Da Vinci - Documentation Templates and Rules
2.2.0 - STU 2.2

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 2.2.0 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: DTR Base Questionnaire - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 2

Definitions for the dtr-base-questionnaire resource profile

- Key Elements Table
- Differential Table
- Snapshot Table

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

0. Questionnaire
Definition | 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.
Short | A structured set of questions
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Form, CRF, Survey
Invariants | dom-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()`) cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (`name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')`) sdc-2: If version is present, versionAlgorithm must be present. (`version.exists() implies extension.where(url='http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm').exists()`) sdc-3: Semver is the preferred version algorithm - package machinery doesn't work well with artifacts using alternate versioning schemes (`extension.where(url='http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm').all(value.ofType(Coding).where(system='http://hl7.org/fhir/version-algorithm' and code='semver').exists())`) dtrq-6: If audience is 'clinical' or 'patient' then estimatedCompletionTime must contain clinicalTime. (`extension.exists(url = 'http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/questionnaireAudience' and (value = 'clinical' or value = 'patient')) and extension.exists(url = 'http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/estimated-completion-time') implies extension.where(url = 'http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/estimated-completion-time').extension.where(url = 'clinicalTime').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.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Questionnaire.extension:terminologyServer
Slice Name | terminologyServer
Definition | Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the resource or a particular portion of the resource (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 (one of) the preferredTerminologyServer(s) rather than the local repository. Systems SHOULD evaluate value sets using terminology servers as follows: First, try any terminology servers declared on the element in question. If there are more then one, try them in the order they appear. Then try any servers that appear on ancestor elements in order of closest ancestor up to any on the resource root If there are no declared servers or none of the ones listed provide a useful response, the form filler may then try any of the typical servers it would normally use. A 'useful response' means a response that provides a valid (though potentially empty) expansion. Clients MAY wish to log/report errors returned by terminology servers.
Short | Preferred 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Preferred Terminology Server) (Extension Type: url)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Questionnaire.extension:versionAlgorithm
Slice Name | versionAlgorithm
Definition | Indicates the mechanism used to compare versions to determine which is more current.
Short | How to compare versions
Comments | If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Artifact Version Algorithm) (Extension Type: Choice of: string, Coding)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Questionnaire.extension:copyrightLabel
Slice Name | copyrightLabel
Definition | A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').
Short | Copyright holder and year(s)
Comments | Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Artifact Copyright Label) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Questionnaire.extension:designNote
Slice Name | designNote
Definition | Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.
Short | Design 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 QuestionnaireResponse would use Observation.
Control | 0..1
Type | Extension(Design Note) (Extension Type: markdown)
Is Modifier | false
Summary | false
Invariants | 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())
12. Questionnaire.extension:performerType
Slice Name | performerType
Definition | Indicates the types of resources that can record answers to a Questionnaire. Open Issue: Should this extension be moved to core?
Short | Resource that can record answers to this Questionnaire
Control | 0..*
Type | Extension(Performer type) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
14. Questionnaire.extension:assemble-expectation
Slice Name | assemble-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.
Short | Questionnaire 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.
Control | 0..0
Type | Extension(Assembly Expectations for Questionnaire) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
16. Questionnaire.extension:estimatedCompletionTime
Slice Name | estimatedCompletionTime
Definition | Provides information about the typical completion time for the form. (Refer to the Guidelines for estimated time to complete a DTR questionnaire)
Short | Extension
Control | 0..1
Type | Extension(Estimated Completion Time) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | 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()`)
18. Questionnaire.extension:audience
Slice Name | audience
Definition | Provides a code to express the intended audience for the Questionnaire form.
Short | Questionnaire Audience
Control | 0..*
Type | Extension(Questionnaire Audience) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
20. Questionnaire.extension:RequestSpecific
Slice Name | RequestSpecific
Definition | If this flag is 'true' then a distinct QuestionnaireResponse is needed for each request where that Questionnaire is solicited. If false, then a single QuestionnaireResponse can be used across all requests where the specified Questionnaire url and version was solicited. (i.e., You can fill out the form once and re-use rather than completing multiple times. Typically, re-use of a form is limited to the scope of a single encounter)
Short | Request Specific Flag
Control | 0..1
Type | Extension(Request Specific Flag) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
22. Questionnaire.extension:styleSensitive
Slice Name | styleSensitive
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.
Short | Are 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.
Control | 0..1
Type | Extension(Style sensitive) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | 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())
24. 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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This 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
26. Questionnaire.extension:styleSensitive.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/rendering-styleSensitive`
28. 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).
Short | Value of extension
Control | 10..1
Type | boolean, 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] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Pattern Value | `false`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Questionnaire.extension:signatureRequired
Slice Name | signatureRequired
Definition | Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.
Short | There'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.
Control | 0..1
Type | Extension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
32. Questionnaire.extension:variable
Slice Name | variable
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.
Short | Variable 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.
Control | 0..*
Type | Extension(Variable) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
34. Questionnaire.extension:constraint
Slice Name | constraint
Definition | Specifies a constraint that is enforced on instantiated (or target) resources. This extension can be applied to definitional resources (such as ActivityDefinition or Measure) and indicates that the constraint should be enforced on resources that are instantiated from the definition.
Short | A constraint on the target resource
Comments | Can be used on any definitional artifact to define a constraint that is enforced in the context of an instantiated resource. The constraint expression will have access to `%target` and `%definition` variables, where target is the instantiated resource, and definition is the definition used to instantiate.
Control | 0..*
Type | Extension(Target Constraint) (Complex Extension)
Is Modifier | false
Invariants | 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()`)
36. Questionnaire.extension:cqf-library
Slice Name | cqf-library
Definition | A reference to a Library containing the formal logic used by the artifact.
Short | The 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.
Control | 0..*
Type | Extension(CQF Library) (Extension Type: canonical(Library))
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
38. 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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This 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
40. Questionnaire.extension:cqf-library.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/cqf-library`
42. 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).
Short | Value of extension
Control | 10..1
Type | canonical(SDC Library), 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] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Questionnaire.extension:launchContext
Slice Name | launchContext
Definition | Resources that provide context for form processing logic (pre-population, flow-control, drop-down selection, etc.) when creating/displaying/editing a QuestionnaireResponse.
Short | Context resources needed for Questionnaire
Comments | 3 of these launch contexts are aligned with the existing SMART on FHIR "launch" contexts.
Control | 0..*
Type | Extension(Launch Contexts) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
46. Questionnaire.extension:itemPopulationContext
Slice Name | itemPopulationContext
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.
Short | Establishes mapping context for a Questionnaire item
Control | 0..1
Type | Extension(Item population context) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
48. Questionnaire.extension:entryMode
Slice Name | entryMode
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.
Short | sequential | 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.
Control | 0..1
Type | Extension(Entry mode) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
50. Questionnaire.extension:endpoint
Slice Name | endpoint
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.
Short | Where 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.
Control | 0..0
Type | Extension(Endpoint) (Extension Type: uri)
Is Modifier | false
Summary | false
Invariants | 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())
52. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | 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())
54. 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.
Short | Canonical 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.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | … This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) cnl-1: Warning Questionnaire.url URL should not contain | or # - these characters make processing canonical references problematic (`exists() implies matches('^[^|# ]+$')`)
56. 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.
Short | Business 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].
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Questionnaire.title
Definition | A short, descriptive, user-friendly title for the questionnaire.
Short | Name for this questionnaire (human friendly)
Comments | This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Questionnaire.status
Definition | The status of this questionnaire. Enables tracking the life-cycle of the content.
Short | draft | active | retired | unknown
Comments | Allows filtering of questionnaires that are appropriate for use versus not.
Control | 1..1
Binding | The codes SHALL be taken from PublicationStatus http://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.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Questionnaire.subjectType
Definition | The types of subjects that can be the subject of responses created for the questionnaire.
Short | Resource that can be subject of QuestionnaireResponse
Comments | If none are specified, then the subject is unlimited.
Control | 10..1*
Binding | The codes SHALL be taken from ResourceType http://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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | A Questionnaire SHOULD specify the subject. However, it is optional to support legacy questionnaires.
Pattern Value | `Patient`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Questionnaire.subjectType.extension:subjectType
Slice Name | subjectType
Definition | R5: `Questionnaire.subjectType` additional codes
Short | R5: subjectType additional codes
Comments | Element `Questionnaire.subjectType` is mapped to FHIR R4 element `Questionnaire.subjectType` as `RelatedTo`. The mappings for `Questionnaire.subjectType` do not allow expression of the necessary codes, per the bindings on the source and target. If none are specified, then the subject is unlimited.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(R5: subjectType additional codes) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
66. Questionnaire.effectivePeriod
Definition | The period during which the questionnaire content was or is planned to be in active use.
Short | When 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.
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Summary | true
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.
Invariants | ele-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.
Short | Questions and sections within the Questionnaire
Comments | The content of the questionnaire is constructed from an ordered, hierarchical collection of items.
Control | 0..* This element is affected by the following invariants: que-3
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-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-1a: Group items must have nested items when Questionanire is complete (`(type='group' and %resource.status='complete') implies item.empty().not()`) que-1b: Groups should have items (`type='group' implies item.empty().not()`) que-1c: Display items cannot have child items (`type='display' implies item.empty()`) que-14: Can only have answerConstraint if answerOption, answerValueSet, or answerExpression are present. (This is a warning because other extensions may serve the same purpose) (`extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.item.answerConstraint').exists() implies answerOption.exists() or answerValueSet.exists() or extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').exists()`) dtrq-2: if item type is 'choice' or 'open-choice', then it should have either the answerOption, answerValueSet, or answerExpression extension (`(type='choice' or type='open-choice') implies answerOption.exists() or answerValueSet.exists() or extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').exists()`) dtrq-3: if item type is Quantity, then it should have either the unitOption or unitValueSet extension (`(type='quantity') implies extension.where(url='http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption').exists() or extension.where(url='http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet').exists()`) dtrq-4: if item type is Reference, then it must have a referenceResource extension (`(type='reference') implies extension.where(url='http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource').exists()`) dtrq-5: if item type is Reference, then it should have a candidateExpression extension (`(type='reference') implies extension.where(url='http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression').exists()`) 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:hidden
Slice Name | hidden
Definition | If true, indicates that the extended item should not be displayed to the user.
Short | Don'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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Questionnaire Hidden) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
72. Questionnaire.item.extension:terminologyServer
Slice Name | terminologyServer
Definition | Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the resource or a particular portion of the resource (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 (one of) the preferredTerminologyServer(s) rather than the local repository. Systems SHOULD evaluate value sets using terminology servers as follows: First, try any terminology servers declared on the element in question. If there are more then one, try them in the order they appear. Then try any servers that appear on ancestor elements in order of closest ancestor up to any on the resource root If there are no declared servers or none of the ones listed provide a useful response, the form filler may then try any of the typical servers it would normally use. A 'useful response' means a response that provides a valid (though potentially empty) expansion. Clients MAY wish to log/report errors returned by terminology servers.
Short | Preferred terminology server
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Preferred Terminology Server) (Extension Type: url)
Is Modifier | false
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
74. Questionnaire.item.extension:disabledDisplay
Slice Name | disabledDisplay
Definition | R5: `Questionnaire.item.disabledDisplay` (new:code)
Short | R5: hidden | protected (new)
Comments | Element `Questionnaire.item.disabledDisplay` has a context of Questionnaire.item based on following the parent source element upwards and mapping to `Questionnaire`. Element `Questionnaire.item.disabledDisplay` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If not specified, rendering behavior is up to the client. This element is only meaningful if enableWhen or an equivalent extension is present
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(R5: hidden | protected (new)) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
76. Questionnaire.item.extension:answerConstraint
Slice Name | answerConstraint
Definition | R5: `Questionnaire.item.answerConstraint` (new:code)
Short | R5: optionsOnly | optionsOrType | optionsOrString (new)
Comments | Element `Questionnaire.item.answerConstraint` has a context of Questionnaire.item based on following the parent source element upwards and mapping to `Questionnaire`. Element `Questionnaire.item.answerConstraint` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(R5: optionsOnly | optionsOrType | optionsOrString (new)) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
78. Questionnaire.item.extension:designNote
Slice Name | designNote
Definition | Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.
Short | Design 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 QuestionnaireResponse would use Observation.
Control | 0..1
Type | Extension(Design Note) (Extension Type: markdown)
Is Modifier | false
Summary | false
Invariants | 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())
80. Questionnaire.item.extension:itemOptionalDisplay
Slice Name | itemOptionalDisplay
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.
Short | Can 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.
Control | 0..0
Type | Extension(Optional Display?) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | 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())
82. Questionnaire.item.extension:itemControl
Slice Name | itemControl
Definition | The type of data entry control or structure that should be used to render the item.
Short | E.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.
Control | 0..1
Type | Extension(Questionnaire Item Control) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
84. Questionnaire.item.extension:choiceOrientation
Slice Name | choiceOrientation
Definition | Identifies the desired orientation when rendering a list of choices (typically radio-box or check-box lists).
Short | horizontal | 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.
Control | 0..1
Type | Extension(Questionnaire ChoiceOrientation) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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())
86. Questionnaire.item.extension:displayCategory
Slice Name | displayCategory
Definition | Describes the intended purpose of the rendered text. For example - instructions, guidance on access control, maintenance information, etc.
Short | Purpose of rendered text
Comments | ​See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Display Category) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | 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())
88. Questionnaire.item.extension:supportHyperlink
Slice Name | supportHyperlink
Definition | A labeled hyperlink for display alongside a questionnaire item, providing supporting guidance to the user.
Short | A labeled hyperlink for user guidance
Control | 0..1
Type | Extension(Questionnaire Support Hyperlink) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | 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()`)
90. Questionnaire.item.extension:sliderStepValue
Slice Name | sliderStepValue
Definition | For slider-based controls, indicates the step size to use when toggling the control up or down.
Short | Increment value for slider
Comments | ​See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Slider Step Value) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | 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())
92. Questionnaire.item.extension:entryFormat
Slice Name | entryFormat
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.
Short | User prompt for format
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Entry format) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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())
94. Questionnaire.item.extension:usageMode
Slice Name | usageMode
Definition | Identifies that the specified element should only appear in certain "modes" of operation.
Short | capture | display | display-non-empty | capture-display | capture-display-non-empty
Comments | ​See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(QuestionnaireResponse Usage Mode) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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())
96. Questionnaire.item.extension:itemSignatureRequired
Slice Name | itemSignatureRequired
Definition | Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.
Short | Is 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.
Control | 0..1
Type | Extension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | 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())
98. Questionnaire.item.extension:minOccurs
Slice Name | minOccurs
Definition | The minimum number of times the group must appear, or the minimum number of answers for a question - when greater than 1.
Short | Minimum repetitions
Comments | ​Default assumption for "required" elements is minOccurs=1. See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Min Occurs) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
100. Questionnaire.item.extension:maxOccurs
Slice Name | maxOccurs
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.
Short | Maximum 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.
Control | 0..1
Type | Extension(Questionnaire Max Occurs) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
102. Questionnaire.item.extension:minLength
Slice Name | minLength
Definition | The minimum number of characters that must be present in the simple data type to be considered a "valid" instance.
Short | At 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.
Control | 0..1
Type | Extension(Min length) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | 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())
104. Questionnaire.item.extension:regex
Slice Name | regex
Definition | A regular expression that defines the syntax for the data element to be considered valid.
Short | Regular expression pattern
Control | 0..1
Type | Extension(Regex) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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())
106. Questionnaire.item.extension:minValue
Slice Name | minValue
Definition | The inclusive lower bound on the range of allowed values for the data element.
Short | Must 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.
Control | 0..1
Type | Extension(Min value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, Quantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
108. Questionnaire.item.extension:maxValue
Slice Name | maxValue
Definition | The inclusive upper bound on the range of allowed values for the data element.
Short | Must 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.
Control | 0..1
Type | Extension(Max value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, Quantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
110. Questionnaire.item.extension:maxDecimalPlaces
Slice Name | maxDecimalPlaces
Definition | Identifies the maximum number of decimal places that may be specified for the data element.
Short | Maximum digits after decimal
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide. This specifies the maximum number of digits that can appear after the decimal point in a number. It counts all the digits to the right of the decimal point when the number is written out in full, standard decimal form (without 'e' or 'E'). For example, a number in scientific notation like 1.23e-4 equals 0.000123 when expanded; it would be consistent with a maximum number of decimal places of 6 or more.
Control | 0..1
Type | Extension(Max decimal places) (Extension Type: Choice of: integer, Quantity)
Is Modifier | false
Summary | false
Invariants | 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())
112. Questionnaire.item.extension:mimeType
Slice Name | mimeType
Definition | Identifies the kind(s) of attachment allowed to be sent for an element.
Short | Type 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.
Control | 0..1
Type | Extension(Mime type) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
114. Questionnaire.item.extension:maxSize
Slice Name | maxSize
Definition | For attachment answers, indicates the maximum size in bytes an attachment can be.
Short | Max 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.
Control | 0..1
Type | Extension(Max size) (Extension Type: decimal)
Is Modifier | false
Summary | false
Invariants | 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())
116. Questionnaire.item.extension:unitOption
Slice Name | unitOption
Definition | A unit that the user may choose when providing a quantity value.
Short | Unit 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.
Control | 0..*
Type | Extension(QuestionnaireResponse Unit Option) (Extension Type: Coding)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
118. Questionnaire.item.extension:referenceResource
Slice Name | referenceResource
Definition | Where the type for a question is "Reference", indicates a type of resource that is permitted.
Short | Allowed 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.
Control | 0..*
Type | Extension(Questionnaire Reference Resource) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
120. Questionnaire.item.extension:referenceProfile
Slice Name | referenceProfile
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.
Short | Allowed 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.
Control | 0..*
Type | Extension(Questionnaire Reference Profile) (Extension Type: canonical(StructureDefinition))
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
122. Questionnaire.item.extension:itemConstraint
Slice Name | itemConstraint
Definition | Specifies a constraint that is enforced on instantiated (or target) resources. This extension can be applied to definitional resources (such as ActivityDefinition or Measure) and indicates that the constraint should be enforced on resources that are instantiated from the definition.
Short | A constraint on the target resource
Comments | Can be used on any definitional artifact to define a constraint that is enforced in the context of an instantiated resource. The constraint expression will have access to `%target` and `%definition` variables, where target is the instantiated resource, and definition is the definition used to instantiate.
Control | 0..*
Type | Extension(Target Constraint) (Complex Extension)
Is Modifier | false
Invariants | 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()`)
124. Questionnaire.item.extension:unit
Slice Name | unit
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.
Short | Unit for numeric answer
Comments | The human-readable unit is conveyed as a display element. This element is for computation purposes.
Control | 0..1
Type | Extension(Questionnaire Unit) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | 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())
126. Questionnaire.item.extension:unitValueSet
Slice Name | unitValueSet
Definition | A set of units that the user may choose when providing a quantity value.
Short | Unit 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.
Control | 0..1
Type | Extension(QuestionnaireResponse Unit ValueSet) (Extension Type: canonical(ValueSet))
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
128. Questionnaire.item.extension:itemMedia
Slice Name | itemMedia
Definition | Media to render/make available as an accompaniment to the question being asked
Short | Media to display
Control | 0..1
Type | Extension(Item Media) (Extension Type: Attachment)
Is Modifier | false
Summary | false
Invariants | 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())
130. Questionnaire.item.extension:shortText
Slice Name | shortText
Definition | The short text for the item.
Short | Short 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).
Control | 0..1
Type | Extension(Short Text) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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())
132. Questionnaire.item.extension:openLabel
Slice Name | openLabel
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.
Short | Image to display
Control | 0..1
Type | Extension(Label for 'open' items) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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())
134. Questionnaire.item.extension:choiceColumn
Slice Name | choiceColumn
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).
Short | Guide for rendering multi-column choices
Comments | Each repetition represents a column to display.
Control | 0..*
Type | Extension(Choice column) (Complex Extension)
Is Modifier | false
Invariants | 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()`)
136. Questionnaire.item.extension:width
Slice Name | width
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.
Short | Width of column for question
Comments | code missing = pixels; code = % = percentage.
Control | 0..1
Type | Extension(Width of column) (Extension Type: Quantity)
Is Modifier | false
Summary | false
Invariants | 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())
138. Questionnaire.item.extension:collapsible
Slice Name | collapsible
Definition | Indicates whether the child items of a group or question item is displayed in collapsible form.
Short | Indicates whether the child items of a group or question item is displayed in collapsible form.
Control | 0..1
Type | Extension(Collapsible) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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())
140. Questionnaire.item.extension:minQuantity
Slice Name | minQuantity
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.
Short | Must 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.
Control | 0..1
Type | Extension(Min quantity) (Extension Type: Quantity)
Is Modifier | false
Summary | false
Invariants | 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())
142. Questionnaire.item.extension:maxQuantity
Slice Name | maxQuantity
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.
Short | Must 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.
Control | 0..1
Type | Extension(Max quantity) (Extension Type: Quantity)
Is Modifier | false
Summary | false
Invariants | 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())
144. Questionnaire.item.extension:lookupQuestionnaire
Slice Name | lookupQuestionnaire
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.
Short | Questionnaire to populate a reference
Control | 0..1
Type | Extension(Lookup questionnaire) (Extension Type: canonical(Questionnaire))
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
146. Questionnaire.item.extension:candidateExpression
Slice Name | candidateExpression
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.
Short | Expression 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. If the expression returns coded data, it *SHALL return the information as either code or Coding, not CodeableConcept. If the expression returns elements of type 'code', when the user selects one or more candidates, the code will be matched against the allowed Codings (from answerValueSet, answerOptions, or answerExpresssion). In this case, it is an error if there is more than one Coding with the same code.
Control | 0..1
Type | Extension(Candidate Answers Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
148. Questionnaire.item.extension:candidateExpression.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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
150. Questionnaire.item.extension:candidateExpression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression`
152. Questionnaire.item.extension:candidateExpression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Type | Expression, 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, boolean, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
154. Questionnaire.item.extension:candidateExpression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Definition | Provides an alternate expression containing the compiled JSON ELM for an expression. (NOTE: The expectation is that this extension will transition to the core extensions pack)
Short | Alternative Expression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
156. Questionnaire.item.extension:candidateExpression.value[x].language
Definition | The media type of the language for the expression.
Short | text/cql | text/fhirpath | application/x-fhir-query | etc.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ExpressionLanguage http://hl7.org/fhir/ValueSet/expression-language|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/expression-language|4.0.1` ) The media type of the expression language.
Additional Bindings | Purpose
http://www.rfc-editor.org/bcp/bcp13.txt | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
158. Questionnaire.item.extension:initialExpression
Slice Name | initialExpression
Definition | Initial value for a question answer as determined by an evaluated expression.
Short | Expression-determined initial value
Comments | Initial value is only calculated at the time the QuestionnaireResponse is first generated. If the expression returns coded data, it *SHALL return the information as either code or Coding, not CodeableConcept. If the expression returns elements of type 'code', when the user selects one or more candidates, the code will be matched against the allowed Codings (from answerValueSet, answerOptions, or answerExpression). In this case, it is an error if there is more than one Coding with the same code.
Control | 0..1
Type | Extension(Initial Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
160. Questionnaire.item.extension:initialExpression.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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
162. Questionnaire.item.extension:initialExpression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression`
164. Questionnaire.item.extension:initialExpression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Type | Expression, 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, boolean, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. Questionnaire.item.extension:initialExpression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Definition | Provides an alternate expression containing the compiled JSON ELM for an expression. (NOTE: The expectation is that this extension will transition to the core extensions pack)
Short | Alternative Expression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
168. Questionnaire.item.extension:initialExpression.value[x].language
Definition | The media type of the language for the expression.
Short | text/cql | text/fhirpath | application/x-fhir-query | etc.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ExpressionLanguage http://hl7.org/fhir/ValueSet/expression-language|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/expression-language|4.0.1` ) The media type of the expression language.
Additional Bindings | Purpose
http://www.rfc-editor.org/bcp/bcp13.txt | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. Questionnaire.item.extension:calculatedExpression
Slice Name | calculatedExpression
Definition | Calculated value for a question answer as determined by an evaluated expression.
Short | Expression-determined initial value
Comments | Calculated value is updated as other answers in the QuestionnaireResponse are filled in.
Control | 0..1
Type | Extension(Calculated Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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.extension:calculatedExpression.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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
174. Questionnaire.item.extension:calculatedExpression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression`
176. Questionnaire.item.extension:calculatedExpression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | Expression, 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, boolean, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
178. Questionnaire.item.extension:calculatedExpression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Definition | Provides an alternate expression containing the compiled JSON ELM for an expression. (NOTE: The expectation is that this extension will transition to the core extensions pack)
Short | Alternative Expression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
180. Questionnaire.item.extension:calculatedExpression.value[x].language
Definition | The media type of the language for the expression.
Short | text/cql | text/fhirpath | application/x-fhir-query | etc.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ExpressionLanguage http://hl7.org/fhir/ValueSet/expression-language|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/expression-language|4.0.1` ) The media type of the expression language.
Additional Bindings | Purpose
http://www.rfc-editor.org/bcp/bcp13.txt | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
182. Questionnaire.item.extension:contextExpression
Slice Name | contextExpression
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.
Short | Expression for information to guide answers
Control | 0..*
Type | Extension(Answer Context Expression) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | 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()`)
184. Questionnaire.item.extension:contextExpression.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.
Short | ExtensionAdditional 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.
Control | 20..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
186. Questionnaire.item.extension:contextExpression.extension:label
Slice Name | label
Definition | The text to display in the form filler user interface that explains what the returned context information means
Short | Context labelAdditional content defined by implementations
Control | 10..1*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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())
188. Questionnaire.item.extension:contextExpression.extension:label.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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
190. Questionnaire.item.extension:contextExpression.extension:label.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `label`
192. Questionnaire.item.extension:contextExpression.extension:label.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | string, 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, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
194. Questionnaire.item.extension:contextExpression.extension:expression
Slice Name | expression
Definition | An Extension
Short | ExtensionAdditional content defined by implementations
Control | 10..1*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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())
196. Questionnaire.item.extension:contextExpression.extension:expression.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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
198. Questionnaire.item.extension:contextExpression.extension:expression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `expression`
200. Questionnaire.item.extension:contextExpression.extension:expression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | Expression, 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, boolean, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
202. Questionnaire.item.extension:contextExpression.extension:expression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Definition | Provides an alternate expression containing the compiled JSON ELM for an expression. (NOTE: The expectation is that this extension will transition to the core extensions pack)
Short | Alternative Expression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
204. Questionnaire.item.extension:contextExpression.extension:expression.value[x].language
Definition | The media type of the language for the expression.
Short | text/cql | text/fhirpath | application/x-fhir-query | etc.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ExpressionLanguage http://hl7.org/fhir/ValueSet/expression-language|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/expression-language|4.0.1` ) The media type of the expression language.
Additional Bindings | Purpose
http://www.rfc-editor.org/bcp/bcp13.txt | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. Questionnaire.item.extension:contextExpression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-contextExpression`
208. Questionnaire.item.extension:contextExpression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..01
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
212. Questionnaire.item.linkId
Definition | An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.
Short | Unique 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
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.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) que-15: Link ids must be 255 characters or less (`$this.length() <= 255`)
214. 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.
Short | E.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.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
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 Names | label
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
216. 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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This 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
218. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
Slice Name | itemPrefixRenderingStyle
Definition | Indicates an HTML style that should be applied when rendering this element.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. NOTE: HTML styles can include references to external content (images, fonts, etc.), which may constitute a security issue, as resolving the link can allow tracking. See here for more detail. ​For questionnaires, see additional guidance and examples in the SDC implementation guide. This style applies to the base string. If there is also a rendering-xhtml or rendering-markdown extension, they must declare any relevant styles within those extension values. Setting styles on elements can be risky. It presumes knowledge of how elements are rendered "by default". For example, setting the color of an element to 'blue' to highlight it might be fine - unless the default background color for a particular renderer is already blue. As well, it's not a given that all elements will be represented by a single HTML element. One element might be referenced by a collection of table cells that span rows and columns. Setting a border style on all of those cells wouldn't give the desired results and auto-tweaking the border style on each cell (deciding whether the border is top,left, right, etc.) would require complex coding. Finally, systems might not be using HTML for their UI at all and will need to map the specified styles to their own UI mechanism. For this reason, this element is best used when: a) the default UI characteristics are already well understood (because the specification applies to a single system or to a set of systems that are already required to comply with specific UI expectations b) the set of allowed style values is tightly controlled to only those that are necessary and sensible in that context
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
220. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
Slice Name | itemPrefixRenderingXhtml
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.
Short | String equivalent with html markup
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
222. Questionnaire.item.text
Definition | The name of a section, the text of a question or text content for a display item.
Short | Primary 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. This is optional only to support form assembly situations where the text may be generated from another source. In an assembled Questionnaire, it should always be present. 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
224. 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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This 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
226. Questionnaire.item.text.extension:itemTextRenderingStyle
Slice Name | itemTextRenderingStyle
Definition | Indicates an HTML style that should be applied when rendering this element.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. NOTE: HTML styles can include references to external content (images, fonts, etc.), which may constitute a security issue, as resolving the link can allow tracking. See here for more detail. ​For questionnaires, see additional guidance and examples in the SDC implementation guide. This style applies to the base string. If there is also a rendering-xhtml or rendering-markdown extension, they must declare any relevant styles within those extension values. Setting styles on elements can be risky. It presumes knowledge of how elements are rendered "by default". For example, setting the color of an element to 'blue' to highlight it might be fine - unless the default background color for a particular renderer is already blue. As well, it's not a given that all elements will be represented by a single HTML element. One element might be referenced by a collection of table cells that span rows and columns. Setting a border style on all of those cells wouldn't give the desired results and auto-tweaking the border style on each cell (deciding whether the border is top,left, right, etc.) would require complex coding. Finally, systems might not be using HTML for their UI at all and will need to map the specified styles to their own UI mechanism. For this reason, this element is best used when: a) the default UI characteristics are already well understood (because the specification applies to a single system or to a set of systems that are already required to comply with specific UI expectations b) the set of allowed style values is tightly controlled to only those that are necessary and sensible in that context
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
228. Questionnaire.item.text.extension:itemTextRenderingXhtml
Slice Name | itemTextRenderingXhtml
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.
Short | String equivalent with html markup
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
230. 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.).
Short | group | 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.
Control | 1..1
Binding | The codes SHALL be taken from QuestionnaireItemType http://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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Defines the format in which the user is to be prompted for the answer.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
232. 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.
Short | Only 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.
Control | 0..*
Type | BackboneElement
Is Modifier | true because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
Summary | false
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.
Invariants | ele-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))
234. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
236. Questionnaire.item.enableWhen.question
Definition | The linkId for the question whose answer (or lack of answer) governs whether this item is enabled.
Short | Question 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
238. Questionnaire.item.enableWhen.operator
Definition | Specifies the criteria by which the question is enabled.
Short | exists | = | != | > | < | >= | <=
Control | 1..1
Binding | The codes SHALL be taken from QuestionnaireItemOperator http://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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
240. 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.
Short | Value for question comparison based on operator
Control | 1..1 This element is affected by the following invariants: que-7
Binding | For example codes, see QuestionnaireAnswerCodes http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1 (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Allowed values to answer questions.
Type | Choice of: boolean, decimal, integer, date, dateTime, time, string, Coding, Quantity, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
242. Questionnaire.item.enableBehavior
Definition | Controls how multiple enableWhen values are interpreted - whether all or any must be true.
Short | all | any
Comments | This element must be specified if more than one enableWhen value is provided.
Control | 0..1 This element is affected by the following invariants: que-12
Binding | The codes SHALL be taken from EnableWhenBehavior http://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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
244. 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.
Short | Whether 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.
Control | 0..1 This element is affected by the following invariants: que-6
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Meaning if Missing | Items are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
246. 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.
Short | Whether 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.
Control | 0..1 This element is affected by the following invariants: que-6
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
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 Missing | Items are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
248. Questionnaire.item.readOnly
Definition | An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.
Short | Don'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.
Control | 0..1 This element is affected by the following invariants: que-9
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
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.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
250. 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.
Short | Valueset 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.
Control | 0..1 This element is affected by the following invariants: que-4, que-5
Type | canonical(SDC Value Set, ValueSet)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
252. Questionnaire.item.answerOption
Definition | One of the permitted answers for a "choice" or "open-choice" question.
Short | Permitted 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.
Control | 0..* This element is affected by the following invariants: que-4, que-5
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
254. 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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This 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
256. Questionnaire.item.answerOption.extension:optionExclusive
Slice Name | optionExclusive
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.
Short | Option is exclusive
Comments | ​See additional guidance and examples in the SDC implementation guide.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Questionnaire Option Exclusive) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
258. Questionnaire.item.answerOption.extension:ordinalValue
Slice Name | ordinalValue
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.
Short | Assigned 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Ordinal Value) (Extension Type: decimal)
Is Modifier | false
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
260. Questionnaire.item.answerOption.extension:itemAnswerMedia
Slice Name | itemAnswerMedia
Definition | Media to render/make available as an accompaniment to a specific answer option
Short | Answer Media to display
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Item Answer Media) (Extension Type: Attachment)
Is Modifier | false
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
262. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
264. Questionnaire.item.answerOption.value[x]
Definition | A potential answer that's allowed as the answer to this question.
Short | Answer value
Comments | The data type of the value must agree with the item.type.
Control | 1..1
Binding | For example codes, see QuestionnaireAnswerCodes http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1 (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Allowed values to answer questions.
Type | Choice of: integer, date, time, string, Coding, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Questionnaire.item.answerOption.value[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
266. Questionnaire.item.answerOption.value[x].extension:answerOptionRenderingXhtml
Slice Name | answerOptionRenderingXhtml
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.
Short | String equivalent with html markup
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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())
268. Questionnaire.item.answerOption.value[x]:valueCoding
Slice Name | valueCoding
Definition | A potential answer that's allowed as the answer to this question.
Short | Answer value
Comments | The data type of the value must agree with the item.type.
Control | 01..1
Binding | For example codes, see QuestionnaireAnswerCodes http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1 (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Allowed values to answer questions.
Type | Coding, date, string, Reference(Resource), integer, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) sdc-base-1: AnswerOption.valueCoding must have at least one of code or display (`code.exists() or display.exists()`) sdc-base-2: If code exists, system must exist (`code.exists() implies system.exists()`)
270. Questionnaire.item.answerOption.value[x]:valueReference
Slice Name | valueReference
Definition | A potential answer that's allowed as the answer to this question.
Short | Answer value
Comments | The data type of the value must agree with the item.type.
Control | 01..1
Type | Reference(Resource, Resource), date, string, Coding, integer, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) sdc-base-4: Reference must have at least one of reference, display, and identifier (`reference.exists() or display.exists() or identifier.exists()`)
272. Questionnaire.item.initial
Definition | One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.
Short | Initial 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.
Control | 0..* This element is affected by the following invariants: que-8, que-13
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | In some workflows, having defaults saves time.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
274. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
276. Questionnaire.item.initial.value[x]
Definition | The actual value to for an initial answer.
Short | Actual value for initializing the question
Comments | The type of the initial value must be consistent with the type of the item.
Control | 1..1
Binding | For example codes, see QuestionnaireAnswerCodes http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1 (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Allowed values to answer questions.
Type | Choice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
278. Questionnaire.item.item
Definition | Text, questions and other groups to be nested beneath a question or group.
Short | Nested 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.
Control | 0..* This element is affected by the following invariants: que-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
Is Modifier | false
Must Support | true
Summary | false
Requirements | Reports can consist of complex nested groups.
Invariants | ele-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 foundhere

0. Questionnaire
Invariants | dtrq-6: If audience is 'clinical' or 'patient' then estimatedCompletionTime must contain clinicalTime. (`extension.exists(url = 'http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/questionnaireAudience' and (value = 'clinical' or value = 'patient')) and extension.exists(url = 'http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/estimated-completion-time') implies extension.where(url = 'http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/estimated-completion-time').extension.where(url = 'clinicalTime').exists()`)
2. Questionnaire.text
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 Name | terminologyServer
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 Support | true
8. Questionnaire.extension:assemble-expectation
Slice Name | assemble-expectation
Control | 0..0
10. Questionnaire.extension:estimatedCompletionTime
Slice Name | estimatedCompletionTime
Control | 0..1
Type | Extension(Estimated Completion Time) (Complex Extension)
Must Support | true
12. Questionnaire.extension:audience
Slice Name | audience
Control | 0..*
Type | Extension(Questionnaire Audience) (Extension Type: code)
Must Support | true
14. Questionnaire.extension:RequestSpecific
Slice Name | RequestSpecific
Control | 0..1
Type | Extension(Request Specific Flag) (Extension Type: boolean)
Must Support | true
16. Questionnaire.extension:styleSensitive
Slice Name | styleSensitive
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.
Control | 0..1
Type | Extension(Style sensitive) (Extension Type: boolean)
18. Questionnaire.extension:styleSensitive.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Pattern Value | `false`
20. Questionnaire.extension:signatureRequired
Slice Name | signatureRequired
Short | There's a cost to support this.
Control | 0..1
Type | Extension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
Must Support | true
22. Questionnaire.extension:variable
Slice Name | variable
Control | 0..*
Type | Extension(Variable) (Extension Type: Expression)
Must Support | true
24. Questionnaire.extension:constraint
Slice Name | constraint
Control | 0..*
Type | Extension(Target Constraint) (Complex Extension)
26. Questionnaire.extension:cqf-library
Slice Name | cqf-library
Short | The library can contain CQL, FHIRPath or x-fhir-query. The implementers must handle any of the above.
Control | 0..*
Type | Extension(CQF Library) (Extension Type: canonical(Library))
Must Support | true
28. Questionnaire.extension:cqf-library.value[x]
Type | canonical(SDC Library)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
30. Questionnaire.extension:launchContext
Slice Name | launchContext
Control | 0..*
Type | Extension(Launch Contexts) (Complex Extension)
Must Support | true
32. Questionnaire.extension:itemPopulationContext
Slice Name | itemPopulationContext
Control | 0..*
Type | Extension(Item population context) (Extension Type: Expression)
Must Support | true
34. Questionnaire.extension:entryMode
Slice Name | entryMode
Control | 0..*
Type | Extension(Entry mode) (Extension Type: code)
Must Support | true
36. Questionnaire.extension:endpoint
Slice Name | endpoint
Control | 0..0
Type | Extension(Endpoint) (Extension Type: uri)
38. Questionnaire.subjectType
Control | 1..1
Pattern Value | `Patient`
40. Questionnaire.effectivePeriod
Must Support | true
42. Questionnaire.item
Invariants | dtrq-2: if item type is 'choice' or 'open-choice', then it should have either the answerOption, answerValueSet, or answerExpression extension (`(type='choice' or type='open-choice') implies answerOption.exists() or answerValueSet.exists() or extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').exists()`) dtrq-3: if item type is Quantity, then it should have either the unitOption or unitValueSet extension (`(type='quantity') implies extension.where(url='http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption').exists() or extension.where(url='http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet').exists()`) dtrq-4: if item type is Reference, then it must have a referenceResource extension (`(type='reference') implies extension.where(url='http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource').exists()`) dtrq-5: if item type is Reference, then it should have a candidateExpression extension (`(type='reference') implies extension.where(url='http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression').exists()`)
44. Questionnaire.item.extension:itemOptionalDisplay
Slice Name | itemOptionalDisplay
Control | 0..0
46. Questionnaire.item.extension:itemControl
Slice Name | itemControl
Control | 0..1
Type | Extension(Questionnaire Item Control) (Extension Type: CodeableConcept)
Must Support | true
48. Questionnaire.item.extension:choiceOrientation
Slice Name | choiceOrientation
Control | 0..1
Type | Extension(Questionnaire ChoiceOrientation) (Extension Type: code)
50. Questionnaire.item.extension:displayCategory
Slice Name | displayCategory
Control | 0..1
Type | Extension(Questionnaire Display Category) (Extension Type: CodeableConcept)
52. Questionnaire.item.extension:supportHyperlink
Slice Name | supportHyperlink
Control | 0..1
Type | Extension(Questionnaire Support Hyperlink) (Complex Extension)
Must Support | true
54. Questionnaire.item.extension:sliderStepValue
Slice Name | sliderStepValue
Control | 0..1
Type | Extension(Questionnaire Slider Step Value) (Extension Type: integer)
56. Questionnaire.item.extension:entryFormat
Slice Name | entryFormat
Control | 0..1
Type | Extension(Entry format) (Extension Type: string)
58. Questionnaire.item.extension:usageMode
Slice Name | usageMode
Control | 0..1
Type | Extension(QuestionnaireResponse Usage Mode) (Extension Type: code)
60. Questionnaire.item.extension:itemSignatureRequired
Slice Name | itemSignatureRequired
Control | 0..1
Type | Extension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
62. Questionnaire.item.extension:minOccurs
Slice Name | minOccurs
Control | 0..1
Type | Extension(Questionnaire Min Occurs) (Extension Type: integer)
64. Questionnaire.item.extension:maxOccurs
Slice Name | maxOccurs
Control | 0..1
Type | Extension(Questionnaire Max Occurs) (Extension Type: integer)
66. Questionnaire.item.extension:minLength
Slice Name | minLength
Control | 0..1
Type | Extension(Min length) (Extension Type: integer)
68. Questionnaire.item.extension:regex
Slice Name | regex
Control | 0..1
Type | Extension(Regex) (Extension Type: string)
70. Questionnaire.item.extension:minValue
Slice Name | minValue
Control | 0..1
Type | Extension(Min value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, Quantity)
72. Questionnaire.item.extension:maxValue
Slice Name | maxValue
Control | 0..1
Type | Extension(Max value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, Quantity)
74. Questionnaire.item.extension:maxDecimalPlaces
Slice Name | maxDecimalPlaces
Control | 0..1
Type | Extension(Max decimal places) (Extension Type: Choice of: integer, Quantity)
76. Questionnaire.item.extension:mimeType
Slice Name | mimeType
Control | 0..1
Type | Extension(Mime type) (Extension Type: code)
Must Support | true
78. Questionnaire.item.extension:maxSize
Slice Name | maxSize
Control | 0..1
Type | Extension(Max size) (Extension Type: decimal)
80. Questionnaire.item.extension:unitOption
Slice Name | unitOption
Control | 0..*
Type | Extension(QuestionnaireResponse Unit Option) (Extension Type: Coding)
Must Support | true
82. Questionnaire.item.extension:referenceResource
Slice Name | referenceResource
Control | 0..*
Type | Extension(Questionnaire Reference Resource) (Extension Type: code)
Must Support | true
84. Questionnaire.item.extension:referenceProfile
Slice Name | referenceProfile
Control | 0..*
Type | Extension(Questionnaire Reference Profile) (Extension Type: canonical(StructureDefinition))
Must Support | true
86. Questionnaire.item.extension:itemConstraint
Slice Name | itemConstraint
Control | 0..*
Type | Extension(Target Constraint) (Complex Extension)
88. Questionnaire.item.extension:unit
Slice Name | unit
Control | 0..1
Type | Extension(Questionnaire Unit) (Extension Type: Coding)
90. Questionnaire.item.extension:unitValueSet
Slice Name | unitValueSet
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.
Control | 0..1
Type | Extension(QuestionnaireResponse Unit ValueSet) (Extension Type: canonical(ValueSet))
Must Support | true
92. Questionnaire.item.extension:itemMedia
Slice Name | itemMedia
Control | 0..1
Type | Extension(Item Media) (Extension Type: Attachment)
94. Questionnaire.item.extension:shortText
Slice Name | shortText
Control | 0..1
Type | Extension(Short Text) (Extension Type: string)
96. Questionnaire.item.extension:openLabel
Slice Name | openLabel
Control | 0..1
Type | Extension(Label for 'open' items) (Extension Type: string)
98. Questionnaire.item.extension:choiceColumn
Slice Name | choiceColumn
Control | 0..*
Type | Extension(Choice column) (Complex Extension)
100. Questionnaire.item.extension:width
Slice Name | width
Control | 0..1
Type | Extension(Width of column) (Extension Type: Quantity)
102. Questionnaire.item.extension:collapsible
Slice Name | collapsible
Control | 0..1
Type | Extension(Collapsible) (Extension Type: code)
104. Questionnaire.item.extension:minQuantity
Slice Name | minQuantity
Control | 0..1
Type | Extension(Min quantity) (Extension Type: Quantity)
106. Questionnaire.item.extension:maxQuantity
Slice Name | maxQuantity
Control | 0..1
Type | Extension(Max quantity) (Extension Type: Quantity)
108. Questionnaire.item.extension:lookupQuestionnaire
Slice Name | lookupQuestionnaire
Control | 0..1
Type | Extension(Lookup questionnaire) (Extension Type: canonical(Questionnaire))
Must Support | true
110. Questionnaire.item.extension:candidateExpression
Slice Name | candidateExpression
Control | 0..1
Type | Extension(Candidate Answers Expression) (Extension Type: Expression)
Must Support | true
112. Questionnaire.item.extension:candidateExpression.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
114. Questionnaire.item.extension:candidateExpression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Must Support | true
116. Questionnaire.item.extension:initialExpression
Slice Name | initialExpression
Control | 0..1
Type | Extension(Initial Expression) (Extension Type: Expression)
Must Support | true
118. Questionnaire.item.extension:initialExpression.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
120. Questionnaire.item.extension:initialExpression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Must Support | true
122. Questionnaire.item.extension:calculatedExpression
Slice Name | calculatedExpression
Control | 0..1
Type | Extension(Calculated Expression) (Extension Type: Expression)
Must Support | true
124. Questionnaire.item.extension:calculatedExpression.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
126. Questionnaire.item.extension:calculatedExpression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Must Support | true
128. Questionnaire.item.extension:contextExpression
Slice Name | contextExpression
Control | 0..*
Type | Extension(Answer Context Expression) (Complex Extension)
Must Support | true
130. Questionnaire.item.extension:contextExpression.extension:expression
Slice Name | expression
132. Questionnaire.item.extension:contextExpression.extension:expression.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
134. Questionnaire.item.extension:contextExpression.extension:expression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Must Support | true
136. Questionnaire.item.prefix
138. Questionnaire.item.prefix.extension
Slicing | This 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
140. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
Slice Name | itemPrefixRenderingStyle
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
142. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
Slice Name | itemPrefixRenderingXhtml
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
144. Questionnaire.item.text
Control | 1..?
146. Questionnaire.item.text.extension
Slicing | This 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
148. Questionnaire.item.text.extension:itemTextRenderingStyle
Slice Name | itemTextRenderingStyle
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
150. Questionnaire.item.text.extension:itemTextRenderingXhtml
Slice Name | itemTextRenderingXhtml
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Must Support | true
152. Questionnaire.item.enableBehavior
Must Support | true
154. Questionnaire.item.answerOption
156. Questionnaire.item.answerOption.extension
Slicing | This 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
158. Questionnaire.item.answerOption.extension:optionExclusive
Slice Name | optionExclusive
Control | 0..1
Type | Extension(Questionnaire Option Exclusive) (Extension Type: boolean)
Must Support | true
160. Questionnaire.item.answerOption.extension:ordinalValue
Slice Name | ordinalValue
Control | 0..1
Type | Extension(Ordinal Value) (Extension Type: decimal)
162. Questionnaire.item.answerOption.extension:itemAnswerMedia
Slice Name | itemAnswerMedia
Control | 0..1
Type | Extension(Item Answer Media) (Extension Type: Attachment)
164. Questionnaire.item.answerOption.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
166. Questionnaire.item.answerOption.value[x].extension:answerOptionRenderingXhtml
Slice Name | answerOptionRenderingXhtml
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Must Support | true

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

0. Questionnaire
Definition | 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.
Short | A structured set of questions
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Form, CRF, Survey
Invariants | dom-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()`) cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (`name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')`) sdc-2: If version is present, versionAlgorithm must be present. (`version.exists() implies extension.where(url='http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm').exists()`) sdc-3: Semver is the preferred version algorithm - package machinery doesn't work well with artifacts using alternate versioning schemes (`extension.where(url='http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm').all(value.ofType(Coding).where(system='http://hl7.org/fhir/version-algorithm' and code='semver').exists())`) dtrq-6: If audience is 'clinical' or 'patient' then estimatedCompletionTime must contain clinicalTime. (`extension.exists(url = 'http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/questionnaireAudience' and (value = 'clinical' or value = 'patient')) and extension.exists(url = 'http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/estimated-completion-time') implies extension.where(url = 'http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/estimated-completion-time').extension.where(url = 'clinicalTime').exists()`)
2. Questionnaire.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical 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.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-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.
Short | Language 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-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.
Short | Text 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.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This 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.
Short | generated | extensions | additional | empty
Control | 1..1
Binding | The codes SHALL be taken from NarrativeStatus (required to `http://hl7.org/fhir/ValueSet/narrative-status|4.0.1` ) The status of a resource narrative.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-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.
Short | Limited 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.
Control | 1..1
Type | xhtml
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-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.
Short | Contained, 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.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
22. Questionnaire.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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:terminologyServer
Slice Name | terminologyServer
Definition | Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the resource or a particular portion of the resource (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 (one of) the preferredTerminologyServer(s) rather than the local repository. Systems SHOULD evaluate value sets using terminology servers as follows: First, try any terminology servers declared on the element in question. If there are more then one, try them in the order they appear. Then try any servers that appear on ancestor elements in order of closest ancestor up to any on the resource root If there are no declared servers or none of the ones listed provide a useful response, the form filler may then try any of the typical servers it would normally use. A 'useful response' means a response that provides a valid (though potentially empty) expansion. Clients MAY wish to log/report errors returned by terminology servers.
Short | Preferred 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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Preferred Terminology Server) (Extension Type: url)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
26. Questionnaire.extension:versionAlgorithm
Slice Name | versionAlgorithm
Definition | Indicates the mechanism used to compare versions to determine which is more current.
Short | How to compare versions
Comments | If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Artifact Version Algorithm) (Extension Type: Choice of: string, Coding)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
28. Questionnaire.extension:copyrightLabel
Slice Name | copyrightLabel
Definition | A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').
Short | Copyright holder and year(s)
Comments | Defines the content expected to be rendered in all representations of the artifact. The (c) symbol should NOT be included in this string. It is expected to be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Artifact Copyright Label) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`)
30. Questionnaire.extension:designNote
Slice Name | designNote
Definition | Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.
Short | Design 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 QuestionnaireResponse would use Observation.
Control | 0..1
Type | Extension(Design Note) (Extension Type: markdown)
Is Modifier | false
Summary | false
Invariants | 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()`)
32. Questionnaire.extension:performerType
Slice Name | performerType
Definition | Indicates the types of resources that can record answers to a Questionnaire. Open Issue: Should this extension be moved to core?
Short | Resource that can record answers to this Questionnaire
Control | 0..*
Type | Extension(Performer type) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
34. Questionnaire.extension:assemble-expectation
Slice Name | assemble-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.
Short | Questionnaire 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.
Control | 0..0
Type | Extension(Assembly Expectations for Questionnaire) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
36. Questionnaire.extension:estimatedCompletionTime
Slice Name | estimatedCompletionTime
Definition | Provides information about the typical completion time for the form. (Refer to the Guidelines for estimated time to complete a DTR questionnaire)
Short | Extension
Control | 0..1
Type | Extension(Estimated Completion Time) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | 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()`)
38. Questionnaire.extension:audience
Slice Name | audience
Definition | Provides a code to express the intended audience for the Questionnaire form.
Short | Questionnaire Audience
Control | 0..*
Type | Extension(Questionnaire Audience) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
40. Questionnaire.extension:RequestSpecific
Slice Name | RequestSpecific
Definition | If this flag is 'true' then a distinct QuestionnaireResponse is needed for each request where that Questionnaire is solicited. If false, then a single QuestionnaireResponse can be used across all requests where the specified Questionnaire url and version was solicited. (i.e., You can fill out the form once and re-use rather than completing multiple times. Typically, re-use of a form is limited to the scope of a single encounter)
Short | Request Specific Flag
Control | 0..1
Type | Extension(Request Specific Flag) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
42. Questionnaire.extension:styleSensitive
Slice Name | styleSensitive
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.
Short | Are 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.
Control | 0..1
Type | Extension(Style sensitive) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
44. Questionnaire.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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
46. Questionnaire.extension:styleSensitive.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
48. Questionnaire.extension:styleSensitive.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/rendering-styleSensitive`
50. 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).
Short | Value of extension
Control | 1..1
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Pattern Value | `false`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Questionnaire.extension:signatureRequired
Slice Name | signatureRequired
Definition | Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.
Short | There'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.
Control | 0..1
Type | Extension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
54. Questionnaire.extension:variable
Slice Name | variable
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.
Short | Variable 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.
Control | 0..*
Type | Extension(Variable) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
56. Questionnaire.extension:constraint
Slice Name | constraint
Definition | Specifies a constraint that is enforced on instantiated (or target) resources. This extension can be applied to definitional resources (such as ActivityDefinition or Measure) and indicates that the constraint should be enforced on resources that are instantiated from the definition.
Short | A constraint on the target resource
Comments | Can be used on any definitional artifact to define a constraint that is enforced in the context of an instantiated resource. The constraint expression will have access to `%target` and `%definition` variables, where target is the instantiated resource, and definition is the definition used to instantiate.
Control | 0..*
Type | Extension(Target Constraint) (Complex Extension)
Is Modifier | false
Invariants | 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()`)
58. Questionnaire.extension:cqf-library
Slice Name | cqf-library
Definition | A reference to a Library containing the formal logic used by the artifact.
Short | The 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.
Control | 0..*
Type | Extension(CQF Library) (Extension Type: canonical(Library))
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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.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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
62. Questionnaire.extension:cqf-library.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
64. Questionnaire.extension:cqf-library.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/cqf-library`
66. 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).
Short | Value of extension
Control | 1..1
Type | canonical(SDC Library)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Questionnaire.extension:launchContext
Slice Name | launchContext
Definition | Resources that provide context for form processing logic (pre-population, flow-control, drop-down selection, etc.) when creating/displaying/editing a QuestionnaireResponse.
Short | Context resources needed for Questionnaire
Comments | 3 of these launch contexts are aligned with the existing SMART on FHIR "launch" contexts.
Control | 0..*
Type | Extension(Launch Contexts) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | 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()`)
70. Questionnaire.extension:itemPopulationContext
Slice Name | itemPopulationContext
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.
Short | Establishes mapping context for a Questionnaire item
Control | 0..1
Type | Extension(Item population context) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
72. Questionnaire.extension:entryMode
Slice Name | entryMode
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.
Short | sequential | 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.
Control | 0..1
Type | Extension(Entry mode) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
74. Questionnaire.extension:endpoint
Slice Name | endpoint
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.
Short | Where 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.
Control | 0..0
Type | Extension(Endpoint) (Extension Type: uri)
Is Modifier | false
Summary | false
Invariants | 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()`)
76. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | 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()`)
78. 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.
Short | Canonical 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.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | … This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) cnl-1: Warning Questionnaire.url URL should not contain | or # - these characters make processing canonical references problematic (`exists() implies matches('^[^|# ]+$')`)
80. 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.
Short | Additional 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.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. 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.
Short | Business 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].
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. 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.
Short | Name 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.
Control | 0..1 This element is affected by the following invariants: inv-0
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Support human navigation and code generation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. Questionnaire.title
Definition | A short, descriptive, user-friendly title for the questionnaire.
Short | Name for this questionnaire (human friendly)
Comments | This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. Questionnaire.derivedFrom
Definition | The URL of a Questionnaire that this Questionnaire is based on.
Short | Instantiates protocol or definition
Control | 0..*
Type | canonical(Questionnaire)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Allows a Questionnaire to be created based on another Questionnaire.
Invariants | ele-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.
Short | draft | active | retired | unknown
Comments | Allows filtering of questionnaires that are appropriate for use versus not.
Control | 1..1
Binding | The codes SHALL be taken from PublicationStatus (required to `http://hl7.org/fhir/ValueSet/publication-status|4.0.1` ) The lifecycle status of an artifact.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-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.
Short | For testing purposes, not real usage
Comments | Allows filtering of questionnaires that are appropriate for use versus not.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire.
Invariants | ele-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.
Short | Resource that can be subject of QuestionnaireResponse
Comments | If none are specified, then the subject is unlimited.
Control | 1..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | A Questionnaire SHOULD specify the subject. However, it is optional to support legacy questionnaires.
Pattern Value | `Patient`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Questionnaire.subjectType.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
98. Questionnaire.subjectType.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.subjectType.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
100. Questionnaire.subjectType.extension:subjectType
Slice Name | subjectType
Definition | R5: `Questionnaire.subjectType` additional codes
Short | R5: subjectType additional codes
Comments | Element `Questionnaire.subjectType` is mapped to FHIR R4 element `Questionnaire.subjectType` as `RelatedTo`. The mappings for `Questionnaire.subjectType` do not allow expression of the necessary codes, per the bindings on the source and target. If none are specified, then the subject is unlimited.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(R5: subjectType additional codes) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
102. Questionnaire.subjectType.value
Definition | Primitive value for code
Short | Primitive value for code
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
104. 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.
Short | Date 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.
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | Revision Date
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. Questionnaire.publisher
Definition | The name of the organization or individual that published the questionnaire.
Short | Name 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.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Helps establish the "authority/credibility" of the questionnaire. May also allow for contact.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. Questionnaire.contact
Definition | Contact details to assist a user in finding and communicating with the publisher.
Short | Contact details for the publisher
Comments | May be a web site, an email address, a telephone number, etc.
Control | 0..*
Type | ContactDetail
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
110. Questionnaire.description
Definition | A free text natural language description of the questionnaire from a consumer's perspective.
Short | Natural 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).
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
112. 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.
Short | The 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.
Control | 0..*
Type | UsageContext
Is Modifier | false
Summary | true
Requirements | Assist in searching for appropriate content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. Questionnaire.jurisdiction
Definition | A legal or geographic region in which the questionnaire is intended to be used.
Short | Intended 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from Jurisdiction ValueSet (extensible to `http://hl7.org/fhir/ValueSet/jurisdiction|4.0.1` ) Countries and regions within which this artifact is targeted for use.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. Questionnaire.purpose
Definition | Explanation of why this questionnaire is needed and why it has been designed as it has.
Short | Why 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.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. 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.
Short | Use and/or publishing restrictions
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Consumers must be able to determine any legal restrictions on the use of the questionnaire and/or its content.
Alternate Names | License, Restrictions
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. 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.
Short | When 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.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. 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.
Short | When the questionnaire was last reviewed
Comments | If specified, this date follows the original approval date.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. Questionnaire.effectivePeriod
Definition | The period during which the questionnaire content was or is planned to be in active use.
Short | When 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.
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. Questionnaire.code
Definition | An identifier for this question or group of questions in a particular terminology such as LOINC.
Short | Concept that represents the overall questionnaire
Control | 0..*
Binding | For example codes, see QuestionnaireQuestionCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-questions|4.0.1` ) Codes for questionnaires, groups and individual questions.
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. Questionnaire.item
Definition | A particular question, question grouping or display text that is part of the questionnaire.
Short | Questions and sections within the Questionnaire
Comments | The content of the questionnaire is constructed from an ordered, hierarchical collection of items.
Control | 0..* This element is affected by the following invariants: que-3
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-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-1a: Group items must have nested items when Questionanire is complete (`(type='group' and %resource.status='complete') implies item.empty().not()`) que-1b: Groups should have items (`type='group' implies item.empty().not()`) que-1c: Display items cannot have child items (`type='display' implies item.empty()`) que-14: Can only have answerConstraint if answerOption, answerValueSet, or answerExpression are present. (This is a warning because other extensions may serve the same purpose) (`extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.item.answerConstraint').exists() implies answerOption.exists() or answerValueSet.exists() or extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').exists()`) dtrq-2: if item type is 'choice' or 'open-choice', then it should have either the answerOption, answerValueSet, or answerExpression extension (`(type='choice' or type='open-choice') implies answerOption.exists() or answerValueSet.exists() or extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').exists()`) dtrq-3: if item type is Quantity, then it should have either the unitOption or unitValueSet extension (`(type='quantity') implies extension.where(url='http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption').exists() or extension.where(url='http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet').exists()`) dtrq-4: if item type is Reference, then it must have a referenceResource extension (`(type='reference') implies extension.where(url='http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource').exists()`) dtrq-5: if item type is Reference, then it should have a candidateExpression extension (`(type='reference') implies extension.where(url='http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression').exists()`)
130. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
132. Questionnaire.item.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
134. Questionnaire.item.extension:hidden
Slice Name | hidden
Definition | If true, indicates that the extended item should not be displayed to the user.
Short | Don'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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Questionnaire Hidden) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
136. Questionnaire.item.extension:terminologyServer
Slice Name | terminologyServer
Definition | Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the resource or a particular portion of the resource (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 (one of) the preferredTerminologyServer(s) rather than the local repository. Systems SHOULD evaluate value sets using terminology servers as follows: First, try any terminology servers declared on the element in question. If there are more then one, try them in the order they appear. Then try any servers that appear on ancestor elements in order of closest ancestor up to any on the resource root If there are no declared servers or none of the ones listed provide a useful response, the form filler may then try any of the typical servers it would normally use. A 'useful response' means a response that provides a valid (though potentially empty) expansion. Clients MAY wish to log/report errors returned by terminology servers.
Short | Preferred terminology server
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Preferred Terminology Server) (Extension Type: url)
Is Modifier | false
Summary | false
Invariants | 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()`)
138. Questionnaire.item.extension:disabledDisplay
Slice Name | disabledDisplay
Definition | R5: `Questionnaire.item.disabledDisplay` (new:code)
Short | R5: hidden | protected (new)
Comments | Element `Questionnaire.item.disabledDisplay` has a context of Questionnaire.item based on following the parent source element upwards and mapping to `Questionnaire`. Element `Questionnaire.item.disabledDisplay` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If not specified, rendering behavior is up to the client. This element is only meaningful if enableWhen or an equivalent extension is present
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(R5: hidden | protected (new)) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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()`)
140. Questionnaire.item.extension:answerConstraint
Slice Name | answerConstraint
Definition | R5: `Questionnaire.item.answerConstraint` (new:code)
Short | R5: optionsOnly | optionsOrType | optionsOrString (new)
Comments | Element `Questionnaire.item.answerConstraint` has a context of Questionnaire.item based on following the parent source element upwards and mapping to `Questionnaire`. Element `Questionnaire.item.answerConstraint` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(R5: optionsOnly | optionsOrType | optionsOrString (new)) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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()`)
142. Questionnaire.item.extension:designNote
Slice Name | designNote
Definition | Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.
Short | Design 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 QuestionnaireResponse would use Observation.
Control | 0..1
Type | Extension(Design Note) (Extension Type: markdown)
Is Modifier | false
Summary | false
Invariants | 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()`)
144. Questionnaire.item.extension:itemOptionalDisplay
Slice Name | itemOptionalDisplay
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.
Short | Can 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.
Control | 0..0
Type | Extension(Optional Display?) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | 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()`)
146. Questionnaire.item.extension:itemControl
Slice Name | itemControl
Definition | The type of data entry control or structure that should be used to render the item.
Short | E.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.
Control | 0..1
Type | Extension(Questionnaire Item Control) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
148. Questionnaire.item.extension:choiceOrientation
Slice Name | choiceOrientation
Definition | Identifies the desired orientation when rendering a list of choices (typically radio-box or check-box lists).
Short | horizontal | 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.
Control | 0..1
Type | Extension(Questionnaire ChoiceOrientation) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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()`)
150. Questionnaire.item.extension:displayCategory
Slice Name | displayCategory
Definition | Describes the intended purpose of the rendered text. For example - instructions, guidance on access control, maintenance information, etc.
Short | Purpose of rendered text
Comments | ​See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Display Category) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | 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()`)
152. Questionnaire.item.extension:supportHyperlink
Slice Name | supportHyperlink
Definition | A labeled hyperlink for display alongside a questionnaire item, providing supporting guidance to the user.
Short | A labeled hyperlink for user guidance
Control | 0..1
Type | Extension(Questionnaire Support Hyperlink) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | 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()`)
154. Questionnaire.item.extension:sliderStepValue
Slice Name | sliderStepValue
Definition | For slider-based controls, indicates the step size to use when toggling the control up or down.
Short | Increment value for slider
Comments | ​See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Slider Step Value) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | 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()`)
156. Questionnaire.item.extension:entryFormat
Slice Name | entryFormat
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.
Short | User prompt for format
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Entry format) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`)
158. Questionnaire.item.extension:usageMode
Slice Name | usageMode
Definition | Identifies that the specified element should only appear in certain "modes" of operation.
Short | capture | display | display-non-empty | capture-display | capture-display-non-empty
Comments | ​See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(QuestionnaireResponse Usage Mode) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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()`)
160. Questionnaire.item.extension:itemSignatureRequired
Slice Name | itemSignatureRequired
Definition | Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.
Short | Is 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.
Control | 0..1
Type | Extension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | 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()`)
162. Questionnaire.item.extension:minOccurs
Slice Name | minOccurs
Definition | The minimum number of times the group must appear, or the minimum number of answers for a question - when greater than 1.
Short | Minimum repetitions
Comments | ​Default assumption for "required" elements is minOccurs=1. See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Min Occurs) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | 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.extension:maxOccurs
Slice Name | maxOccurs
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.
Short | Maximum 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.
Control | 0..1
Type | Extension(Questionnaire Max Occurs) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | 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.extension:minLength
Slice Name | minLength
Definition | The minimum number of characters that must be present in the simple data type to be considered a "valid" instance.
Short | At 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.
Control | 0..1
Type | Extension(Min length) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | 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()`)
168. Questionnaire.item.extension:regex
Slice Name | regex
Definition | A regular expression that defines the syntax for the data element to be considered valid.
Short | Regular expression pattern
Control | 0..1
Type | Extension(Regex) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`)
170. Questionnaire.item.extension:minValue
Slice Name | minValue
Definition | The inclusive lower bound on the range of allowed values for the data element.
Short | Must 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.
Control | 0..1
Type | Extension(Min value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, Quantity)
Is Modifier | false
Summary | false
Invariants | 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.extension:maxValue
Slice Name | maxValue
Definition | The inclusive upper bound on the range of allowed values for the data element.
Short | Must 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.
Control | 0..1
Type | Extension(Max value) (Extension Type: Choice of: date, dateTime, time, decimal, integer, Quantity)
Is Modifier | false
Summary | false
Invariants | 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.extension:maxDecimalPlaces
Slice Name | maxDecimalPlaces
Definition | Identifies the maximum number of decimal places that may be specified for the data element.
Short | Maximum digits after decimal
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide. This specifies the maximum number of digits that can appear after the decimal point in a number. It counts all the digits to the right of the decimal point when the number is written out in full, standard decimal form (without 'e' or 'E'). For example, a number in scientific notation like 1.23e-4 equals 0.000123 when expanded; it would be consistent with a maximum number of decimal places of 6 or more.
Control | 0..1
Type | Extension(Max decimal places) (Extension Type: Choice of: integer, Quantity)
Is Modifier | false
Summary | false
Invariants | 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.extension:mimeType
Slice Name | mimeType
Definition | Identifies the kind(s) of attachment allowed to be sent for an element.
Short | Type 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.
Control | 0..1
Type | Extension(Mime type) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
178. Questionnaire.item.extension:maxSize
Slice Name | maxSize
Definition | For attachment answers, indicates the maximum size in bytes an attachment can be.
Short | Max 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.
Control | 0..1
Type | Extension(Max size) (Extension Type: decimal)
Is Modifier | false
Summary | false
Invariants | 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()`)
180. Questionnaire.item.extension:unitOption
Slice Name | unitOption
Definition | A unit that the user may choose when providing a quantity value.
Short | Unit 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.
Control | 0..*
Type | Extension(QuestionnaireResponse Unit Option) (Extension Type: Coding)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
182. Questionnaire.item.extension:referenceResource
Slice Name | referenceResource
Definition | Where the type for a question is "Reference", indicates a type of resource that is permitted.
Short | Allowed 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.
Control | 0..*
Type | Extension(Questionnaire Reference Resource) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
184. Questionnaire.item.extension:referenceProfile
Slice Name | referenceProfile
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.
Short | Allowed 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.
Control | 0..*
Type | Extension(Questionnaire Reference Profile) (Extension Type: canonical(StructureDefinition))
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
186. Questionnaire.item.extension:itemConstraint
Slice Name | itemConstraint
Definition | Specifies a constraint that is enforced on instantiated (or target) resources. This extension can be applied to definitional resources (such as ActivityDefinition or Measure) and indicates that the constraint should be enforced on resources that are instantiated from the definition.
Short | A constraint on the target resource
Comments | Can be used on any definitional artifact to define a constraint that is enforced in the context of an instantiated resource. The constraint expression will have access to `%target` and `%definition` variables, where target is the instantiated resource, and definition is the definition used to instantiate.
Control | 0..*
Type | Extension(Target Constraint) (Complex Extension)
Is Modifier | false
Invariants | 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()`)
188. Questionnaire.item.extension:unit
Slice Name | unit
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.
Short | Unit for numeric answer
Comments | The human-readable unit is conveyed as a display element. This element is for computation purposes.
Control | 0..1
Type | Extension(Questionnaire Unit) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | 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()`)
190. Questionnaire.item.extension:unitValueSet
Slice Name | unitValueSet
Definition | A set of units that the user may choose when providing a quantity value.
Short | Unit 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.
Control | 0..1
Type | Extension(QuestionnaireResponse Unit ValueSet) (Extension Type: canonical(ValueSet))
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
192. Questionnaire.item.extension:itemMedia
Slice Name | itemMedia
Definition | Media to render/make available as an accompaniment to the question being asked
Short | Media to display
Control | 0..1
Type | Extension(Item Media) (Extension Type: Attachment)
Is Modifier | false
Summary | false
Invariants | 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()`)
194. Questionnaire.item.extension:shortText
Slice Name | shortText
Definition | The short text for the item.
Short | Short 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).
Control | 0..1
Type | Extension(Short Text) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`)
196. Questionnaire.item.extension:openLabel
Slice Name | openLabel
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.
Short | Image to display
Control | 0..1
Type | Extension(Label for 'open' items) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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.extension:choiceColumn
Slice Name | choiceColumn
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).
Short | Guide for rendering multi-column choices
Comments | Each repetition represents a column to display.
Control | 0..*
Type | Extension(Choice column) (Complex Extension)
Is Modifier | false
Invariants | 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()`)
200. Questionnaire.item.extension:width
Slice Name | width
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.
Short | Width of column for question
Comments | code missing = pixels; code = % = percentage.
Control | 0..1
Type | Extension(Width of column) (Extension Type: Quantity)
Is Modifier | false
Summary | false
Invariants | 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()`)
202. Questionnaire.item.extension:collapsible
Slice Name | collapsible
Definition | Indicates whether the child items of a group or question item is displayed in collapsible form.
Short | Indicates whether the child items of a group or question item is displayed in collapsible form.
Control | 0..1
Type | Extension(Collapsible) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | 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()`)
204. Questionnaire.item.extension:minQuantity
Slice Name | minQuantity
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.
Short | Must 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.
Control | 0..1
Type | Extension(Min quantity) (Extension Type: Quantity)
Is Modifier | false
Summary | false
Invariants | 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.extension:maxQuantity
Slice Name | maxQuantity
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.
Short | Must 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.
Control | 0..1
Type | Extension(Max quantity) (Extension Type: Quantity)
Is Modifier | false
Summary | false
Invariants | 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()`)
208. Questionnaire.item.extension:lookupQuestionnaire
Slice Name | lookupQuestionnaire
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.
Short | Questionnaire to populate a reference
Control | 0..1
Type | Extension(Lookup questionnaire) (Extension Type: canonical(Questionnaire))
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
210. Questionnaire.item.extension:candidateExpression
Slice Name | candidateExpression
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.
Short | Expression 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. If the expression returns coded data, it *SHALL return the information as either code or Coding, not CodeableConcept. If the expression returns elements of type 'code', when the user selects one or more candidates, the code will be matched against the allowed Codings (from answerValueSet, answerOptions, or answerExpresssion). In this case, it is an error if there is more than one Coding with the same code.
Control | 0..1
Type | Extension(Candidate Answers Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
212. Questionnaire.item.extension:candidateExpression.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
214. Questionnaire.item.extension:candidateExpression.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
216. Questionnaire.item.extension:candidateExpression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression`
218. Questionnaire.item.extension:candidateExpression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Type | Expression
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. Questionnaire.item.extension:candidateExpression.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
222. Questionnaire.item.extension:candidateExpression.value[x].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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
224. Questionnaire.item.extension:candidateExpression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Definition | Provides an alternate expression containing the compiled JSON ELM for an expression. (NOTE: The expectation is that this extension will transition to the core extensions pack)
Short | Alternative Expression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
226. Questionnaire.item.extension:candidateExpression.value[x].description
Definition | A brief, natural language description of the condition that effectively communicates the intended semantics.
Short | Natural language description of the condition
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
228. Questionnaire.item.extension:candidateExpression.value[x].name
Definition | A short name assigned to the expression to allow for multiple reuse of the expression in the context where it is defined.
Short | Short name assigned to expression for reuse
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
230. Questionnaire.item.extension:candidateExpression.value[x].language
Definition | The media type of the language for the expression.
Short | text/cql | text/fhirpath | application/x-fhir-query | etc.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ExpressionLanguage (extensible to `http://hl7.org/fhir/ValueSet/expression-language|4.0.1` ) The media type of the expression language.
Additional Bindings | Purpose
http://www.rfc-editor.org/bcp/bcp13.txt | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
232. Questionnaire.item.extension:candidateExpression.value[x].expression
Definition | An expression in the specified language that returns a value.
Short | Expression in specified language
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. Questionnaire.item.extension:candidateExpression.value[x].reference
Definition | A URI that defines where the expression is found.
Short | Where the expression is found
Comments | If both a reference and an expression is found, the reference SHALL point to the same expression.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
236. Questionnaire.item.extension:initialExpression
Slice Name | initialExpression
Definition | Initial value for a question answer as determined by an evaluated expression.
Short | Expression-determined initial value
Comments | Initial value is only calculated at the time the QuestionnaireResponse is first generated. If the expression returns coded data, it *SHALL return the information as either code or Coding, not CodeableConcept. If the expression returns elements of type 'code', when the user selects one or more candidates, the code will be matched against the allowed Codings (from answerValueSet, answerOptions, or answerExpression). In this case, it is an error if there is more than one Coding with the same code.
Control | 0..1
Type | Extension(Initial Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
238. Questionnaire.item.extension:initialExpression.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
240. Questionnaire.item.extension:initialExpression.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
242. Questionnaire.item.extension:initialExpression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression`
244. Questionnaire.item.extension:initialExpression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Type | Expression
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
246. Questionnaire.item.extension:initialExpression.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
248. Questionnaire.item.extension:initialExpression.value[x].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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
250. Questionnaire.item.extension:initialExpression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Definition | Provides an alternate expression containing the compiled JSON ELM for an expression. (NOTE: The expectation is that this extension will transition to the core extensions pack)
Short | Alternative Expression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
252. Questionnaire.item.extension:initialExpression.value[x].description
Definition | A brief, natural language description of the condition that effectively communicates the intended semantics.
Short | Natural language description of the condition
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
254. Questionnaire.item.extension:initialExpression.value[x].name
Definition | A short name assigned to the expression to allow for multiple reuse of the expression in the context where it is defined.
Short | Short name assigned to expression for reuse
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
256. Questionnaire.item.extension:initialExpression.value[x].language
Definition | The media type of the language for the expression.
Short | text/cql | text/fhirpath | application/x-fhir-query | etc.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ExpressionLanguage (extensible to `http://hl7.org/fhir/ValueSet/expression-language|4.0.1` ) The media type of the expression language.
Additional Bindings | Purpose
http://www.rfc-editor.org/bcp/bcp13.txt | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
258. Questionnaire.item.extension:initialExpression.value[x].expression
Definition | An expression in the specified language that returns a value.
Short | Expression in specified language
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
260. Questionnaire.item.extension:initialExpression.value[x].reference
Definition | A URI that defines where the expression is found.
Short | Where the expression is found
Comments | If both a reference and an expression is found, the reference SHALL point to the same expression.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
262. Questionnaire.item.extension:calculatedExpression
Slice Name | calculatedExpression
Definition | Calculated value for a question answer as determined by an evaluated expression.
Short | Expression-determined initial value
Comments | Calculated value is updated as other answers in the QuestionnaireResponse are filled in.
Control | 0..1
Type | Extension(Calculated Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
264. Questionnaire.item.extension:calculatedExpression.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
266. Questionnaire.item.extension:calculatedExpression.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
268. Questionnaire.item.extension:calculatedExpression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression`
270. Questionnaire.item.extension:calculatedExpression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Expression
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
272. Questionnaire.item.extension:calculatedExpression.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
274. Questionnaire.item.extension:calculatedExpression.value[x].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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
276. Questionnaire.item.extension:calculatedExpression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Definition | Provides an alternate expression containing the compiled JSON ELM for an expression. (NOTE: The expectation is that this extension will transition to the core extensions pack)
Short | Alternative Expression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
278. Questionnaire.item.extension:calculatedExpression.value[x].description
Definition | A brief, natural language description of the condition that effectively communicates the intended semantics.
Short | Natural language description of the condition
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
280. Questionnaire.item.extension:calculatedExpression.value[x].name
Definition | A short name assigned to the expression to allow for multiple reuse of the expression in the context where it is defined.
Short | Short name assigned to expression for reuse
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
282. Questionnaire.item.extension:calculatedExpression.value[x].language
Definition | The media type of the language for the expression.
Short | text/cql | text/fhirpath | application/x-fhir-query | etc.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ExpressionLanguage (extensible to `http://hl7.org/fhir/ValueSet/expression-language|4.0.1` ) The media type of the expression language.
Additional Bindings | Purpose
http://www.rfc-editor.org/bcp/bcp13.txt | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
284. Questionnaire.item.extension:calculatedExpression.value[x].expression
Definition | An expression in the specified language that returns a value.
Short | Expression in specified language
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
286. Questionnaire.item.extension:calculatedExpression.value[x].reference
Definition | A URI that defines where the expression is found.
Short | Where the expression is found
Comments | If both a reference and an expression is found, the reference SHALL point to the same expression.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
288. Questionnaire.item.extension:contextExpression
Slice Name | contextExpression
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.
Short | Expression for information to guide answers
Control | 0..*
Type | Extension(Answer Context Expression) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | 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()`)
290. Questionnaire.item.extension:contextExpression.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
292. Questionnaire.item.extension:contextExpression.extension
Definition | An Extension
Short | Extension
Control | 2..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
294. Questionnaire.item.extension:contextExpression.extension:label
Slice Name | label
Definition | The text to display in the form filler user interface that explains what the returned context information means
Short | Context label
Control | 1..1
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
296. Questionnaire.item.extension:contextExpression.extension:label.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
298. Questionnaire.item.extension:contextExpression.extension:label.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
300. Questionnaire.item.extension:contextExpression.extension:label.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `label`
302. Questionnaire.item.extension:contextExpression.extension:label.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
304. Questionnaire.item.extension:contextExpression.extension:expression
Slice Name | expression
Definition | An Extension
Short | Extension
Control | 1..1
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
306. Questionnaire.item.extension:contextExpression.extension:expression.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
308. Questionnaire.item.extension:contextExpression.extension:expression.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
310. Questionnaire.item.extension:contextExpression.extension:expression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `expression`
312. Questionnaire.item.extension:contextExpression.extension:expression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Expression
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
314. Questionnaire.item.extension:contextExpression.extension:expression.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
316. Questionnaire.item.extension:contextExpression.extension:expression.value[x].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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
318. Questionnaire.item.extension:contextExpression.extension:expression.value[x].extension:alternativeExpression
Slice Name | alternativeExpression
Definition | Provides an alternate expression containing the compiled JSON ELM for an expression. (NOTE: The expectation is that this extension will transition to the core extensions pack)
Short | Alternative Expression
Control | 0..1
Type | Extension(Alternative Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
320. Questionnaire.item.extension:contextExpression.extension:expression.value[x].description
Definition | A brief, natural language description of the condition that effectively communicates the intended semantics.
Short | Natural language description of the condition
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
322. Questionnaire.item.extension:contextExpression.extension:expression.value[x].name
Definition | A short name assigned to the expression to allow for multiple reuse of the expression in the context where it is defined.
Short | Short name assigned to expression for reuse
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
324. Questionnaire.item.extension:contextExpression.extension:expression.value[x].language
Definition | The media type of the language for the expression.
Short | text/cql | text/fhirpath | application/x-fhir-query | etc.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ExpressionLanguage (extensible to `http://hl7.org/fhir/ValueSet/expression-language|4.0.1` ) The media type of the expression language.
Additional Bindings | Purpose
http://www.rfc-editor.org/bcp/bcp13.txt | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
326. Questionnaire.item.extension:contextExpression.extension:expression.value[x].expression
Definition | An expression in the specified language that returns a value.
Short | Expression in specified language
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
328. Questionnaire.item.extension:contextExpression.extension:expression.value[x].reference
Definition | A URI that defines where the expression is found.
Short | Where the expression is found
Comments | If both a reference and an expression is found, the reference SHALL point to the same expression.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
330. Questionnaire.item.extension:contextExpression.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-contextExpression`
332. Questionnaire.item.extension:contextExpression.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..0
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
334. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
336. Questionnaire.item.linkId
Definition | An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.
Short | Unique 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) que-15: Link ids must be 255 characters or less (`$this.length() <= 255`)
338. 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).
Short | ElementDefinition - 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.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
340. 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).
Short | Corresponding concept for this item in a terminology
Comments | The value may come from the ElementDefinition referred to by .definition.
Control | 0..* This element is affected by the following invariants: que-3
Binding | For example codes, see QuestionnaireQuestionCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-questions|4.0.1` ) Codes for questionnaires, groups and individual questions.
Type | Coding
Is Modifier | false
Summary | false
Requirements | Allows linking of groups of questions to formal terminologies.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
342. 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.
Short | E.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.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
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 Names | label
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
344. Questionnaire.item.prefix.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
346. Questionnaire.item.prefix.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
348. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
Slice Name | itemPrefixRenderingStyle
Definition | Indicates an HTML style that should be applied when rendering this element.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. NOTE: HTML styles can include references to external content (images, fonts, etc.), which may constitute a security issue, as resolving the link can allow tracking. See here for more detail. ​For questionnaires, see additional guidance and examples in the SDC implementation guide. This style applies to the base string. If there is also a rendering-xhtml or rendering-markdown extension, they must declare any relevant styles within those extension values. Setting styles on elements can be risky. It presumes knowledge of how elements are rendered "by default". For example, setting the color of an element to 'blue' to highlight it might be fine - unless the default background color for a particular renderer is already blue. As well, it's not a given that all elements will be represented by a single HTML element. One element might be referenced by a collection of table cells that span rows and columns. Setting a border style on all of those cells wouldn't give the desired results and auto-tweaking the border style on each cell (deciding whether the border is top,left, right, etc.) would require complex coding. Finally, systems might not be using HTML for their UI at all and will need to map the specified styles to their own UI mechanism. For this reason, this element is best used when: a) the default UI characteristics are already well understood (because the specification applies to a single system or to a set of systems that are already required to comply with specific UI expectations b) the set of allowed style values is tightly controlled to only those that are necessary and sensible in that context
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`)
350. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
Slice Name | itemPrefixRenderingXhtml
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.
Short | String equivalent with html markup
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`)
352. Questionnaire.item.prefix.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Max Length: | 1048576
354. Questionnaire.item.text
Definition | The name of a section, the text of a question or text content for a display item.
Short | Primary 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. This is optional only to support form assembly situations where the text may be generated from another source. In an assembled Questionnaire, it should always be present.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
356. Questionnaire.item.text.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
358. Questionnaire.item.text.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
360. Questionnaire.item.text.extension:itemTextRenderingStyle
Slice Name | itemTextRenderingStyle
Definition | Indicates an HTML style that should be applied when rendering this element.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. NOTE: HTML styles can include references to external content (images, fonts, etc.), which may constitute a security issue, as resolving the link can allow tracking. See here for more detail. ​For questionnaires, see additional guidance and examples in the SDC implementation guide. This style applies to the base string. If there is also a rendering-xhtml or rendering-markdown extension, they must declare any relevant styles within those extension values. Setting styles on elements can be risky. It presumes knowledge of how elements are rendered "by default". For example, setting the color of an element to 'blue' to highlight it might be fine - unless the default background color for a particular renderer is already blue. As well, it's not a given that all elements will be represented by a single HTML element. One element might be referenced by a collection of table cells that span rows and columns. Setting a border style on all of those cells wouldn't give the desired results and auto-tweaking the border style on each cell (deciding whether the border is top,left, right, etc.) would require complex coding. Finally, systems might not be using HTML for their UI at all and will need to map the specified styles to their own UI mechanism. For this reason, this element is best used when: a) the default UI characteristics are already well understood (because the specification applies to a single system or to a set of systems that are already required to comply with specific UI expectations b) the set of allowed style values is tightly controlled to only those that are necessary and sensible in that context
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`)
362. Questionnaire.item.text.extension:itemTextRenderingXhtml
Slice Name | itemTextRenderingXhtml
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.
Short | String equivalent with html markup
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
364. Questionnaire.item.text.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Max Length: | 1048576
366. 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.).
Short | group | 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).
Control | 1..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Defines the format in which the user is to be prompted for the answer.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
368. 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.
Short | Only 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.
Control | 0..*
Type | BackboneElement
Is Modifier | true because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
Summary | false
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.
Invariants | ele-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)`)
370. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
372. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
374. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
376. Questionnaire.item.enableWhen.question
Definition | The linkId for the question whose answer (or lack of answer) governs whether this item is enabled.
Short | Question 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
378. Questionnaire.item.enableWhen.operator
Definition | Specifies the criteria by which the question is enabled.
Short | exists | = | != | > | < | >= | <=
Control | 1..1
Binding | The codes SHALL be taken from QuestionnaireItemOperator (required to `http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1` ) The criteria by which a question is enabled.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
380. 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.
Short | Value for question comparison based on operator
Control | 1..1 This element is affected by the following invariants: que-7
Binding | For example codes, see QuestionnaireAnswerCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Allowed values to answer questions.
Type | Choice of: boolean, decimal, integer, date, dateTime, time, string, Coding, Quantity, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
382. Questionnaire.item.enableBehavior
Definition | Controls how multiple enableWhen values are interpreted - whether all or any must be true.
Short | all | any
Comments | This element must be specified if more than one enableWhen value is provided.
Control | 0..1 This element is affected by the following invariants: que-12
Binding | The codes SHALL be taken from EnableWhenBehavior (required to `http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1` ) Controls how multiple enableWhen values are interpreted - whether all or any must be true.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
384. 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.
Short | Whether 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.
Control | 0..1 This element is affected by the following invariants: que-6
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Meaning if Missing | Items are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
386. 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)
Short | Whether 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.
Control | 0..1 This element is affected by the following invariants: que-6
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
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 Missing | Items are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
388. Questionnaire.item.readOnly
Definition | An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.
Short | Don'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.
Control | 0..1 This element is affected by the following invariants: que-9
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
390. Questionnaire.item.maxLength
Definition | The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse.
Short | No 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.
Control | 0..1 This element is affected by the following invariants: que-10
Type | integer
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
392. 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.
Short | Valueset 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.
Control | 0..1 This element is affected by the following invariants: que-4, que-5
Type | canonical(SDC Value Set)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
394. Questionnaire.item.answerOption
Definition | One of the permitted answers for a "choice" or "open-choice" question.
Short | Permitted 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.
Control | 0..* This element is affected by the following invariants: que-4, que-5
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
396. Questionnaire.item.answerOption.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
398. Questionnaire.item.answerOption.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
400. Questionnaire.item.answerOption.extension:optionExclusive
Slice Name | optionExclusive
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.
Short | Option is exclusive
Comments | ​See additional guidance and examples in the SDC implementation guide.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Questionnaire Option Exclusive) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
402. Questionnaire.item.answerOption.extension:ordinalValue
Slice Name | ordinalValue
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.
Short | Assigned 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Ordinal Value) (Extension Type: decimal)
Is Modifier | false
Summary | false
Invariants | 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()`)
404. Questionnaire.item.answerOption.extension:itemAnswerMedia
Slice Name | itemAnswerMedia
Definition | Media to render/make available as an accompaniment to a specific answer option
Short | Answer Media to display
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Item Answer Media) (Extension Type: Attachment)
Is Modifier | false
Summary | false
Invariants | 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()`)
406. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
408. Questionnaire.item.answerOption.value[x]
Definition | A potential answer that's allowed as the answer to this question.
Short | Answer value
Comments | The data type of the value must agree with the item.type.
Control | 1..1
Binding | For example codes, see QuestionnaireAnswerCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Allowed values to answer questions.
Type | Choice of: integer, date, time, string, Coding, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Questionnaire.item.answerOption.value[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
410. Questionnaire.item.answerOption.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
412. Questionnaire.item.answerOption.value[x].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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.answerOption.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
414. Questionnaire.item.answerOption.value[x].extension:answerOptionRenderingXhtml
Slice Name | answerOptionRenderingXhtml
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.
Short | String equivalent with html markup
Comments | ​For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
416. Questionnaire.item.answerOption.value[x]:valueCoding
Slice Name | valueCoding
Definition | A potential answer that's allowed as the answer to this question.
Short | Answer value
Comments | The data type of the value must agree with the item.type.
Control | 0..1
Binding | For example codes, see QuestionnaireAnswerCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Allowed values to answer questions.
Type | Coding
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) sdc-base-1: AnswerOption.valueCoding must have at least one of code or display (`code.exists() or display.exists()`) sdc-base-2: If code exists, system must exist (`code.exists() implies system.exists()`)
418. Questionnaire.item.answerOption.value[x]:valueReference
Slice Name | valueReference
Definition | A potential answer that's allowed as the answer to this question.
Short | Answer value
Comments | The data type of the value must agree with the item.type.
Control | 0..1
Type | Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) sdc-base-4: Reference must have at least one of reference, display, and identifier (`reference.exists() or display.exists() or identifier.exists()`)
420. Questionnaire.item.answerOption.initialSelected
Definition | Indicates whether the answer value is selected when the list of possible answers is initially shown.
Short | Whether option is selected by default
Comments | Use this instead of initial[v] if answerValueSet is present.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Meaning if Missing | Only selected items explicitly marked to be selected
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
422. Questionnaire.item.initial
Definition | One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.
Short | Initial 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.
Control | 0..* This element is affected by the following invariants: que-8, que-13
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | In some workflows, having defaults saves time.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
424. Questionnaire.item.initial.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
426. Questionnaire.item.initial.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
428. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
430. Questionnaire.item.initial.value[x]
Definition | The actual value to for an initial answer.
Short | Actual value for initializing the question
Comments | The type of the initial value must be consistent with the type of the item.
Control | 1..1
Binding | For example codes, see QuestionnaireAnswerCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Allowed values to answer questions.
Type | Choice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
432. Questionnaire.item.item
Definition | Text, questions and other groups to be nested beneath a question or group.
Short | Nested 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.
Control | 0..* This element is affected by the following invariants: que-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
Is Modifier | false
Must Support | true
Summary | false
Requirements | Reports can consist of complex nested groups.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)