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復健訓練量表實作指引 (Rehabilitation Training Scale Implementation Guide)
0.2.0 - ci-build

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復健訓練量表實作指引 (Rehabilitation Training Scale Implementation Guide), published by Kimsber. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Kimsber/Rehab-IG/ and changes regularly. See the Directory of published versions

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Resource Profile: IADLQuestionnaireResponse - Detailed Descriptions

Draft as of 2026-06-11

Definitions for the IADLQuestionnaireResponse resource profile.

  • Key Elements Table
  • Differential Elements Table
  • Snapshot Elements Table

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

0. QuestionnaireResponse
Definition

Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems.


A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to.

ShortStandard Questionnaire ResponseA structured set of questions and their answers
Comments

The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.

Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesForm, QuestionnaireAnswers, Form Data
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
sdcqr-1: Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject. (subject.exists())
sdcqr-2: When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers. ((QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
sdcqr-3: Can either have source or source extension, but not both (source.count() + extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-QuestionnaireResponse.source').count() <=1)
2. QuestionnaireResponse.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. QuestionnaireResponse.extension:adheresTo
Slice NameadheresTo
Definition

The action represented by this resource has been determined to satisfy the expectations established by the referenced Definition resource.

ShortFollows rules from
Comments

If changes are made to this event record, the determination must be made whether, with the change, the action still complies with the referenced Definition. Revisions may result in adheresTo assertions being removed, or - if the system has an algorithm for determining which targets are appropriate - being added. Adherence may be asserted after the fact. It is possible for a Request or Event to adhere to a Definition even if the author/performer of the action was not aware of the Definition at the time the action was taken/requested.

Also see the notes in the workflow extensions area for more guidance on this element.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(adheres to) (Extension Type: Choice of: canonical(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), Reference(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), uri)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. QuestionnaireResponse.extension:adheresTo.extension
Definition

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

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

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

    Shortidentifies the meaning of the extension
    Comments

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

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

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

    ShortValue of extension
    Control10..1
    TypeChoice of: canonical(ActivityDefinition, PlanDefinition), Reference(ActivityDefinition, PlanDefinition), uri, 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, TriggerDefinition, Quantity, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. QuestionnaireResponse.extension:triggeredBy
    Slice NametriggeredBy
    Definition

    This resource came into being as a result of expectations set in the referenced Definition resource. I.e. This resource represents a 'step' dictated within the protocol/order set/etc.

    ShortCreated because of following
    Comments

    See the notes in the workflow extensions area for more guidance on this element.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Triggered by) (Extension Type: Choice of: canonical(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), Reference(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), uri)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. QuestionnaireResponse.extension:triggeredBy.extension
    Definition

    An Extension


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

    ShortExtensionAdditional content defined by implementations
    Comments

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

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

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

      Shortidentifies the meaning of the extension
      Comments

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

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

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

      ShortValue of extension
      Control10..1
      TypeChoice of: canonical(ActivityDefinition, PlanDefinition), Reference(ActivityDefinition, PlanDefinition), uri, 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, TriggerDefinition, Quantity, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. QuestionnaireResponse.extension:signature
      Slice Namesignature
      Definition

      Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

      ShortA signature attesting to the content
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      22. QuestionnaireResponse.extension:completionMode
      Slice NamecompletionMode
      Definition

      Indicates how the individual completing the QuestionnaireResponse provided their responses.

      ShortE.g. Verbal, written, electronic
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(QuestionnaireResponse Completion Mode) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      24. QuestionnaireResponse.modifierExtension
      Definition

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

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

      ShortExtensions that cannot be ignored
      Comments

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

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

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

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      26. QuestionnaireResponse.identifier
      Definition

      A business identifier assigned to a particular completed (or partially completed) questionnaire.

      ShortUnique id for this set of answers
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Used for tracking, registration and other business purposes.

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

      The Questionnaire that defines and organizes the questions for which answers are being provided.

      ShortForm being answered
      Comments

      For SDC, this SHALL be the version-specific URL of the form as hosted on the Form Manager.


      If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.).

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

      Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.

      Alternate NamesForm
      Fixed Valuehttps://build.fhir.org/ig/Kimsber/Rehab-IG/Questionnaire/IDALQuestionnaireInstance
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. QuestionnaireResponse.questionnaire.extension:questionnaireDisplay
      Slice NamequestionnaireDisplay
      Definition

      The title or other name to display when referencing a resource by canonical URL.

      ShortDisplay name for canonical reference
      Comments

      This SHALL be the title of the Questionnaire at the time the QuestionnaireResponse was originally authored.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Display Name) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      32. QuestionnaireResponse.status
      Definition

      The position of the questionnaire response within its overall lifecycle.

      Shortin-progress | completed | amended | entered-in-error | stopped
      Comments

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

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

      Lifecycle status of the questionnaire response.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished.

      Pattern Valuecompleted
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. QuestionnaireResponse.subject
      Definition

      The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information.

      ShortThe subject of the questions
      Comments

      If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse


      If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.

      Control10..1
      TypeReference(根據醫院實際病人範例進行資料定義, Resource)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Allows linking the answers to the individual the answers describe. May also affect access control.

      Alternate NamesPatient, Focus
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. QuestionnaireResponse.subject.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. QuestionnaireResponse.authored
      Definition

      Identifies when this version of the answer set was created. Changes whenever the answers are updated.


      The date and/or time that this set of answers were last changed.

      ShortDate the answers were gathered
      Comments

      May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.

      This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible.

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

      Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.

      Alternate NamesDate Created, Date published, Date Issued, Date updated
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. QuestionnaireResponse.author
      Definition

      Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.

      ShortPerson who received and recorded the answers
      Comments

      Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated.

      Control0..1
      TypeReference(Device, Practitioner, PractitionerRole, Patient, RelatedPerson, Organization)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Requirements

      Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.

      Alternate NamesLaboratory, Service, Practitioner, Department, Company, Performer
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. QuestionnaireResponse.source
      Definition

      The person who answered the questions about the subject.

      ShortThe person who answered the questions
      Comments

      If not specified, no inference can be made about who provided the data.

      Control0..1
      TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Requirements

      When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. QuestionnaireResponse.source.extension:r5Source
      Slice Namer5Source
      Definition

      Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.

      ShortAlternative reference (target type is wrong)
      Comments

      Given that a reference SHALL have a display or reference, using this extension implies that there's a display present.

      Control0..1
      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      46. QuestionnaireResponse.source.extension:r5Source.extension
      Definition

      An Extension


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

      ShortExtensionAdditional content defined by implementations
      Comments

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

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on QuestionnaireResponse.source.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 48. QuestionnaireResponse.source.extension:r5Source.url
        Definition

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

        Shortidentifies the meaning of the extension
        Comments

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

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttp://hl7.org/fhir/StructureDefinition/alternate-reference
        50. QuestionnaireResponse.source.extension:r5Source.value[x]
        Definition

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

        ShortValue of extension
        Control10..1
        TypeReference(Device, Organization), 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, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. QuestionnaireResponse.source.reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control10..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. QuestionnaireResponse.item
        Definition

        A group or question item from the original questionnaire for which answers are provided.

        ShortGroups and questions
        Comments

        Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

        Control90..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
        qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
        qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
        SlicingThis element introduces a set of slices on QuestionnaireResponse.item. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • value @ linkId
        • 56. QuestionnaireResponse.item.extension:itemMedia
          Slice NameitemMedia
          Definition

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

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

          Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

          ShortA signature attesting to the content
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          60. QuestionnaireResponse.item.modifierExtension
          Definition

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

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

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          62. QuestionnaireResponse.item.linkId
          Definition

          The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

          ShortPointer to specific item from Questionnaire
          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

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

          Text that is displayed above the contents of the group or as the text of the question being answered.

          ShortName for group or question text
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Allows the questionnaire response to be read without access to the questionnaire.

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

          The respondent's answer(s) to the question.

          ShortThe response(s) to the question
          Comments

          The value is nested because we cannot have a repeating structure that has variable type.

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. QuestionnaireResponse.item.answer.extension:itemAnswerMedia
          Slice NameitemAnswerMedia
          Definition

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

          ShortAnswer Media to display
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Item Answer Media) (Extension Type: Attachment)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          70. QuestionnaireResponse.item.answer.extension:itemWeight
          Slice NameitemWeight
          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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

          ShortAssigned Ordinal Value
          Comments

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

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

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Item Weight) (Extension Type: decimal)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          72. QuestionnaireResponse.item.answer.modifierExtension
          Definition

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

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

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          74. QuestionnaireResponse.item.answer.value[x]
          Definition

          The answer (or one of the answers) provided by the respondent to the question.

          ShortSingle-valued answer to the question
          Comments

          More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

          Control0..1
          BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1
          (example to http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1)

          Code indicating the response provided for a question.

          TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summaryfalse
          Requirements

          Ability to retain a single-valued answer to a question.

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

          Nested groups and/or questions found within this particular answer.

          ShortNested groups and questions
          Control0..*
          TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

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

          Questions or sub-groups nested beneath a question or group.

          ShortNested questionnaire response items
          Control0..*
          TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Reports can consist of complex nested groups.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. QuestionnaireResponse.item:F1
          Slice NameF1
          Definition

          A group or question item from the original questionnaire for which answers are provided.

          ShortGroups and questions
          Comments

          Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

          Control10..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
          qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
          qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
          82. QuestionnaireResponse.item:F1.extension:itemMedia
          Slice NameitemMedia
          Definition

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

          ShortMedia to display
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Item Media) (Extension Type: Attachment)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          84. QuestionnaireResponse.item:F1.extension:ItemSignature
          Slice NameItemSignature
          Definition

          Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

          ShortA signature attesting to the content
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          86. QuestionnaireResponse.item:F1.modifierExtension
          Definition

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

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

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          88. QuestionnaireResponse.item:F1.linkId
          Definition

          The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

          ShortPointer to specific item from Questionnaire
          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

          Fixed ValueA-telephone
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. QuestionnaireResponse.item:F1.text
          Definition

          Text that is displayed above the contents of the group or as the text of the question being answered.

          ShortName for group or question text
          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Allows the questionnaire response to be read without access to the questionnaire.

          Pattern ValueA.使用電話
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. QuestionnaireResponse.item:F1.answer
          Definition

          The respondent's answer(s) to the question.

          ShortThe response(s) to the question
          Comments

          The value is nested because we cannot have a repeating structure that has variable type.

          Control10..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. QuestionnaireResponse.item:F1.answer.extension:itemAnswerMedia
          Slice NameitemAnswerMedia
          Definition

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

          ShortAnswer Media to display
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Item Answer Media) (Extension Type: Attachment)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          96. QuestionnaireResponse.item:F1.answer.extension:itemWeight
          Slice NameitemWeight
          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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

          ShortAssigned Ordinal Value
          Comments

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

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

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Item Weight) (Extension Type: decimal)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          98. QuestionnaireResponse.item:F1.answer.modifierExtension
          Definition

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

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

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          100. QuestionnaireResponse.item:F1.answer.value[x]
          Definition

          The answer (or one of the answers) provided by the respondent to the question.

          ShortSingle-valued answer to the question
          Comments

          More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

          Control10..1
          Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Ability to retain a single-valued answer to a question.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 102. QuestionnaireResponse.item:F1.answer.value[x]:valueInteger
            Slice NamevalueInteger
            Definition

            The answer (or one of the answers) provided by the respondent to the question.

            ShortSingle-valued answer to the question
            Comments

            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

            Control0..1
            Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Ability to retain a single-valued answer to a question.

            Min Value1
            Max Value4
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            104. QuestionnaireResponse.item:F1.answer.item
            Definition

            Nested groups and/or questions found within this particular answer.

            ShortNested groups and questions
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            106. QuestionnaireResponse.item:F1.item
            Definition

            Questions or sub-groups nested beneath a question or group.

            ShortNested questionnaire response items
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Reports can consist of complex nested groups.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            108. QuestionnaireResponse.item:F2
            Slice NameF2
            Definition

            A group or question item from the original questionnaire for which answers are provided.

            ShortGroups and questions
            Comments

            Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            110. QuestionnaireResponse.item:F2.extension:itemMedia
            Slice NameitemMedia
            Definition

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

            ShortMedia to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            112. QuestionnaireResponse.item:F2.extension:ItemSignature
            Slice NameItemSignature
            Definition

            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

            ShortA signature attesting to the content
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            114. QuestionnaireResponse.item:F2.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            116. QuestionnaireResponse.item:F2.linkId
            Definition

            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

            ShortPointer to specific item from Questionnaire
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

            Pattern ValueB-shopping
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            118. QuestionnaireResponse.item:F2.text
            Definition

            Text that is displayed above the contents of the group or as the text of the question being answered.

            ShortName for group or question text
            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Allows the questionnaire response to be read without access to the questionnaire.

            Pattern ValueB.購物
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            120. QuestionnaireResponse.item:F2.answer
            Definition

            The respondent's answer(s) to the question.

            ShortThe response(s) to the question
            Comments

            The value is nested because we cannot have a repeating structure that has variable type.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            122. QuestionnaireResponse.item:F2.answer.extension:itemAnswerMedia
            Slice NameitemAnswerMedia
            Definition

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

            ShortAnswer Media to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Answer Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            124. QuestionnaireResponse.item:F2.answer.extension:itemWeight
            Slice NameitemWeight
            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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

            ShortAssigned Ordinal Value
            Comments

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

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Weight) (Extension Type: decimal)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            126. QuestionnaireResponse.item:F2.answer.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            128. QuestionnaireResponse.item:F2.answer.value[x]
            Definition

            The answer (or one of the answers) provided by the respondent to the question.

            ShortSingle-valued answer to the question
            Comments

            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

            Control10..1
            Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Ability to retain a single-valued answer to a question.

            Min Value1
            Max Value4
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            130. QuestionnaireResponse.item:F2.answer.item
            Definition

            Nested groups and/or questions found within this particular answer.

            ShortNested groups and questions
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            132. QuestionnaireResponse.item:F2.item
            Definition

            Questions or sub-groups nested beneath a question or group.

            ShortNested questionnaire response items
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Reports can consist of complex nested groups.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            134. QuestionnaireResponse.item:F3
            Slice NameF3
            Definition

            A group or question item from the original questionnaire for which answers are provided.

            ShortGroups and questions
            Comments

            Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            136. QuestionnaireResponse.item:F3.extension:itemMedia
            Slice NameitemMedia
            Definition

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

            ShortMedia to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            138. QuestionnaireResponse.item:F3.extension:ItemSignature
            Slice NameItemSignature
            Definition

            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

            ShortA signature attesting to the content
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            140. QuestionnaireResponse.item:F3.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            142. QuestionnaireResponse.item:F3.linkId
            Definition

            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

            ShortPointer to specific item from Questionnaire
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

            Pattern ValueC-food-preparation
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            144. QuestionnaireResponse.item:F3.text
            Definition

            Text that is displayed above the contents of the group or as the text of the question being answered.

            ShortName for group or question text
            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Allows the questionnaire response to be read without access to the questionnaire.

            Pattern ValueC.備餐
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            146. QuestionnaireResponse.item:F3.answer
            Definition

            The respondent's answer(s) to the question.

            ShortThe response(s) to the question
            Comments

            The value is nested because we cannot have a repeating structure that has variable type.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            148. QuestionnaireResponse.item:F3.answer.extension:itemAnswerMedia
            Slice NameitemAnswerMedia
            Definition

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

            ShortAnswer Media to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Answer Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            150. QuestionnaireResponse.item:F3.answer.extension:itemWeight
            Slice NameitemWeight
            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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

            ShortAssigned Ordinal Value
            Comments

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

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Weight) (Extension Type: decimal)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            152. QuestionnaireResponse.item:F3.answer.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            154. QuestionnaireResponse.item:F3.answer.value[x]
            Definition

            The answer (or one of the answers) provided by the respondent to the question.

            ShortSingle-valued answer to the question
            Comments

            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

            Control10..1
            Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Ability to retain a single-valued answer to a question.

            Min Value1
            Max Value4
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            156. QuestionnaireResponse.item:F3.answer.item
            Definition

            Nested groups and/or questions found within this particular answer.

            ShortNested groups and questions
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            158. QuestionnaireResponse.item:F3.item
            Definition

            Questions or sub-groups nested beneath a question or group.

            ShortNested questionnaire response items
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Reports can consist of complex nested groups.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            160. QuestionnaireResponse.item:F4
            Slice NameF4
            Definition

            A group or question item from the original questionnaire for which answers are provided.

            ShortGroups and questions
            Comments

            Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            162. QuestionnaireResponse.item:F4.extension:itemMedia
            Slice NameitemMedia
            Definition

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

            ShortMedia to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            164. QuestionnaireResponse.item:F4.extension:ItemSignature
            Slice NameItemSignature
            Definition

            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

            ShortA signature attesting to the content
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            166. QuestionnaireResponse.item:F4.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            168. QuestionnaireResponse.item:F4.linkId
            Definition

            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

            ShortPointer to specific item from Questionnaire
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

            Pattern ValueD-housekeeping
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            170. QuestionnaireResponse.item:F4.text
            Definition

            Text that is displayed above the contents of the group or as the text of the question being answered.

            ShortName for group or question text
            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Allows the questionnaire response to be read without access to the questionnaire.

            Pattern ValueD.處理家務
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            172. QuestionnaireResponse.item:F4.answer
            Definition

            The respondent's answer(s) to the question.

            ShortThe response(s) to the question
            Comments

            The value is nested because we cannot have a repeating structure that has variable type.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            174. QuestionnaireResponse.item:F4.answer.extension:itemAnswerMedia
            Slice NameitemAnswerMedia
            Definition

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

            ShortAnswer Media to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Answer Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            176. QuestionnaireResponse.item:F4.answer.extension:itemWeight
            Slice NameitemWeight
            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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

            ShortAssigned Ordinal Value
            Comments

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

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Weight) (Extension Type: decimal)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            178. QuestionnaireResponse.item:F4.answer.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            180. QuestionnaireResponse.item:F4.answer.value[x]
            Definition

            The answer (or one of the answers) provided by the respondent to the question.

            ShortSingle-valued answer to the question
            Comments

            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

            Control10..1
            Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Ability to retain a single-valued answer to a question.

            Min Value1
            Max Value4
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            182. QuestionnaireResponse.item:F4.answer.item
            Definition

            Nested groups and/or questions found within this particular answer.

            ShortNested groups and questions
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            184. QuestionnaireResponse.item:F4.item
            Definition

            Questions or sub-groups nested beneath a question or group.

            ShortNested questionnaire response items
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Reports can consist of complex nested groups.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            186. QuestionnaireResponse.item:F5
            Slice NameF5
            Definition

            A group or question item from the original questionnaire for which answers are provided.

            ShortGroups and questions
            Comments

            Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            188. QuestionnaireResponse.item:F5.extension:itemMedia
            Slice NameitemMedia
            Definition

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

            ShortMedia to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            190. QuestionnaireResponse.item:F5.extension:ItemSignature
            Slice NameItemSignature
            Definition

            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

            ShortA signature attesting to the content
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            192. QuestionnaireResponse.item:F5.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            194. QuestionnaireResponse.item:F5.linkId
            Definition

            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

            ShortPointer to specific item from Questionnaire
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

            Pattern ValueE-laundry
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            196. QuestionnaireResponse.item:F5.text
            Definition

            Text that is displayed above the contents of the group or as the text of the question being answered.

            ShortName for group or question text
            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Allows the questionnaire response to be read without access to the questionnaire.

            Pattern ValueE.洗衣服
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            198. QuestionnaireResponse.item:F5.answer
            Definition

            The respondent's answer(s) to the question.

            ShortThe response(s) to the question
            Comments

            The value is nested because we cannot have a repeating structure that has variable type.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            200. QuestionnaireResponse.item:F5.answer.extension:itemAnswerMedia
            Slice NameitemAnswerMedia
            Definition

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

            ShortAnswer Media to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Answer Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            202. QuestionnaireResponse.item:F5.answer.extension:itemWeight
            Slice NameitemWeight
            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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

            ShortAssigned Ordinal Value
            Comments

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

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Weight) (Extension Type: decimal)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            204. QuestionnaireResponse.item:F5.answer.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            206. QuestionnaireResponse.item:F5.answer.value[x]
            Definition

            The answer (or one of the answers) provided by the respondent to the question.

            ShortSingle-valued answer to the question
            Comments

            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

            Control10..1
            Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Ability to retain a single-valued answer to a question.

            Min Value1
            Max Value3
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            208. QuestionnaireResponse.item:F5.answer.item
            Definition

            Nested groups and/or questions found within this particular answer.

            ShortNested groups and questions
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            210. QuestionnaireResponse.item:F5.item
            Definition

            Questions or sub-groups nested beneath a question or group.

            ShortNested questionnaire response items
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Reports can consist of complex nested groups.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            212. QuestionnaireResponse.item:F6
            Slice NameF6
            Definition

            A group or question item from the original questionnaire for which answers are provided.

            ShortGroups and questions
            Comments

            Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            214. QuestionnaireResponse.item:F6.extension:itemMedia
            Slice NameitemMedia
            Definition

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

            ShortMedia to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            216. QuestionnaireResponse.item:F6.extension:ItemSignature
            Slice NameItemSignature
            Definition

            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

            ShortA signature attesting to the content
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            218. QuestionnaireResponse.item:F6.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            220. QuestionnaireResponse.item:F6.linkId
            Definition

            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

            ShortPointer to specific item from Questionnaire
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

            Pattern ValueF-transportation
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            222. QuestionnaireResponse.item:F6.text
            Definition

            Text that is displayed above the contents of the group or as the text of the question being answered.

            ShortName for group or question text
            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Allows the questionnaire response to be read without access to the questionnaire.

            Pattern ValueF.外出
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            224. QuestionnaireResponse.item:F6.answer
            Definition

            The respondent's answer(s) to the question.

            ShortThe response(s) to the question
            Comments

            The value is nested because we cannot have a repeating structure that has variable type.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            226. QuestionnaireResponse.item:F6.answer.extension:itemAnswerMedia
            Slice NameitemAnswerMedia
            Definition

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

            ShortAnswer Media to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Answer Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            228. QuestionnaireResponse.item:F6.answer.extension:itemWeight
            Slice NameitemWeight
            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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

            ShortAssigned Ordinal Value
            Comments

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

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Weight) (Extension Type: decimal)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            230. QuestionnaireResponse.item:F6.answer.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            232. QuestionnaireResponse.item:F6.answer.value[x]
            Definition

            The answer (or one of the answers) provided by the respondent to the question.

            ShortSingle-valued answer to the question
            Comments

            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

            Control10..1
            Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Ability to retain a single-valued answer to a question.

            Min Value1
            Max Value5
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            234. QuestionnaireResponse.item:F6.answer.item
            Definition

            Nested groups and/or questions found within this particular answer.

            ShortNested groups and questions
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            236. QuestionnaireResponse.item:F6.item
            Definition

            Questions or sub-groups nested beneath a question or group.

            ShortNested questionnaire response items
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Reports can consist of complex nested groups.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            238. QuestionnaireResponse.item:F7
            Slice NameF7
            Definition

            A group or question item from the original questionnaire for which answers are provided.

            ShortGroups and questions
            Comments

            Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            240. QuestionnaireResponse.item:F7.extension:itemMedia
            Slice NameitemMedia
            Definition

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

            ShortMedia to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            242. QuestionnaireResponse.item:F7.extension:ItemSignature
            Slice NameItemSignature
            Definition

            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

            ShortA signature attesting to the content
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            244. QuestionnaireResponse.item:F7.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            246. QuestionnaireResponse.item:F7.linkId
            Definition

            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

            ShortPointer to specific item from Questionnaire
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

            Pattern ValueG-medications
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            248. QuestionnaireResponse.item:F7.text
            Definition

            Text that is displayed above the contents of the group or as the text of the question being answered.

            ShortName for group or question text
            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Allows the questionnaire response to be read without access to the questionnaire.

            Pattern ValueG.服用藥物
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            250. QuestionnaireResponse.item:F7.answer
            Definition

            The respondent's answer(s) to the question.

            ShortThe response(s) to the question
            Comments

            The value is nested because we cannot have a repeating structure that has variable type.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            252. QuestionnaireResponse.item:F7.answer.extension:itemAnswerMedia
            Slice NameitemAnswerMedia
            Definition

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

            ShortAnswer Media to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Answer Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            254. QuestionnaireResponse.item:F7.answer.extension:itemWeight
            Slice NameitemWeight
            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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

            ShortAssigned Ordinal Value
            Comments

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

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Weight) (Extension Type: decimal)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            256. QuestionnaireResponse.item:F7.answer.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            258. QuestionnaireResponse.item:F7.answer.value[x]
            Definition

            The answer (or one of the answers) provided by the respondent to the question.

            ShortSingle-valued answer to the question
            Comments

            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

            Control10..1
            Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Ability to retain a single-valued answer to a question.

            Min Value1
            Max Value3
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            260. QuestionnaireResponse.item:F7.answer.item
            Definition

            Nested groups and/or questions found within this particular answer.

            ShortNested groups and questions
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            262. QuestionnaireResponse.item:F7.item
            Definition

            Questions or sub-groups nested beneath a question or group.

            ShortNested questionnaire response items
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Reports can consist of complex nested groups.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            264. QuestionnaireResponse.item:F8
            Slice NameF8
            Definition

            A group or question item from the original questionnaire for which answers are provided.

            ShortGroups and questions
            Comments

            Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            266. QuestionnaireResponse.item:F8.extension:itemMedia
            Slice NameitemMedia
            Definition

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

            ShortMedia to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            268. QuestionnaireResponse.item:F8.extension:ItemSignature
            Slice NameItemSignature
            Definition

            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

            ShortA signature attesting to the content
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            270. QuestionnaireResponse.item:F8.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            272. QuestionnaireResponse.item:F8.linkId
            Definition

            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

            ShortPointer to specific item from Questionnaire
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

            Pattern ValueH-finances
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            274. QuestionnaireResponse.item:F8.text
            Definition

            Text that is displayed above the contents of the group or as the text of the question being answered.

            ShortName for group or question text
            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Allows the questionnaire response to be read without access to the questionnaire.

            Pattern ValueH.處理財務的能力
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            276. QuestionnaireResponse.item:F8.answer
            Definition

            The respondent's answer(s) to the question.

            ShortThe response(s) to the question
            Comments

            The value is nested because we cannot have a repeating structure that has variable type.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            278. QuestionnaireResponse.item:F8.answer.extension:itemAnswerMedia
            Slice NameitemAnswerMedia
            Definition

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

            ShortAnswer Media to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Answer Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            280. QuestionnaireResponse.item:F8.answer.extension:itemWeight
            Slice NameitemWeight
            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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

            ShortAssigned Ordinal Value
            Comments

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

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Weight) (Extension Type: decimal)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            282. QuestionnaireResponse.item:F8.answer.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            284. QuestionnaireResponse.item:F8.answer.value[x]
            Definition

            The answer (or one of the answers) provided by the respondent to the question.

            ShortSingle-valued answer to the question
            Comments

            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

            Control10..1
            Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Ability to retain a single-valued answer to a question.

            Min Value1
            Max Value3
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            286. QuestionnaireResponse.item:F8.answer.item
            Definition

            Nested groups and/or questions found within this particular answer.

            ShortNested groups and questions
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            288. QuestionnaireResponse.item:F8.item
            Definition

            Questions or sub-groups nested beneath a question or group.

            ShortNested questionnaire response items
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Reports can consist of complex nested groups.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            290. QuestionnaireResponse.item:totalScoreSection
            Slice NametotalScoreSection
            Definition

            A group or question item from the original questionnaire for which answers are provided.

            ShortGroups and questions
            Comments

            Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
            292. QuestionnaireResponse.item:totalScoreSection.extension:itemMedia
            Slice NameitemMedia
            Definition

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

            ShortMedia to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            294. QuestionnaireResponse.item:totalScoreSection.extension:ItemSignature
            Slice NameItemSignature
            Definition

            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

            ShortA signature attesting to the content
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            296. QuestionnaireResponse.item:totalScoreSection.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            298. QuestionnaireResponse.item:totalScoreSection.linkId
            Definition

            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

            ShortPointer to specific item from Questionnaire
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

            Fixed ValueI-total-score-IADL
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            300. QuestionnaireResponse.item:totalScoreSection.text
            Definition

            Text that is displayed above the contents of the group or as the text of the question being answered.

            ShortName for group or question text
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Allows the questionnaire response to be read without access to the questionnaire.

            Pattern ValueI.IADL總分計算
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            302. QuestionnaireResponse.item:totalScoreSection.answer
            Definition

            The respondent's answer(s) to the question.

            ShortThe response(s) to the question
            Comments

            The value is nested because we cannot have a repeating structure that has variable type.

            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            304. QuestionnaireResponse.item:totalScoreSection.answer.extension:itemAnswerMedia
            Slice NameitemAnswerMedia
            Definition

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

            ShortAnswer Media to display
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Answer Media) (Extension Type: Attachment)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            306. QuestionnaireResponse.item:totalScoreSection.answer.extension:itemWeight
            Slice NameitemWeight
            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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

            ShortAssigned Ordinal Value
            Comments

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

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Item Weight) (Extension Type: decimal)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            308. QuestionnaireResponse.item:totalScoreSection.answer.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            310. QuestionnaireResponse.item:totalScoreSection.answer.value[x]
            Definition

            The answer (or one of the answers) provided by the respondent to the question.

            ShortSingle-valued answer to the question
            Comments

            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

            Control0..1
            Typeinteger, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Requirements

            Ability to retain a single-valued answer to a question.

            Min Value8
            Max Value30
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            312. QuestionnaireResponse.item:totalScoreSection.answer.item
            Definition

            Nested groups and/or questions found within this particular answer.

            ShortNested groups and questions
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

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

            Questions or sub-groups nested beneath a question or group.

            ShortNested questionnaire response items
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Reports can consist of complex nested groups.

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

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

            0. QuestionnaireResponse
            2. QuestionnaireResponse.questionnaire
            Fixed Valuehttps://build.fhir.org/ig/Kimsber/Rehab-IG/Questionnaire/IDALQuestionnaireInstance
            4. QuestionnaireResponse.status
            Pattern Valuecompleted
            6. QuestionnaireResponse.subject
            TypeReference(根據醫院實際病人範例進行資料定義)
            8. QuestionnaireResponse.item
            Control9..?
            SlicingThis element introduces a set of slices on QuestionnaireResponse.item. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • value @ linkId
            • 10. QuestionnaireResponse.item:F1
              Slice NameF1
              Control1..1
              12. QuestionnaireResponse.item:F1.linkId
              Fixed ValueA-telephone
              14. QuestionnaireResponse.item:F1.text
              Control1..?
              Pattern ValueA.使用電話
              16. QuestionnaireResponse.item:F1.answer
              Control1..1
              18. QuestionnaireResponse.item:F1.answer.value[x]
              Control1..?
              Typeinteger
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 20. QuestionnaireResponse.item:F1.answer.value[x]:valueInteger
                Slice NamevalueInteger
                Control0..1
                Typeinteger
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Min Value1
                Max Value4
                22. QuestionnaireResponse.item:F2
                Slice NameF2
                Control1..1
                Must Supporttrue
                24. QuestionnaireResponse.item:F2.linkId
                Pattern ValueB-shopping
                26. QuestionnaireResponse.item:F2.text
                Control1..?
                Pattern ValueB.購物
                28. QuestionnaireResponse.item:F2.answer
                Control1..1
                30. QuestionnaireResponse.item:F2.answer.value[x]
                Control1..?
                Typeinteger
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Min Value1
                Max Value4
                32. QuestionnaireResponse.item:F3
                Slice NameF3
                Control1..1
                Must Supporttrue
                34. QuestionnaireResponse.item:F3.linkId
                Pattern ValueC-food-preparation
                36. QuestionnaireResponse.item:F3.text
                Control1..?
                Pattern ValueC.備餐
                38. QuestionnaireResponse.item:F3.answer
                Control1..1
                40. QuestionnaireResponse.item:F3.answer.value[x]
                Control1..?
                Typeinteger
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Min Value1
                Max Value4
                42. QuestionnaireResponse.item:F4
                Slice NameF4
                Control1..1
                Must Supporttrue
                44. QuestionnaireResponse.item:F4.linkId
                Pattern ValueD-housekeeping
                46. QuestionnaireResponse.item:F4.text
                Control1..?
                Pattern ValueD.處理家務
                48. QuestionnaireResponse.item:F4.answer
                Control1..1
                50. QuestionnaireResponse.item:F4.answer.value[x]
                Control1..?
                Typeinteger
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Min Value1
                Max Value4
                52. QuestionnaireResponse.item:F5
                Slice NameF5
                Control1..1
                Must Supporttrue
                54. QuestionnaireResponse.item:F5.linkId
                Pattern ValueE-laundry
                56. QuestionnaireResponse.item:F5.text
                Control1..?
                Pattern ValueE.洗衣服
                58. QuestionnaireResponse.item:F5.answer
                Control1..1
                60. QuestionnaireResponse.item:F5.answer.value[x]
                Control1..?
                Typeinteger
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Min Value1
                Max Value3
                62. QuestionnaireResponse.item:F6
                Slice NameF6
                Control1..1
                Must Supporttrue
                64. QuestionnaireResponse.item:F6.linkId
                Pattern ValueF-transportation
                66. QuestionnaireResponse.item:F6.text
                Control1..?
                Pattern ValueF.外出
                68. QuestionnaireResponse.item:F6.answer
                Control1..1
                70. QuestionnaireResponse.item:F6.answer.value[x]
                Control1..?
                Typeinteger
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Min Value1
                Max Value5
                72. QuestionnaireResponse.item:F7
                Slice NameF7
                Control1..1
                Must Supporttrue
                74. QuestionnaireResponse.item:F7.linkId
                Pattern ValueG-medications
                76. QuestionnaireResponse.item:F7.text
                Control1..?
                Pattern ValueG.服用藥物
                78. QuestionnaireResponse.item:F7.answer
                Control1..1
                80. QuestionnaireResponse.item:F7.answer.value[x]
                Control1..?
                Typeinteger
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Min Value1
                Max Value3
                82. QuestionnaireResponse.item:F8
                Slice NameF8
                Control1..1
                Must Supporttrue
                84. QuestionnaireResponse.item:F8.linkId
                Pattern ValueH-finances
                86. QuestionnaireResponse.item:F8.text
                Control1..?
                Pattern ValueH.處理財務的能力
                88. QuestionnaireResponse.item:F8.answer
                Control1..1
                90. QuestionnaireResponse.item:F8.answer.value[x]
                Control1..?
                Typeinteger
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Min Value1
                Max Value3
                92. QuestionnaireResponse.item:totalScoreSection
                Slice NametotalScoreSection
                Control1..1
                Must Supporttrue
                94. QuestionnaireResponse.item:totalScoreSection.linkId
                Fixed ValueI-total-score-IADL
                96. QuestionnaireResponse.item:totalScoreSection.text
                Pattern ValueI.IADL總分計算
                98. QuestionnaireResponse.item:totalScoreSection.answer
                Control1..1
                100. QuestionnaireResponse.item:totalScoreSection.answer.value[x]
                Typeinteger
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Min Value8
                Max Value30

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

                0. QuestionnaireResponse
                Definition

                Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems.

                ShortStandard Questionnaire Response
                Comments

                The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.

                Control0..*
                Is Modifierfalse
                Summaryfalse
                Alternate NamesForm, QuestionnaireAnswers, Form Data
                Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                dom-6: A resource should have narrative for robust management (text.`div`.exists())
                sdcqr-1: Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject. (subject.exists())
                sdcqr-2: When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers. ((QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                sdcqr-3: Can either have source or source extension, but not both (source.count() + extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-QuestionnaireResponse.source').count() <=1)
                2. QuestionnaireResponse.id
                Definition

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

                ShortLogical id of this artifact
                Comments

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

                Control0..1
                Typeid
                Is Modifierfalse
                Summarytrue
                4. QuestionnaireResponse.meta
                Definition

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

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

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

                ShortA set of rules under which this content was created
                Comments

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

                Control0..1
                Typeuri
                Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                8. QuestionnaireResponse.language
                Definition

                The base language in which the resource is written.

                ShortLanguage of the resource content
                Comments

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

                Control0..1
                BindingThe codes SHOULD be taken from CommonLanguages
                (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                A human language.

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

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

                ShortText summary of the resource, for human interpretation
                Comments

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

                Control0..1
                TypeNarrative
                Is Modifierfalse
                Summaryfalse
                Alternate Namesnarrative, html, xhtml, display
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                12. QuestionnaireResponse.contained
                Definition

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

                ShortContained, inline Resources
                Comments

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

                Control0..*
                TypeResource
                Is Modifierfalse
                Summaryfalse
                Alternate Namesinline resources, anonymous resources, contained resources
                14. QuestionnaireResponse.extension
                Definition

                An Extension

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

                  The action represented by this resource has been determined to satisfy the expectations established by the referenced Definition resource.

                  ShortFollows rules from
                  Comments

                  If changes are made to this event record, the determination must be made whether, with the change, the action still complies with the referenced Definition. Revisions may result in adheresTo assertions being removed, or - if the system has an algorithm for determining which targets are appropriate - being added. Adherence may be asserted after the fact. It is possible for a Request or Event to adhere to a Definition even if the author/performer of the action was not aware of the Definition at the time the action was taken/requested.

                  Also see the notes in the workflow extensions area for more guidance on this element.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(adheres to) (Extension Type: Choice of: canonical(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), Reference(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), uri)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  18. QuestionnaireResponse.extension:adheresTo.id
                  Definition

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

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

                  An Extension

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

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

                    Shortidentifies the meaning of the extension
                    Comments

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

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

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

                    ShortValue of extension
                    Control1..1
                    TypeChoice of: canonical(ActivityDefinition, PlanDefinition), Reference(ActivityDefinition, PlanDefinition), uri
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    26. QuestionnaireResponse.extension:triggeredBy
                    Slice NametriggeredBy
                    Definition

                    This resource came into being as a result of expectations set in the referenced Definition resource. I.e. This resource represents a 'step' dictated within the protocol/order set/etc.

                    ShortCreated because of following
                    Comments

                    See the notes in the workflow extensions area for more guidance on this element.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Triggered by) (Extension Type: Choice of: canonical(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), Reference(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), uri)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    28. QuestionnaireResponse.extension:triggeredBy.id
                    Definition

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

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

                    An Extension

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

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

                      Shortidentifies the meaning of the extension
                      Comments

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

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

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

                      ShortValue of extension
                      Control1..1
                      TypeChoice of: canonical(ActivityDefinition, PlanDefinition), Reference(ActivityDefinition, PlanDefinition), uri
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      36. QuestionnaireResponse.extension:signature
                      Slice Namesignature
                      Definition

                      Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                      ShortA signature attesting to the content
                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      38. QuestionnaireResponse.extension:completionMode
                      Slice NamecompletionMode
                      Definition

                      Indicates how the individual completing the QuestionnaireResponse provided their responses.

                      ShortE.g. Verbal, written, electronic
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(QuestionnaireResponse Completion Mode) (Extension Type: CodeableConcept)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      40. QuestionnaireResponse.modifierExtension
                      Definition

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

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

                      ShortExtensions that cannot be ignored
                      Comments

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

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                      Summaryfalse
                      Requirements

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

                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      42. QuestionnaireResponse.identifier
                      Definition

                      A business identifier assigned to a particular completed (or partially completed) questionnaire.

                      ShortUnique id for this set of answers
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..1
                      TypeIdentifier
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Used for tracking, registration and other business purposes.

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

                      The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse. For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.

                      ShortRequest fulfilled by this QuestionnaireResponse
                      Control0..*
                      TypeReference(CarePlan, ServiceRequest)
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.

                      Alternate Namesorder
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      46. QuestionnaireResponse.partOf
                      Definition

                      A procedure or observation that this questionnaire was performed as part of the execution of. For example, the surgery a checklist was executed as part of.

                      ShortPart of this action
                      Comments

                      Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire. For relationships to referrals, and other types of requests, use basedOn.

                      Control0..*
                      TypeReference(Observation, Procedure)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      48. QuestionnaireResponse.questionnaire
                      Definition

                      The Questionnaire that defines and organizes the questions for which answers are being provided.

                      ShortForm being answered
                      Comments

                      For SDC, this SHALL be the version-specific URL of the form as hosted on the Form Manager.

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

                      Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.

                      Alternate NamesForm
                      Fixed Valuehttps://build.fhir.org/ig/Kimsber/Rehab-IG/Questionnaire/IDALQuestionnaireInstance
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      50. QuestionnaireResponse.questionnaire.id
                      Definition

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

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

                      An Extension

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

                        The title or other name to display when referencing a resource by canonical URL.

                        ShortDisplay name for canonical reference
                        Comments

                        This SHALL be the title of the Questionnaire at the time the QuestionnaireResponse was originally authored.

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

                        Primitive value for canonical

                        ShortPrimitive value for canonical
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        58. QuestionnaireResponse.status
                        Definition

                        The position of the questionnaire response within its overall lifecycle.

                        Shortin-progress | completed | amended | entered-in-error | stopped
                        Comments

                        This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

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

                        Lifecycle status of the questionnaire response.

                        Typecode
                        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished.

                        Pattern Valuecompleted
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        60. QuestionnaireResponse.subject
                        Definition

                        The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information.

                        ShortThe subject of the questions
                        Comments

                        If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse

                        Control1..1
                        TypeReference(根據醫院實際病人範例進行資料定義)
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Allows linking the answers to the individual the answers describe. May also affect access control.

                        Alternate NamesPatient, Focus
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        62. QuestionnaireResponse.subject.id
                        Definition

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

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

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

                        ShortAdditional content defined by implementations
                        Comments

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

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

                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                          ShortLiteral reference, Relative, internal or absolute URL
                          Comments

                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                          Control1..1
                          This element is affected by the following invariants: ref-1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          68. QuestionnaireResponse.subject.type
                          Definition

                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                          ShortType the reference refers to (e.g. "Patient")
                          Comments

                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                          Control0..1
                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                          (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                          Aa resource (or, for logical models, the URI of the logical model).

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

                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                          ShortLogical reference, when literal reference is not known
                          Comments

                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          72. QuestionnaireResponse.subject.display
                          Definition

                          Plain text narrative that identifies the resource in addition to the resource reference.

                          ShortText alternative for the resource
                          Comments

                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          74. QuestionnaireResponse.encounter
                          Definition

                          The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated.

                          ShortEncounter created as part of
                          Comments

                          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.

                          Control0..1
                          TypeReference(Encounter)
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Provides context for the information that was captured. May also affect access control.

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

                          Identifies when this version of the answer set was created. Changes whenever the answers are updated.

                          ShortDate the answers were gathered
                          Comments

                          May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.

                          This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible.

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

                          Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.

                          Alternate NamesDate Created, Date published, Date Issued, Date updated
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          78. QuestionnaireResponse.author
                          Definition

                          Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.

                          ShortPerson who received and recorded the answers
                          Comments

                          Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated.

                          Control0..1
                          TypeReference(Device, Practitioner, PractitionerRole, Patient, RelatedPerson, Organization)
                          Is Modifierfalse
                          Must Supporttrue
                          Must Support TypesNo must-support rules about the choice of types/profiles
                          Summarytrue
                          Requirements

                          Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.

                          Alternate NamesLaboratory, Service, Practitioner, Department, Company, Performer
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          80. QuestionnaireResponse.source
                          Definition

                          The person who answered the questions about the subject.

                          ShortThe person who answered the questions
                          Comments

                          If not specified, no inference can be made about who provided the data.

                          Control0..1
                          TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson)
                          Is Modifierfalse
                          Must Supporttrue
                          Must Support TypesNo must-support rules about the choice of types/profiles
                          Summarytrue
                          Requirements

                          When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.

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

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

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

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

                          ShortAdditional content defined by implementations
                          Comments

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

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on QuestionnaireResponse.source.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 86. QuestionnaireResponse.source.extension:r5Source
                            Slice Namer5Source
                            Definition

                            Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.

                            ShortAlternative reference (target type is wrong)
                            Comments

                            Given that a reference SHALL have a display or reference, using this extension implies that there's a display present.

                            Control0..1
                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            88. QuestionnaireResponse.source.extension:r5Source.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            90. QuestionnaireResponse.source.extension:r5Source.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..0
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on QuestionnaireResponse.source.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 92. QuestionnaireResponse.source.extension:r5Source.url
                              Definition

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

                              Shortidentifies the meaning of the extension
                              Comments

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

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/alternate-reference
                              94. QuestionnaireResponse.source.extension:r5Source.value[x]
                              Definition

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

                              ShortValue of extension
                              Control1..1
                              TypeReference(Device, Organization)
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              96. QuestionnaireResponse.source.reference
                              Definition

                              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                              ShortLiteral reference, Relative, internal or absolute URL
                              Comments

                              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                              Control1..1
                              This element is affected by the following invariants: ref-1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              98. QuestionnaireResponse.source.type
                              Definition

                              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                              ShortType the reference refers to (e.g. "Patient")
                              Comments

                              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from ResourceType
                              (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                              Aa resource (or, for logical models, the URI of the logical model).

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

                              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                              ShortLogical reference, when literal reference is not known
                              Comments

                              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..1
                              TypeIdentifier
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              102. QuestionnaireResponse.source.display
                              Definition

                              Plain text narrative that identifies the resource in addition to the resource reference.

                              ShortText alternative for the resource
                              Comments

                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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

                              A group or question item from the original questionnaire for which answers are provided.

                              ShortGroups and questions
                              Comments

                              Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                              Control9..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                              qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                              SlicingThis element introduces a set of slices on QuestionnaireResponse.item. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                              • value @ linkId
                              • 106. QuestionnaireResponse.item.id
                                Definition

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

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

                                An Extension

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

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

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

                                  Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                  ShortA signature attesting to the content
                                  Control0..*
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  114. QuestionnaireResponse.item.modifierExtension
                                  Definition

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

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

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

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

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

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  116. QuestionnaireResponse.item.linkId
                                  Definition

                                  The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                  ShortPointer to specific item from Questionnaire
                                  Control1..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

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

                                  A reference to an ElementDefinition that provides the details for the item.

                                  ShortElementDefinition - details for the item
                                  Comments

                                  The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                  There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                  A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

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

                                  Text that is displayed above the contents of the group or as the text of the question being answered.

                                  ShortName for group or question text
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Allows the questionnaire response to be read without access to the questionnaire.

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

                                  The respondent's answer(s) to the question.

                                  ShortThe response(s) to the question
                                  Comments

                                  The value is nested because we cannot have a repeating structure that has variable type.

                                  Control0..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  124. QuestionnaireResponse.item.answer.id
                                  Definition

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

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

                                  An Extension

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

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

                                    ShortAnswer Media to display
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    130. QuestionnaireResponse.item.answer.extension:itemWeight
                                    Slice NameitemWeight
                                    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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                    ShortAssigned Ordinal Value
                                    Comments

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

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

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Item Weight) (Extension Type: decimal)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    132. QuestionnaireResponse.item.answer.modifierExtension
                                    Definition

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

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

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    Comments

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

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                    Summarytrue
                                    Requirements

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

                                    Alternate Namesextensions, user content, modifiers
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    134. QuestionnaireResponse.item.answer.value[x]
                                    Definition

                                    The answer (or one of the answers) provided by the respondent to the question.

                                    ShortSingle-valued answer to the question
                                    Comments

                                    More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                    Control0..1
                                    BindingFor example codes, see QuestionnaireAnswerCodes
                                    (example to http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1)

                                    Code indicating the response provided for a question.

                                    TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                    Summaryfalse
                                    Requirements

                                    Ability to retain a single-valued answer to a question.

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

                                    Nested groups and/or questions found within this particular answer.

                                    ShortNested groups and questions
                                    Control0..*
                                    TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

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

                                    Questions or sub-groups nested beneath a question or group.

                                    ShortNested questionnaire response items
                                    Control0..*
                                    TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Reports can consist of complex nested groups.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    140. QuestionnaireResponse.item:F1
                                    Slice NameF1
                                    Definition

                                    A group or question item from the original questionnaire for which answers are provided.

                                    ShortGroups and questions
                                    Comments

                                    Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                    Control1..1
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                    qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                    142. QuestionnaireResponse.item:F1.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    144. QuestionnaireResponse.item:F1.extension
                                    Definition

                                    An Extension

                                    ShortExtension
                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on QuestionnaireResponse.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 146. QuestionnaireResponse.item:F1.extension:itemMedia
                                      Slice NameitemMedia
                                      Definition

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

                                      ShortMedia to display
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Item Media) (Extension Type: Attachment)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      148. QuestionnaireResponse.item:F1.extension:ItemSignature
                                      Slice NameItemSignature
                                      Definition

                                      Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                      ShortA signature attesting to the content
                                      Control0..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      150. QuestionnaireResponse.item:F1.modifierExtension
                                      Definition

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

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

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

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

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      152. QuestionnaireResponse.item:F1.linkId
                                      Definition

                                      The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                      ShortPointer to specific item from Questionnaire
                                      Control1..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                      Fixed ValueA-telephone
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      154. QuestionnaireResponse.item:F1.definition
                                      Definition

                                      A reference to an ElementDefinition that provides the details for the item.

                                      ShortElementDefinition - details for the item
                                      Comments

                                      The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                      There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                      A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      156. QuestionnaireResponse.item:F1.text
                                      Definition

                                      Text that is displayed above the contents of the group or as the text of the question being answered.

                                      ShortName for group or question text
                                      Control1..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      Allows the questionnaire response to be read without access to the questionnaire.

                                      Pattern ValueA.使用電話
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      158. QuestionnaireResponse.item:F1.answer
                                      Definition

                                      The respondent's answer(s) to the question.

                                      ShortThe response(s) to the question
                                      Comments

                                      The value is nested because we cannot have a repeating structure that has variable type.

                                      Control1..1
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      160. QuestionnaireResponse.item:F1.answer.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      162. QuestionnaireResponse.item:F1.answer.extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 164. QuestionnaireResponse.item:F1.answer.extension:itemAnswerMedia
                                        Slice NameitemAnswerMedia
                                        Definition

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

                                        ShortAnswer Media to display
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        166. QuestionnaireResponse.item:F1.answer.extension:itemWeight
                                        Slice NameitemWeight
                                        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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                        ShortAssigned Ordinal Value
                                        Comments

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

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

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(Item Weight) (Extension Type: decimal)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        168. QuestionnaireResponse.item:F1.answer.modifierExtension
                                        Definition

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

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

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

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

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

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

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        170. QuestionnaireResponse.item:F1.answer.value[x]
                                        Definition

                                        The answer (or one of the answers) provided by the respondent to the question.

                                        ShortSingle-valued answer to the question
                                        Comments

                                        More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                        Control1..1
                                        Typeinteger
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Ability to retain a single-valued answer to a question.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                        • type @ $this
                                        • 172. QuestionnaireResponse.item:F1.answer.value[x]:valueInteger
                                          Slice NamevalueInteger
                                          Definition

                                          The answer (or one of the answers) provided by the respondent to the question.

                                          ShortSingle-valued answer to the question
                                          Comments

                                          More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                          Control0..1
                                          Typeinteger
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Ability to retain a single-valued answer to a question.

                                          Min Value1
                                          Max Value4
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          174. QuestionnaireResponse.item:F1.answer.item
                                          Definition

                                          Nested groups and/or questions found within this particular answer.

                                          ShortNested groups and questions
                                          Control0..*
                                          TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          176. QuestionnaireResponse.item:F1.item
                                          Definition

                                          Questions or sub-groups nested beneath a question or group.

                                          ShortNested questionnaire response items
                                          Control0..*
                                          TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Reports can consist of complex nested groups.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          178. QuestionnaireResponse.item:F2
                                          Slice NameF2
                                          Definition

                                          A group or question item from the original questionnaire for which answers are provided.

                                          ShortGroups and questions
                                          Comments

                                          Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                          Control1..1
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                          qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                          180. QuestionnaireResponse.item:F2.id
                                          Definition

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

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          182. QuestionnaireResponse.item:F2.extension
                                          Definition

                                          An Extension

                                          ShortExtension
                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on QuestionnaireResponse.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 184. QuestionnaireResponse.item:F2.extension:itemMedia
                                            Slice NameitemMedia
                                            Definition

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

                                            ShortMedia to display
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension(Item Media) (Extension Type: Attachment)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            186. QuestionnaireResponse.item:F2.extension:ItemSignature
                                            Slice NameItemSignature
                                            Definition

                                            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                            ShortA signature attesting to the content
                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            188. QuestionnaireResponse.item:F2.modifierExtension
                                            Definition

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

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

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

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

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

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            190. QuestionnaireResponse.item:F2.linkId
                                            Definition

                                            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                            ShortPointer to specific item from Questionnaire
                                            Control1..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                            Pattern ValueB-shopping
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            192. QuestionnaireResponse.item:F2.definition
                                            Definition

                                            A reference to an ElementDefinition that provides the details for the item.

                                            ShortElementDefinition - details for the item
                                            Comments

                                            The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                            There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                            A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            194. QuestionnaireResponse.item:F2.text
                                            Definition

                                            Text that is displayed above the contents of the group or as the text of the question being answered.

                                            ShortName for group or question text
                                            Control1..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            Allows the questionnaire response to be read without access to the questionnaire.

                                            Pattern ValueB.購物
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            196. QuestionnaireResponse.item:F2.answer
                                            Definition

                                            The respondent's answer(s) to the question.

                                            ShortThe response(s) to the question
                                            Comments

                                            The value is nested because we cannot have a repeating structure that has variable type.

                                            Control1..1
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            198. QuestionnaireResponse.item:F2.answer.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            200. QuestionnaireResponse.item:F2.answer.extension
                                            Definition

                                            An Extension

                                            ShortExtension
                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 202. QuestionnaireResponse.item:F2.answer.extension:itemAnswerMedia
                                              Slice NameitemAnswerMedia
                                              Definition

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

                                              ShortAnswer Media to display
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              204. QuestionnaireResponse.item:F2.answer.extension:itemWeight
                                              Slice NameitemWeight
                                              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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                              ShortAssigned Ordinal Value
                                              Comments

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

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

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Item Weight) (Extension Type: decimal)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              206. QuestionnaireResponse.item:F2.answer.modifierExtension
                                              Definition

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

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

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              208. QuestionnaireResponse.item:F2.answer.value[x]
                                              Definition

                                              The answer (or one of the answers) provided by the respondent to the question.

                                              ShortSingle-valued answer to the question
                                              Comments

                                              More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                              Control1..1
                                              Typeinteger
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Ability to retain a single-valued answer to a question.

                                              Min Value1
                                              Max Value4
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              210. QuestionnaireResponse.item:F2.answer.item
                                              Definition

                                              Nested groups and/or questions found within this particular answer.

                                              ShortNested groups and questions
                                              Control0..*
                                              TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              212. QuestionnaireResponse.item:F2.item
                                              Definition

                                              Questions or sub-groups nested beneath a question or group.

                                              ShortNested questionnaire response items
                                              Control0..*
                                              TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Reports can consist of complex nested groups.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              214. QuestionnaireResponse.item:F3
                                              Slice NameF3
                                              Definition

                                              A group or question item from the original questionnaire for which answers are provided.

                                              ShortGroups and questions
                                              Comments

                                              Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                              Control1..1
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                              qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                              216. QuestionnaireResponse.item:F3.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              218. QuestionnaireResponse.item:F3.extension
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on QuestionnaireResponse.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 220. QuestionnaireResponse.item:F3.extension:itemMedia
                                                Slice NameitemMedia
                                                Definition

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

                                                ShortMedia to display
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(Item Media) (Extension Type: Attachment)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                222. QuestionnaireResponse.item:F3.extension:ItemSignature
                                                Slice NameItemSignature
                                                Definition

                                                Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                                ShortA signature attesting to the content
                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                224. QuestionnaireResponse.item:F3.modifierExtension
                                                Definition

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

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

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

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

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

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

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                226. QuestionnaireResponse.item:F3.linkId
                                                Definition

                                                The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                                ShortPointer to specific item from Questionnaire
                                                Control1..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                                Pattern ValueC-food-preparation
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                228. QuestionnaireResponse.item:F3.definition
                                                Definition

                                                A reference to an ElementDefinition that provides the details for the item.

                                                ShortElementDefinition - details for the item
                                                Comments

                                                The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                                There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                                A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                230. QuestionnaireResponse.item:F3.text
                                                Definition

                                                Text that is displayed above the contents of the group or as the text of the question being answered.

                                                ShortName for group or question text
                                                Control1..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Allows the questionnaire response to be read without access to the questionnaire.

                                                Pattern ValueC.備餐
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                232. QuestionnaireResponse.item:F3.answer
                                                Definition

                                                The respondent's answer(s) to the question.

                                                ShortThe response(s) to the question
                                                Comments

                                                The value is nested because we cannot have a repeating structure that has variable type.

                                                Control1..1
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                234. QuestionnaireResponse.item:F3.answer.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                236. QuestionnaireResponse.item:F3.answer.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 238. QuestionnaireResponse.item:F3.answer.extension:itemAnswerMedia
                                                  Slice NameitemAnswerMedia
                                                  Definition

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

                                                  ShortAnswer Media to display
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  240. QuestionnaireResponse.item:F3.answer.extension:itemWeight
                                                  Slice NameitemWeight
                                                  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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                                  ShortAssigned Ordinal Value
                                                  Comments

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

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

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension(Item Weight) (Extension Type: decimal)
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  242. QuestionnaireResponse.item:F3.answer.modifierExtension
                                                  Definition

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

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

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

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

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                  Summarytrue
                                                  Requirements

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

                                                  Alternate Namesextensions, user content, modifiers
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  244. QuestionnaireResponse.item:F3.answer.value[x]
                                                  Definition

                                                  The answer (or one of the answers) provided by the respondent to the question.

                                                  ShortSingle-valued answer to the question
                                                  Comments

                                                  More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                                  Control1..1
                                                  Typeinteger
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Ability to retain a single-valued answer to a question.

                                                  Min Value1
                                                  Max Value4
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  246. QuestionnaireResponse.item:F3.answer.item
                                                  Definition

                                                  Nested groups and/or questions found within this particular answer.

                                                  ShortNested groups and questions
                                                  Control0..*
                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  248. QuestionnaireResponse.item:F3.item
                                                  Definition

                                                  Questions or sub-groups nested beneath a question or group.

                                                  ShortNested questionnaire response items
                                                  Control0..*
                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Reports can consist of complex nested groups.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  250. QuestionnaireResponse.item:F4
                                                  Slice NameF4
                                                  Definition

                                                  A group or question item from the original questionnaire for which answers are provided.

                                                  ShortGroups and questions
                                                  Comments

                                                  Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                                  Control1..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                                  qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                                  252. QuestionnaireResponse.item:F4.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  254. QuestionnaireResponse.item:F4.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on QuestionnaireResponse.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 256. QuestionnaireResponse.item:F4.extension:itemMedia
                                                    Slice NameitemMedia
                                                    Definition

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

                                                    ShortMedia to display
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(Item Media) (Extension Type: Attachment)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    258. QuestionnaireResponse.item:F4.extension:ItemSignature
                                                    Slice NameItemSignature
                                                    Definition

                                                    Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                                    ShortA signature attesting to the content
                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    260. QuestionnaireResponse.item:F4.modifierExtension
                                                    Definition

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

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

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

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

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

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

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    262. QuestionnaireResponse.item:F4.linkId
                                                    Definition

                                                    The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                                    ShortPointer to specific item from Questionnaire
                                                    Control1..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Requirements

                                                    Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                                    Pattern ValueD-housekeeping
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    264. QuestionnaireResponse.item:F4.definition
                                                    Definition

                                                    A reference to an ElementDefinition that provides the details for the item.

                                                    ShortElementDefinition - details for the item
                                                    Comments

                                                    The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                                    There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                                    A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    266. QuestionnaireResponse.item:F4.text
                                                    Definition

                                                    Text that is displayed above the contents of the group or as the text of the question being answered.

                                                    ShortName for group or question text
                                                    Control1..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Requirements

                                                    Allows the questionnaire response to be read without access to the questionnaire.

                                                    Pattern ValueD.處理家務
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    268. QuestionnaireResponse.item:F4.answer
                                                    Definition

                                                    The respondent's answer(s) to the question.

                                                    ShortThe response(s) to the question
                                                    Comments

                                                    The value is nested because we cannot have a repeating structure that has variable type.

                                                    Control1..1
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    270. QuestionnaireResponse.item:F4.answer.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    272. QuestionnaireResponse.item:F4.answer.extension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 274. QuestionnaireResponse.item:F4.answer.extension:itemAnswerMedia
                                                      Slice NameitemAnswerMedia
                                                      Definition

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

                                                      ShortAnswer Media to display
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      276. QuestionnaireResponse.item:F4.answer.extension:itemWeight
                                                      Slice NameitemWeight
                                                      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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                                      ShortAssigned Ordinal Value
                                                      Comments

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

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

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(Item Weight) (Extension Type: decimal)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      278. QuestionnaireResponse.item:F4.answer.modifierExtension
                                                      Definition

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

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

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

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

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

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

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      280. QuestionnaireResponse.item:F4.answer.value[x]
                                                      Definition

                                                      The answer (or one of the answers) provided by the respondent to the question.

                                                      ShortSingle-valued answer to the question
                                                      Comments

                                                      More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                                      Control1..1
                                                      Typeinteger
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Ability to retain a single-valued answer to a question.

                                                      Min Value1
                                                      Max Value4
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      282. QuestionnaireResponse.item:F4.answer.item
                                                      Definition

                                                      Nested groups and/or questions found within this particular answer.

                                                      ShortNested groups and questions
                                                      Control0..*
                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      284. QuestionnaireResponse.item:F4.item
                                                      Definition

                                                      Questions or sub-groups nested beneath a question or group.

                                                      ShortNested questionnaire response items
                                                      Control0..*
                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Reports can consist of complex nested groups.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      286. QuestionnaireResponse.item:F5
                                                      Slice NameF5
                                                      Definition

                                                      A group or question item from the original questionnaire for which answers are provided.

                                                      ShortGroups and questions
                                                      Comments

                                                      Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                                      Control1..1
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                                      qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                                      288. QuestionnaireResponse.item:F5.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      290. QuestionnaireResponse.item:F5.extension
                                                      Definition

                                                      An Extension

                                                      ShortExtension
                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on QuestionnaireResponse.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 292. QuestionnaireResponse.item:F5.extension:itemMedia
                                                        Slice NameitemMedia
                                                        Definition

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

                                                        ShortMedia to display
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension(Item Media) (Extension Type: Attachment)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        294. QuestionnaireResponse.item:F5.extension:ItemSignature
                                                        Slice NameItemSignature
                                                        Definition

                                                        Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                                        ShortA signature attesting to the content
                                                        Control0..*
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        296. QuestionnaireResponse.item:F5.modifierExtension
                                                        Definition

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

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

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

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

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        Requirements

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

                                                        Alternate Namesextensions, user content, modifiers
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        298. QuestionnaireResponse.item:F5.linkId
                                                        Definition

                                                        The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                                        ShortPointer to specific item from Questionnaire
                                                        Control1..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Requirements

                                                        Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                                        Pattern ValueE-laundry
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        300. QuestionnaireResponse.item:F5.definition
                                                        Definition

                                                        A reference to an ElementDefinition that provides the details for the item.

                                                        ShortElementDefinition - details for the item
                                                        Comments

                                                        The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                                        There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                                        A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        302. QuestionnaireResponse.item:F5.text
                                                        Definition

                                                        Text that is displayed above the contents of the group or as the text of the question being answered.

                                                        ShortName for group or question text
                                                        Control1..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Requirements

                                                        Allows the questionnaire response to be read without access to the questionnaire.

                                                        Pattern ValueE.洗衣服
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        304. QuestionnaireResponse.item:F5.answer
                                                        Definition

                                                        The respondent's answer(s) to the question.

                                                        ShortThe response(s) to the question
                                                        Comments

                                                        The value is nested because we cannot have a repeating structure that has variable type.

                                                        Control1..1
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        306. QuestionnaireResponse.item:F5.answer.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        308. QuestionnaireResponse.item:F5.answer.extension
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 310. QuestionnaireResponse.item:F5.answer.extension:itemAnswerMedia
                                                          Slice NameitemAnswerMedia
                                                          Definition

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

                                                          ShortAnswer Media to display
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          312. QuestionnaireResponse.item:F5.answer.extension:itemWeight
                                                          Slice NameitemWeight
                                                          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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                                          ShortAssigned Ordinal Value
                                                          Comments

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

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

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(Item Weight) (Extension Type: decimal)
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          314. QuestionnaireResponse.item:F5.answer.modifierExtension
                                                          Definition

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

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

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

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

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

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

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          316. QuestionnaireResponse.item:F5.answer.value[x]
                                                          Definition

                                                          The answer (or one of the answers) provided by the respondent to the question.

                                                          ShortSingle-valued answer to the question
                                                          Comments

                                                          More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                                          Control1..1
                                                          Typeinteger
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

                                                          Ability to retain a single-valued answer to a question.

                                                          Min Value1
                                                          Max Value3
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          318. QuestionnaireResponse.item:F5.answer.item
                                                          Definition

                                                          Nested groups and/or questions found within this particular answer.

                                                          ShortNested groups and questions
                                                          Control0..*
                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

                                                          It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          320. QuestionnaireResponse.item:F5.item
                                                          Definition

                                                          Questions or sub-groups nested beneath a question or group.

                                                          ShortNested questionnaire response items
                                                          Control0..*
                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

                                                          Reports can consist of complex nested groups.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          322. QuestionnaireResponse.item:F6
                                                          Slice NameF6
                                                          Definition

                                                          A group or question item from the original questionnaire for which answers are provided.

                                                          ShortGroups and questions
                                                          Comments

                                                          Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                                          Control1..1
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                                          qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                                          324. QuestionnaireResponse.item:F6.id
                                                          Definition

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

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          326. QuestionnaireResponse.item:F6.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on QuestionnaireResponse.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 328. QuestionnaireResponse.item:F6.extension:itemMedia
                                                            Slice NameitemMedia
                                                            Definition

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

                                                            ShortMedia to display
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(Item Media) (Extension Type: Attachment)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            330. QuestionnaireResponse.item:F6.extension:ItemSignature
                                                            Slice NameItemSignature
                                                            Definition

                                                            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                                            ShortA signature attesting to the content
                                                            Control0..*
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            332. QuestionnaireResponse.item:F6.modifierExtension
                                                            Definition

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

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

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            Comments

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

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                            Summarytrue
                                                            Requirements

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

                                                            Alternate Namesextensions, user content, modifiers
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            334. QuestionnaireResponse.item:F6.linkId
                                                            Definition

                                                            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                                            ShortPointer to specific item from Questionnaire
                                                            Control1..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Requirements

                                                            Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                                            Pattern ValueF-transportation
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            336. QuestionnaireResponse.item:F6.definition
                                                            Definition

                                                            A reference to an ElementDefinition that provides the details for the item.

                                                            ShortElementDefinition - details for the item
                                                            Comments

                                                            The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                                            There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                                            A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            338. QuestionnaireResponse.item:F6.text
                                                            Definition

                                                            Text that is displayed above the contents of the group or as the text of the question being answered.

                                                            ShortName for group or question text
                                                            Control1..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Requirements

                                                            Allows the questionnaire response to be read without access to the questionnaire.

                                                            Pattern ValueF.外出
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            340. QuestionnaireResponse.item:F6.answer
                                                            Definition

                                                            The respondent's answer(s) to the question.

                                                            ShortThe response(s) to the question
                                                            Comments

                                                            The value is nested because we cannot have a repeating structure that has variable type.

                                                            Control1..1
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            342. QuestionnaireResponse.item:F6.answer.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            344. QuestionnaireResponse.item:F6.answer.extension
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 346. QuestionnaireResponse.item:F6.answer.extension:itemAnswerMedia
                                                              Slice NameitemAnswerMedia
                                                              Definition

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

                                                              ShortAnswer Media to display
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              348. QuestionnaireResponse.item:F6.answer.extension:itemWeight
                                                              Slice NameitemWeight
                                                              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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                                              ShortAssigned Ordinal Value
                                                              Comments

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

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

                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension(Item Weight) (Extension Type: decimal)
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              350. QuestionnaireResponse.item:F6.answer.modifierExtension
                                                              Definition

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

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

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

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

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                              Summarytrue
                                                              Requirements

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

                                                              Alternate Namesextensions, user content, modifiers
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              352. QuestionnaireResponse.item:F6.answer.value[x]
                                                              Definition

                                                              The answer (or one of the answers) provided by the respondent to the question.

                                                              ShortSingle-valued answer to the question
                                                              Comments

                                                              More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                                              Control1..1
                                                              Typeinteger
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Requirements

                                                              Ability to retain a single-valued answer to a question.

                                                              Min Value1
                                                              Max Value5
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              354. QuestionnaireResponse.item:F6.answer.item
                                                              Definition

                                                              Nested groups and/or questions found within this particular answer.

                                                              ShortNested groups and questions
                                                              Control0..*
                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Requirements

                                                              It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              356. QuestionnaireResponse.item:F6.item
                                                              Definition

                                                              Questions or sub-groups nested beneath a question or group.

                                                              ShortNested questionnaire response items
                                                              Control0..*
                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Requirements

                                                              Reports can consist of complex nested groups.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              358. QuestionnaireResponse.item:F7
                                                              Slice NameF7
                                                              Definition

                                                              A group or question item from the original questionnaire for which answers are provided.

                                                              ShortGroups and questions
                                                              Comments

                                                              Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                                              Control1..1
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                                              qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                                              360. QuestionnaireResponse.item:F7.id
                                                              Definition

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

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              362. QuestionnaireResponse.item:F7.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on QuestionnaireResponse.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 364. QuestionnaireResponse.item:F7.extension:itemMedia
                                                                Slice NameitemMedia
                                                                Definition

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

                                                                ShortMedia to display
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension(Item Media) (Extension Type: Attachment)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                366. QuestionnaireResponse.item:F7.extension:ItemSignature
                                                                Slice NameItemSignature
                                                                Definition

                                                                Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                                                ShortA signature attesting to the content
                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                368. QuestionnaireResponse.item:F7.modifierExtension
                                                                Definition

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

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                Requirements

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

                                                                Alternate Namesextensions, user content, modifiers
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                370. QuestionnaireResponse.item:F7.linkId
                                                                Definition

                                                                The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                                                ShortPointer to specific item from Questionnaire
                                                                Control1..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Requirements

                                                                Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                                                Pattern ValueG-medications
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                372. QuestionnaireResponse.item:F7.definition
                                                                Definition

                                                                A reference to an ElementDefinition that provides the details for the item.

                                                                ShortElementDefinition - details for the item
                                                                Comments

                                                                The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                                                There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                                                A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                374. QuestionnaireResponse.item:F7.text
                                                                Definition

                                                                Text that is displayed above the contents of the group or as the text of the question being answered.

                                                                ShortName for group or question text
                                                                Control1..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Requirements

                                                                Allows the questionnaire response to be read without access to the questionnaire.

                                                                Pattern ValueG.服用藥物
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                376. QuestionnaireResponse.item:F7.answer
                                                                Definition

                                                                The respondent's answer(s) to the question.

                                                                ShortThe response(s) to the question
                                                                Comments

                                                                The value is nested because we cannot have a repeating structure that has variable type.

                                                                Control1..1
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                378. QuestionnaireResponse.item:F7.answer.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                380. QuestionnaireResponse.item:F7.answer.extension
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 382. QuestionnaireResponse.item:F7.answer.extension:itemAnswerMedia
                                                                  Slice NameitemAnswerMedia
                                                                  Definition

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

                                                                  ShortAnswer Media to display
                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  384. QuestionnaireResponse.item:F7.answer.extension:itemWeight
                                                                  Slice NameitemWeight
                                                                  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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                                                  ShortAssigned Ordinal Value
                                                                  Comments

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

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

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension(Item Weight) (Extension Type: decimal)
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  386. QuestionnaireResponse.item:F7.answer.modifierExtension
                                                                  Definition

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

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

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  Comments

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

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                  Summarytrue
                                                                  Requirements

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

                                                                  Alternate Namesextensions, user content, modifiers
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  388. QuestionnaireResponse.item:F7.answer.value[x]
                                                                  Definition

                                                                  The answer (or one of the answers) provided by the respondent to the question.

                                                                  ShortSingle-valued answer to the question
                                                                  Comments

                                                                  More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                                                  Control1..1
                                                                  Typeinteger
                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Ability to retain a single-valued answer to a question.

                                                                  Min Value1
                                                                  Max Value3
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  390. QuestionnaireResponse.item:F7.answer.item
                                                                  Definition

                                                                  Nested groups and/or questions found within this particular answer.

                                                                  ShortNested groups and questions
                                                                  Control0..*
                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Requirements

                                                                  It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  392. QuestionnaireResponse.item:F7.item
                                                                  Definition

                                                                  Questions or sub-groups nested beneath a question or group.

                                                                  ShortNested questionnaire response items
                                                                  Control0..*
                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Reports can consist of complex nested groups.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  394. QuestionnaireResponse.item:F8
                                                                  Slice NameF8
                                                                  Definition

                                                                  A group or question item from the original questionnaire for which answers are provided.

                                                                  ShortGroups and questions
                                                                  Comments

                                                                  Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                                                  Control1..1
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                                                  qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                                                  396. QuestionnaireResponse.item:F8.id
                                                                  Definition

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

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  398. QuestionnaireResponse.item:F8.extension
                                                                  Definition

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on QuestionnaireResponse.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 400. QuestionnaireResponse.item:F8.extension:itemMedia
                                                                    Slice NameitemMedia
                                                                    Definition

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

                                                                    ShortMedia to display
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeExtension(Item Media) (Extension Type: Attachment)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    402. QuestionnaireResponse.item:F8.extension:ItemSignature
                                                                    Slice NameItemSignature
                                                                    Definition

                                                                    Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                                                    ShortA signature attesting to the content
                                                                    Control0..*
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    404. QuestionnaireResponse.item:F8.modifierExtension
                                                                    Definition

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

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

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

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

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

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

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    406. QuestionnaireResponse.item:F8.linkId
                                                                    Definition

                                                                    The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                                                    ShortPointer to specific item from Questionnaire
                                                                    Control1..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                                                    Pattern ValueH-finances
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    408. QuestionnaireResponse.item:F8.definition
                                                                    Definition

                                                                    A reference to an ElementDefinition that provides the details for the item.

                                                                    ShortElementDefinition - details for the item
                                                                    Comments

                                                                    The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                                                    There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                                                    A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    410. QuestionnaireResponse.item:F8.text
                                                                    Definition

                                                                    Text that is displayed above the contents of the group or as the text of the question being answered.

                                                                    ShortName for group or question text
                                                                    Control1..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Allows the questionnaire response to be read without access to the questionnaire.

                                                                    Pattern ValueH.處理財務的能力
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    412. QuestionnaireResponse.item:F8.answer
                                                                    Definition

                                                                    The respondent's answer(s) to the question.

                                                                    ShortThe response(s) to the question
                                                                    Comments

                                                                    The value is nested because we cannot have a repeating structure that has variable type.

                                                                    Control1..1
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    414. QuestionnaireResponse.item:F8.answer.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    416. QuestionnaireResponse.item:F8.answer.extension
                                                                    Definition

                                                                    An Extension

                                                                    ShortExtension
                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 418. QuestionnaireResponse.item:F8.answer.extension:itemAnswerMedia
                                                                      Slice NameitemAnswerMedia
                                                                      Definition

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

                                                                      ShortAnswer Media to display
                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      420. QuestionnaireResponse.item:F8.answer.extension:itemWeight
                                                                      Slice NameitemWeight
                                                                      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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                                                      ShortAssigned Ordinal Value
                                                                      Comments

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

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

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension(Item Weight) (Extension Type: decimal)
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      422. QuestionnaireResponse.item:F8.answer.modifierExtension
                                                                      Definition

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

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

                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                      Comments

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

                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                      Summarytrue
                                                                      Requirements

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

                                                                      Alternate Namesextensions, user content, modifiers
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      424. QuestionnaireResponse.item:F8.answer.value[x]
                                                                      Definition

                                                                      The answer (or one of the answers) provided by the respondent to the question.

                                                                      ShortSingle-valued answer to the question
                                                                      Comments

                                                                      More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                                                      Control1..1
                                                                      Typeinteger
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Ability to retain a single-valued answer to a question.

                                                                      Min Value1
                                                                      Max Value3
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      426. QuestionnaireResponse.item:F8.answer.item
                                                                      Definition

                                                                      Nested groups and/or questions found within this particular answer.

                                                                      ShortNested groups and questions
                                                                      Control0..*
                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Requirements

                                                                      It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      428. QuestionnaireResponse.item:F8.item
                                                                      Definition

                                                                      Questions or sub-groups nested beneath a question or group.

                                                                      ShortNested questionnaire response items
                                                                      Control0..*
                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Reports can consist of complex nested groups.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      430. QuestionnaireResponse.item:totalScoreSection
                                                                      Slice NametotalScoreSection
                                                                      Definition

                                                                      A group or question item from the original questionnaire for which answers are provided.

                                                                      ShortGroups and questions
                                                                      Comments

                                                                      Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                                                      Control1..1
                                                                      TypeBackboneElement
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                                                      qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                                                      432. QuestionnaireResponse.item:totalScoreSection.id
                                                                      Definition

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

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

                                                                      An Extension

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

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

                                                                        ShortMedia to display
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension(Item Media) (Extension Type: Attachment)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        438. QuestionnaireResponse.item:totalScoreSection.extension:ItemSignature
                                                                        Slice NameItemSignature
                                                                        Definition

                                                                        Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                                                        ShortA signature attesting to the content
                                                                        Control0..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        440. QuestionnaireResponse.item:totalScoreSection.modifierExtension
                                                                        Definition

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

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

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

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

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        442. QuestionnaireResponse.item:totalScoreSection.linkId
                                                                        Definition

                                                                        The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                                                        ShortPointer to specific item from Questionnaire
                                                                        Control1..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                                                        Fixed ValueI-total-score-IADL
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        444. QuestionnaireResponse.item:totalScoreSection.definition
                                                                        Definition

                                                                        A reference to an ElementDefinition that provides the details for the item.

                                                                        ShortElementDefinition - details for the item
                                                                        Comments

                                                                        The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                                                        There is no need for this element if the item pointed to by the linkId has a definition listed.

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

                                                                        A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        446. QuestionnaireResponse.item:totalScoreSection.text
                                                                        Definition

                                                                        Text that is displayed above the contents of the group or as the text of the question being answered.

                                                                        ShortName for group or question text
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows the questionnaire response to be read without access to the questionnaire.

                                                                        Pattern ValueI.IADL總分計算
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        448. QuestionnaireResponse.item:totalScoreSection.answer
                                                                        Definition

                                                                        The respondent's answer(s) to the question.

                                                                        ShortThe response(s) to the question
                                                                        Comments

                                                                        The value is nested because we cannot have a repeating structure that has variable type.

                                                                        Control1..1
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        450. QuestionnaireResponse.item:totalScoreSection.answer.id
                                                                        Definition

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

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

                                                                        An Extension

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

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

                                                                          ShortAnswer Media to display
                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          456. QuestionnaireResponse.item:totalScoreSection.answer.extension:itemWeight
                                                                          Slice NameitemWeight
                                                                          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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                                                          ShortAssigned Ordinal Value
                                                                          Comments

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

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

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension(Item Weight) (Extension Type: decimal)
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          458. QuestionnaireResponse.item:totalScoreSection.answer.modifierExtension
                                                                          Definition

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

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

                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                          Comments

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

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                          Summarytrue
                                                                          Requirements

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

                                                                          Alternate Namesextensions, user content, modifiers
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          460. QuestionnaireResponse.item:totalScoreSection.answer.value[x]
                                                                          Definition

                                                                          The answer (or one of the answers) provided by the respondent to the question.

                                                                          ShortSingle-valued answer to the question
                                                                          Comments

                                                                          More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                                                          Control0..1
                                                                          Typeinteger
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Ability to retain a single-valued answer to a question.

                                                                          Min Value8
                                                                          Max Value30
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          462. QuestionnaireResponse.item:totalScoreSection.answer.item
                                                                          Definition

                                                                          Nested groups and/or questions found within this particular answer.

                                                                          ShortNested groups and questions
                                                                          Control0..*
                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Requirements

                                                                          It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

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

                                                                          Questions or sub-groups nested beneath a question or group.

                                                                          ShortNested questionnaire response items
                                                                          Control0..*
                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Reports can consist of complex nested groups.

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

                                                                          IG © 2026+ Kimsber. Package fhir.rehabig#0.2.0 based on FHIR 4.0.1. Generated 2026-06-11
                                                                          Links: Table of Contents | QA Report