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: DTRStdQuestionnaire - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the dtr-std-questionnaire 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:terminologyServer
Slice NameterminologyServer
Comments

Multiple repetitions are available to support availability (one server might be down) as well as to accommodate the possibility that different servers might be needed for different value sets. In either case, client behavior is to try different servers from the available list until one is successful. There is no implication to the order in which the servers are listed. If no service is listed and terminology services are needed, the $expand operation should be invoked on the base URL for the payer.

Must Supporttrue
8. Questionnaire.extension:assemble-expectation
Slice Nameassemble-expectation
Control0..0
10. 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)
12. Questionnaire.extension:styleSensitive.value[x]
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Pattern Valuefalse
14. Questionnaire.extension:entryMode
Slice NameentryMode
Control0..*
TypeExtension(Entry mode) (Extension Type: code)
Must Supporttrue
16. Questionnaire.extension:endpoint
Slice Nameendpoint
Control0..0
TypeExtension(Endpoint) (Extension Type: uri)
18. Questionnaire.extension:signatureRequired
Slice NamesignatureRequired
ShortThere's a cost to support this.
Control0..1
TypeExtension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
Must Supporttrue
20. Questionnaire.extension:constraint
Slice Nameconstraint
Control0..*
TypeExtension(Questionnaire Constraint) (Complex Extension)
22. 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
24. Questionnaire.extension:cqf-library.value[x]
Typecanonical(SDCLibrary)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
26. Questionnaire.extension:launchContext
Slice NamelaunchContext
Control0..*
TypeExtension(Launch context resources) (Complex Extension)
Must Supporttrue
28. Questionnaire.extension:variable
Slice Namevariable
Control0..*
TypeExtension(Variable) (Extension Type: Expression)
Must Supporttrue
30. Questionnaire.extension:itemPopulationContext
Slice NameitemPopulationContext
Control0..*
TypeExtension(Item population context) (Extension Type: Expression)
Must Supporttrue
32. Questionnaire.title
34. Questionnaire.title.extension
SlicingThis element introduces a set of slices on Questionnaire.title.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 36. Questionnaire.title.extension:titleRenderingStyle
    Slice NametitleRenderingStyle
    Control0..1
    TypeExtension(Rendering Style) (Extension Type: string)
    38. Questionnaire.title.extension:titleRenderingXhtml
    Slice NametitleRenderingXhtml
    Control0..1
    TypeExtension(XHTML Representation) (Extension Type: string)
    40. Questionnaire.subjectType
    Control1..1
    Pattern ValuePatient
    42. Questionnaire.effectivePeriod
    Must Supporttrue
    44. Questionnaire.item
    46. Questionnaire.item.extension:itemMedia
    Slice NameitemMedia
    Control0..1
    TypeExtension(Item Media) (Extension Type: Attachment)
    48. Questionnaire.item.extension:itemOptionalDisplay
    Slice NameitemOptionalDisplay
    Control0..1
    TypeExtension(Optional Display?) (Extension Type: boolean)
    50. Questionnaire.item.extension:shortText
    Slice NameshortText
    Control0..1
    TypeExtension(Short text) (Extension Type: string)
    52. Questionnaire.item.extension:itemHidden
    Slice NameitemHidden
    Control0..1
    TypeExtension(Questionnaire Hidden) (Extension Type: boolean)
    Must Supporttrue
    54. Questionnaire.item.extension:openLabel
    Slice NameopenLabel
    Control0..1
    TypeExtension(Label for 'open' items) (Extension Type: string)
    56. Questionnaire.item.extension:itemControl
    Slice NameitemControl
    Control0..1
    TypeExtension(Questionnaire Item Control) (Extension Type: CodeableConcept)
    Must Supporttrue
    58. Questionnaire.item.extension:choiceOrientation
    Slice NamechoiceOrientation
    Control0..1
    TypeExtension(Questionnaire ChoiceOrientation) (Extension Type: code)
    60. Questionnaire.item.extension:displayCategory
    Slice NamedisplayCategory
    Control0..1
    TypeExtension(Questionnaire Display Category) (Extension Type: CodeableConcept)
    62. Questionnaire.item.extension:supportLink
    Slice NamesupportLink
    Control0..*
    TypeExtension(Questionnaire Support Link) (Extension Type: uri)
    Must Supporttrue
    64. Questionnaire.item.extension:choiceColumn
    Slice NamechoiceColumn
    Control0..*
    TypeExtension(Choice column) (Complex Extension)
    66. Questionnaire.item.extension:width
    Slice Namewidth
    Control0..1
    TypeExtension(Width of column) (Extension Type: Quantity)
    68. Questionnaire.item.extension:sliderStepValue
    Slice NamesliderStepValue
    Control0..1
    TypeExtension(Questionnaire Slider Step Value) (Extension Type: integer)
    70. Questionnaire.item.extension:entryFormat
    Slice NameentryFormat
    Control0..1
    TypeExtension(Entry format) (Extension Type: string)
    72. Questionnaire.item.extension:collapsible
    Slice Namecollapsible
    Control0..1
    TypeExtension(Collapsible) (Extension Type: code)
    74. Questionnaire.item.extension:usageMode
    Slice NameusageMode
    Control0..1
    TypeExtension(QuestionnaireResponse Usage Mode) (Extension Type: code)
    76. Questionnaire.item.extension:itemSignatureRequired
    Slice NameitemSignatureRequired
    Control0..1
    TypeExtension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
    78. Questionnaire.item.extension:minOccurs
    Slice NameminOccurs
    Control0..1
    TypeExtension(Questionnaire Min Occurs) (Extension Type: integer)
    80. Questionnaire.item.extension:maxOccurs
    Slice NamemaxOccurs
    Control0..1
    TypeExtension(Questionnaire Max Occurs) (Extension Type: integer)
    82. Questionnaire.item.extension:minLength
    Slice NameminLength
    Control0..1
    TypeExtension(Min length) (Extension Type: integer)
    84. Questionnaire.item.extension:regex
    Slice Nameregex
    Control0..1
    TypeExtension(regex) (Extension Type: string)
    86. Questionnaire.item.extension:minValue
    Slice NameminValue
    Control0..1
    TypeExtension(Min value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, Quantity)
    88. Questionnaire.item.extension:maxValue
    Slice NamemaxValue
    Control0..1
    TypeExtension(Max value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, Quantity)
    90. Questionnaire.item.extension:minQuantity
    Slice NameminQuantity
    Control0..1
    TypeExtension(Min quantity) (Extension Type: Quantity)
    92. Questionnaire.item.extension:maxQuantity
    Slice NamemaxQuantity
    Control0..1
    TypeExtension(Max quantity) (Extension Type: Quantity)
    94. Questionnaire.item.extension:maxDecimalPlaces
    Slice NamemaxDecimalPlaces
    Control0..1
    TypeExtension(Max decimal places) (Extension Type: integer)
    96. Questionnaire.item.extension:mimeType
    Slice NamemimeType
    Control0..1
    TypeExtension(Mime type) (Extension Type: code)
    Must Supporttrue
    98. Questionnaire.item.extension:maxSize
    Slice NamemaxSize
    Control0..1
    TypeExtension(Max size) (Extension Type: decimal)
    100. Questionnaire.item.extension:answerOptionsToggleExpression
    Slice NameanswerOptionsToggleExpression
    Control0..1
    TypeExtension(Answer Options Toggle Expression) (Complex Extension)
    102. Questionnaire.item.extension:unitOption
    Slice NameunitOption
    Control0..*
    TypeExtension(QuestionnaireResponse Unit Option) (Extension Type: Coding)
    Must Supporttrue
    104. Questionnaire.item.extension:unitValueSet
    Slice NameunitValueSet
    Comments

    Provide either unitOption(s) or unitValueSet. If either of the extensions are present, the units for a Quantity element are constrained to only the units listed by the extensions - i.e. it is treated as a "required", not an "extensible" binding. In the absence of either, any unit is valid. See additional guidance and examples in the SDC implementation guide. If this extension present and an answer is provided for the question item in the QuestionnaireResponse, then the valueQuantity SHALL have a Quantity.code and Quantity.system that match the Coding.code and system of one of the allowed values if the Coding has a code and/or system. If the Coding only has a display, then the Quantity.unit must match. (Note that Coding with only a display is strongly discouraged.) If there is a match on code and system, but no match on display/unit, systems MAY raise a warning. However, because of translation and bandwidth considerations, some systems MAY opt to drop the unit or express it in an alternate language. Validation of the Quantity unit MAY be performed by using the $validateCode operation, populating the elements passed into the operation from the Quantity.code, system and unit elements.

    Control0..1
    TypeExtension(QuestionnaireResponse Unit ValueSet) (Extension Type: canonical(ValueSet))
    Must Supporttrue
    106. Questionnaire.item.extension:referenceResource
    Slice NamereferenceResource
    Control0..*
    TypeExtension(Questionnaire Reference Resource) (Extension Type: code)
    Must Supporttrue
    108. Questionnaire.item.extension:referenceProfile
    Slice NamereferenceProfile
    Control0..*
    TypeExtension(Questionnaire Reference Profile) (Extension Type: canonical(StructureDefinition))
    Must Supporttrue
    110. Questionnaire.item.extension:candidateExpression
    Slice NamecandidateExpression
    Control0..1
    TypeExtension(Candidate Answers Expression) (Extension Type: Expression)
    Must Supporttrue
    112. Questionnaire.item.extension:lookupQuestionnaire
    Slice NamelookupQuestionnaire
    Control0..1
    TypeExtension(Lookup questionnaire) (Extension Type: canonical)
    Must Supporttrue
    114. Questionnaire.item.extension:itemConstraint
    Slice NameitemConstraint
    Control0..*
    TypeExtension(Questionnaire Constraint) (Complex Extension)
    116. Questionnaire.item.extension:initialExpression
    Slice NameinitialExpression
    Control0..1
    TypeExtension(initial.exists().not()) (Extension Type: Expression)
    Must Supporttrue
    118. Questionnaire.item.extension:calculatedExpression
    Slice NamecalculatedExpression
    Control0..1
    TypeExtension(Calculated expression) (Extension Type: Expression)
    Must Supporttrue
    120. Questionnaire.item.extension:enableWhenExpression
    Slice NameenableWhenExpression
    Control0..1
    TypeExtension(Enable when expression) (Extension Type: Expression)
    Must Supporttrue
    122. Questionnaire.item.extension:unit
    Slice Nameunit
    Control0..1
    TypeExtension(Questionnaire Unit) (Extension Type: Coding)
    124. Questionnaire.item.extension:contextExpression
    Slice NamecontextExpression
    Control0..*
    TypeExtension(Answer Context Expression) (Complex Extension)
    Must Supporttrue
    126. Questionnaire.item.prefix
    128. Questionnaire.item.prefix.extension
    SlicingThis element introduces a set of slices on Questionnaire.item.prefix.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 130. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
      Slice NameitemPrefixRenderingStyle
      Control0..1
      TypeExtension(Rendering Style) (Extension Type: string)
      132. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
      Slice NameitemPrefixRenderingXhtml
      Control0..1
      TypeExtension(XHTML Representation) (Extension Type: string)
      134. Questionnaire.item.text
      136. Questionnaire.item.text.extension
      SlicingThis element introduces a set of slices on Questionnaire.item.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 138. Questionnaire.item.text.extension:itemTextRenderingStyle
        Slice NameitemTextRenderingStyle
        Control0..1
        TypeExtension(Rendering Style) (Extension Type: string)
        140. Questionnaire.item.text.extension:itemTextRenderingXhtml
        Slice NameitemTextRenderingXhtml
        Control0..1
        TypeExtension(XHTML Representation) (Extension Type: string)
        Must Supporttrue
        142. Questionnaire.item.text.extension:itemTextCqfExpression
        Slice NameitemTextCqfExpression
        Control0..1
        TypeExtension(CQF Expression) (Extension Type: Expression)
        144. Questionnaire.item.enableWhen
        Must Supporttrue
        146. Questionnaire.item.enableBehavior
        Must Supporttrue
        148. Questionnaire.item.required
        150. Questionnaire.item.required.value
        Must Supportfalse
        152. Questionnaire.item.required.value.extension
        SlicingThis element introduces a set of slices on Questionnaire.item.required.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 154. Questionnaire.item.required.value.extension:requiredExpression
          Slice NamerequiredExpression
          Control0..1
          TypeExtension(CQF Expression) (Extension Type: Expression)
          156. Questionnaire.item.repeats
          158. Questionnaire.item.repeats.value
          Must Supportfalse
          160. Questionnaire.item.repeats.value.extension
          SlicingThis element introduces a set of slices on Questionnaire.item.repeats.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 162. Questionnaire.item.repeats.value.extension:repeatsExpression
            Slice NamerepeatsExpression
            Control0..1
            TypeExtension(CQF Expression) (Extension Type: Expression)
            164. Questionnaire.item.readOnly
            166. Questionnaire.item.readOnly.value
            Must Supportfalse
            168. Questionnaire.item.readOnly.value.extension
            SlicingThis element introduces a set of slices on Questionnaire.item.readOnly.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 170. Questionnaire.item.readOnly.value.extension:readOnlyExpression
              Slice NamereadOnlyExpression
              Control0..1
              TypeExtension(CQF Expression) (Extension Type: Expression)
              172. Questionnaire.item.answerValueSet
              174. Questionnaire.item.answerValueSet.value
              Must Supportfalse
              176. Questionnaire.item.answerValueSet.value.extension
              SlicingThis element introduces a set of slices on Questionnaire.item.answerValueSet.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 178. Questionnaire.item.answerValueSet.value.extension:answerValueSetExpression
                Slice NameanswerValueSetExpression
                Control0..1
                TypeExtension(CQF Expression) (Extension Type: Expression)
                180. Questionnaire.item.answerOption
                182. Questionnaire.item.answerOption.extension
                SlicingThis element introduces a set of slices on Questionnaire.item.answerOption.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 184. Questionnaire.item.answerOption.extension:itemAnswerMedia
                  Slice NameitemAnswerMedia
                  Control0..1
                  TypeExtension(Item Answer Media) (Extension Type: Attachment)
                  186. Questionnaire.item.answerOption.extension:optionExclusive
                  Slice NameoptionExclusive
                  Control0..1
                  TypeExtension(Questionnaire Option Exclusive) (Extension Type: boolean)
                  Must Supporttrue
                  188. Questionnaire.item.answerOption.extension:ordinalValue
                  Slice NameordinalValue
                  Control0..1
                  TypeExtension(Ordinal Value) (Extension Type: decimal)
                  190. Questionnaire.item.answerOption.value[x]
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Must Supporttrue
                  192. Questionnaire.item.answerOption.value[x].extension:answerOptionRenderingXhtml
                  Slice NameanswerOptionRenderingXhtml
                  Control0..1
                  TypeExtension(XHTML Representation) (Extension Type: string)
                  Must Supporttrue

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

                  0. Questionnaire
                  Definition

                  Sets minimum expectations for questionnaire support for SDC-conformant systems, regardless of which SDC capabilities they're making use of.


                  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.

                  ShortA 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:designNote
                  Slice NamedesignNote
                  Definition

                  Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

                  ShortDesign comments
                  Comments

                  Allows capture of todos, rationale for design decisions, etc. It can also be used to capture comments about the completion of the form in general. Allows commentary to be captured during the process of answering a questionnaire (if not already supported by the form design) as well as after the form is completed. Comments are not part of the "data" of the form. If a form prompts for a comment, this should be captured in an answer, not in this element. Formal assessments of the QuestionnareResponse would use Observation.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Design Note) (Extension Type: markdown)
                  Is Modifierfalse
                  Must Supportfalse
                  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())
                  12. Questionnaire.extension:terminologyServer
                  Slice NameterminologyServer
                  Definition

                  Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the whole questionnaire or a particular group or question within the questionnaire (depending on where the extension appears). If a full URL is not provided AND the requested query is a terminology operation (e.g. $lookup or $expand) the client SHOULD execute the operation against the preferredTerminologyServer rather than the local repository.

                  ShortPreferred terminology server
                  Comments

                  Multiple repetitions are available to support availability (one server might be down) as well as to accommodate the possibility that different servers might be needed for different value sets. In either case, client behavior is to try different servers from the available list until one is successful. There is no implication to the order in which the servers are listed. If no service is listed and terminology services are needed, the $expand operation should be invoked on the base URL for the payer.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Preferred terminology server) (Extension Type: 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:performerType
                  Slice NameperformerType
                  Definition

                  Indicates the types of resources that can record answers to a Questionnaire. Open Issue: Should this extension be moved to core?

                  ShortResource that can record answers to this Questionnaire
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Performer type) (Extension Type: code)
                  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())
                  16. Questionnaire.extension:assemble-expectation
                  Slice Nameassemble-expectation
                  Definition

                  If present, indicates that this questionnaire has expectations with respect to assembly. Specifically, indicates whether this form requires assembly (i.e. it can't be used directly without invoking the $assemble operation operation on it) and/or whether it is intended for use only as a 'child' in an assembly process. The assembly processs might mean filling in item metadata based on information looked up from item.definitions and/or retrieving sub-questionnaires pointed to by sub-questionnaire extensions.

                  ShortQuestionnaire is modular
                  Comments

                  SDC-conformant Questionnaires SHALL declare this extension if they require an assembly process prior to use. If not declared, then the Questionnaire is not necessarily safe for use as a child form and does not require assembly prior to use.

                  Control0..0
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Assembly Expectations for Questionnaire) (Extension Type: code)
                  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())
                  18. 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())
                  20. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 22. 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
                    24. 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] NoteSeeChoice of Data Typesfor 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()))
                    26. Questionnaire.extension:entryMode
                    Slice NameentryMode
                    Definition

                    Indicates how questions within the questionnaire should be presented to the end-user. Specifically, differentiates whether the questions should be displayed one-at-a-time with no ability to adjust prior entries; one-at-a-time or continuously expanding where all questions up to the current question can be looked at and edited, or random, where all questions can be seen and the questions can be filled out in any order desired.

                    Shortsequential | prior-edit | random
                    Comments

                    The prior-edit functionality can be accomplished by adding questions to the screen as each subsequent question is answered (resulting in all questions being displayed in a single screen) or with a view that shows only one question at a time but allows backward navigation to view and/or edit prior answers.

                    Control0..*
                    TypeExtension(Entry mode) (Extension Type: code)
                    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())
                    28. Questionnaire.extension:endpoint
                    Slice Nameendpoint
                    Definition

                    The base URL for the server to which questionnaire response associated with this questionnaire should be submitted. If multiple repetitions are present, the completed form should be sent to all listed endpoints.

                    ShortWhere to send answers
                    Comments

                    Indicates that the form has been designed with an expectation that it will be submitted to the specified URI. If multiple endpoints are specified, expectation is that answers are submitted to all endpoints.

                    If no end-point is specified, then the form is not exclusively designed to be submitted to a specific site. If and where the form needs to be submitted or how the form should be internally processed must be inferred from external context or system business rules.

                    Endpoints may have expectations around authorization, etc. Some of this may be learned by consulting the CapabilityStatement associated with the endpoint.

                    Control0..0
                    TypeExtension(Endpoint) (Extension Type: uri)
                    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())
                    30. Questionnaire.extension:signatureRequired
                    Slice NamesignatureRequired
                    Definition

                    Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.

                    ShortThere's a cost to support this.
                    Comments

                    If this appears at the Questionnaire level, then the signature will be gathered for the entire form when it is marked complete. If it appears on a particular item, then it will be gathered on that question or group when it is filled in. (E.g. seeking the user's initials beside certain questions.)

                    The signature can be captured using the http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature extension. See additional guidance and examples in the SDC implementation guide.

                    Control0..1
                    TypeExtension(Questionnaire Signature Required) (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())
                    32. Questionnaire.extension:constraint
                    Slice Nameconstraint
                    Definition

                    An invariant that must be satisfied before responses to the questionnaire can be considered "complete".

                    ShortConstraint
                    Comments

                    This maps to the ElementDefinition.constraint element. See additional guidance and examples in the SDC implementation guide.

                    Control0..*
                    TypeExtension(Questionnaire Constraint) (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())
                    34. 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())
                    36. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 38. 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
                      40. 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] NoteSeeChoice of Data Typesfor 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()))
                      42. Questionnaire.extension:launchContext
                      Slice NamelaunchContext
                      Definition

                      Resources that provide context for form processing logic (pre-population, flow-control, drop-down selection, etc.) when creating/displaying/editing a QuestionnaireResponse.

                      ShortContext resources needed for Questionnaire
                      Comments

                      3 of these launch contexts are aligned with the existing SMART on FHIR "launch" contexts.

                      Control0..*
                      TypeExtension(Launch context resources) (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())
                      44. Questionnaire.extension:variable
                      Slice Namevariable
                      Definition

                      Variable specifying a logic to generate a variable for use in subsequent logic. The name of the variable will be added to FHIRPath's context when processing descendants of the element that contains this extension as well as extensions within the same element.

                      ShortVariable for processing
                      Comments

                      Ordering of variable extension declarations is significant as variables declared in one repetition of this extension might be used in subsequent extension repetitions

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

                      Control0..*
                      TypeExtension(Variable) (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())
                      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.

                      Control10..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      … 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()))
                      52. 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 version Id, 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()))
                      54. 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.

                      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.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 areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 58. 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())
                        60. 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())
                        62. 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()))
                        64. 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.

                        Control10..1*
                        BindingThe codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types|4.0.1
                        (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
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        A Questionnaire SHOULD specify the subject. However, it is optional to support legacy questionnaires.

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

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

                        ShortWhen 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()))
                        68. 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)
                        sdc-1: An item cannot have an answerExpression if answerOption or answerValueSet is already present. (extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').empty().not() implies (answerOption.empty() and answerValueSet.empty()))
                        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)
                        70. Questionnaire.item.extension:designNote
                        Slice NamedesignNote
                        Definition

                        Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

                        ShortDesign comments
                        Comments

                        Allows capture of todos, rationale for design decisions, etc. It can also be used to capture comments about specific groups or questions within it. Allows commentary to be captured during the process of answering a questionnaire (if not already supported by the form design) as well as after the form is completed. Comments are not part of the "data" of the form. If a form prompts for a comment, this should be captured in an answer, not in this element. Formal assessments of the QuestionnareResponse would use Observation.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Design Note) (Extension Type: markdown)
                        Is Modifierfalse
                        Must Supportfalse
                        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())
                        72. Questionnaire.item.extension:terminologyServer
                        Slice NameterminologyServer
                        Definition

                        Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the whole questionnaire or a particular group or question within the questionnaire (depending on where the extension appears). If a full URL is not provided AND the requested query is a terminology operation (e.g. $lookup or $expand) the client SHOULD execute the operation against the preferredTerminologyServer rather than the local repository.

                        ShortPreferred terminology server
                        Comments

                        This includes those referenced by answerValueSet as well as the unitValueSet extension.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Preferred terminology server) (Extension Type: url)
                        Is Modifierfalse
                        Must Supportfalse
                        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())
                        74. 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())
                        76. 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..1
                        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())
                        78. 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())
                        80. Questionnaire.item.extension:itemHidden
                        Slice NameitemHidden
                        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. See additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(Questionnaire Hidden) (Extension Type: boolean)
                        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())
                        82. 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())
                        84. 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())
                        86. 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())
                        88. 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())
                        90. 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())
                        92. 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())
                        94. 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())
                        96. 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())
                        98. 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())
                        100. 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())
                        102. Questionnaire.item.extension:usageMode
                        Slice NameusageMode
                        Definition

                        Identifies that the specified element should only appear in certain "modes" of operation.

                        Shortcapture | display | display-non-empty | capture-display | capture-display-non-empty
                        Comments

                        See additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(QuestionnaireResponse Usage Mode) (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())
                        104. Questionnaire.item.extension:itemSignatureRequired
                        Slice NameitemSignatureRequired
                        Definition

                        Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.

                        ShortIs signature needed?
                        Comments

                        If this appears at the Questionnaire level, then the signature will be gathered for the entire form when it is marked complete. If it appears on a particular item, then it will be gathered on that question or group when it is filled in. (E.g. seeking the user's initials beside certain questions.)

                        The signature can be captured using the http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature extension. See additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(Questionnaire Signature Required) (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())
                        106. Questionnaire.item.extension:minOccurs
                        Slice NameminOccurs
                        Definition

                        The minimum number of times the group must appear, or the minimum number of answers for a question - when greater than 1.

                        ShortMinimum repetitions
                        Comments

                        Default assumption for "required" elements is minOccurs=1. See additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(Questionnaire Min Occurs) (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())
                        108. Questionnaire.item.extension:maxOccurs
                        Slice NamemaxOccurs
                        Definition

                        The maximum number of times the group must appear, or the maximum number of answers for a question - when greater than 1 and not unlimited.

                        ShortMaximum repetitions
                        Comments

                        Only relevant if the element has repeats=true and there's a need to constrain the number of allowed repetitions. See additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(Questionnaire Max Occurs) (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())
                        110. Questionnaire.item.extension:minLength
                        Slice NameminLength
                        Definition

                        The minimum number of characters that must be present in the simple data type to be considered a "valid" instance.

                        ShortAt least this many characters
                        Comments

                        For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(Min length) (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())
                        112. Questionnaire.item.extension:regex
                        Slice Nameregex
                        Definition

                        A regular expression that defines the syntax for the data element to be considered valid.

                        ShortRegular expression pattern
                        Control0..1
                        TypeExtension(regex) (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())
                        114. Questionnaire.item.extension:minValue
                        Slice NameminValue
                        Definition

                        The inclusive lower bound on the range of allowed values for the data element.

                        ShortMust be >= this value
                        Comments

                        Data type specified must be the same as the data type for the data element. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(Min value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, 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())
                        116. Questionnaire.item.extension:maxValue
                        Slice NamemaxValue
                        Definition

                        The inclusive upper bound on the range of allowed values for the data element.

                        ShortMust be <= this value
                        Comments

                        Data type specified must be the same as the data type for the data element. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(Max value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, 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())
                        118. Questionnaire.item.extension:minQuantity
                        Slice NameminQuantity
                        Definition

                        The inclusive lower bound on the range of allowed values for a 'quantity' type question. Open Issue: Revisit whether this should be folded into the regular minValue extension once there are better capabilities around defining conformance expectations regarding extensions.

                        ShortMust be >= this value
                        Comments

                        This must only be used if the set of permitted units is constrained to UCUM codes and the minimum checks will be performed by converting the answer.valueQuantity to the same units as the minQuantity unit prior to comparison.

                        Control0..1
                        TypeExtension(Min quantity) (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())
                        120. Questionnaire.item.extension:maxQuantity
                        Slice NamemaxQuantity
                        Definition

                        The inclusive upper bound on the range of allowed values for a 'quantity' type question. Open Issue: Revisit whether this should be folded into the regular maxValue extension once there are better capabilities around defining conformance expectations regarding extensions.

                        ShortMust be <= this value
                        Comments

                        This must only be used if the set of permitted units is constrained to UCUM codes and the maximum checks will be performed by converting the answer.valueQuantity to the same units as the maxQuantity unit prior to comparison.

                        Control0..1
                        TypeExtension(Max quantity) (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())
                        122. Questionnaire.item.extension:maxDecimalPlaces
                        Slice NamemaxDecimalPlaces
                        Definition

                        Identifies the maximum number of decimal places that may be specified for the data element.

                        ShortMaximum digits after decimal
                        Comments

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

                        Control0..1
                        TypeExtension(Max decimal places) (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())
                        124. Questionnaire.item.extension:mimeType
                        Slice NamemimeType
                        Definition

                        Identifies the kind(s) of attachment allowed to be sent for an element.

                        ShortType of attachment
                        Comments

                        This extension only has meaning if the element has a type of Attachment. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(Mime type) (Extension Type: code)
                        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:maxSize
                        Slice NamemaxSize
                        Definition

                        For attachment answers, indicates the maximum size in bytes an attachment can be.

                        ShortMax size in bytes
                        Comments

                        This extension only has meaning if the element has a type of Attachment. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                        Control0..1
                        TypeExtension(Max size) (Extension Type: decimal)
                        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())
                        128. Questionnaire.item.extension:answerOptionsToggleExpression
                        Slice NameanswerOptionsToggleExpression
                        Definition

                        A complex expression that provides a list of the allowed options that should be enabled or disabled based on the evaluation of a provided expression. It allows toggling of allowed answers based on context, including the answers provided to other expressions.

                        ShortExpression constraining allowed answers
                        Comments

                        For example, this allows a list of conditions to be modified based on the gender of the patient

                        Control0..1
                        TypeExtension(Answer Options Toggle Expression) (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())
                        130. Questionnaire.item.extension:unitOption
                        Slice NameunitOption
                        Definition

                        A unit that the user may choose when providing a quantity value.

                        ShortUnit choice
                        Comments

                        Provide either unitOption(s) or unitValueSet. If either of the extensions are present, the units for a Quantity element are constrained to only the units listed by the extensions - i.e. it is treated as a "required", not an "extensible" binding. In the absence of either, any unit is valid. See additional guidance and examples in the SDC implementation guide. If this extension present and an answer is provided for the question item in the QuestionnaireResponse, then the valueQuantity SHALL have a Quantity.code and Quantity.system that match the Coding.code and system of one of the allowed values if the Coding has a code and/or system. If the Coding only has a display, then the Quantity.unit must match. (Note that Coding with only a display is strongly discouraged.) If there is a match on code and system, but no match on display/unit, systems MAY raise a warning. However, because of translation and bandwidth considerations, some systems MAY opt to drop the unit or express it in an alternate language.

                        Control0..*
                        TypeExtension(QuestionnaireResponse Unit Option) (Extension Type: Coding)
                        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())
                        132. Questionnaire.item.extension:unitValueSet
                        Slice NameunitValueSet
                        Definition

                        A set of units that the user may choose when providing a quantity value.

                        ShortUnit choices
                        Comments

                        Provide either unitOption(s) or unitValueSet. If either of the extensions are present, the units for a Quantity element are constrained to only the units listed by the extensions - i.e. it is treated as a "required", not an "extensible" binding. In the absence of either, any unit is valid. See additional guidance and examples in the SDC implementation guide. If this extension present and an answer is provided for the question item in the QuestionnaireResponse, then the valueQuantity SHALL have a Quantity.code and Quantity.system that match the Coding.code and system of one of the allowed values if the Coding has a code and/or system. If the Coding only has a display, then the Quantity.unit must match. (Note that Coding with only a display is strongly discouraged.) If there is a match on code and system, but no match on display/unit, systems MAY raise a warning. However, because of translation and bandwidth considerations, some systems MAY opt to drop the unit or express it in an alternate language. Validation of the Quantity unit MAY be performed by using the $validateCode operation, populating the elements passed into the operation from the Quantity.code, system and unit elements.

                        Control0..1
                        TypeExtension(QuestionnaireResponse Unit ValueSet) (Extension Type: canonical(ValueSet))
                        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())
                        134. Questionnaire.item.extension:referenceResource
                        Slice NamereferenceResource
                        Definition

                        Where the type for a question is "Reference", indicates a type of resource that is permitted.

                        ShortAllowed resource for reference
                        Comments

                        This extension only has meaning if the question.type = Reference. If no allowedResource extensions are present, the presumption is that any type of resource is permitted. If multiple are present, then any of the specified types are permitted. See additional guidance and examples in the SDC implementation guide.

                        Control0..*
                        TypeExtension(Questionnaire Reference Resource) (Extension Type: code)
                        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())
                        136. Questionnaire.item.extension:referenceProfile
                        Slice NamereferenceProfile
                        Definition

                        Where the type for a question is "Reference", indicates a profile that the resource instances pointed to in answers to this question must be valid against.

                        ShortAllowed profile for reference
                        Comments

                        If multiple profiles are present, then the resource must be valid against at least one of them. See additional guidance and examples in the SDC implementation guide.

                        Control0..*
                        TypeExtension(Questionnaire Reference Profile) (Extension Type: canonical(StructureDefinition))
                        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: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())
                        140. Questionnaire.item.extension:lookupQuestionnaire
                        Slice NamelookupQuestionnaire
                        Definition

                        For items of type reference, the reference can be populated either by picking an existing entity or by creating a new one. In the latter case, this Questionnaire allows specifying the Questionnaire to use in creating the target instance. Typically this will result in a QuestionnaireResponse that can be extracted to produce the desired resource. However, if the target resource for the reference is a QuestionnaireResponse, then the QuestionnaireResponse resulting from the Questionnaire can be referenced directly.

                        ShortQuestionnaire to populate a reference
                        Control0..1
                        TypeExtension(Lookup questionnaire) (Extension Type: canonical)
                        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:itemConstraint
                        Slice NameitemConstraint
                        Definition

                        An invariant that must be satisfied before responses to the questionnaire can be considered "complete".

                        ShortConstraint
                        Comments

                        This maps to the ElementDefinition.constraint element. See additional guidance and examples in the SDC implementation guide.

                        Control0..*
                        TypeExtension(Questionnaire Constraint) (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())
                        144. 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())
                        146. Questionnaire.item.extension:calculatedExpression
                        Slice NamecalculatedExpression
                        Definition

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

                        ShortExpression-determined initial value
                        Comments

                        Calculated value is updated as other answers in the QuestionnaireResponse are filled in.

                        Control0..1
                        TypeExtension(Calculated 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())
                        148. Questionnaire.item.extension:enableWhenExpression
                        Slice NameenableWhenExpression
                        Definition

                        An expression that returns a boolean value for whether to enable the item.

                        ShortExpression for when to enable the item
                        Comments

                        This is only permitted when the containing item does NOT have any enableWhen elements.

                        Control0..1
                        TypeExtension(Enable when 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())
                        150. 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())
                        152. 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())
                        154. 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())
                        156. 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()))
                        158. 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()))
                        160. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 162. 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())
                          164. 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())
                          166. 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.

                          Control0..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()))
                          168. 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 areUnordered 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())
                            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())
                            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())
                            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())
                            174. Questionnaire.item.text.extension:itemTextCqfExpression
                            Slice NameitemTextCqfExpression
                            Definition

                            An expression that, when evaluated, provides the value for the element on which it appears.

                            ShortAn dynamic expression
                            Comments

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

                            Control0..1
                            TypeExtension(CQF Expression) (Extension Type: Expression)
                            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())
                            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

                            Time is handled using "string". File is handled using Attachment. (Content can be sent as a contained binary).


                            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()))
                            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..*
                            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
                            Must Supporttrue
                            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))
                            180. Questionnaire.item.enableWhen.modifierExtension
                            Definition

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

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

                            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())
                            182. Questionnaire.item.enableWhen.question
                            Definition

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

                            ShortQuestion that determines whether item is enabled
                            Comments

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

                            Control1..1
                            Typestring
                            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()))
                            184. Questionnaire.item.enableWhen.operator
                            Definition

                            Specifies the criteria by which the question is enabled.

                            Shortexists | = | != | > | < | >= | <=
                            Control1..1
                            BindingThe codes SHALL be taken from QuestionnaireItemOperatorhttp://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1
                            (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1)

                            The criteria by which a question is enabled.

                            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()))
                            186. Questionnaire.item.enableWhen.answer[x]
                            Definition

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

                            ShortValue for question comparison based on operator
                            Control1..1
                            This element is affected by the following invariants: que-7
                            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, Coding, Quantity, Reference(Resource)
                            [x] NoteSeeChoice of Data Typesfor 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()))
                            188. 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..1
                            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
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            190. 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()))
                            192. Questionnaire.item.required.value
                            Definition

                            The actual value

                            ShortPrimitive value for boolean
                            Control0..1
                            Typeboolean
                            Is Modifierfalse
                            Must Supportfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            194. Questionnaire.item.required.value.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.required.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 196. Questionnaire.item.required.value.extension:requiredExpression
                              Slice NamerequiredExpression
                              Definition

                              An expression that, when evaluated, provides the value for the element on which it appears.

                              ShortAn dynamic expression
                              Comments

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

                              Control0..1
                              TypeExtension(CQF Expression) (Extension Type: Expression)
                              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())
                              198. Questionnaire.item.repeats
                              Definition

                              An indication, if true, that a QuestionnaireResponse for this item may include multiple answers associated with a single instance of this item (for question-type items) or multiple repetitions of the item (for group-type items)


                              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()))
                              200. Questionnaire.item.repeats.value
                              Definition

                              The actual value

                              ShortPrimitive value for boolean
                              Control0..1
                              Typeboolean
                              Is Modifierfalse
                              Must Supportfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              202. Questionnaire.item.repeats.value.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.repeats.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 204. Questionnaire.item.repeats.value.extension:repeatsExpression
                                Slice NamerepeatsExpression
                                Definition

                                An expression that, when evaluated, provides the value for the element on which it appears.

                                ShortAn dynamic expression
                                Comments

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

                                Control0..1
                                TypeExtension(CQF Expression) (Extension Type: Expression)
                                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())
                                206. 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()))
                                208. Questionnaire.item.readOnly.value
                                Definition

                                The actual value

                                ShortPrimitive value for boolean
                                Control0..1
                                Typeboolean
                                Is Modifierfalse
                                Must Supportfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                210. Questionnaire.item.readOnly.value.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.readOnly.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 212. Questionnaire.item.readOnly.value.extension:readOnlyExpression
                                  Slice NamereadOnlyExpression
                                  Definition

                                  An expression that, when evaluated, provides the value for the element on which it appears.

                                  ShortAn dynamic expression
                                  Comments

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

                                  Control0..1
                                  TypeExtension(CQF Expression) (Extension Type: Expression)
                                  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())
                                  214. 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
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  216. 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(SDC ValueSet, ValueSet)
                                  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()))
                                  218. Questionnaire.item.answerValueSet.value
                                  Definition

                                  Primitive value for canonical


                                  The actual value

                                  ShortPrimitive value for canonicalPrimitive value for uri
                                  Control0..1
                                  Typestringuri
                                  Is Modifierfalse
                                  Must Supportfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  220. Questionnaire.item.answerValueSet.value.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.answerValueSet.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 222. Questionnaire.item.answerValueSet.value.extension:answerValueSetExpression
                                    Slice NameanswerValueSetExpression
                                    Definition

                                    An expression that, when evaluated, provides the value for the element on which it appears.

                                    ShortAn dynamic expression
                                    Comments

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

                                    Control0..1
                                    TypeExtension(CQF Expression) (Extension Type: Expression)
                                    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())
                                    224. 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()))
                                    226. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 228. 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())
                                      230. Questionnaire.item.answerOption.extension:optionExclusive
                                      Slice NameoptionExclusive
                                      Definition

                                      If true, indicates that if this answerOption is selected, no other possible answers may be selected, even if the item is a repeating question.

                                      ShortOption is exclusive
                                      Comments

                                      See additional guidance and examples in the SDC implementation guide.

                                      Control0..1
                                      TypeExtension(Questionnaire Option Exclusive) (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())
                                      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())
                                      232. Questionnaire.item.answerOption.extension:ordinalValue
                                      Slice NameordinalValue
                                      Definition

                                      A numeric value that allows the comparison (less than, greater than) or other numerical manipulation of a concept (e.g. Adding up components of a score). Scores are usually a whole number, but occasionally decimals are encountered in scores.

                                      ShortAssigned Ordinal Value
                                      Comments

                                      Scores are commonly encountered in various clinical assessment scales. Assigning a value to a concept should generally be done in a formal code system that defines the value, or in an applicable value set for the concept, but some concepts do not have a formal definition (or are not even represented as a concept formally, especially in Questionnaires, so this extension is allowed to appear ouside those preferred contexts. Scores may even be assigned arbitrarily during use (hence, on Coding). The value may be constrained to an integer in some contexts of use. Todo: Scoring algorithms may also be defined directly, but how this is done is not yet defined.

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Ordinal Value) (Extension Type: decimal)
                                      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())
                                      234. 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())
                                      236. 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] NoteSeeChoice of Data Typesfor 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()))
                                      238. Questionnaire.item.answerOption.value[x].extension:answerOptionRenderingXhtml
                                      Slice NameanswerOptionRenderingXhtml
                                      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
                                      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())
                                      240. 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()))
                                      242. 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())
                                      244. 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] NoteSeeChoice of Data Typesfor 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()))
                                      246. 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
                                      TypeSeettp://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

                                      Sets minimum expectations for questionnaire support for SDC-conformant systems, regardless of which SDC capabilities they're making use of.

                                      ShortA 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())
                                      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 areUnordered 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
                                        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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 24. Questionnaire.extension:designNote
                                          Slice NamedesignNote
                                          Definition

                                          Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

                                          ShortDesign comments
                                          Comments

                                          Allows capture of todos, rationale for design decisions, etc. It can also be used to capture comments about the completion of the form in general. Allows commentary to be captured during the process of answering a questionnaire (if not already supported by the form design) as well as after the form is completed. Comments are not part of the "data" of the form. If a form prompts for a comment, this should be captured in an answer, not in this element. Formal assessments of the QuestionnareResponse would use Observation.

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(Design Note) (Extension Type: markdown)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          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:terminologyServer
                                          Slice NameterminologyServer
                                          Definition

                                          Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the whole questionnaire or a particular group or question within the questionnaire (depending on where the extension appears). If a full URL is not provided AND the requested query is a terminology operation (e.g. $lookup or $expand) the client SHOULD execute the operation against the preferredTerminologyServer rather than the local repository.

                                          ShortPreferred terminology server
                                          Comments

                                          Multiple repetitions are available to support availability (one server might be down) as well as to accommodate the possibility that different servers might be needed for different value sets. In either case, client behavior is to try different servers from the available list until one is successful. There is no implication to the order in which the servers are listed. If no service is listed and terminology services are needed, the $expand operation should be invoked on the base URL for the payer.

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(Preferred terminology server) (Extension Type: 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())
                                          28. Questionnaire.extension:performerType
                                          Slice NameperformerType
                                          Definition

                                          Indicates the types of resources that can record answers to a Questionnaire. Open Issue: Should this extension be moved to core?

                                          ShortResource that can record answers to this Questionnaire
                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(Performer type) (Extension Type: code)
                                          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())
                                          30. Questionnaire.extension:assemble-expectation
                                          Slice Nameassemble-expectation
                                          Definition

                                          If present, indicates that this questionnaire has expectations with respect to assembly. Specifically, indicates whether this form requires assembly (i.e. it can't be used directly without invoking the $assemble operation operation on it) and/or whether it is intended for use only as a 'child' in an assembly process. The assembly processs might mean filling in item metadata based on information looked up from item.definitions and/or retrieving sub-questionnaires pointed to by sub-questionnaire extensions.

                                          ShortQuestionnaire is modular
                                          Comments

                                          SDC-conformant Questionnaires SHALL declare this extension if they require an assembly process prior to use. If not declared, then the Questionnaire is not necessarily safe for use as a child form and does not require assembly prior to use.

                                          Control0..0
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(Assembly Expectations for Questionnaire) (Extension Type: code)
                                          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())
                                          32. 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())
                                          34. 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
                                          36. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 38. 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
                                            40. 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] NoteSeeChoice of Data Typesfor 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()))
                                            42. Questionnaire.extension:entryMode
                                            Slice NameentryMode
                                            Definition

                                            Indicates how questions within the questionnaire should be presented to the end-user. Specifically, differentiates whether the questions should be displayed one-at-a-time with no ability to adjust prior entries; one-at-a-time or continuously expanding where all questions up to the current question can be looked at and edited, or random, where all questions can be seen and the questions can be filled out in any order desired.

                                            Shortsequential | prior-edit | random
                                            Comments

                                            The prior-edit functionality can be accomplished by adding questions to the screen as each subsequent question is answered (resulting in all questions being displayed in a single screen) or with a view that shows only one question at a time but allows backward navigation to view and/or edit prior answers.

                                            Control0..*
                                            TypeExtension(Entry mode) (Extension Type: code)
                                            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())
                                            44. Questionnaire.extension:endpoint
                                            Slice Nameendpoint
                                            Definition

                                            The base URL for the server to which questionnaire response associated with this questionnaire should be submitted. If multiple repetitions are present, the completed form should be sent to all listed endpoints.

                                            ShortWhere to send answers
                                            Comments

                                            Indicates that the form has been designed with an expectation that it will be submitted to the specified URI. If multiple endpoints are specified, expectation is that answers are submitted to all endpoints.

                                            If no end-point is specified, then the form is not exclusively designed to be submitted to a specific site. If and where the form needs to be submitted or how the form should be internally processed must be inferred from external context or system business rules.

                                            Endpoints may have expectations around authorization, etc. Some of this may be learned by consulting the CapabilityStatement associated with the endpoint.

                                            Control0..0
                                            TypeExtension(Endpoint) (Extension Type: uri)
                                            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())
                                            46. Questionnaire.extension:signatureRequired
                                            Slice NamesignatureRequired
                                            Definition

                                            Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.

                                            ShortThere's a cost to support this.
                                            Comments

                                            If this appears at the Questionnaire level, then the signature will be gathered for the entire form when it is marked complete. If it appears on a particular item, then it will be gathered on that question or group when it is filled in. (E.g. seeking the user's initials beside certain questions.)

                                            The signature can be captured using the http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature extension. See additional guidance and examples in the SDC implementation guide.

                                            Control0..1
                                            TypeExtension(Questionnaire Signature Required) (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())
                                            48. Questionnaire.extension:constraint
                                            Slice Nameconstraint
                                            Definition

                                            An invariant that must be satisfied before responses to the questionnaire can be considered "complete".

                                            ShortConstraint
                                            Comments

                                            This maps to the ElementDefinition.constraint element. See additional guidance and examples in the SDC implementation guide.

                                            Control0..*
                                            TypeExtension(Questionnaire Constraint) (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())
                                            50. 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())
                                            52. 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
                                            54. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 56. 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
                                              58. 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] NoteSeeChoice of Data Typesfor 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()))
                                              60. Questionnaire.extension:launchContext
                                              Slice NamelaunchContext
                                              Definition

                                              Resources that provide context for form processing logic (pre-population, flow-control, drop-down selection, etc.) when creating/displaying/editing a QuestionnaireResponse.

                                              ShortContext resources needed for Questionnaire
                                              Comments

                                              3 of these launch contexts are aligned with the existing SMART on FHIR "launch" contexts.

                                              Control0..*
                                              TypeExtension(Launch context resources) (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())
                                              62. Questionnaire.extension:variable
                                              Slice Namevariable
                                              Definition

                                              Variable specifying a logic to generate a variable for use in subsequent logic. The name of the variable will be added to FHIRPath's context when processing descendants of the element that contains this extension as well as extensions within the same element.

                                              ShortVariable for processing
                                              Comments

                                              Ordering of variable extension declarations is significant as variables declared in one repetition of this extension might be used in subsequent extension repetitions

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

                                              Control0..*
                                              TypeExtension(Variable) (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())
                                              64. 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())
                                              66. 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())
                                              68. 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.

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

                                              … 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()))
                                              70. 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()))
                                              72. 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 version Id, 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()))
                                              74. 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()))
                                              76. 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.

                                              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()))
                                              78. 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
                                              80. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 82. 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())
                                                84. 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())
                                                86. 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 Length:1048576
                                                88. Questionnaire.derivedFrom
                                                Definition

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

                                                ShortInstantiates protocol or definition
                                                Control0..*
                                                Typecanonical(Questionnaire)
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                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()))
                                                90. 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()))
                                                92. 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()))
                                                94. 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.

                                                Control1..1
                                                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
                                                Must Supporttrue
                                                Summarytrue
                                                Requirements

                                                A Questionnaire SHOULD specify the subject. However, it is optional to support legacy questionnaires.

                                                Pattern ValuePatient
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                96. 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()))
                                                98. 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()))
                                                100. 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()))
                                                102. 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()))
                                                104. 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()))
                                                106. 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()))
                                                108. 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()))
                                                110. 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()))
                                                112. 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()))
                                                114. 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()))
                                                116. Questionnaire.effectivePeriod
                                                Definition

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

                                                ShortWhen 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()))
                                                118. 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()))
                                                120. 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)
                                                sdc-1: An item cannot have an answerExpression if answerOption or answerValueSet is already present. (extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').empty().not() implies (answerOption.empty() and answerValueSet.empty()))
                                                122. 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
                                                124. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 126. Questionnaire.item.extension:designNote
                                                  Slice NamedesignNote
                                                  Definition

                                                  Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

                                                  ShortDesign comments
                                                  Comments

                                                  Allows capture of todos, rationale for design decisions, etc. It can also be used to capture comments about specific groups or questions within it. Allows commentary to be captured during the process of answering a questionnaire (if not already supported by the form design) as well as after the form is completed. Comments are not part of the "data" of the form. If a form prompts for a comment, this should be captured in an answer, not in this element. Formal assessments of the QuestionnareResponse would use Observation.

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension(Design Note) (Extension Type: markdown)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  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:terminologyServer
                                                  Slice NameterminologyServer
                                                  Definition

                                                  Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the whole questionnaire or a particular group or question within the questionnaire (depending on where the extension appears). If a full URL is not provided AND the requested query is a terminology operation (e.g. $lookup or $expand) the client SHOULD execute the operation against the preferredTerminologyServer rather than the local repository.

                                                  ShortPreferred terminology server
                                                  Comments

                                                  This includes those referenced by answerValueSet as well as the unitValueSet extension.

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension(Preferred terminology server) (Extension Type: url)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  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: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())
                                                  132. 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..1
                                                  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())
                                                  134. 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())
                                                  136. Questionnaire.item.extension:itemHidden
                                                  Slice NameitemHidden
                                                  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. See additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(Questionnaire Hidden) (Extension Type: boolean)
                                                  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: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())
                                                  140. 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())
                                                  142. 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())
                                                  144. 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())
                                                  146. 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())
                                                  148. 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())
                                                  150. 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())
                                                  152. 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())
                                                  154. 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())
                                                  156. 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())
                                                  158. Questionnaire.item.extension:usageMode
                                                  Slice NameusageMode
                                                  Definition

                                                  Identifies that the specified element should only appear in certain "modes" of operation.

                                                  Shortcapture | display | display-non-empty | capture-display | capture-display-non-empty
                                                  Comments

                                                  See additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(QuestionnaireResponse Usage Mode) (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())
                                                  160. Questionnaire.item.extension:itemSignatureRequired
                                                  Slice NameitemSignatureRequired
                                                  Definition

                                                  Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.

                                                  ShortIs signature needed?
                                                  Comments

                                                  If this appears at the Questionnaire level, then the signature will be gathered for the entire form when it is marked complete. If it appears on a particular item, then it will be gathered on that question or group when it is filled in. (E.g. seeking the user's initials beside certain questions.)

                                                  The signature can be captured using the http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature extension. See additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(Questionnaire Signature Required) (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())
                                                  162. Questionnaire.item.extension:minOccurs
                                                  Slice NameminOccurs
                                                  Definition

                                                  The minimum number of times the group must appear, or the minimum number of answers for a question - when greater than 1.

                                                  ShortMinimum repetitions
                                                  Comments

                                                  Default assumption for "required" elements is minOccurs=1. See additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(Questionnaire Min Occurs) (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())
                                                  164. Questionnaire.item.extension:maxOccurs
                                                  Slice NamemaxOccurs
                                                  Definition

                                                  The maximum number of times the group must appear, or the maximum number of answers for a question - when greater than 1 and not unlimited.

                                                  ShortMaximum repetitions
                                                  Comments

                                                  Only relevant if the element has repeats=true and there's a need to constrain the number of allowed repetitions. See additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(Questionnaire Max Occurs) (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())
                                                  166. Questionnaire.item.extension:minLength
                                                  Slice NameminLength
                                                  Definition

                                                  The minimum number of characters that must be present in the simple data type to be considered a "valid" instance.

                                                  ShortAt least this many characters
                                                  Comments

                                                  For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(Min length) (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())
                                                  168. Questionnaire.item.extension:regex
                                                  Slice Nameregex
                                                  Definition

                                                  A regular expression that defines the syntax for the data element to be considered valid.

                                                  ShortRegular expression pattern
                                                  Control0..1
                                                  TypeExtension(regex) (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())
                                                  170. Questionnaire.item.extension:minValue
                                                  Slice NameminValue
                                                  Definition

                                                  The inclusive lower bound on the range of allowed values for the data element.

                                                  ShortMust be >= this value
                                                  Comments

                                                  Data type specified must be the same as the data type for the data element. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(Min value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, 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())
                                                  172. Questionnaire.item.extension:maxValue
                                                  Slice NamemaxValue
                                                  Definition

                                                  The inclusive upper bound on the range of allowed values for the data element.

                                                  ShortMust be <= this value
                                                  Comments

                                                  Data type specified must be the same as the data type for the data element. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(Max value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, 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())
                                                  174. Questionnaire.item.extension:minQuantity
                                                  Slice NameminQuantity
                                                  Definition

                                                  The inclusive lower bound on the range of allowed values for a 'quantity' type question. Open Issue: Revisit whether this should be folded into the regular minValue extension once there are better capabilities around defining conformance expectations regarding extensions.

                                                  ShortMust be >= this value
                                                  Comments

                                                  This must only be used if the set of permitted units is constrained to UCUM codes and the minimum checks will be performed by converting the answer.valueQuantity to the same units as the minQuantity unit prior to comparison.

                                                  Control0..1
                                                  TypeExtension(Min quantity) (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())
                                                  176. Questionnaire.item.extension:maxQuantity
                                                  Slice NamemaxQuantity
                                                  Definition

                                                  The inclusive upper bound on the range of allowed values for a 'quantity' type question. Open Issue: Revisit whether this should be folded into the regular maxValue extension once there are better capabilities around defining conformance expectations regarding extensions.

                                                  ShortMust be <= this value
                                                  Comments

                                                  This must only be used if the set of permitted units is constrained to UCUM codes and the maximum checks will be performed by converting the answer.valueQuantity to the same units as the maxQuantity unit prior to comparison.

                                                  Control0..1
                                                  TypeExtension(Max quantity) (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())
                                                  178. Questionnaire.item.extension:maxDecimalPlaces
                                                  Slice NamemaxDecimalPlaces
                                                  Definition

                                                  Identifies the maximum number of decimal places that may be specified for the data element.

                                                  ShortMaximum digits after decimal
                                                  Comments

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

                                                  Control0..1
                                                  TypeExtension(Max decimal places) (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())
                                                  180. Questionnaire.item.extension:mimeType
                                                  Slice NamemimeType
                                                  Definition

                                                  Identifies the kind(s) of attachment allowed to be sent for an element.

                                                  ShortType of attachment
                                                  Comments

                                                  This extension only has meaning if the element has a type of Attachment. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(Mime type) (Extension Type: code)
                                                  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())
                                                  182. Questionnaire.item.extension:maxSize
                                                  Slice NamemaxSize
                                                  Definition

                                                  For attachment answers, indicates the maximum size in bytes an attachment can be.

                                                  ShortMax size in bytes
                                                  Comments

                                                  This extension only has meaning if the element has a type of Attachment. For questionnaires, see additional guidance and examples in the SDC implementation guide.

                                                  Control0..1
                                                  TypeExtension(Max size) (Extension Type: decimal)
                                                  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())
                                                  184. Questionnaire.item.extension:answerOptionsToggleExpression
                                                  Slice NameanswerOptionsToggleExpression
                                                  Definition

                                                  A complex expression that provides a list of the allowed options that should be enabled or disabled based on the evaluation of a provided expression. It allows toggling of allowed answers based on context, including the answers provided to other expressions.

                                                  ShortExpression constraining allowed answers
                                                  Comments

                                                  For example, this allows a list of conditions to be modified based on the gender of the patient

                                                  Control0..1
                                                  TypeExtension(Answer Options Toggle Expression) (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())
                                                  186. Questionnaire.item.extension:unitOption
                                                  Slice NameunitOption
                                                  Definition

                                                  A unit that the user may choose when providing a quantity value.

                                                  ShortUnit choice
                                                  Comments

                                                  Provide either unitOption(s) or unitValueSet. If either of the extensions are present, the units for a Quantity element are constrained to only the units listed by the extensions - i.e. it is treated as a "required", not an "extensible" binding. In the absence of either, any unit is valid. See additional guidance and examples in the SDC implementation guide. If this extension present and an answer is provided for the question item in the QuestionnaireResponse, then the valueQuantity SHALL have a Quantity.code and Quantity.system that match the Coding.code and system of one of the allowed values if the Coding has a code and/or system. If the Coding only has a display, then the Quantity.unit must match. (Note that Coding with only a display is strongly discouraged.) If there is a match on code and system, but no match on display/unit, systems MAY raise a warning. However, because of translation and bandwidth considerations, some systems MAY opt to drop the unit or express it in an alternate language.

                                                  Control0..*
                                                  TypeExtension(QuestionnaireResponse Unit Option) (Extension Type: Coding)
                                                  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())
                                                  188. Questionnaire.item.extension:unitValueSet
                                                  Slice NameunitValueSet
                                                  Definition

                                                  A set of units that the user may choose when providing a quantity value.

                                                  ShortUnit choices
                                                  Comments

                                                  Provide either unitOption(s) or unitValueSet. If either of the extensions are present, the units for a Quantity element are constrained to only the units listed by the extensions - i.e. it is treated as a "required", not an "extensible" binding. In the absence of either, any unit is valid. See additional guidance and examples in the SDC implementation guide. If this extension present and an answer is provided for the question item in the QuestionnaireResponse, then the valueQuantity SHALL have a Quantity.code and Quantity.system that match the Coding.code and system of one of the allowed values if the Coding has a code and/or system. If the Coding only has a display, then the Quantity.unit must match. (Note that Coding with only a display is strongly discouraged.) If there is a match on code and system, but no match on display/unit, systems MAY raise a warning. However, because of translation and bandwidth considerations, some systems MAY opt to drop the unit or express it in an alternate language. Validation of the Quantity unit MAY be performed by using the $validateCode operation, populating the elements passed into the operation from the Quantity.code, system and unit elements.

                                                  Control0..1
                                                  TypeExtension(QuestionnaireResponse Unit ValueSet) (Extension Type: canonical(ValueSet))
                                                  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())
                                                  190. Questionnaire.item.extension:referenceResource
                                                  Slice NamereferenceResource
                                                  Definition

                                                  Where the type for a question is "Reference", indicates a type of resource that is permitted.

                                                  ShortAllowed resource for reference
                                                  Comments

                                                  This extension only has meaning if the question.type = Reference. If no allowedResource extensions are present, the presumption is that any type of resource is permitted. If multiple are present, then any of the specified types are permitted. See additional guidance and examples in the SDC implementation guide.

                                                  Control0..*
                                                  TypeExtension(Questionnaire Reference Resource) (Extension Type: code)
                                                  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())
                                                  192. Questionnaire.item.extension:referenceProfile
                                                  Slice NamereferenceProfile
                                                  Definition

                                                  Where the type for a question is "Reference", indicates a profile that the resource instances pointed to in answers to this question must be valid against.

                                                  ShortAllowed profile for reference
                                                  Comments

                                                  If multiple profiles are present, then the resource must be valid against at least one of them. See additional guidance and examples in the SDC implementation guide.

                                                  Control0..*
                                                  TypeExtension(Questionnaire Reference Profile) (Extension Type: canonical(StructureDefinition))
                                                  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())
                                                  194. 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())
                                                  196. Questionnaire.item.extension:lookupQuestionnaire
                                                  Slice NamelookupQuestionnaire
                                                  Definition

                                                  For items of type reference, the reference can be populated either by picking an existing entity or by creating a new one. In the latter case, this Questionnaire allows specifying the Questionnaire to use in creating the target instance. Typically this will result in a QuestionnaireResponse that can be extracted to produce the desired resource. However, if the target resource for the reference is a QuestionnaireResponse, then the QuestionnaireResponse resulting from the Questionnaire can be referenced directly.

                                                  ShortQuestionnaire to populate a reference
                                                  Control0..1
                                                  TypeExtension(Lookup questionnaire) (Extension Type: canonical)
                                                  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())
                                                  198. Questionnaire.item.extension:itemConstraint
                                                  Slice NameitemConstraint
                                                  Definition

                                                  An invariant that must be satisfied before responses to the questionnaire can be considered "complete".

                                                  ShortConstraint
                                                  Comments

                                                  This maps to the ElementDefinition.constraint element. See additional guidance and examples in the SDC implementation guide.

                                                  Control0..*
                                                  TypeExtension(Questionnaire Constraint) (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())
                                                  200. 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())
                                                  202. Questionnaire.item.extension:calculatedExpression
                                                  Slice NamecalculatedExpression
                                                  Definition

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

                                                  ShortExpression-determined initial value
                                                  Comments

                                                  Calculated value is updated as other answers in the QuestionnaireResponse are filled in.

                                                  Control0..1
                                                  TypeExtension(Calculated 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())
                                                  204. Questionnaire.item.extension:enableWhenExpression
                                                  Slice NameenableWhenExpression
                                                  Definition

                                                  An expression that returns a boolean value for whether to enable the item.

                                                  ShortExpression for when to enable the item
                                                  Comments

                                                  This is only permitted when the containing item does NOT have any enableWhen elements.

                                                  Control0..1
                                                  TypeExtension(Enable when 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())
                                                  206. 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())
                                                  208. 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())
                                                  210. 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())
                                                  212. 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()))
                                                  214. 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()))
                                                  216. 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()))
                                                  218. 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()))
                                                  220. 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
                                                  222. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 224. 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())
                                                    226. 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())
                                                    228. 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 Length:1048576
                                                    230. 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.

                                                    Control0..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()))
                                                    232. 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
                                                    234. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 236. 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())
                                                      238. 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())
                                                      240. Questionnaire.item.text.extension:itemTextCqfExpression
                                                      Slice NameitemTextCqfExpression
                                                      Definition

                                                      An expression that, when evaluated, provides the value for the element on which it appears.

                                                      ShortAn dynamic expression
                                                      Comments

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

                                                      Control0..1
                                                      TypeExtension(CQF Expression) (Extension Type: Expression)
                                                      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())
                                                      242. 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 Length:1048576
                                                      244. 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

                                                      Time is handled using "string". File is handled using Attachment. (Content can be sent as a contained binary).

                                                      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()))
                                                      246. 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..*
                                                      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
                                                      Must Supporttrue
                                                      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))
                                                      248. Questionnaire.item.enableWhen.id
                                                      Definition

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

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

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

                                                      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())
                                                      252. Questionnaire.item.enableWhen.modifierExtension