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Your User Friendly Name for MyContentIG Here, published by HL7 International - [Some] Work Group. This guide is not an authorized publication; it is the continuous build for version 0.4.6 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/sample-content-ig/ and changes regularly. See the Directory of published versions

: Questionnaire Measure Example - XML Representation

Draft as of 2024-05-05

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<Measure xmlns="http://hl7.org/fhir">
  <id value="QuestionnaireMeasureExample"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <table class="narrative-table">
    <tbody>
<tr>

<th colspan="2" scope="row" class="row-header">Knowledge Artifact Metadata</th>

</tr>

<tr>

<th scope="row" class="row-header">Name (machine-readable)</th>

<td class="content-container">QuestionnaireMeasureExample</td>
</tr>


<tr>

<th scope="row" class="row-header">Title (human-readable)</th>

<td class="content-container">Questionnaire Measure Example</td>
</tr>



<tr>

<th scope="row" class="row-header">Status</th>

<td class="content-container">Draft</td>
</tr>


<tr>

<th scope="row" class="row-header">Experimental</th>

<td class="content-container">true</td>
</tr>


<tr>

<th scope="row" class="row-header">Description</th>

<td class="content-container"><div><p>Example measure illustrating a continuous variable measure calculating scores from multiple questionnaires</p>
</div></td>
</tr>












<tr>

<th scope="row" class="row-header">Measure Steward</th>

<td class="content-container">HL7 International - [Some] Work Group</td>
</tr>


<tr>

<th scope="row" class="row-header">Steward Contact Details</th>

<td class="content-container"><a href="http://hl7.org/Special/committees/[something]">http://hl7.org/Special/committees/[something]</a></td>
</tr>











<tr>

<th colspan="2" scope="row" class="row-header">Measure Metadata</th>

</tr>






<tr>

<th scope="row" class="row-header">Version Number</th>

<td class="content-container">0.4.6</td>
</tr>


<tr>

<th scope="row" class="row-header">Measure Scoring</th>

<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-scoring continuous-variable}">Continuous Variable</span></td>
</tr>



<tr>

<th scope="row" class="row-header">Measure Type</th>

<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-type process}">Process</span></td>
</tr>






<tr>

<th scope="row" class="row-header">Improvement Notation</th>

<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}">Increased score indicates improvement</span></td>
</tr>








  
    
    <tr>

<th colspan="2" scope="row" class="row-header">Measure Population Criteria (ID: group-1)</th>

</tr>
  
  
  
  
    <tr>
      
        
<th scope="row" class="row-header">Initial Population</th>

      
      <td class="content-container">
        
        <em>ID</em>: 8A48538B-80BB-4E8B-9716-559C657278FD
        <br/>
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#questionnairemeasureexample-initial-population">Initial Population</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        
<th scope="row" class="row-header">Measure Population</th>

      
      <td class="content-container">
        
        <em>ID</em>: 8FBD6CFA-99E4-4108-B083-91067C55170E
        <br/>
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#questionnairemeasureexample-measure-population">Measure Population</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        
<th scope="row" class="row-header">Measure Observation</th>

      
      <td class="content-container">
        
        <em>ID</em>: 8B71AD15-47EB-4939-8318-1DF60CABCFD6
        <br/>
        
        
          <em>Description</em>: No description provided
        
        
          
            
            <em>Logic Definition</em>: <a href="#questionnairemeasureexample-measureobservation">MeasureObservation</a> 
          
        
      </td>
    </tr>
  

  
  













<tr>

<th colspan="2" scope="row" class="row-header">Measure Logic</th>

</tr>

<tr>

<th scope="row" class="row-header">Primary Library</th>

<td class="content-container"><a href="Library-QuestionnaireMeasureExample.html">Measure calculating scores from multiple questionnaires example</a></td>
</tr>




  
  

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library PHQ9Logic
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="Library-PHQ9LogicExample.html">PHQ-9 Depression Scoring Logic Example</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://somewhere.org/fhir/uv/mycontentig/Library/PHQ9LogicExample</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Library FHIRHelpers
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <code>http://hl7.org/fhir/Library/FHIRHelpers|4.0.1</code>
    <br/>
    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/FHIRHelpers|4.0.1</tt>
    
  </td>
</tr>

<tr>
  
  
  
  
  
<th scope="row" class="row-header">Dependency</th>

  
  <td class="content-container">
    
    <em>Description</em>: Code system LOINC
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: <a href="http://terminology.hl7.org/5.2.0/CodeSystem-v3-loinc.html">Logical Observation Identifiers, Names and Codes (LOINC)</a>
    <br/>
    <em>Canonical URL</em>: <tt>http://loinc.org</tt>
    
  </td>
</tr>


  
  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
      <em>Code</em>: LA6568-5
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
      <em>Code</em>: LA6569-3
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
      <em>Code</em>: LA6570-1
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
      <em>Code</em>: LA6571-9
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Measurement Period
    <br/>
    <em>Use</em>: In
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: Period
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Initial Population
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: boolean
  </td>
</tr>
  
  <tr>
  
<th scope="row" class="row-header">Parameter</th>

  <td class="content-container">
    <em>Name</em>: Measure Population
    <br/>
    <em>Use</em>: Out
    <br/>
    <em>Min Cardinality</em>: 0
    <br/>
    <em>Max Cardinality</em>: 1
    <br/>
    <em>Type</em>: boolean
  </td>
</tr>
  
  
  <tr>
    <th colspan="2" scope="row" class="section-header"><a name="effective-data-requirements"> </a>Measure Logic Data Requirements</th>
  </tr>
  
  
<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Patient
    <br/>
  
    <em>Profile(s)</em>: 
  
    <a href="http://hl7.org/fhir/R4/patient.html">Patient</a>
    <br/>        
  
   
   
   
  </td>
</tr>

  
  <tr>

<th colspan="2" scope="row" class="row-header">Measure Logic Definitions</th>

</tr>
  
          
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="phq9logicexample-questionnaireresponse"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> PHQ9LogicExample</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">// Use the QuestionnaireResponse provided as a parameter if available
// Otherwise look it up from the record
define &quot;QuestionnaireResponse&quot;:
  if response is not null then
    response
  else
    Last(
      [QuestionnaireResponse] QR
        where QR.questionnaire = 'http://somewhere.org/fhir/uv/mycontentig/Questionnaire/phq-9-questionnaire'
        sort by (authored as FHIR.dateTime) desc
    )</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="phq9logicexample-responses"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> PHQ9LogicExample</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">// NOTE: This ties this logic directly to this particular rendering of the Questionnaire.
// Ideally the items would be filtered based on Code of the Item, rather than the LinkId,
// but that would require pulling in the Questionnaire because the QuestionnaireResponse
// only has the LinkId.
define &quot;Responses&quot;:
  &quot;QuestionnaireResponse&quot; QR
    return QR.item I where I.linkId in {
      'LittleInterest',
      'FeelingDown',
      'TroubleSleeping',
      'FeelingTired',
      'BadApetite',
      'FeelingBadAboutSelf',
      'TroubleConcetrating',
      'MovingSpeaking'
    }</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="phq9logicexample-calculatetotalscore"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> PHQ9LogicExample</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;CalculateTotalScore&quot;:
  Sum(&quot;Responses&quot; R return all AnswerCardinality(First(R.answer.value)))</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="questionnairemeasureexample-initial-population"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> QuestionnaireMeasureExample</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:
  AgeInYearsAt(start of &quot;Measurement Period&quot;) &gt;= 18</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="questionnairemeasureexample-measure-population"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> QuestionnaireMeasureExample</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">// Likely some condition or other relevant characteristic such as a depression diagnosis
define &quot;Measure Population&quot;:
  true</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="questionnairemeasureexample-measureobservation"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> QuestionnaireMeasureExample</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
Measure observation is a function defined in terms of the types of members of the measure
population, Patient in this case. In a population evaluation scenario, the measure
observation is evaluated for every member of the population.

In an individual report scenario, however, the measure observation is evaluated for
the current patient. Note that the patient context is flowing through the call here
*/
define function &quot;MeasureObservation&quot;(patient Patient):
  PHQ9Logic.CalculateTotalScore</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-tostring"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value string): value.value</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="phq9logicexample-answercardinality"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> PHQ9LogicExample</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@source: https://www.med.umich.edu/1info/FHP/practiceguides/depress/score.pdf
*/
define function &quot;AnswerCardinality&quot;(answer Coding):
  case
    when answer ~ &quot;Not at all&quot; then 0
    when answer ~ &quot;Several days&quot; then 1
    when answer ~ &quot;More than half the days&quot; then 2
    when answer ~ &quot;Nearly every day&quot; then 3
    else null
  end</code></pre>
  </td>

</tr>
        
<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-tocode"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }</code></pre>
  </td>

</tr>

  

<tr>
  <th colspan="2" scope="row" class="row-header">Generated using version 0.4.6 of the sample-content-ig Liquid templates</th>
</tr>
    </tbody>
  </table>
</div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements"/>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="LA6568-5"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="LA6569-3"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="LA6570-1"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="LA6571-9"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PHQ9LogicExample"/>
        </extension>
        <extension url="name">
          <valueString value="QuestionnaireResponse"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="// Use the QuestionnaireResponse provided as a parameter if available
// Otherwise look it up from the record
define &quot;QuestionnaireResponse&quot;:
  if response is not null then
    response
  else
    Last(
      [QuestionnaireResponse] QR
        where QR.questionnaire = 'http://somewhere.org/fhir/uv/mycontentig/Questionnaire/phq-9-questionnaire'
        sort by (authored as FHIR.dateTime) desc
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PHQ9LogicExample"/>
        </extension>
        <extension url="name">
          <valueString value="Responses"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="// NOTE: This ties this logic directly to this particular rendering of the Questionnaire.
// Ideally the items would be filtered based on Code of the Item, rather than the LinkId,
// but that would require pulling in the Questionnaire because the QuestionnaireResponse
// only has the LinkId.
define &quot;Responses&quot;:
  &quot;QuestionnaireResponse&quot; QR
    return QR.item I where I.linkId in {
      'LittleInterest',
      'FeelingDown',
      'TroubleSleeping',
      'FeelingTired',
      'BadApetite',
      'FeelingBadAboutSelf',
      'TroubleConcetrating',
      'MovingSpeaking'
    }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PHQ9LogicExample"/>
        </extension>
        <extension url="name">
          <valueString value="CalculateTotalScore"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;CalculateTotalScore&quot;:
  Sum(&quot;Responses&quot; R return all AnswerCardinality(First(R.answer.value)))"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="QuestionnaireMeasureExample"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Initial Population&quot;:
  AgeInYearsAt(start of &quot;Measurement Period&quot;) &gt;= 18"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="QuestionnaireMeasureExample"/>
        </extension>
        <extension url="name">
          <valueString value="Measure Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="// Likely some condition or other relevant characteristic such as a depression diagnosis
define &quot;Measure Population&quot;:
  true"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="QuestionnaireMeasureExample"/>
        </extension>
        <extension url="name">
          <valueString value="MeasureObservation"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
Measure observation is a function defined in terms of the types of members of the measure
population, Patient in this case. In a population evaluation scenario, the measure
observation is evaluated for every member of the population.

In an individual report scenario, however, the measure observation is evaluated for
the current patient. Note that the patient context is flowing through the call here
*/
define function &quot;MeasureObservation&quot;(patient Patient):
  PHQ9Logic.CalculateTotalScore"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToString"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToString(value string): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="PHQ9LogicExample"/>
        </extension>
        <extension url="name">
          <valueString value="AnswerCardinality"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@source: https://www.med.umich.edu/1info/FHP/practiceguides/depress/score.pdf
*/
define function &quot;AnswerCardinality&quot;(answer Coding):
  case
    when answer ~ &quot;Not at all&quot; then 0
    when answer ~ &quot;Several days&quot; then 1
    when answer ~ &quot;More than half the days&quot; then 2
    when answer ~ &quot;Nearly every day&quot; then 3
    else null
  end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToCode"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <name value="EffectiveDataRequirements"/>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="module-definition"/>
        </coding>
      </type>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library PHQ9Logic"/>
        <resource
                  value="http://somewhere.org/fhir/uv/mycontentig/Library/PHQ9LogicExample"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource value="http://hl7.org/fhir/Library/FHIRHelpers|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system LOINC"/>
        <resource value="http://loinc.org"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Measure Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <dataRequirement>
        <type value="Patient"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
    <valueReference>🔗 
      <reference value="Device/cqf-tooling"/>
    </valueReference>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
    <valueReference>
      <reference value="#effective-data-requirements"/>
    </valueReference>
  </extension>
  <url
       value="http://somewhere.org/fhir/uv/mycontentig/Measure/QuestionnaireMeasureExample"/>
  <version value="0.4.6"/>
  <name value="QuestionnaireMeasureExample"/>
  <title value="Questionnaire Measure Example"/>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2024-05-05T18:40:05-07:00"/>
  <publisher value="HL7 International - [Some] Work Group"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/Special/committees/[something]"/>
    </telecom>
  </contact>
  <description
               value="Example measure illustrating a continuous variable measure calculating scores from multiple questionnaires"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <library
           value="http://somewhere.org/fhir/uv/mycontentig/Library/QuestionnaireMeasureExample"/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="continuous-variable"/>
      <display value="Continuous Variable"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
      <code value="process"/>
    </coding>
  </type>
  <improvementNotation>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
      <code value="increase"/>
    </coding>
  </improvementNotation>
  <group id="group-1">
    <population id="8A48538B-80BB-4E8B-9716-559C657278FD">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
          <display value="Initial Population"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population id="8FBD6CFA-99E4-4108-B083-91067C55170E">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-population"/>
          <display value="Measure Population"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Measure Population"/>
      </criteria>
    </population>
    <population id="8B71AD15-47EB-4939-8318-1DF60CABCFD6">
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod">
        <valueCode value="average"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference">
        <valueString value="8FBD6CFA-99E4-4108-B083-91067C55170E"/>
      </extension>
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="measure-observation"/>
          <display value="Measure Observation"/>
        </coding>
      </code>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="MeasureObservation"/>
      </criteria>
    </population>
  </group>
</Measure>