Clinical Decision Support for Chronic Pain Management and Shared Decision-Making IG
0.1.0 - CI Build
Clinical Decision Support for Chronic Pain Management and Shared Decision-Making IG
0.1.0 - CI Build
Clinical Decision Support for Chronic Pain Management and Shared Decision-Making IG, published by CQF. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cds4cpm/ and changes regularly. See the Directory of published versions
| Active as of 2024-03-22 |
<Questionnaire xmlns="http://hl7.org/fhir">
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<div xmlns="http://www.w3.org/1999/xhtml"><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkId for the item">LinkId</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the itemcan appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description & Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> mypainquestionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">A questionnaire to use with the MyPAIN application for a patient to assess their pain levels, locations, and treatments for use in consultation with a clinician to determine further treatments.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://fhir.org/guides/cqf/cds4cpm/Questionnaire/mypain-questionnaire#0.1.0</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> 1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">My Pain Location. We’d like to ask you a few questions about your pain and how it is affecting your life. Please describe the location(s) of any pain you have had in the past 7 days. Please select only one pain type per location.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 1.1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Head. What type of HEAD pain?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.1">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 1.2</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Neck. What type of NECK pain?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.2">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 1.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Shoulders. What type of SHOULDERS pain?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.3">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 1.4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Arms. What type of ARMS pain?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.4">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 1.5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Upper Back. What type of UPPER BACK pain?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.5">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.6" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 1.6</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Lower Back. What type of LOWER BACK pain?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.6">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.7" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 1.7</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Hands. What type of HANDS pain?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.7">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.8" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 1.8</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Abdomen. What type of ABDOMEN pain?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.8">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.9" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 1.9</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Pelvis. What type of PELVIS pain?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.9">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.10" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 1.10</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Hips. What type of HIPS pain?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.10">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.11" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 1.11</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Upper Legs. What type of UPPER LEGS pain?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.11">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.12" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 1.12</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Knees. What type of KNEES pain?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.12">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.13" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 1.13</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Lower Legs. What type of LOWER LEGS pain?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.13">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.14" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 1.14</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Feet. What type of FEET pain?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.14">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.1.15" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 1.15</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Everywhere. What type of EVERYWHERE pain?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.1.15">6 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.1.16" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Text" class="hierarchy"/> 1.16</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Other, please describe. Other, please describe</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> 2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">My Pain Intensity. Thinking about your overall pain, in the past 7 days, please respond to the questions below:</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.2.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 2.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How intense was your pain at its worst?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.2.1">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.2.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 2.2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How intense was your average pain?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.2.2">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.2.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 2.3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is your level of pain right now?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.2.3">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> 3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">My Pain Interference. Thinking about your overall pain, in the past 7 days, please respond to the questions below:</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.3.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 3.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How much did pain interfere with your day to day activities?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.3.1">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.3.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 3.2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How much did pain interfere with your work around the home?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.3.2">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.3.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 3.3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How much did pain interfere with your ability to participate in social activities?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.3.3">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.3.4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 3.4</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How much did pain interfere with your household chores?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.3.4">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> 4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">My Pain Interference. Thinking about your overall pain, in the past 7 days, please respond to the questions below:</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.4.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 4.1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How much did pain interfere with the things you usually do for fun?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.4.1">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.4.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 4.2</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How much did pain interfere with your enjoyment of social activities?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.4.2">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.4.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 4.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How much did pain interfere with your enjoyment of life?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.4.3">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.4.4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 4.4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How much did pain interfere with your family life?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.4.4">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: white; background-color: inherit" title="Display" class="hierarchy"/> 5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">About My Treatments. We’d like to know more about how you manage your pain and what has worked for you. When answering these questions, please <strong>focus on pain</strong> related to what brings you in for your upcoming medical visit. <br/><br/> These treatments are organized into sections by type: <br/> Basic therapies <br/>Mind-body therapies<br/>New therapies<br/>Non-prescription medicines <br/>Prescription medicines</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.6" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> 6</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">About My Treatments. What have you tried in the <strong>past 6 months</strong> to help you with your pain? Select all answers that apply. We also want to know if it worked for you.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.6.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 6.1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Exercises at home (such as those assigned by a therapist) or outside (such as walking, jogging, swimming). Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.6.1">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.6.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 6.2</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Sleep positioners or devices (such as additional pillows, padding, etc.). Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.6.2">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.6.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 6.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Stretching. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.6.3">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.6.4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 6.4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Weight loss or changes in your diet. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.6.4">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.6.5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 6.5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Setting and reaching activity goals. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.6.5">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.6.6" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 6.6</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Ice or Heat Therapy. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.6.6">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.6.7" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 6.7</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Physical Therapy. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.6.7">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.6.8" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 6.8</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Acupuncture. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.6.8">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.6.9" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 6.9</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Chiropractic treatment. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.6.9">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.6.10" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Text" class="hierarchy"/> 6.10</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Other, please describe. Other, please describe</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.7" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> 7</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">About My Treatments. Have you used any of the following <strong>items you can buy without a prescription from your doctor</strong> to help with your pain in the <strong>last 6 months</strong> (select all that apply)?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.7.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 7.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Pain relievers (such as Advil, Aleve, Aspirin, Ibuprofen, Motrin, Tylenol). Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.7.1">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.7.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 7.2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Herbal or nutritional pain relievers (such as ginseng or kava kava). Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.7.2">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.7.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 7.3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Cremes, lotions, gels or patches applied to the skin (for example BENGAY®, TIGER BALM® or BiOFREEZE®). Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.7.3">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.7.4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: white; background-color: inherit" title="Text" class="hierarchy"/> 7.4</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Other items you can buy without a prescription from your doctor, please describe. Other, please describe</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.8" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> 8</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">About My Treatments. Have you used any of the following <strong>prescription medications</strong> to help with your pain in the <strong>last 6 months</strong>?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.8.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 8.1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Opioid medications (such as hydrocodone, oxycodone, codeine, morphine and fentanyl). Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.8.1">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.8.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 8.2</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Procedure or Injection (such as a shot to relieve inflammation). Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.8.2">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.8.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 8.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Non-opioid medications as prescribed by a doctor (such as Celebrex or Cymbalta). Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.8.3">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.8.4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 8.4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Medical marijuana. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.8.4">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.8.5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: white; background-color: inherit" title="Text" class="hierarchy"/> 8.5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Other, please describe. Other, please describe</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.9" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> 9</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">About My Treatments. Have you tried any of the following <strong>new therapies</strong> to help with your pain in the <strong>last 6 months</strong> (select all that apply)?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.9.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 9.1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Yoga. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.9.1">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.9.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 9.2</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Massage. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.9.2">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.9.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 9.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Meditation. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.9.3">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.9.4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 9.4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Relaxation or mindfulness-based training. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.9.4">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.9.5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 9.5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Group or individual therapy for pain. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.9.5">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.9.6" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 9.6</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Cognitive behavioral therapy. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.9.6">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.9.7" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 9.7</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Acceptance or commitment therapy. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.9.7">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.9.8" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 9.8</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Sleep management (such as a sleep study or CPAP). Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.9.8">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.9.9" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: white; background-color: inherit" title="Text" class="hierarchy"/> 9.9</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Other, please describe. Other, please describe</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.10" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> 10</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">About My Treatments. Have you tried any of the following <strong>new therapies</strong> to help with your pain in the <strong>last 6 months</strong> (select all that apply)?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.10.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 10.1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Aromatherapy. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.10.1">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.10.2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 10.2</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Crystals. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.10.2">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.10.3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 10.3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Essential oils. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.10.3">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.10.4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 10.4</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">CBD oil. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.10.4">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" id="item.10.5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> 10.5</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Music therapy. Did it work?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.10.5">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.10.6" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Text" class="hierarchy"/> 10.6</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Other, please describe. Other, please describe</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.11" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: white; background-color: inherit" title="Text" class="hierarchy"/> 11</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">About My Goals. We’d like to know more about you and your goals. What are your most important activity goals? For example: I’d like to be able to walk without pain.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.12" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Text" class="hierarchy"/> 12</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">About My Goals. What are the biggest barriers to achieving your activity goals? For example: I have a lot of stress from work which makes my pain worse.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.13" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: white; background-color: inherit" title="Text" class="hierarchy"/> 13</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Managing Chronic Pain. Below is a link to a video produced by the American Chronic Pain Association about living with chronic pain. We’d like to suggest you watch the video to help you prepare for your upcoming visit. This video can help you prepare to ask questions that are important to you when you visit with your provider. <br/> <br/> <a id="replace" value="video"></a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Text" class="hierarchy"/> 14</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Managing Chronic Pain. The website linked below provides some information from the U.S. Pain Foundation about the causes and diagnosis of pain in general, treatment options and self management and well-being when living with pain. This information can help you prepare to ask questions that are important to you when you visit with your provider.<br/> <br/> <img width="100%" src="https://uspainfoundation.org//wp-content/uploads/2017/07/Woman-holding-neck-1024x682.jpg"/> <a id="replace" value="pain-link"></a> </td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item.15" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> 15</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">MyPAIN Feedback. Please indicate your level of agreement with the following statement:</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item.15.1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> 15.1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Using the MyPAIN tool has helped me begin preparing for a conversation with my provider about managing my pain.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.15.1">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.16" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: white; background-color: inherit" title="Text" class="hierarchy"/> 16</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">MyPAIN Feedback. Do you have any other feedback or thoughts to share on your use of MyPAIN?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Option Sets</b></p><a name="opt-item.1.1"> </a><p><b>Answer options for 1.1</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.2"> </a><p><b>Answer options for 1.2</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.3"> </a><p><b>Answer options for 1.3</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.4"> </a><p><b>Answer options for 1.4</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.5"> </a><p><b>Answer options for 1.5</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.6"> </a><p><b>Answer options for 1.6</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.7"> </a><p><b>Answer options for 1.7</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.8"> </a><p><b>Answer options for 1.8</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.9"> </a><p><b>Answer options for 1.9</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.10"> </a><p><b>Answer options for 1.10</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.11"> </a><p><b>Answer options for 1.11</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.12"> </a><p><b>Answer options for 1.12</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.13"> </a><p><b>Answer options for 1.13</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.14"> </a><p><b>Answer options for 1.14</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.1.15"> </a><p><b>Answer options for 1.15</b></p><ul><li style="font-size: 11px">http://snomed.info/sct#55145008 ("Stabbing")</li><li style="font-size: 11px">http://snomed.info/sct#36349006 ("Burning")</li><li style="font-size: 11px">http://snomed.info/sct#27635008 ("Aching")</li><li style="font-size: 11px">http://snomed.info/sct#786837007 ("Tingling")</li><li style="font-size: 11px">http://snomed.info/sct#162506004 ("Prickling")</li><li style="font-size: 11px">http://snomed.info/sct#29695002 ("Throbbing")</li></ul><a name="opt-item.2.1"> </a><p><b>Answer options for 2.1</b></p><ul><li style="font-size: 11px">http://loinc.org#LA13879-4 ("Had no pain")</li><li style="font-size: 11px">http://loinc.org#LA6752-5 ("Mild")</li><li style="font-size: 11px">http://loinc.org#LA6751-7 ("Moderate")</li><li style="font-size: 11px">http://loinc.org#LA6750-9 ("Severe")</li><li style="font-size: 11px">http://loinc.org#LA13958-6 ("Very Severe")</li></ul><a name="opt-item.2.2"> </a><p><b>Answer options for 2.2</b></p><ul><li style="font-size: 11px">http://loinc.org#LA13879-4 ("Had no pain")</li><li style="font-size: 11px">http://loinc.org#LA6752-5 ("Mild")</li><li style="font-size: 11px">http://loinc.org#LA6751-7 ("Moderate")</li><li style="font-size: 11px">http://loinc.org#LA6750-9 ("Severe")</li><li style="font-size: 11px">http://loinc.org#LA13958-6 ("Very Severe")</li></ul><a name="opt-item.2.3"> </a><p><b>Answer options for 2.3</b></p><ul><li style="font-size: 11px">http://loinc.org#LA131-5 ("Had no pain")</li><li style="font-size: 11px">http://loinc.org#LA6752-5 ("Mild")</li><li style="font-size: 11px">http://loinc.org#LA6751-7 ("Moderate")</li><li style="font-size: 11px">http://loinc.org#LA6750-9 ("Severe")</li><li style="font-size: 11px">http://loinc.org#LA13958-6 ("Very Severe")</li></ul><a name="opt-item.3.1"> </a><p><b>Answer options for 3.1</b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 ("Not at all")</li><li style="font-size: 11px">http://loinc.org#LA13863-8 ("A little bit")</li><li style="font-size: 11px">http://loinc.org#LA13909-9 ("Somewhat")</li><li style="font-size: 11px">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style="font-size: 11px">http://loinc.org#LA13914-9 ("Very much")</li></ul><a name="opt-item.3.2"> </a><p><b>Answer options for 3.2</b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 ("Not at all")</li><li style="font-size: 11px">http://loinc.org#LA13863-8 ("A little bit")</li><li style="font-size: 11px">http://loinc.org#LA13909-9 ("Somewhat")</li><li style="font-size: 11px">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style="font-size: 11px">http://loinc.org#LA13914-9 ("Very much")</li></ul><a name="opt-item.3.3"> </a><p><b>Answer options for 3.3</b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 ("Not at all")</li><li style="font-size: 11px">http://loinc.org#LA13863-8 ("A little bit")</li><li style="font-size: 11px">http://loinc.org#LA13909-9 ("Somewhat")</li><li style="font-size: 11px">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style="font-size: 11px">http://loinc.org#LA13914-9 ("Very much")</li></ul><a name="opt-item.3.4"> </a><p><b>Answer options for 3.4</b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 ("Not at all")</li><li style="font-size: 11px">http://loinc.org#LA13863-8 ("A little bit")</li><li style="font-size: 11px">http://loinc.org#LA13909-9 ("Somewhat")</li><li style="font-size: 11px">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style="font-size: 11px">http://loinc.org#LA13914-9 ("Very much")</li></ul><a name="opt-item.4.1"> </a><p><b>Answer options for 4.1</b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 ("Not at all")</li><li style="font-size: 11px">http://loinc.org#LA13863-8 ("A little bit")</li><li style="font-size: 11px">http://loinc.org#LA13909-9 ("Somewhat")</li><li style="font-size: 11px">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style="font-size: 11px">http://loinc.org#LA13914-9 ("Very much")</li></ul><a name="opt-item.4.2"> </a><p><b>Answer options for 4.2</b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 ("Not at all")</li><li style="font-size: 11px">http://loinc.org#LA13863-8 ("A little bit")</li><li style="font-size: 11px">http://loinc.org#LA13909-9 ("Somewhat")</li><li style="font-size: 11px">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style="font-size: 11px">http://loinc.org#LA13914-9 ("Very much")</li></ul><a name="opt-item.4.3"> </a><p><b>Answer options for 4.3</b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 ("Not at all")</li><li style="font-size: 11px">http://loinc.org#LA13863-8 ("A little bit")</li><li style="font-size: 11px">http://loinc.org#LA13909-9 ("Somewhat")</li><li style="font-size: 11px">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style="font-size: 11px">http://loinc.org#LA13914-9 ("Very much")</li></ul><a name="opt-item.4.4"> </a><p><b>Answer options for 4.4</b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 ("Not at all")</li><li style="font-size: 11px">http://loinc.org#LA13863-8 ("A little bit")</li><li style="font-size: 11px">http://loinc.org#LA13909-9 ("Somewhat")</li><li style="font-size: 11px">http://loinc.org#LA13902-4 ("Quite a bit")</li><li style="font-size: 11px">http://loinc.org#LA13914-9 ("Very much")</li></ul><a name="opt-item.6.1"> </a><p><b>Answer options for 6.1</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.6.2"> </a><p><b>Answer options for 6.2</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.6.3"> </a><p><b>Answer options for 6.3</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.6.4"> </a><p><b>Answer options for 6.4</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.6.5"> </a><p><b>Answer options for 6.5</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.6.6"> </a><p><b>Answer options for 6.6</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.6.7"> </a><p><b>Answer options for 6.7</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.6.8"> </a><p><b>Answer options for 6.8</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.6.9"> </a><p><b>Answer options for 6.9</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.7.1"> </a><p><b>Answer options for 7.1</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.7.2"> </a><p><b>Answer options for 7.2</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.7.3"> </a><p><b>Answer options for 7.3</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.8.1"> </a><p><b>Answer options for 8.1</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.8.2"> </a><p><b>Answer options for 8.2</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.8.3"> </a><p><b>Answer options for 8.3</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.8.4"> </a><p><b>Answer options for 8.4</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.9.1"> </a><p><b>Answer options for 9.1</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.9.2"> </a><p><b>Answer options for 9.2</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.9.3"> </a><p><b>Answer options for 9.3</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.9.4"> </a><p><b>Answer options for 9.4</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.9.5"> </a><p><b>Answer options for 9.5</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.9.6"> </a><p><b>Answer options for 9.6</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.9.7"> </a><p><b>Answer options for 9.7</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.9.8"> </a><p><b>Answer options for 9.8</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.10.1"> </a><p><b>Answer options for 10.1</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.10.2"> </a><p><b>Answer options for 10.2</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.10.3"> </a><p><b>Answer options for 10.3</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.10.4"> </a><p><b>Answer options for 10.4</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.10.5"> </a><p><b>Answer options for 10.5</b></p><ul><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1000 ("Never")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1001 ("Sometimes")</li><li style="font-size: 11px">http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes#mpqr-1002 ("Always")</li></ul><a name="opt-item.15.1"> </a><p><b>Answer options for 15.1</b></p><ul><li style="font-size: 11px">https://loinc.org/LL1606-4/#LA15238-1 ("Disagree a lot")</li><li style="font-size: 11px">https://loinc.org/LL1606-4/#LA15239-9 ("Disagree a little")</li><li style="font-size: 11px">https://loinc.org/LL1606-4/#LA15240-7 ("Neither agree nor disagree")</li><li style="font-size: 11px">https://loinc.org/LL1606-4/#LA15241-5 ("Agree a little")</li><li style="font-size: 11px">https://loinc.org/LL1606-4/#LA15242-3 ("Agree a lot")</li></ul></div>
</text>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
<valueCode value="shareable"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
<valueCode value="publishable"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeRepresentationLevel">
<valueCode value="narrative"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
<valueCode value="computable"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeRepresentationLevel">
<valueCode value="structured"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
<valueCode value="executable"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeRepresentationLevel">
<valueCode value="executable"/>
</extension>
<url
value="http://fhir.org/guides/cqf/cds4cpm/Questionnaire/mypain-questionnaire"/>
<version value="0.1.0"/>
<name value="mypainquestionnaire"/>
<title value="MyPain Questionnaire"/>
<status value="active"/>
<experimental value="false"/>
<subjectType value="Patient"/>
<date value="2024-03-22T17:08:36+00:00"/>
<publisher value="CQF"/>
<contact>
<telecom>
<system value="url"/>
<value
value="http://fhir.org/guides/cqf/cds4cpm/ImplementationGuide/cqf.fhir.cds4cpm"/>
</telecom>
</contact>
<description
value="A questionnaire to use with the MyPAIN application for a patient to assess their pain levels, locations, and treatments for use in consultation with a clinician to determine further treatments."/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<item>
<linkId value="1"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="pain-location"/>
<display
value="Please describe the location(s) of any pain you have had in the past 7 days."/>
</code>
<prefix value="My Pain Location"/>
<text
value="We’d like to ask you a few questions about your pain and how it is affecting your life. Please describe the location(s) of any pain you have had in the past 7 days. Please select only one pain type per location."/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.1"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1038"/>
<display
value="What type of HEAD pain have you had in the last 7 days?"/>
</code>
<prefix value="Head"/>
<text value="What type of HEAD pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
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<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.2"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1039"/>
<display
value="What type of NECK pain have you had in the last 7 days?"/>
</code>
<prefix value="Neck"/>
<text value="What type of NECK pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.3"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1040"/>
<display
value="What type of SHOULDERS pain have you had in the last 7 days?"/>
</code>
<prefix value="Shoulders"/>
<text value="What type of SHOULDERS pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.4"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1041"/>
<display
value="What type of ARMS pain have you had in the last 7 days?"/>
</code>
<prefix value="Arms"/>
<text value="What type of ARMS pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.5"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1042"/>
<display
value="What type of UPPER BACK pain have you had in the last 7 days?"/>
</code>
<prefix value="Upper Back"/>
<text value="What type of UPPER BACK pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
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url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.6"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1043"/>
<display
value="What type of LOWER BACK pain have you had in the last 7 days?"/>
</code>
<prefix value="Lower Back"/>
<text value="What type of LOWER BACK pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.7"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1044"/>
<display
value="What type of HANDS pain have you had in the last 7 days?"/>
</code>
<prefix value="Hands"/>
<text value="What type of HANDS pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.8"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1045"/>
<display
value="What type of ABDOMEN pain have you had in the last 7 days?"/>
</code>
<prefix value="Abdomen"/>
<text value="What type of ABDOMEN pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.9"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1046"/>
<display
value="What type of PELVIS pain have you had in the last 7 days?"/>
</code>
<prefix value="Pelvis"/>
<text value="What type of PELVIS pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.10"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1047"/>
<display
value="What type of HIPS pain have you had in the last 7 days?"/>
</code>
<prefix value="Hips"/>
<text value="What type of HIPS pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.11"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1048"/>
<display
value="What type of UPPER LEGS pain have you had in the last 7 days?"/>
</code>
<prefix value="Upper Legs"/>
<text value="What type of UPPER LEGS pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.12"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1049"/>
<display
value="What type of KNEES pain have you had in the last 7 days?"/>
</code>
<prefix value="Knees"/>
<text value="What type of KNEES pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.13"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1050"/>
<display
value="What type of LOWER LEGS pain have you had in the last 7 days?"/>
</code>
<prefix value="Lower Legs"/>
<text value="What type of LOWER LEGS pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.14"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1051"/>
<display
value="What type of FEET pain have you had in the last 7 days?"/>
</code>
<prefix value="Feet"/>
<text value="What type of FEET pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/pain-types"/>
</extension>
<linkId value="1.15"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1052"/>
<display
value="What type of EVERYWHERE pain have you had in the last 7 days?"/>
</code>
<prefix value="Everywhere"/>
<text value="What type of EVERYWHERE pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="55145008"/>
<display value="Stabbing"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="36349006"/>
<display value="Burning"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="27635008"/>
<display value="Aching"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="786837007"/>
<display value="Tingling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="162506004"/>
<display value="Prickling"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="29695002"/>
<display value="Throbbing"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="1.16"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1053"/>
<display
value="What OTHER pain have you had in the last 7 days? Please describe"/>
</code>
<prefix value="Other, please describe"/>
<text value="Other, please describe"/>
<type value="text"/>
<required value="false"/>
</item>
</item>
<item>
<linkId value="2"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="my-pain-intensity"/>
<display
value="Thinking about your overall pain, in the past 7 days, please respond to the questions below:"/>
</code>
<prefix value="My Pain Intensity"/>
<text
value="Thinking about your overall pain, in the past 7 days, please respond to the questions below:"/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL2949-7"/>
</extension>
<linkId value="2.1"/>
<code>
<system value="http://loinc.org"/>
<code value="75262-6"/>
<display
value="How intense was your pain at its worse in the past 7 days"/>
</code>
<text value="How intense was your pain at its worst?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13879-4"/>
<display value="Had no pain"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6752-5"/>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6751-7"/>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6750-9"/>
<display value="Severe"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13958-6"/>
<display value="Very Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL2949-7"/>
</extension>
<linkId value="2.2"/>
<code>
<system value="http://loinc.org"/>
<code value="75261-8"/>
<display
value="How intense was your average pain in the past 7 days"/>
</code>
<text value="How intense was your average pain?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13879-4"/>
<display value="Had no pain"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6752-5"/>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6751-7"/>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6750-9"/>
<display value="Severe"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13958-6"/>
<display value="Very Severe"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL2951-3"/>
</extension>
<linkId value="2.3"/>
<code>
<system value="http://loinc.org"/>
<code value="75260-0"/>
<display value="What is your level of pain right now"/>
</code>
<text value="What is your level of pain right now?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA131-5"/>
<display value="Had no pain"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6752-5"/>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6751-7"/>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6750-9"/>
<display value="Severe"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13958-6"/>
<display value="Very Severe"/>
</valueCoding>
</answerOption>
</item>
</item>
<item>
<linkId value="3"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="my-pain-interference"/>
<display
value="Thinking about your overall pain, in the past 7 days, please respond to the questions below:"/>
</code>
<prefix value="My Pain Interference"/>
<text
value="Thinking about your overall pain, in the past 7 days, please respond to the questions below:"/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL1017-4"/>
</extension>
<linkId value="3.1"/>
<code>
<system value="http://loinc.org"/>
<code value="61758-9"/>
<display
value="How much did pain interfere with your day to day activities in past 7 days"/>
</code>
<text
value="How much did pain interfere with your day to day activities?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13863-8"/>
<display value="A little bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13909-9"/>
<display value="Somewhat"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13902-4"/>
<display value="Quite a bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13914-9"/>
<display value="Very much"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL1017-4"/>
</extension>
<linkId value="3.2"/>
<code>
<system value="http://loinc.org"/>
<code value="61769-6"/>
<display
value="How much did pain interfere with work around the home in past 7 days"/>
</code>
<text
value="How much did pain interfere with your work around the home?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13863-8"/>
<display value="A little bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13909-9"/>
<display value="Somewhat"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13902-4"/>
<display value="Quite a bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13914-9"/>
<display value="Very much"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL1017-4"/>
</extension>
<linkId value="3.3"/>
<code>
<system value="http://loinc.org"/>
<code value="61773-8"/>
<display
value="How much did pain interfere with your ability to participate in social activities in past 7 days"/>
</code>
<text
value="How much did pain interfere with your ability to participate in social activities?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
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</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13863-8"/>
<display value="A little bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13909-9"/>
<display value="Somewhat"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13902-4"/>
<display value="Quite a bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13914-9"/>
<display value="Very much"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL1017-4"/>
</extension>
<linkId value="3.4"/>
<code>
<system value="http://loinc.org"/>
<code value="61775-3"/>
<display
value="How much did pain interfere with your household chores in past 7 days"/>
</code>
<text value="How much did pain interfere with your household chores?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13863-8"/>
<display value="A little bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13909-9"/>
<display value="Somewhat"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13902-4"/>
<display value="Quite a bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13914-9"/>
<display value="Very much"/>
</valueCoding>
</answerOption>
</item>
</item>
<item>
<linkId value="4"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="my-pain-interference"/>
<display
value="Thinking about your overall pain, in the past 7 days, please respond to the questions below:"/>
</code>
<prefix value="My Pain Interference"/>
<text
value="Thinking about your overall pain, in the past 7 days, please respond to the questions below:"/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL1017-4"/>
</extension>
<linkId value="4.1"/>
<code>
<system value="http://loinc.org"/>
<code value="61761-3"/>
<display
value="How much did pain interfere with the things you usually do for fun in past 7 days"/>
</code>
<text
value="How much did pain interfere with the things you usually do for fun?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13863-8"/>
<display value="A little bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13909-9"/>
<display value="Somewhat"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13902-4"/>
<display value="Quite a bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13914-9"/>
<display value="Very much"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL1017-4"/>
</extension>
<linkId value="4.2"/>
<code>
<system value="http://loinc.org"/>
<code value="61777-9"/>
<display
value="How much did pain interfere with your enjoyment of social activities in past 7 days"/>
</code>
<text
value="How much did pain interfere with your enjoyment of social activities?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13863-8"/>
<display value="A little bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13909-9"/>
<display value="Somewhat"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13902-4"/>
<display value="Quite a bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13914-9"/>
<display value="Very much"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL1017-4"/>
</extension>
<linkId value="4.3"/>
<code>
<system value="http://loinc.org"/>
<code value="61794-4"/>
<display
value="How much did pain interfere with your enjoyment of life in past 7 days"/>
</code>
<text value="How much did pain interfere with your enjoyment of life?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13863-8"/>
<display value="A little bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13909-9"/>
<display value="Somewhat"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13902-4"/>
<display value="Quite a bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13914-9"/>
<display value="Very much"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL1017-4"/>
</extension>
<linkId value="4.4"/>
<code>
<system value="http://loinc.org"/>
<code value="61762-1"/>
<display
value="How much did pain interfere with your family life in past 7 days"/>
</code>
<text value="How much did pain interfere with your family life?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13863-8"/>
<display value="A little bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13909-9"/>
<display value="Somewhat"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13902-4"/>
<display value="Quite a bit"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13914-9"/>
<display value="Very much"/>
</valueCoding>
</answerOption>
</item>
</item>
<item>
<linkId value="5"/>
<prefix value="About My Treatments"/>
<text
value="We’d like to know more about how you manage your pain and what has worked for you. When answering these questions, please <strong>focus on pain</strong> related to what brings you in for your upcoming medical visit. <br/><br/> These treatments are organized into sections by type: <br/> Basic therapies <br/>Mind-body therapies<br/>New therapies<br/>Non-prescription medicines <br/>Prescription medicines"/>
<type value="display"/>
</item>
<item>
<linkId value="6"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="about-my-treatments"/>
<display
value="What have you tried in the <strong>past 6 months</strong> to help you with your pain? Select all answers that apply. We also want to know if it worked for you."/>
</code>
<prefix value="About My Treatments"/>
<text
value="What have you tried in the <strong>past 6 months</strong> to help you with your pain? Select all answers that apply. We also want to know if it worked for you."/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="6.1"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1008"/>
<display
value="How often have Exercises at home (such as those assigned by a therapist) or outside (such as walking, jogging, swimming) you have tried in the past 6 months helped you with your pain?"/>
</code>
<prefix
value="Exercises at home (such as those assigned by a therapist) or outside (such as walking, jogging, swimming)"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="6.2"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1009"/>
<display
value="How often have Sleep positioners or devices (such as additional pillows, padding, etc.) you have tried in the past 6 months helped you with your pain?"/>
</code>
<prefix
value="Sleep positioners or devices (such as additional pillows, padding, etc.)"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
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<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="6.3"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1010"/>
<display
value="How often has Stretching you have tried in the past 6 months helped you with your pain?"/>
</code>
<prefix value="Stretching"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
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<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
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<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
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<valueCanonical
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</extension>
<linkId value="6.4"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1011"/>
<display
value="How often has Weight loss or changes in your diet you have tried in the past 6 months helped you with your pain?"/>
</code>
<prefix value="Weight loss or changes in your diet"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
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<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
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</extension>
<linkId value="6.5"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1012"/>
<display
value="How often has Setting and reaching activity goals you have tried in the past 6 months helped you with your pain?"/>
</code>
<prefix value="Setting and reaching activity goals"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
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<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
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</extension>
<linkId value="6.6"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1013"/>
<display
value="How often has Ice or heat therapy you have tried in the past 6 months helped you with your pain?"/>
</code>
<prefix value="Ice or Heat Therapy"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="6.7"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1014"/>
<display
value="How often has Physical therapy you have tried in the past 6 months helped you with your pain?"/>
</code>
<prefix value="Physical Therapy"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="6.8"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1015"/>
<display
value="How often has Acupuncture you have tried in the past 6 months helped you with your pain?"/>
</code>
<prefix value="Acupuncture"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="6.9"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1016"/>
<display
value="How often has Chiropractic treatment you have tried in the past 6 months helped you with your pain?"/>
</code>
<prefix value="Chiropractic treatment"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="6.10"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1054"/>
<display
value="How often have Other strategies or methods you have tried in the last 6 months helped with your pain? Please describe"/>
</code>
<prefix value="Other, please describe"/>
<text value="Other, please describe"/>
<type value="text"/>
<required value="false"/>
</item>
</item>
<item>
<linkId value="7"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="about-my-treatments"/>
<display
value="Have you used any of the following <strong>items you can buy without a prescription from your doctor</strong> to help with your pain in the <strong>last 6 months</strong> (select all that apply)?"/>
</code>
<prefix value="About My Treatments"/>
<text
value="Have you used any of the following <strong>items you can buy without a prescription from your doctor</strong> to help with your pain in the <strong>last 6 months</strong> (select all that apply)?"/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="7.1"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1017"/>
<display
value="How often have Pain relievers (such as Advil, Aleve, Aspirin, Ibuprofen, Motrin, Tylenol) you can buy without a prescription from your doctor that you have used in the last 6 months helped with your pain?"/>
</code>
<prefix
value="Pain relievers (such as Advil, Aleve, Aspirin, Ibuprofen, Motrin, Tylenol)"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="7.2"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1018"/>
<display
value="How often have Herbal or nutritional pain relievers (such as ginseng or kava kava) that you have used in the last 6 months helped with your pain?"/>
</code>
<prefix
value="Herbal or nutritional pain relievers (such as ginseng or kava kava)"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="7.3"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1019"/>
<display
value="How often have Cremes, lotions, gels or patches applied to the skin (for example Bengay, Tiger Balm or BioFreeze) that you have used in the last 6 months helped with your pain?"/>
</code>
<prefix
value="Cremes, lotions, gels or patches applied to the skin (for example BENGAY®, TIGER BALM® or BiOFREEZE®)"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="7.4"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1055"/>
<display
value="Have you used any Other items you can buy without a prescription from your doctor to help with your pain in the last 6 months? Please describe"/>
</code>
<prefix
value="Other items you can buy without a prescription from your doctor, please describe"/>
<text value="Other, please describe"/>
<type value="text"/>
<required value="false"/>
</item>
</item>
<item>
<linkId value="8"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="about-my-treatments"/>
<display
value="Have you used any of the following <strong>prescription medications</strong> to help with your pain in the <strong>last 6 months</strong>?"/>
</code>
<prefix value="About My Treatments"/>
<text
value="Have you used any of the following <strong>prescription medications</strong> to help with your pain in the <strong>last 6 months</strong>?"/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="8.1"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1020"/>
<display
value="How often have prescription Opioid medications (such as hydrocodone, oxycodone, codeine, morphine and fentanyl) helped with your pain in the last 6 months?"/>
</code>
<prefix
value="Opioid medications (such as hydrocodone, oxycodone, codeine, morphine and fentanyl)"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="8.2"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1021"/>
<display
value="How often have prescription Cortisone injections (a shot to relieve inflammation) helped with your pain in the last 6 months?"/>
</code>
<prefix
value="Procedure or Injection (such as a shot to relieve inflammation)"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="8.3"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1022"/>
<display
value="How often have prescription Non-opioid medications as prescribed by a doctor (such as Celebrex, Cymbalta) helped with your pain in the last 6 months?"/>
</code>
<prefix
value="Non-opioid medications as prescribed by a doctor (such as Celebrex or Cymbalta)"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="8.4"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1056"/>
<display
value="How often has Medical marijuana helped with your pain in the last 6 months?"/>
</code>
<prefix value="Medical marijuana"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="8.5"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1057"/>
<display
value="Have you used any Other prescription medications to help with your pain in the last 6 months?: Please describe"/>
</code>
<prefix value="Other, please describe"/>
<text value="Other, please describe"/>
<type value="text"/>
<required value="false"/>
</item>
</item>
<item>
<linkId value="9"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="about-my-treatments"/>
<display
value="Have you tried any of the following <strong>new therapies</strong> to help with your pain in the <strong>last 6 months</strong> (select all that apply)?"/>
</code>
<prefix value="About My Treatments"/>
<text
value="Have you tried any of the following <strong>new therapies</strong> to help with your pain in the <strong>last 6 months</strong> (select all that apply)?"/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="9.1"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1023"/>
<display
value="How often has Yoga helped with your pain in the last 6 months?"/>
</code>
<prefix value="Yoga"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="9.2"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1024"/>
<display
value="How often has Massage helped with your pain in the last 6 months?"/>
</code>
<prefix value="Massage"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="9.3"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1025"/>
<display
value="How often has Meditation helped with your pain in the last 6 months?"/>
</code>
<prefix value="Meditation"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="9.4"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1026"/>
<display
value="How often has Relaxation or mindfulness-based training helped with your pain in the last 6 months?"/>
</code>
<prefix value="Relaxation or mindfulness-based training"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="9.5"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1027"/>
<display
value="How often has Group or individual therapy for pain helped with your pain in the last 6 months?"/>
</code>
<prefix value="Group or individual therapy for pain"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="9.6"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1058"/>
<display
value="How often has Cognitive behavioral therapy helped with your pain in the last 6 months?"/>
</code>
<prefix value="Cognitive behavioral therapy"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="9.7"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1028"/>
<display
value="How often has Acceptance and commitment therapy helped with your pain in the last 6 months?"/>
</code>
<prefix value="Acceptance or commitment therapy"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="9.8"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1029"/>
<display
value="How often has Sleep management (such as a sleep study or CPAP) helped with your pain in the last 6 months?"/>
</code>
<prefix value="Sleep management (such as a sleep study or CPAP)"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="9.9"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1059"/>
<display
value="Have you tried any Other mind-body techniques or therapies to help with your pain in the last 6 months? Please describe"/>
</code>
<prefix value="Other, please describe"/>
<text value="Other, please describe"/>
<type value="text"/>
<required value="false"/>
</item>
</item>
<item>
<linkId value="10"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="about-my-treatments"/>
<display
value="Have you tried any of the following <strong>new therapies</strong> to help with your pain in the <strong>last 6 months</strong> (select all that apply)?"/>
</code>
<prefix value="About My Treatments"/>
<text
value="Have you tried any of the following <strong>new therapies</strong> to help with your pain in the <strong>last 6 months</strong> (select all that apply)?"/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="10.1"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1030"/>
<display
value="How often has Aromatherapy helped with your pain in the last 6 months?"/>
</code>
<prefix value="Aromatherapy"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="10.2"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1031"/>
<display
value="How often have Crystals helped with your pain in the last 6 months?"/>
</code>
<prefix value="Crystals"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="10.3"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1032"/>
<display
value="How often have Essential oils helped with your pain in the last 6 months?"/>
</code>
<prefix value="Essential oils"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="10.4"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1060"/>
<display
value="How often has CBD oil helped with your pain in the last 6 months?"/>
</code>
<prefix value="CBD oil"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical
value="http://fhir.org/guides/cqf/cds4cpm/ValueSet/three-item-likert"/>
</extension>
<linkId value="10.5"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1033"/>
<display
value="How often has Music therapy helped with your pain in the last 6 months?"/>
</code>
<prefix value="Music therapy"/>
<text value="Did it work?"/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1000"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1001"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaireresponse-codes"/>
<code value="mpqr-1002"/>
<display value="Always"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="10.6"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1034"/>
<display
value="Have you tried any Other new treatments to help with your pain in the last 6 months? Please describe"/>
</code>
<prefix value="Other, please describe"/>
<text value="Other, please describe"/>
<type value="text"/>
<required value="false"/>
</item>
</item>
<item>
<linkId value="11"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="about-my-goals"/>
<display value="We’d like to know more about you and your goals."/>
</code>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1035"/>
<display
value="What are your most important activity goals? For example: I’d like to be able to walk without pain."/>
</code>
<prefix value="About My Goals"/>
<text
value="We’d like to know more about you and your goals. What are your most important activity goals? For example: I’d like to be able to walk without pain."/>
<type value="text"/>
<required value="false"/>
</item>
<item>
<linkId value="12"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="about-my-goals"/>
<display value="We’d like to know more about you and your goals."/>
</code>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1036"/>
<display
value="What are the biggest barriers to achieving your activity goals? For example: I have a lot of stress from work which makes my pain worse."/>
</code>
<prefix value="About My Goals"/>
<text
value="What are the biggest barriers to achieving your activity goals? For example: I have a lot of stress from work which makes my pain worse."/>
<type value="text"/>
<required value="false"/>
</item>
<item>
<linkId value="13"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1061"/>
<display value="Did the patient view the 4 flat tires video"/>
</code>
<prefix value="Managing Chronic Pain"/>
<text
value="Below is a link to a video produced by the American Chronic Pain Association about living with chronic pain. We’d like to suggest you watch the video to help you prepare for your upcoming visit. This video can help you prepare to ask questions that are important to you when you visit with your provider. <br/> <br/> <a id="replace" value="video"></a>"/>
<type value="text"/>
</item>
<item>
<linkId value="14"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1062"/>
<display value="Did the patient access the US Chronic Pain website"/>
</code>
<prefix value="Managing Chronic Pain"/>
<text
value="The website linked below provides some information from the U.S. Pain Foundation about the causes and diagnosis of pain in general, treatment options and self management and well-being when living with pain. This information can help you prepare to ask questions that are important to you when you visit with your provider.<br/> <br/> <img width="100%" src="https://uspainfoundation.org//wp-content/uploads/2017/07/Woman-holding-neck-1024x682.jpg"/> <a id="replace" value="pain-link"></a> "/>
<type value="text"/>
</item>
<item>
<linkId value="15"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mypain-feedback"/>
<display value="Feedback about your use of MyPAIN"/>
</code>
<prefix value="MyPAIN Feedback"/>
<text
value="Please indicate your level of agreement with the following statement:"/>
<type value="group"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
<text value="Drop down"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource">
<valueCanonical value="http://loinc.org/vs/LL1606-4"/>
</extension>
<linkId value="15.1"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1063"/>
<display
value="Please indicate your level of agreement with the following statement: Using the MyPAIN tool has helped me begin preparing for a conversation with my provider about managing my pain."/>
</code>
<text
value="Using the MyPAIN tool has helped me begin preparing for a conversation with my provider about managing my pain."/>
<type value="choice"/>
<required value="false"/>
<answerOption>
<valueCoding>
<system value="https://loinc.org/LL1606-4/"/>
<code value="LA15238-1"/>
<display value="Disagree a lot"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="https://loinc.org/LL1606-4/"/>
<code value="LA15239-9"/>
<display value="Disagree a little"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="https://loinc.org/LL1606-4/"/>
<code value="LA15240-7"/>
<display value="Neither agree nor disagree"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="https://loinc.org/LL1606-4/"/>
<code value="LA15241-5"/>
<display value="Agree a little"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="https://loinc.org/LL1606-4/"/>
<code value="LA15242-3"/>
<display value="Agree a lot"/>
</valueCoding>
</answerOption>
</item>
</item>
<item>
<linkId value="16"/>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mpq-1064"/>
<display
value="Do you have any other feedback or thoughts to share on your use of MyPAIN?"/>
</code>
<code>
<system
value="http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes"/>
<code value="mypain-feedback"/>
<display value="Feedback on your use of MyPAIN"/>
</code>
<prefix value="MyPAIN Feedback"/>
<text
value="Do you have any other feedback or thoughts to share on your use of MyPAIN?"/>
<type value="text"/>
<required value="false"/>
</item>
</Questionnaire>
IG © 2019+ CQF. Package cqf.fhir.cds4cpm#0.1.0 based on FHIR 4.0.1. Generated 2024-03-22
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