Structured Data Capture
3.0.0 - STU 3 International flag

Structured Data Capture, published by HL7 International - FHIR Infrastructure Work Group. This is not an authorized publication; it is the continuous build for version 3.0.0). This version is based on the current content of https://github.com/HL7/sdc/ and changes regularly. See the Directory of published versions

Questionnaire: SDC-Advanced Form Behavior

Official URL: http://build.fhir.org/ig/HL7/sdc/questionnaire-sdc-profile-example-form-behavior Version: 3.0.0
Standards status: Informative Computable Name: SDCAdvancedRenderingExample
Structure
LinkIdTextCardinalityTypeFlagsDescription & Constraintsdoco
.. SDCAdvancedRenderingExampleQuestionnairehttp://build.fhir.org/ig/HL7/sdc/questionnaire-sdc-profile-example-form-behavior#3.0.0
... 1Value constraints0..1group
.... 1.1First Name0..1stringMax Length: 50
.... 1.2Last Name0..1string
.... 1.3Postal Code (A1A 1A1)0..1string
.... 1.4Enter your weight in kg0..1decimal
.... 1.5Body Weight0..1quantity
.... 1.6Attach Proof of Citizenship0..1attachment
... 2Value constraints0..1group
.... 2.1(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more.0..1choiceOptions: 4 options
.... 2.3Activity Level0..1choiceValue Set: http://loinc.org/vs/LL4882-8
.... 2.5Applicable health conditions0..*choiceValue Set: #vsConditionsAll
.... 2.6Email*1..1string
.... 2.7Current Date:0..1dateiconExpressions:
.... 2.7.1null0..1display
.... 2.8Heart History (check all that applies)0..*open-choiceOptions: 5 options
.... 2.9Heart History (check at least 2):1..*choiceOptions: 5 options
.... 2.10Heart History (check no more than 3):1..*choiceOptions: 5 options
.... 2.11What treatments do you now have for heart disease? (select all that applies)0..*choiceOptions: 6 options
.... 2.12Dosage0..1quantity
.... 2.13Specify age:0..1quantity
.... 2.14Select your preferred practitioner:0..1reference
... 3Calculation0..1group
.... 3.1Deadline for submission (7 days from now)0..1dateiconExpressions:
.... 3.2null0..1group
..... 3.2.1Last Name:0..1stringiconExpressions:
..... 3.2.2First Name:0..1stringiconExpressions:
..... 3.2.3Gender:0..1stringiconExpressions:
.... 3.3Calculated Expression0..1group
..... 3.3.1Weight (kg)0..1decimal
..... 3.3.2Body Height (inches)0..1decimal
..... 3.3.3Your Body Mass Index (BMI) is0..1decimaliconExpressions:
.... 3.4CQF-related Example0..1group
..... 3.4.1Enter weight in kg0..1decimal
..... 3.4.2Enter email address0..1string
.... 3.5null0..1display
... 4Other Controls0..1group
.... 4.1Marital Status0..1choiceValue Set: MaritalStatus
Initial Value: Coding = MaritalStatus#D "Divorced"
.... 4.2null0..1group
..... 4.2.1Choose Gender0..1choiceValue Set: AdministrativeGender
..... 4.2.2Are you pregnant? (enableWhen = gender is Female)0..1choiceEnable When: 4.2.1 = Female (AdministrativeGender#female)
Value Set: Yes/No/Don't Know
..... 4.2.3Are you diabetic? (enableWhen = gender is Female)0..1choiceEnable When: 4.2.1 = Female (AdministrativeGender#female)
Value Set: Yes/No/Don't Know
..... 4.2.4Have you been diagnosed with Gestational Diabetes? (enableBehavior = only when pregnant and diabetic)0..1choiceEnable When:
  • 4.2.2 = Yes (v2 Y/N Indicator#Y)
  • 4.2.3 = Yes (v2 Y/N Indicator#Y)

Value Set: Yes/No/Don't Know
..... 4.2.5Enter your birthdate (MM/DD/YYYY)0..1dateValue Set: AdministrativeGender
..... 4.2.6Have you had mammogram before?(enableWhenExpression = only when gender is female and age > 40)0..1choiceValue Set: Yes/No/Don't Know
Expressions:
  • Enable When: %resource.repeat(item).where(linkId='4.2.b.1').answer.value.code ='female' and today().toString().substring(0, 4).toInteger() - %resource.repeat(item).where(linkId='4.2.b.5').answer.value.toString().substring(0, 4).toInteger() >= 40
.... 4.4Signature of Patient1..1attachment
.... 4.5All the practitioners below can speak the patient's language. Choose all preferred practioners:0..*referenceExpressions:
  • Candidates: Practitioner?communication=&active=true
.... 4.6null0..1group
..... 4.6.1Home Address0..1display
..... 4.6.2Address0..1stringDefinition: Patient.address.line
Expressions:
..... 4.6.3City0..1stringDefinition: Patient.address.city
Expressions:
..... 4.6.4Province0..1choiceDefinition: Patient.address.state
Options: 10 options
Expressions:
..... 4.6.5Postal Code0..1stringDefinition: Patient.address.postalCode
Expressions:

doco Documentation for this format

Option Sets

Answer options for 2.1

  • LOINC: LA28397-0 ("Often true")
  • LOINC: LA6729-3 ("Sometimes true")
  • LOINC: LA28398-8 ("Never true")
  • LOINC: LA15775-2 ("Don't know/refused")

Answer options for 2.8

  • http://example.org/CodeSystem/procedures#U1 ("Heart attack")
  • http://example.org/CodeSystem/procedures#U2 ("Heart surgery")
  • http://example.org/CodeSystem/procedures#U3 ("Cardiac catheterization")
  • http://example.org/CodeSystem/procedures#U4 ("Coronary angioplasty (PTCA)")
  • http://example.org/CodeSystem/procedures#U5 ("Cardiac pacemaker")

Answer options for 2.9

  • http://example.org/CodeSystem/procedures#U1 ("Heart attack")
  • http://example.org/CodeSystem/procedures#U2 ("Heart surgery")
  • http://example.org/CodeSystem/procedures#U3 ("Cardiac catheterization")
  • http://example.org/CodeSystem/procedures#U4 ("Coronary angioplasty (PTCA)")
  • http://example.org/CodeSystem/procedures#U5 ("Cardiac pacemaker")

Answer options for 2.10

  • http://example.org/CodeSystem/procedures#U1 ("Heart attack")
  • http://example.org/CodeSystem/procedures#U2 ("Heart surgery")
  • http://example.org/CodeSystem/procedures#U3 ("Cardiac catheterization")
  • http://example.org/CodeSystem/procedures#U4 ("Coronary angioplasty (PTCA)")
  • http://example.org/CodeSystem/procedures#U5 ("Cardiac pacemaker")

Answer options for 2.11

  • http://example.org/CodeSystem/treatments#noTreatment ("NoTreatment")
  • http://example.org/CodeSystem/treatments#aspirin ("Aspirin")
  • http://example.org/CodeSystem/treatments#otherMeds ("Other medicines, tablets, or pills")
  • http://example.org/CodeSystem/treatments#diet ("Diet")
  • http://example.org/CodeSystem/treatments#exercise ("Exercise")
  • http://example.org/CodeSystem/treatments#none ("None of the above")

Answer options for 4.6.4

  • http://example.org/CodeSystem/provinces#Alberta ("Alberta")
  • http://example.org/CodeSystem/provinces#BritishColumbia ("British Columbia")
  • http://example.org/CodeSystem/provinces#Manitoba ("Manitoba")
  • http://example.org/CodeSystem/provinces#NewBrunswick ("New Brunswick")
  • http://example.org/CodeSystem/provinces#NewfoundlandAndLabrador ("Newfoundland and Labrador")
  • http://example.org/CodeSystem/provinces#NovaScotia ("Nova Scotia")
  • http://example.org/CodeSystem/provinces#Ontario ("Ontario")
  • http://example.org/CodeSystem/provinces#PrinceEdwardIsland ("Prince Edward Island")
  • http://example.org/CodeSystem/provinces#Quebec ("Quebec")
  • http://example.org/CodeSystem/provinces#Saskatchewan ("Saskatchewan")