaptive QuestionnaireA structured set of questions
          Control0..*
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate NamesForm, CRF, Survey
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.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-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
          que-2: The link ids for groups and questions must be unique within the questionnaire (descendants().linkId.isDistinct())
          que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
          que-2: The link ids for groups and questions must be unique within the questionnaire (descendants().linkId.isDistinct())
          2. Questionnaire.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.

          ShortA set of rules under which this content was created
          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.

          Control0..1
          Typeuri
          Is Modifiertrue because 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
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          4. Questionnaire.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.

          ShortText summary of the resource, for human interpretation
          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.

          Control10..1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Questionnaire.text.status
          Definition

          The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

          Shortgenerated | extensions | additional | empty
          Control1..1
          BindingThe codes SHALL be taken from NarrativeStatushttp://hl7.org/fhir/ValueSet/narrative-status|4.0.1
          (required to http://hl7.org/fhir/ValueSet/narrative-status|4.0.1)

          The status of a resource narrative.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. Questionnaire.text.div
          Definition

          The actual narrative content, a stripped down version of XHTML.

          ShortLimited xhtml content
          Comments

          The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, 'anchor' elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.


          The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

          Control1..1
          Typexhtml
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
          txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
          txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
          txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
          10. Questionnaire.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the resource. 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.

          ShortExtensionAdditional content defined by implementations
          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.

          Control10..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Questionnaire.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 12. Questionnaire.extension:questionnaireAdaptive
            Slice NamequestionnaireAdaptive
            Definition

            Marks a questionnaire as being adaptive. Value can either be a boolean (if true, indicates adaptive) or a URL for the base URL of a server that can perform the nextQuestion operation for this particular questionnaire.

            ShortMarks a questionnaire as being adaptive.
            Comments

            There can only be one in a questionnaire if the value used is boolean.

            Control1..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Questionnaire adaptive) (Extension Type: Choice of: boolean, url)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            14. Questionnaire.extension:styleSensitive
            Slice NamestyleSensitive
            Definition

            Indicates that the style extensions (style, markdown and xhtml) in this resource instance are essential to the interpretation of the instance and that systems that are not capable of rendering using those extensions should not be used to render the resource.

            ShortAre styles important for processing?
            Comments

            If set to true, all systems that claim to support this extension and that render elements from the resource SHALL either render the content as required by the style extensions (style, xhtml and markdown or shall indicate to the user that the resource (or specific elements in the resource) cannot be appropriately rendered by the system.

            Control0..1
            TypeExtension(Style sensitive) (Extension Type: boolean)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            16. Questionnaire.extension:styleSensitive.extension
            Definition

            An Extension


            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.

            ShortExtensionAdditional content defined by implementations
            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.

            Control0..0*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Questionnaire.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 18. Questionnaire.extension:styleSensitive.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/rendering-styleSensitive
              20. Questionnaire.extension:styleSensitive.value[x]
              Definition

              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

              ShortValue of extension
              Control10..1
              This element is affected by the following invariants: ext-1
              Typeboolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
              [x] NoteSee Choice of Data Types for further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Pattern Valuefalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. Questionnaire.extension:cqf-library
              Slice Namecqf-library
              Definition

              A reference to a Library containing the formal logic used by the artifact.

              ShortThe library can contain CQL, FHIRPath or x-fhir-query. The implementers must handle any of the above.
              Comments

              For questionnaires, see additional guidance and examples in the SDC implementation guide.

              Control0..*
              TypeExtension(CQF Library) (Extension Type: canonical(Library))
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              24. Questionnaire.extension:cqf-library.extension
              Definition

              An Extension


              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.

              ShortExtensionAdditional content defined by implementations
              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.

              Control0..0*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Questionnaire.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 26. Questionnaire.extension:cqf-library.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies the meaning of the extension
                Comments

                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                Control1..1
                Typeuri
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                Fixed Valuehttp://hl7.org/fhir/StructureDefinition/cqf-library
                28. Questionnaire.extension:cqf-library.value[x]
                Definition

                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                ShortValue of extension
                Control10..1
                This element is affected by the following invariants: ext-1
                Typecanonical(SDCLibrary), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                30. Questionnaire.extension:itemPopulationContext
                Slice NameitemPopulationContext
                Definition

                Specifies a query or other expression that identifies the resource (or set of resources for a repeating item) that should be used to support the population of this Questionnaire or Questionnaire.item on initial population. When populating the questionnaire, it will set the specified variable name to that resource repetition for use in processing items within the group.

                ShortEstablishes mapping context for a Questionnaire item
                Control0..*
                TypeExtension(Item population context) (Extension Type: Expression)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                32. Questionnaire.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).

                ShortExtensions that cannot be ignored
                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.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                Summaryfalse
                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
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                34. Questionnaire.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.

                ShortCanonical identifier for this questionnaire, represented as a URI (globally unique)
                Comments

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

                Control0..01
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                We prohibit URL because this Questionnaire is a one-off for a specific response and therefore does not have its own canonical URL. The URL of the base questionnaire is captured using Questionnaire.derivedFrom


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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. Questionnaire.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.

                ShortBusiness version of the questionnaire
                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].

                NoteThis is a business versionId, not a resource version id (see discussion)
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. Questionnaire.title
                Definition

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

                ShortName for this questionnaire (human friendly)
                Comments

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

                Control10..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. Questionnaire.title.extension
                Definition

                An Extension


                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.

                ShortExtensionAdditional content defined by implementations
                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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Questionnaire.title.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 42. Questionnaire.title.extension:titleRenderingStyle
                  Slice NametitleRenderingStyle
                  Definition

                  Identifies how the specified element should be rendered when displayed.

                  ShortHtml style value
                  Comments

                  This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension.

                  For questionnaires, see additional guidance and examples in the SDC implementation guide.

                  Control0..1
                  TypeExtension(Rendering Style) (Extension Type: string)
                  Is Modifierfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  44. Questionnaire.title.extension:titleRenderingXhtml
                  Slice NametitleRenderingXhtml
                  Definition

                  This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.

                  ShortString equivalent with html markup
                  Comments

                  For questionnaires, see additional guidance and examples in the SDC implementation guide.

                  Control0..1
                  TypeExtension(XHTML Representation) (Extension Type: string)
                  Is Modifierfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  46. Questionnaire.derivedFrom
                  Definition

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

                  ShortBase Questionnaire this adaptive instance is drivenen fromInstantiates protocol or definition
                  Comments

                  For this profile, there must be exactly one Questionnaire which is the base Questionnaire the 'adaptive' QuestionnaireResponse completion was executed against.

                  Control10..1*
                  Typecanonical(Questionnaire)
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Allows a Questionnaire to be created based on another Questionnaire.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. Questionnaire.status
                  Definition

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

                  Shortdraft | active | retired | unknown
                  Comments

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

                  Control1..1
                  BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

                  The lifecycle status of an artifact.

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. Questionnaire.effectivePeriod
                  Definition

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

                  ShortValidity period for the QuestionnaireWhen the questionnaire is expected to be used
                  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.

                  Control0..1
                  TypePeriod
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. Questionnaire.item
                  Definition

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

                  ShortQuestions and sections within the Questionnaire
                  Comments

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

                  Control0..*
                  This element is affected by the following invariants: que-3
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  que-1: Group 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-3: Display items cannot have a "code" asserted (type!='display' or code.empty())
                  que-4: A question cannot have both answerOption and answerValueSet (answerOption.empty() or answerValueSet.empty())
                  que-5: Only '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-6: Required and repeat aren't permitted for display items (type!='display' or (required.empty() and repeats.empty()))
                  que-8: Initial values can't be specified for groups or display items ((type!='group' and type!='display') or initial.empty())
                  que-9: Read-only can't be specified for "display" items (type!='display' or readOnly.empty())
                  que-10: Maximum length can only be declared for simple question types ((type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty())
                  que-11: If one or more answerOption is present, initial[x] must be missing (answerOption.empty() or initial.empty())
                  que-12: If there are more than one enableWhen, enableBehavior must be specified (enableWhen.count() > 2 implies enableBehavior.exists())
                  que-13: Can only have multiple initial values for repeating items (repeats=true or initial.count() <= 1)
                  que-1: Group 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-3: Display items cannot have a "code" asserted (type!='display' or code.empty())
                  que-4: A question cannot have both answerOption and answerValueSet (answerOption.empty() or answerValueSet.empty())
                  que-5: Only '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-6: Required and repeat aren't permitted for display items (type!='display' or (required.empty() and repeats.empty()))
                  que-8: Initial values can't be specified for groups or display items ((type!='group' and type!='display') or initial.empty())
                  que-9: Read-only can't be specified for "display" items (type!='display' or readOnly.empty())
                  que-10: Maximum length can only be declared for simple question types ((type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty())
                  que-11: If one or more answerOption is present, initial[x] must be missing (answerOption.empty() or initial.empty())
                  que-12: If there are more than one enableWhen, enableBehavior must be specified (enableWhen.count() > 2 implies enableBehavior.exists())
                  que-13: Can only have multiple initial values for repeating items (repeats=true or initial.count() <= 1)
                  54. Questionnaire.item.extension:hidden
                  Slice Namehidden
                  Definition

                  If true, indicates that the extended item should not be displayed to the user.

                  ShortDon't display to user
                  Comments

                  If an item is hidden, all descendant items are hidden as well.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Questionnaire Hidden) (Extension Type: boolean)
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  56. Questionnaire.item.extension:itemMedia
                  Slice NameitemMedia
                  Definition

                  Media to render/make available as an accompaniment to the question being asked

                  ShortMedia to display
                  Control0..1
                  TypeExtension(Item Media) (Extension Type: Attachment)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  58. Questionnaire.item.extension:itemOptionalDisplay
                  Slice NameitemOptionalDisplay
                  Definition

                  This extension is used when defining high-level questionnaires that will then be used as a basis for 'derived' Questionnaires that are further refined for use in specific organizations or contexts. If the extension is present and set to 'true', it means that this item should be considered to be 'optional' from an adaptation perspective and that the question can be removed (i.e. not displayed) in derived questionnaires without impacting the validity of the instrument. Alternatively, the element can be marked as 'hidden' and 'readOnly' and have a value or descendant item values declared using initialValue or initialExpression. If the element with 'optionalDisplay=true' is marked as 'required=true', then this second approach is the only means to exclude the element from display.

                  ShortCan suppress from display to user
                  Comments

                  If a group or question that contains other groups or questions is marked as "optional", all of its contents are automatically also treated as optional.

                  Control0..0
                  TypeExtension(Optional Display?) (Extension Type: boolean)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  60. Questionnaire.item.extension:shortText
                  Slice NameshortText
                  Definition

                  The short text for the item.

                  ShortShort text for the item.
                  Comments

                  This element is useful for an item that require a shorter text when rendered (e.g. when displaying the item on a mobile phone).

                  Control0..1
                  TypeExtension(Short text) (Extension Type: string)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  62. Questionnaire.item.extension:openLabel
                  Slice NameopenLabel
                  Definition

                  The label text to display beside free-text and/or unrestricted type values for an 'open' choice element. E.g. 'Other, please specify', or 'Additional condition', or 'More reason(s)', etc.

                  ShortImage to display
                  Control0..1
                  TypeExtension(Label for 'open' items) (Extension Type: string)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  64. Questionnaire.item.extension:itemControl
                  Slice NameitemControl
                  Definition

                  The type of data entry control or structure that should be used to render the item.

                  ShortE.g. Fly-over, Table, Checkbox, Combo-box, Lookup, etc.
                  Comments

                  Different controls may be appropriate for different item types. It is up to the system rendering a questionnaire as to what controls it will support and for which data types. See additional guidance and examples in the SDC implementation guide.

                  Control0..1
                  TypeExtension(Questionnaire Item Control) (Extension Type: CodeableConcept)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  66. Questionnaire.item.extension:choiceOrientation
                  Slice NamechoiceOrientation
                  Definition

                  Identifies the desired orientation when rendering a list of choices (typically radio-box or check-box lists).

                  Shorthorizontal | vertical
                  Comments

                  Systems may choose to wrap answers rather than attempting to display them all in one row or column. Language conventions may determine the order in which the choices are listed (left-to-right or right-to-left, etc.). See additional guidance and examples in the SDC implementation guide.

                  Control0..1
                  TypeExtension(Questionnaire ChoiceOrientation) (Extension Type: code)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  68. Questionnaire.item.extension:displayCategory
                  Slice NamedisplayCategory
                  Definition

                  Describes the intended purpose of the rendered text. For example - instructions, guidance on access control, maintenance information, etc.

                  ShortPurpose of rendered text
                  Comments

                  See additional guidance and examples in the SDC implementation guide.

                  Control0..1
                  TypeExtension(Questionnaire Display Category) (Extension Type: CodeableConcept)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  70. Questionnaire.item.extension:supportLink
                  Slice NamesupportLink
                  Definition

                  A URL that resolves to additional supporting information or guidance related to the question. See additional guidance and examples in the SDC implementation guide.

                  ShortSupporting information
                  Control0..*
                  TypeExtension(Questionnaire Support Link) (Extension Type: uri)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  72. Questionnaire.item.extension:choiceColumn
                  Slice NamechoiceColumn
                  Definition

                  Provides guidelines for rendering multi-column choices. I.e. when displaying a list of codes (for choice or open-choice items) or a list of resources (for reference items), this extension allows the drop-down to have multiple columns. For codes, the author can pick additional code system properties to display - such as alternate display names strength or form for drug codes, etc. For references, the author can choose particular columns from the resource (e.g. first name, last name, specialty, address).

                  ShortGuide for rendering multi-column choices
                  Comments

                  Each repetition represents a column to display.

                  Control0..*
                  TypeExtension(Choice column) (Complex Extension)
                  Is Modifierfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  74. Questionnaire.item.extension:width
                  Slice Namewidth
                  Definition

                  When used with an item control that causes the question to appear as a column in a table, indicates the width to give to the column for this question.

                  ShortWidth of column for question
                  Comments

                  code missing = pixels; code = % = percentage.

                  Control0..1
                  TypeExtension(Width of column) (Extension Type: Quantity)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  76. Questionnaire.item.extension:sliderStepValue
                  Slice NamesliderStepValue
                  Definition

                  For slider-based controls, indicates the step size to use when toggling the control up or down.

                  ShortIncrement value for slider
                  Comments

                  See additional guidance and examples in the SDC implementation guide.

                  Control0..1
                  TypeExtension(Questionnaire Slider Step Value) (Extension Type: integer)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  78. Questionnaire.item.extension:entryFormat
                  Slice NameentryFormat
                  Definition

                  Additional instructions for the user to guide their input (i.e. a human readable version of a regular expression like "nnn-nnn-nnn"). In most UIs this is the placeholder (or 'ghost') text placed directly inside the edit controls and that disappear when the control gets the focus.

                  ShortUser prompt for format
                  Comments

                  For questionnaires, see additional guidance and examples in the SDC implementation guide.

                  Control0..1
                  TypeExtension(Entry format) (Extension Type: string)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  80. Questionnaire.item.extension:collapsible
                  Slice Namecollapsible
                  Definition

                  Indicates whether the child items of a group or question item is displayed in collapsible form.

                  ShortIndicates whether the child items of a group or question item is displayed in collapsible form.
                  Control0..1
                  TypeExtension(Collapsible) (Extension Type: code)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  82. Questionnaire.item.extension:initialExpression
                  Slice NameinitialExpression
                  Definition

                  Initial value for a question answer as determined by an evaluated expression.

                  ShortExpression-determined initial value
                  Comments

                  Initial value is only calculated at the time the QuestionnaireResponse is first generated.

                  Control0..1
                  TypeExtension(initial.exists().not()) (Extension Type: Expression)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  84. Questionnaire.item.extension:unit
                  Slice Nameunit
                  Definition

                  Provides a computable unit of measure associated with numeric questions to support subsequent computation on responses. This is for use on items of type integer and decimal, and it's purpose is to support converting the integer or decimal answer into a Quantity when extracting the data into a resource.

                  ShortUnit for numeric answer
                  Comments

                  The human-readable unit is conveyed as a display element. This element is for computation purposes.

                  Control0..1
                  TypeExtension(Questionnaire Unit) (Extension Type: Coding)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  86. Questionnaire.item.extension:candidateExpression
                  Slice NamecandidateExpression
                  Definition

                  A FHIRPath or CQL expression, or FHIR Query that resolves to a list of candidate answers for the question item or that establishes context for a group item. The user may select from among the candidates to choose answers for the question.

                  ShortExpression for possible answers
                  Comments

                  The results of the expression must correspond to the item type of the question the element appears on or must correspond to a resource, backbone element or complex data type for a group item. Resources are considered a match for the Reference item type. Quantity can be a match for decimal and integer items so long as a questionnaire-unit extension is present.

                  Control0..1
                  TypeExtension(Candidate Answers Expression) (Extension Type: Expression)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  88. Questionnaire.item.extension:contextExpression
                  Slice NamecontextExpression
                  Definition

                  A FHIR Query that resolves to one or more resources that can be displayed to the user to help provide context for answering a question. For example, if the question is "Has the patient discussed this issue on any visits in the past year?", the contextExpression might return the set of patient's encounters for the prior 12 month period to help jog the practitioner's memory.

                  ShortExpression for information to guide answers
                  Control0..*
                  TypeExtension(Answer Context Expression) (Complex Extension)
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  90. Questionnaire.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).

                  ShortExtensions that cannot be ignored even if unrecognized
                  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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  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
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  92. Questionnaire.item.linkId
                  Definition

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

                  ShortUnique id for item in questionnaire
                  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.

                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summaryfalse
                  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.


                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. Questionnaire.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.

                  ShortE.g. "1(a)", "2.5.3"
                  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.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summaryfalse
                  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
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. Questionnaire.item.prefix.extension
                  Definition

                  An Extension


                  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.

                  ShortExtensionAdditional content defined by implementations
                  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.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Questionnaire.item.prefix.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 98. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
                    Slice NameitemPrefixRenderingStyle
                    Definition

                    Identifies how the specified element should be rendered when displayed.

                    ShortHtml style value
                    Comments

                    This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension.

                    For questionnaires, see additional guidance and examples in the SDC implementation guide.

                    Control0..1
                    TypeExtension(Rendering Style) (Extension Type: string)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    100. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
                    Slice NameitemPrefixRenderingXhtml
                    Definition

                    This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.

                    ShortString equivalent with html markup
                    Comments

                    For questionnaires, see additional guidance and examples in the SDC implementation guide.

                    Control0..1
                    TypeExtension(XHTML Representation) (Extension Type: string)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    102. Questionnaire.item.text
                    Definition

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

                    ShortPrimary text for the item
                    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.

                    Control10..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    104. Questionnaire.item.text.extension
                    Definition

                    An Extension


                    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.

                    ShortExtensionAdditional content defined by implementations
                    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.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Questionnaire.item.text.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 106. Questionnaire.item.text.extension:itemTextRenderingStyle
                      Slice NameitemTextRenderingStyle
                      Definition

                      Identifies how the specified element should be rendered when displayed.

                      ShortHtml style value
                      Comments

                      This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension.

                      For questionnaires, see additional guidance and examples in the SDC implementation guide.

                      Control0..1
                      TypeExtension(Rendering Style) (Extension Type: string)
                      Is Modifierfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      108. Questionnaire.item.text.extension:itemTextRenderingXhtml
                      Slice NameitemTextRenderingXhtml
                      Definition

                      This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.

                      ShortString equivalent with html markup
                      Comments

                      For questionnaires, see additional guidance and examples in the SDC implementation guide.

                      Control0..1
                      TypeExtension(XHTML Representation) (Extension Type: string)
                      Is Modifierfalse
                      Must Supporttrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      110. Questionnaire.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.).

                      Shortgroup | display | boolean | decimal | integer | date | dateTime +
                      Comments

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

                      Control1..1
                      BindingThe codes SHALL be taken from QuestionnaireItemTypehttp://hl7.org/fhir/ValueSet/item-type|4.0.1
                      (required to http://hl7.org/fhir/ValueSet/item-type|4.0.1)

                      Distinguishes groups from questions and display text and indicates data type for questions.

                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      112. Questionnaire.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.

                      ShortOnly allow data when
                      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.

                      Control0..0*
                      TypeBackboneElement
                      Is Modifiertrue because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
                      Summaryfalse
                      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.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      que-7: If the operator is 'exists', the value must be a boolean (operator = 'exists' implies (answer is Boolean))
                      que-7: If the operator is 'exists', the value must be a boolean (operator = 'exists' implies (answer is Boolean))
                      118. Questionnaire.item.enableBehavior
                      Definition

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

                      Shortall | any
                      Comments

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

                      Control0..01
                      This element is affected by the following invariants: que-12
                      BindingThe codes SHALL be taken from EnableWhenBehaviorhttp://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1
                      (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1)

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

                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      120. Questionnaire.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.

                      ShortWhether the item must be included in data results
                      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.

                      Control0..1
                      This element is affected by the following invariants: que-6
                      Typeboolean
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Meaning if MissingItems are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      122. Questionnaire.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.

                      ShortWhether the item may repeat
                      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.

                      Control0..1
                      This element is affected by the following invariants: que-6
                      Typeboolean
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

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

                      Meaning if MissingItems are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      124. Questionnaire.item.readOnly
                      Definition

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

                      ShortDon't allow human editing
                      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.

                      Control0..1
                      This element is affected by the following invariants: que-9
                      Typeboolean
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      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.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      126. Questionnaire.item.answerValueSet
                      Definition

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

                      ShortValueset containing permitted answers
                      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.

                      Control0..1
                      This element is affected by the following invariants: que-4, que-5
                      Typecanonical(ValueSet)
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      128. Questionnaire.item.answerOption
                      Definition

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

                      ShortPermitted answer
                      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.

                      Control0..*
                      This element is affected by the following invariants: que-4, que-5
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      130. Questionnaire.item.answerOption.extension
                      Definition

                      An Extension


                      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.

                      ShortExtensionAdditional content defined by implementations
                      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.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Questionnaire.item.answerOption.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 132. Questionnaire.item.answerOption.extension:itemAnswerMedia
                        Slice NameitemAnswerMedia
                        Definition

                        Media to render/make available as an accompaniment to a specific answer option

                        ShortAnswer Media to display
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Item Answer Media) (Extension Type: Attachment)
                        Is Modifierfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        134. Questionnaire.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).

                        ShortExtensions that cannot be ignored even if unrecognized
                        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.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        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
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        136. Questionnaire.item.answerOption.value[x]
                        Definition

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

                        ShortAnswer value
                        Comments

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

                        Control1..1
                        BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers
                        (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

                        Allowed values to answer questions.

                        TypeChoice of: integer, date, time, string, Coding, Reference(Resource)
                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        138. Questionnaire.item.initial
                        Definition

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

                        ShortInitial value(s) when item is first rendered
                        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.

                        Control0..*
                        This element is affected by the following invariants: que-8, que-13
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Requirements

                        In some workflows, having defaults saves time.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        140. Questionnaire.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).

                        ShortExtensions that cannot be ignored even if unrecognized
                        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.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        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
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        142. Questionnaire.item.initial.value[x]
                        Definition

                        The actual value to for an initial answer.

                        ShortActual value for initializing the question
                        Comments

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

                        Control1..1
                        BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers
                        (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

                        Allowed values to answer questions.

                        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]
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        144. Questionnaire.item.item
                        Definition

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

                        ShortNested questionnaire items
                        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.

                        Control0..*
                        This element is affected by the following invariants: que-1
                        TypeSee ttp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Requirements

                        Reports can consist of complex nested groups.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                        Guidance on how to interpret the contents of this table can be found here

                        0. Questionnaire
                        Definition

                        Defines the metadata that should be present when embedding a adaptive Questionnaire as part of a QuestionnaireResponse.

                        ShortAdaptive Questionnaire
                        Control0..*
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Alternate NamesForm, CRF, Survey
                        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.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-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                        dom-6: A resource should have narrative for robust management (text.`div`.exists())
                        que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
                        que-2: The link ids for groups and questions must be unique within the questionnaire (descendants().linkId.isDistinct())
                        2. Questionnaire.id
                        Definition

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

                        ShortLogical id of this artifact
                        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.

                        Control0..1
                        Typeid
                        Is Modifierfalse
                        Summarytrue
                        4. Questionnaire.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.

                        ShortMetadata about the resource
                        Control0..1
                        TypeMeta
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        6. Questionnaire.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.

                        ShortA set of rules under which this content was created
                        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.

                        Control0..1
                        Typeuri
                        Is Modifiertrue because 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
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        8. Questionnaire.language
                        Definition

                        The base language in which the resource is written.

                        ShortLanguage of the resource content
                        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).

                        Control0..1
                        BindingThe codes SHOULD be taken from CommonLanguages
                        (preferred to http://hl7.org/fhir/ValueSet/languages)

                        A human language.

                        Additional BindingsPurpose
                        AllLanguagesMax Binding
                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        10. Questionnaire.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.

                        ShortText summary of the resource, for human interpretation
                        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.

                        Control1..1
                        TypeNarrative
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesnarrative, html, xhtml, display
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        12. Questionnaire.text.id
                        Definition

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

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        14. Questionnaire.text.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.

                        ShortAdditional content defined by implementations
                        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.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Questionnaire.text.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 16. Questionnaire.text.status
                          Definition

                          The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

                          Shortgenerated | extensions | additional | empty
                          Control1..1
                          BindingThe codes SHALL be taken from NarrativeStatus
                          (required to http://hl7.org/fhir/ValueSet/narrative-status|4.0.1)

                          The status of a resource narrative.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          18. Questionnaire.text.div
                          Definition

                          The actual narrative content, a stripped down version of XHTML.

                          ShortLimited xhtml content
                          Comments

                          The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, 'anchor' elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

                          Control1..1
                          Typexhtml
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
                          txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
                          20. Questionnaire.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.

                          ShortContained, inline 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.

                          Control0..*
                          TypeResource
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesinline resources, anonymous resources, contained resources
                          22. Questionnaire.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control1..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Questionnaire.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 24. Questionnaire.extension:questionnaireAdaptive
                            Slice NamequestionnaireAdaptive
                            Definition

                            Marks a questionnaire as being adaptive. Value can either be a boolean (if true, indicates adaptive) or a URL for the base URL of a server that can perform the nextQuestion operation for this particular questionnaire.

                            ShortMarks a questionnaire as being adaptive.
                            Comments

                            There can only be one in a questionnaire if the value used is boolean.

                            Control1..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Questionnaire adaptive) (Extension Type: Choice of: boolean, url)
                            Is Modifierfalse
                            Must Supporttrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            26. Questionnaire.extension:styleSensitive
                            Slice NamestyleSensitive
                            Definition

                            Indicates that the style extensions (style, markdown and xhtml) in this resource instance are essential to the interpretation of the instance and that systems that are not capable of rendering using those extensions should not be used to render the resource.

                            ShortAre styles important for processing?
                            Comments

                            If set to true, all systems that claim to support this extension and that render elements from the resource SHALL either render the content as required by the style extensions (style, xhtml and markdown or shall indicate to the user that the resource (or specific elements in the resource) cannot be appropriately rendered by the system.

                            Control0..1
                            TypeExtension(Style sensitive) (Extension Type: boolean)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            28. Questionnaire.extension:styleSensitive.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typeid
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            30. Questionnaire.extension:styleSensitive.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..0
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Questionnaire.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 32. Questionnaire.extension:styleSensitive.url
                              Definition

                              Source of the definition for the extension code - a logical name or a URL.

                              Shortidentifies the meaning of the extension
                              Comments

                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/rendering-styleSensitive
                              34. Questionnaire.extension:styleSensitive.value[x]
                              Definition

                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                              ShortValue of extension
                              Control1..1
                              This element is affected by the following invariants: ext-1
                              Typeboolean
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Pattern Valuefalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              36. Questionnaire.extension:cqf-library
                              Slice Namecqf-library
                              Definition

                              A reference to a Library containing the formal logic used by the artifact.

                              ShortThe library can contain CQL, FHIRPath or x-fhir-query. The implementers must handle any of the above.
                              Comments

                              For questionnaires, see additional guidance and examples in the SDC implementation guide.

                              Control0..*
                              TypeExtension(CQF Library) (Extension Type: canonical(Library))
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              38. Questionnaire.extension:cqf-library.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typeid
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              40. Questionnaire.extension:cqf-library.extension
                              Definition

                              An Extension

                              ShortExtension
                              Control0..0
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Questionnaire.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 42. Questionnaire.extension:cqf-library.url
                                Definition

                                Source of the definition for the extension code - a logical name or a URL.

                                Shortidentifies the meaning of the extension
                                Comments

                                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                Control1..1
                                Typeuri
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                Fixed Valuehttp://hl7.org/fhir/StructureDefinition/cqf-library
                                44. Questionnaire.extension:cqf-library.value[x]
                                Definition

                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                ShortValue of extension
                                Control1..1
                                This element is affected by the following invariants: ext-1
                                Typecanonical(SDCLibrary)
                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                46. Questionnaire.extension:itemPopulationContext
                                Slice NameitemPopulationContext
                                Definition

                                Specifies a query or other expression that identifies the resource (or set of resources for a repeating item) that should be used to support the population of this Questionnaire or Questionnaire.item on initial population. When populating the questionnaire, it will set the specified variable name to that resource repetition for use in processing items within the group.

                                ShortEstablishes mapping context for a Questionnaire item
                                Control0..*
                                TypeExtension(Item population context) (Extension Type: Expression)
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                48. Questionnaire.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).

                                ShortExtensions that cannot be ignored
                                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.

                                Control0..*
                                TypeExtension
                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                Summaryfalse
                                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
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                50. Questionnaire.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.

                                ShortCanonical identifier for this questionnaire, represented as a URI (globally unique)
                                Comments

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

                                Control0..0
                                Typeuri
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                We prohibit URL because this Questionnaire is a one-off for a specific response and therefore does not have its own canonical URL. The URL of the base questionnaire is captured using Questionnaire.derivedFrom

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                52. Questionnaire.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.

                                ShortAdditional identifier for the questionnaire
                                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.

                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                Control0..*
                                TypeIdentifier
                                Is Modifierfalse
                                Summarytrue
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                54. Questionnaire.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.

                                ShortBusiness version of the questionnaire
                                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].

                                NoteThis is a business versionId, not a resource version id (see discussion)
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                56. Questionnaire.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.

                                ShortName for this questionnaire (computer friendly)
                                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.

                                Control0..1
                                This element is affected by the following invariants: inv-0
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Support human navigation and code generation.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                58. Questionnaire.title
                                Definition

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

                                ShortName for this questionnaire (human friendly)
                                Comments

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

                                Control1..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                60. Questionnaire.title.id
                                Definition

                                unique id for the element within a resource (for internal references)

                                Shortxml:id (or equivalent in JSON)
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                62. Questionnaire.title.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Questionnaire.title.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 64. Questionnaire.title.extension:titleRenderingStyle
                                  Slice NametitleRenderingStyle
                                  Definition

                                  Identifies how the specified element should be rendered when displayed.

                                  ShortHtml style value
                                  Comments

                                  This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension.

                                  For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                  Control0..1
                                  TypeExtension(Rendering Style) (Extension Type: string)
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  66. Questionnaire.title.extension:titleRenderingXhtml
                                  Slice NametitleRenderingXhtml
                                  Definition

                                  This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.

                                  ShortString equivalent with html markup
                                  Comments

                                  For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                  Control0..1
                                  TypeExtension(XHTML Representation) (Extension Type: string)
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  68. Questionnaire.title.value
                                  Definition

                                  The actual value

                                  ShortPrimitive value for string
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  Max Length1048576
                                  70. Questionnaire.derivedFrom
                                  Definition

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

                                  ShortBase Questionnaire this adaptive instance is drivenen from
                                  Comments

                                  For this profile, there must be exactly one Questionnaire which is the base Questionnaire the 'adaptive' QuestionnaireResponse completion was executed against.

                                  Control1..1
                                  Typecanonical(Questionnaire)
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Allows a Questionnaire to be created based on another Questionnaire.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  72. Questionnaire.status
                                  Definition

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

                                  Shortdraft | active | retired | unknown
                                  Comments

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

                                  Control1..1
                                  BindingThe codes SHALL be taken from PublicationStatus
                                  (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

                                  The lifecycle status of an artifact.

                                  Typecode
                                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  74. Questionnaire.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.

                                  ShortFor testing purposes, not real usage
                                  Comments

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

                                  Control0..1
                                  Typeboolean
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  76. Questionnaire.subjectType
                                  Definition

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

                                  ShortResource that can be subject of QuestionnaireResponse
                                  Comments

                                  If none are specified, then the subject is unlimited.

                                  Control0..*
                                  BindingThe codes SHALL be taken from ResourceType
                                  (required to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                                  One of the resource types defined as part of this version of FHIR.

                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  78. Questionnaire.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.

                                  ShortDate last changed
                                  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.

                                  Control0..1
                                  TypedateTime
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Alternate NamesRevision Date
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  80. Questionnaire.publisher
                                  Definition

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

                                  ShortName of the publisher (organization or individual)
                                  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.

                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  82. Questionnaire.contact
                                  Definition

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

                                  ShortContact details for the publisher
                                  Comments

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

                                  Control0..*
                                  TypeContactDetail
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  84. Questionnaire.description
                                  Definition

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

                                  ShortNatural language description of the questionnaire
                                  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).

                                  Control0..1
                                  Typemarkdown
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  86. Questionnaire.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.

                                  ShortThe context that the content is intended to support
                                  Comments

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

                                  Control0..*
                                  TypeUsageContext
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Assist in searching for appropriate content.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  88. Questionnaire.jurisdiction
                                  Definition

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

                                  ShortIntended jurisdiction for questionnaire (if applicable)
                                  Comments

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

                                  Control0..*
                                  BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSet
                                  (extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

                                  Countries and regions within which this artifact is targeted for use.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  90. Questionnaire.purpose
                                  Definition

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

                                  ShortWhy this questionnaire is defined
                                  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.

                                  Control0..1
                                  Typemarkdown
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  92. Questionnaire.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.

                                  ShortUse and/or publishing restrictions
                                  Control0..1
                                  Typemarkdown
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Requirements

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

                                  Alternate NamesLicense, Restrictions
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  94. Questionnaire.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.

                                  ShortWhen the questionnaire was approved by publisher
                                  Comments

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

                                  Control0..1
                                  Typedate
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  96. Questionnaire.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.

                                  ShortWhen the questionnaire was last reviewed
                                  Comments

                                  If specified, this date follows the original approval date.

                                  Control0..1
                                  Typedate
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  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.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  98. Questionnaire.effectivePeriod
                                  Definition

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

                                  ShortValidity period for the Questionnaire
                                  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.

                                  Control0..1
                                  TypePeriod
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  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.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  100. Questionnaire.code
                                  Definition

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

                                  ShortConcept that represents the overall questionnaire
                                  Control0..*
                                  BindingFor example codes, see QuestionnaireQuestionCodes
                                  (example to http://hl7.org/fhir/ValueSet/questionnaire-questions)

                                  Codes for questionnaires, groups and individual questions.

                                  TypeCoding
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  102. Questionnaire.item
                                  Definition

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

                                  ShortQuestions and sections within the Questionnaire
                                  Comments

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

                                  Control0..*
                                  This element is affected by the following invariants: que-3
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  que-1: Group 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-3: Display items cannot have a "code" asserted (type!='display' or code.empty())
                                  que-4: A question cannot have both answerOption and answerValueSet (answerOption.empty() or answerValueSet.empty())
                                  que-5: Only '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-6: Required and repeat aren't permitted for display items (type!='display' or (required.empty() and repeats.empty()))
                                  que-8: Initial values can't be specified for groups or display items ((type!='group' and type!='display') or initial.empty())
                                  que-9: Read-only can't be specified for "display" items (type!='display' or readOnly.empty())
                                  que-10: Maximum length can only be declared for simple question types ((type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty())
                                  que-11: If one or more answerOption is present, initial[x] must be missing (answerOption.empty() or initial.empty())
                                  que-12: If there are more than one enableWhen, enableBehavior must be specified (enableWhen.count() > 2 implies enableBehavior.exists())
                                  que-13: Can only have multiple initial values for repeating items (repeats=true or initial.count() <= 1)
                                  104. Questionnaire.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.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  106. Questionnaire.item.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Questionnaire.item.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 108. Questionnaire.item.extension:hidden
                                    Slice Namehidden
                                    Definition

                                    If true, indicates that the extended item should not be displayed to the user.

                                    ShortDon't display to user
                                    Comments

                                    If an item is hidden, all descendant items are hidden as well.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Questionnaire Hidden) (Extension Type: boolean)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    110. Questionnaire.item.extension:itemMedia
                                    Slice NameitemMedia
                                    Definition

                                    Media to render/make available as an accompaniment to the question being asked

                                    ShortMedia to display
                                    Control0..1
                                    TypeExtension(Item Media) (Extension Type: Attachment)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    112. Questionnaire.item.extension:itemOptionalDisplay
                                    Slice NameitemOptionalDisplay
                                    Definition

                                    This extension is used when defining high-level questionnaires that will then be used as a basis for 'derived' Questionnaires that are further refined for use in specific organizations or contexts. If the extension is present and set to 'true', it means that this item should be considered to be 'optional' from an adaptation perspective and that the question can be removed (i.e. not displayed) in derived questionnaires without impacting the validity of the instrument. Alternatively, the element can be marked as 'hidden' and 'readOnly' and have a value or descendant item values declared using initialValue or initialExpression. If the element with 'optionalDisplay=true' is marked as 'required=true', then this second approach is the only means to exclude the element from display.

                                    ShortCan suppress from display to user
                                    Comments

                                    If a group or question that contains other groups or questions is marked as "optional", all of its contents are automatically also treated as optional.

                                    Control0..0
                                    TypeExtension(Optional Display?) (Extension Type: boolean)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    114. Questionnaire.item.extension:shortText
                                    Slice NameshortText
                                    Definition

                                    The short text for the item.

                                    ShortShort text for the item.
                                    Comments

                                    This element is useful for an item that require a shorter text when rendered (e.g. when displaying the item on a mobile phone).

                                    Control0..1
                                    TypeExtension(Short text) (Extension Type: string)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    116. Questionnaire.item.extension:openLabel
                                    Slice NameopenLabel
                                    Definition

                                    The label text to display beside free-text and/or unrestricted type values for an 'open' choice element. E.g. 'Other, please specify', or 'Additional condition', or 'More reason(s)', etc.

                                    ShortImage to display
                                    Control0..1
                                    TypeExtension(Label for 'open' items) (Extension Type: string)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    118. Questionnaire.item.extension:itemControl
                                    Slice NameitemControl
                                    Definition

                                    The type of data entry control or structure that should be used to render the item.

                                    ShortE.g. Fly-over, Table, Checkbox, Combo-box, Lookup, etc.
                                    Comments

                                    Different controls may be appropriate for different item types. It is up to the system rendering a questionnaire as to what controls it will support and for which data types. See additional guidance and examples in the SDC implementation guide.

                                    Control0..1
                                    TypeExtension(Questionnaire Item Control) (Extension Type: CodeableConcept)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    120. Questionnaire.item.extension:choiceOrientation
                                    Slice NamechoiceOrientation
                                    Definition

                                    Identifies the desired orientation when rendering a list of choices (typically radio-box or check-box lists).

                                    Shorthorizontal | vertical
                                    Comments

                                    Systems may choose to wrap answers rather than attempting to display them all in one row or column. Language conventions may determine the order in which the choices are listed (left-to-right or right-to-left, etc.). See additional guidance and examples in the SDC implementation guide.

                                    Control0..1
                                    TypeExtension(Questionnaire ChoiceOrientation) (Extension Type: code)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    122. Questionnaire.item.extension:displayCategory
                                    Slice NamedisplayCategory
                                    Definition

                                    Describes the intended purpose of the rendered text. For example - instructions, guidance on access control, maintenance information, etc.

                                    ShortPurpose of rendered text
                                    Comments

                                    See additional guidance and examples in the SDC implementation guide.

                                    Control0..1
                                    TypeExtension(Questionnaire Display Category) (Extension Type: CodeableConcept)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    124. Questionnaire.item.extension:supportLink
                                    Slice NamesupportLink
                                    Definition

                                    A URL that resolves to additional supporting information or guidance related to the question. See additional guidance and examples in the SDC implementation guide.

                                    ShortSupporting information
                                    Control0..*
                                    TypeExtension(Questionnaire Support Link) (Extension Type: uri)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    126. Questionnaire.item.extension:choiceColumn
                                    Slice NamechoiceColumn
                                    Definition

                                    Provides guidelines for rendering multi-column choices. I.e. when displaying a list of codes (for choice or open-choice items) or a list of resources (for reference items), this extension allows the drop-down to have multiple columns. For codes, the author can pick additional code system properties to display - such as alternate display names strength or form for drug codes, etc. For references, the author can choose particular columns from the resource (e.g. first name, last name, specialty, address).

                                    ShortGuide for rendering multi-column choices
                                    Comments

                                    Each repetition represents a column to display.

                                    Control0..*
                                    TypeExtension(Choice column) (Complex Extension)
                                    Is Modifierfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    128. Questionnaire.item.extension:width
                                    Slice Namewidth
                                    Definition

                                    When used with an item control that causes the question to appear as a column in a table, indicates the width to give to the column for this question.

                                    ShortWidth of column for question
                                    Comments

                                    code missing = pixels; code = % = percentage.

                                    Control0..1
                                    TypeExtension(Width of column) (Extension Type: Quantity)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    130. Questionnaire.item.extension:sliderStepValue
                                    Slice NamesliderStepValue
                                    Definition

                                    For slider-based controls, indicates the step size to use when toggling the control up or down.

                                    ShortIncrement value for slider
                                    Comments

                                    See additional guidance and examples in the SDC implementation guide.

                                    Control0..1
                                    TypeExtension(Questionnaire Slider Step Value) (Extension Type: integer)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    132. Questionnaire.item.extension:entryFormat
                                    Slice NameentryFormat
                                    Definition

                                    Additional instructions for the user to guide their input (i.e. a human readable version of a regular expression like "nnn-nnn-nnn"). In most UIs this is the placeholder (or 'ghost') text placed directly inside the edit controls and that disappear when the control gets the focus.

                                    ShortUser prompt for format
                                    Comments

                                    For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                    Control0..1
                                    TypeExtension(Entry format) (Extension Type: string)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    134. Questionnaire.item.extension:collapsible
                                    Slice Namecollapsible
                                    Definition

                                    Indicates whether the child items of a group or question item is displayed in collapsible form.

                                    ShortIndicates whether the child items of a group or question item is displayed in collapsible form.
                                    Control0..1
                                    TypeExtension(Collapsible) (Extension Type: code)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    136. Questionnaire.item.extension:initialExpression
                                    Slice NameinitialExpression
                                    Definition

                                    Initial value for a question answer as determined by an evaluated expression.

                                    ShortExpression-determined initial value
                                    Comments

                                    Initial value is only calculated at the time the QuestionnaireResponse is first generated.

                                    Control0..1
                                    TypeExtension(initial.exists().not()) (Extension Type: Expression)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    138. Questionnaire.item.extension:unit
                                    Slice Nameunit
                                    Definition

                                    Provides a computable unit of measure associated with numeric questions to support subsequent computation on responses. This is for use on items of type integer and decimal, and it's purpose is to support converting the integer or decimal answer into a Quantity when extracting the data into a resource.

                                    ShortUnit for numeric answer
                                    Comments

                                    The human-readable unit is conveyed as a display element. This element is for computation purposes.

                                    Control0..1
                                    TypeExtension(Questionnaire Unit) (Extension Type: Coding)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    140. Questionnaire.item.extension:candidateExpression
                                    Slice NamecandidateExpression
                                    Definition

                                    A FHIRPath or CQL expression, or FHIR Query that resolves to a list of candidate answers for the question item or that establishes context for a group item. The user may select from among the candidates to choose answers for the question.

                                    ShortExpression for possible answers
                                    Comments

                                    The results of the expression must correspond to the item type of the question the element appears on or must correspond to a resource, backbone element or complex data type for a group item. Resources are considered a match for the Reference item type. Quantity can be a match for decimal and integer items so long as a questionnaire-unit extension is present.

                                    Control0..1
                                    TypeExtension(Candidate Answers Expression) (Extension Type: Expression)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    142. Questionnaire.item.extension:contextExpression
                                    Slice NamecontextExpression
                                    Definition

                                    A FHIR Query that resolves to one or more resources that can be displayed to the user to help provide context for answering a question. For example, if the question is "Has the patient discussed this issue on any visits in the past year?", the contextExpression might return the set of patient's encounters for the prior 12 month period to help jog the practitioner's memory.

                                    ShortExpression for information to guide answers
                                    Control0..*
                                    TypeExtension(Answer Context Expression) (Complex Extension)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    144. Questionnaire.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).

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    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.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                    Summarytrue
                                    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
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    146. Questionnaire.item.linkId
                                    Definition

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

                                    ShortUnique id for item in questionnaire
                                    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.

                                    Control1..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summaryfalse
                                    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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    148. Questionnaire.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).
                                    ShortElementDefinition - details for the item
                                    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.

                                    Control0..1
                                    Typeuri
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summaryfalse
                                    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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    150. Questionnaire.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).

                                    ShortCorresponding concept for this item in a terminology
                                    Comments

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

                                    Control0..*
                                    This element is affected by the following invariants: que-3
                                    BindingFor example codes, see QuestionnaireQuestionCodes
                                    (example to http://hl7.org/fhir/ValueSet/questionnaire-questions)

                                    Codes for questionnaires, groups and individual questions.

                                    TypeCoding
                                    Is Modifierfalse
                                    Summaryfalse
                                    Requirements

                                    Allows linking of groups of questions to formal terminologies.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    152. Questionnaire.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.

                                    ShortE.g. "1(a)", "2.5.3"
                                    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.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summaryfalse
                                    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
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    154. Questionnaire.item.prefix.id
                                    Definition

                                    unique id for the element within a resource (for internal references)

                                    Shortxml:id (or equivalent in JSON)
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    156. Questionnaire.item.prefix.extension
                                    Definition

                                    An Extension

                                    ShortExtension
                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Questionnaire.item.prefix.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 158. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
                                      Slice NameitemPrefixRenderingStyle
                                      Definition

                                      Identifies how the specified element should be rendered when displayed.

                                      ShortHtml style value
                                      Comments

                                      This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension.

                                      For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                      Control0..1
                                      TypeExtension(Rendering Style) (Extension Type: string)
                                      Is Modifierfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      160. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
                                      Slice NameitemPrefixRenderingXhtml
                                      Definition

                                      This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.

                                      ShortString equivalent with html markup
                                      Comments

                                      For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                      Control0..1
                                      TypeExtension(XHTML Representation) (Extension Type: string)
                                      Is Modifierfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      162. Questionnaire.item.prefix.value
                                      Definition

                                      The actual value

                                      ShortPrimitive value for string
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      Max Length1048576
                                      164. Questionnaire.item.text
                                      Definition

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

                                      ShortPrimary text for the item
                                      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.

                                      Control1..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      166. Questionnaire.item.text.id
                                      Definition

                                      unique id for the element within a resource (for internal references)

                                      Shortxml:id (or equivalent in JSON)
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      168. Questionnaire.item.text.extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Questionnaire.item.text.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 170. Questionnaire.item.text.extension:itemTextRenderingStyle
                                        Slice NameitemTextRenderingStyle
                                        Definition

                                        Identifies how the specified element should be rendered when displayed.

                                        ShortHtml style value
                                        Comments

                                        This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension.

                                        For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                        Control0..1
                                        TypeExtension(Rendering Style) (Extension Type: string)
                                        Is Modifierfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        172. Questionnaire.item.text.extension:itemTextRenderingXhtml
                                        Slice NameitemTextRenderingXhtml
                                        Definition

                                        This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.

                                        ShortString equivalent with html markup
                                        Comments

                                        For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                        Control0..1
                                        TypeExtension(XHTML Representation) (Extension Type: string)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        174. Questionnaire.item.text.value
                                        Definition

                                        The actual value

                                        ShortPrimitive value for string
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        Max Length1048576
                                        176. Questionnaire.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.).

                                        Shortgroup | display | boolean | decimal | integer | date | dateTime +
                                        Comments

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

                                        Control1..1
                                        BindingThe codes SHALL be taken from QuestionnaireItemType
                                        (required to http://hl7.org/fhir/ValueSet/item-type|4.0.1)

                                        Distinguishes groups from questions and display text and indicates data type for questions.

                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

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

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        178. Questionnaire.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.

                                        ShortOnly allow data when
                                        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.

                                        Control0..0
                                        TypeBackboneElement
                                        Is Modifiertrue because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
                                        Summaryfalse
                                        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.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        que-7: If the operator is 'exists', the value must be a boolean (operator = 'exists' implies (answer is Boolean))
                                        186. Questionnaire.item.enableBehavior
                                        Definition

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

                                        Shortall | any
                                        Comments

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

                                        Control0..0
                                        This element is affected by the following invariants: que-12
                                        BindingThe codes SHALL be taken from EnableWhenBehavior
                                        (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1)

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

                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        188. Questionnaire.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.

                                        ShortWhether the item must be included in data results
                                        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.

                                        Control0..1
                                        This element is affected by the following invariants: que-6
                                        Typeboolean
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        Meaning if MissingItems are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        190. Questionnaire.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.

                                        ShortWhether the item may repeat
                                        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.

                                        Control0..1
                                        This element is affected by the following invariants: que-6
                                        Typeboolean
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

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

                                        Meaning if MissingItems are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        192. Questionnaire.item.readOnly
                                        Definition

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

                                        ShortDon't allow human editing
                                        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.

                                        Control0..1
                                        This element is affected by the following invariants: que-9
                                        Typeboolean
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        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.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        194. Questionnaire.item.maxLength
                                        Definition

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

                                        ShortNo more than this many characters
                                        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.

                                        Control0..1
                                        This element is affected by the following invariants: que-10
                                        Typeinteger
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        196. Questionnaire.item.answerValueSet
                                        Definition

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

                                        ShortValueset containing permitted answers
                                        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.

                                        Control0..1
                                        This element is affected by the following invariants: que-4, que-5
                                        Typecanonical(ValueSet)
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        198. Questionnaire.item.answerOption
                                        Definition

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

                                        ShortPermitted answer
                                        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.

                                        Control0..*
                                        This element is affected by the following invariants: que-4, que-5
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        200. Questionnaire.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.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        202. Questionnaire.item.answerOption.extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Questionnaire.item.answerOption.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 204. Questionnaire.item.answerOption.extension:itemAnswerMedia
                                          Slice NameitemAnswerMedia
                                          Definition

                                          Media to render/make available as an accompaniment to a specific answer option

                                          ShortAnswer Media to display
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                          Is Modifierfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          206. Questionnaire.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).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          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
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          208. Questionnaire.item.answerOption.value[x]
                                          Definition

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

                                          ShortAnswer value
                                          Comments

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

                                          Control1..1
                                          BindingFor example codes, see QuestionnaireAnswerCodes
                                          (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

                                          Allowed values to answer questions.

                                          TypeChoice of: integer, date, time, string, Coding, Reference(Resource)
                                          [x] NoteSee Choice of Data Types for further information about how to use [x]
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          210. Questionnaire.item.answerOption.initialSelected
                                          Definition

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

                                          ShortWhether option is selected by default
                                          Comments

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

                                          Control0..1
                                          Typeboolean
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Meaning if MissingOnly selected items explicitly marked to be selected
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          212. Questionnaire.item.initial
                                          Definition

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

                                          ShortInitial value(s) when item is first rendered
                                          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.

                                          Control0..*
                                          This element is affected by the following invariants: que-8, que-13
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          In some workflows, having defaults saves time.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          214. Questionnaire.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.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          216. Questionnaire.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.

                                          ShortAdditional content defined by implementations
                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          218. Questionnaire.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).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          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
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          220. Questionnaire.item.initial.value[x]
                                          Definition

                                          The actual value to for an initial answer.

                                          ShortActual value for initializing the question
                                          Comments

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

                                          Control1..1
                                          BindingFor example codes, see QuestionnaireAnswerCodes
                                          (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

                                          Allowed values to answer questions.

                                          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]
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          222. Questionnaire.item.item
                                          Definition

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

                                          ShortNested questionnaire items
                                          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.

                                          Control0..*
                                          This element is affected by the following invariants: que-1
                                          TypeSee ttp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Reports can consist of complex nested groups.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))