PACIO Sample Data Depot
0.1.0 - draft

PACIO Sample Data Depot, published by MITRE. 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/paciowg/sample-data-fsh/ and changes regularly. See the Directory of published versions

Questionnaire: PROMIS-10

Official URL: https://globalalliantinc.com/fhir/Questionnaire/questionnaire-PROMIS10 Version: 0.1.0
Draft as of 2026-03-26 Computable Name:

PROMIS Global-10

The PROMIS Global-10 is a 10-item patient-reported questionnaire used to gauge the patient’s overall physical and mental health.

Structure

LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. PROMIS Global-10Questionnairehttps://globalalliantinc.com/fhir/Questionnaire/questionnaire-PROMIS10#0.1.0
... mbiWhat is this patient's Medicare Beneficiary Identifier (MBI)?1..1stringValue Set:
... assessment_datePlease report the date this assessment was complete.1..1dateValue Set:
... healthIn general, would you say your health is...1..1choiceValue Set:
Options: 5 options
... physical_healthIn general, how would you rate your physical health?1..1choiceValue Set:
Options: 5 options
... mental_healthIn general, how would you rate your mental health, including your mood and your ability to think?1..1choiceValue Set:
Options: 5 options
... satisfaction_socialIn general, how would you rate your satisfaction with your social activities and relationships?1..1choiceValue Set:
Options: 5 options
... social_activitiesIn general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.)1..1choiceValue Set:
Options: 5 options
... physical_activitiesIn the past 7 days, to what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair?1..1choiceValue Set:
Options: 5 options
... emotionalIn the past 7 days, how often have you been bothered by emotional problems such as feeling anxious, depressed or irritable?1..1choiceValue Set:
Options: 5 options
... fatigueIn the past 7 days, how would you rate your fatigue on average?1..1choiceValue Set:
Options: 5 options
... painOn a scale of 0-10, with 10 being the worst pain imaginable and 0 being no pain, how would you rate your pain on average?1..1choiceValue Set:
Options: 11 options
... physical_health_scorePROMIS-10 Global Health, GPH, raw score0..1decimaliconiconValue Set:
... mental_health_scorePROMIS-10 Global Health, GMH raw score0..1decimaliconiconValue Set:
... physical_health_tscorePROMIS Global Physical Health v1.2 T-Score0..1decimaliconiconValue Set:
... mental_health_tscorePROMIS Global Mental Health v1.2 T-Score0..1decimaliconiconValue Set:

doco Documentation for this format

Options Sets

Answer options for health

  • http://loinc.org#LA9206-9 ("Excellent")
  • http://loinc.org#LA13913-1 ("Very Good")
  • http://loinc.org#LA8967-7 ("Good")
  • http://loinc.org#LA8968-5 ("Fair")
  • http://loinc.org#LA8969-3 ("Poor")

Answer options for quality_of_life

  • http://loinc.org#LA9206-9 ("Excellent")
  • http://loinc.org#LA13913-1 ("Very Good")
  • http://loinc.org#LA8967-7 ("Good")
  • http://loinc.org#LA8968-5 ("Fair")
  • http://loinc.org#LA8969-3 ("Poor")

Answer options for physical_health

  • http://loinc.org#LA9206-9 ("Excellent")
  • http://loinc.org#LA13913-1 ("Very Good")
  • http://loinc.org#LA8967-7 ("Good")
  • http://loinc.org#LA8968-5 ("Fair")
  • http://loinc.org#LA8969-3 ("Poor")

Answer options for mental_health

  • http://loinc.org#LA9206-9 ("Excellent")
  • http://loinc.org#LA13913-1 ("Very Good")
  • http://loinc.org#LA8967-7 ("Good")
  • http://loinc.org#LA8968-5 ("Fair")
  • http://loinc.org#LA8969-3 ("Poor")

Answer options for satisfaction_social

  • http://loinc.org#LA9206-9 ("Excellent")
  • http://loinc.org#LA13913-1 ("Very Good")
  • http://loinc.org#LA8967-7 ("Good")
  • http://loinc.org#LA8968-5 ("Fair")
  • http://loinc.org#LA8969-3 ("Poor")

Answer options for social_activities

  • http://loinc.org#LA9206-9 ("Excellent")
  • http://loinc.org#LA13913-1 ("Very Good")
  • http://loinc.org#LA8967-7 ("Good")
  • http://loinc.org#LA8968-5 ("Fair")
  • http://loinc.org#LA8969-3 ("Poor")

Answer options for physical_activities

  • http://loinc.org#LA13937-0 ("Completely")
  • http://loinc.org#LA13938-8 ("Mostly")
  • http://loinc.org#LA13939-6 ("Moderately")
  • http://loinc.org#LA13940-4 ("A little")
  • http://loinc.org#LA6568-5 ("Not at all")

Answer options for emotional

  • http://loinc.org#LA6270-8 ("Never")
  • http://loinc.org#LA10066-1 ("Rarely")
  • http://loinc.org#LA10082-8 ("Sometimes")
  • http://loinc.org#LA10044-8 ("Often")
  • http://loinc.org#LA9933-8 ("Always")

Answer options for fatigue

  • http://loinc.org#LA137-2 ("None")
  • http://loinc.org#LA6752-5 ("Mild")
  • http://loinc.org#LA6751-7 ("Moderate")
  • http://loinc.org#LA6750-9 ("Severe")
  • http://loinc.org#LA13958-6 ("Very Severe")

Answer options for pain

  • http://loinc.org#LA26951-6 ("0 - No Pain")
  • http://loinc.org#LA6112-2 ("1")
  • http://loinc.org#LA6113-0 ("2")
  • http://loinc.org#LA6114-8 ("3")
  • http://loinc.org#LA6115-5 ("4")
  • http://loinc.org#LA10137-0 ("5")
  • http://loinc.org#LA10138-8 ("6")
  • http://loinc.org#LA10139-6 ("7")
  • http://loinc.org#LA10140-4 ("8")
  • http://loinc.org#LA10141-2 ("9")
  • http://loinc.org#LA26952-4 ("10 - Worst Pain Imaginable")