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
| Draft as of 2026-03-26 |
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="questionnaire-PROMIS10"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire questionnaire-PROMIS10</b></p><a name="questionnaire-PROMIS10"> </a><a name="hcquestionnaire-PROMIS10"> </a><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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Other attributes of the item">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description & Constraints</a><span style="float: right"><a href="https://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 : var(--ig-left,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"/> </td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">PROMIS Global-10</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">https://globalalliantinc.com/fhir/Questionnaire/questionnaire-PROMIS10#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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.mbi" 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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> mbi</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is this patient's Medicare Beneficiary Identifier (MBI)?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.assessment_date" 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-date.png" alt="." style="background-color: white; background-color: inherit" title="date" class="hierarchy"/> assessment_date</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Please report the date this assessment was complete.</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.health" 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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> health</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In general, would you say your health is...</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.health">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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.quality_of_life" 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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> quality_of_life</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In general, would you say your quality of life is...</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.quality_of_life">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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.physical_health" 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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> physical_health</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In general, how would you rate your physical health?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.physical_health">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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.mental_health" 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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> mental_health</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In general, how would you rate your mental health, including your mood and your ability to think?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.mental_health">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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.satisfaction_social" 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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> satisfaction_social</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In general, how would you rate your satisfaction with your social activities and relationships?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.satisfaction_social">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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.social_activities" 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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> social_activities</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In 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.)</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.social_activities">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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.physical_activities" 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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> physical_activities</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In 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?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.physical_activities">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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.emotional" 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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> emotional</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In the past 7 days, how often have you been bothered by emotional problems such as feeling anxious, depressed or irritable?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.emotional">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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.fatigue" 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-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> fatigue</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In the past 7 days, how would you rate your fatigue on average?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.fatigue">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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.pain" 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-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> pain</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">On 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?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.pain">11 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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.physical_health_score" 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-decimal.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="decimal" class="hierarchy"/> physical_health_score</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">PROMIS-10 Global Health, GPH, raw score</td><td style="vertical-align: top; text-align : var(--ig-left,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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Read Only"><img src="icon-qi-readonly.png" alt="icon"/></a><img src="icon-qi-readonly.png" alt="icon"/></td><td style="vertical-align: top; text-align : var(--ig-left,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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.mental_health_score" 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-decimal.png" alt="." style="background-color: white; background-color: inherit" title="decimal" class="hierarchy"/> mental_health_score</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">PROMIS-10 Global Health, GMH raw score</td><td style="vertical-align: top; text-align : var(--ig-left,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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Read Only"><img src="icon-qi-readonly.png" alt="icon"/></a><img src="icon-qi-readonly.png" alt="icon"/></td><td style="vertical-align: top; text-align : var(--ig-left,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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.physical_health_tscore" 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-decimal.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="decimal" class="hierarchy"/> physical_health_tscore</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">PROMIS Global Physical Health v1.2 T-Score</td><td style="vertical-align: top; text-align : var(--ig-left,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 : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Read Only"><img src="icon-qi-readonly.png" alt="icon"/></a><img src="icon-qi-readonly.png" alt="icon"/></td><td style="vertical-align: top; text-align : var(--ig-left,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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.mental_health_tscore" 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-decimal.png" alt="." style="background-color: white; background-color: inherit" title="decimal" class="hierarchy"/> mental_health_tscore</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">PROMIS Global Mental Health v1.2 T-Score</td><td style="vertical-align: top; text-align : var(--ig-left,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 : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/questionnaire-definitions.html#Questionnaire.item.readOnly" title="Is Read Only"><img src="icon-qi-readonly.png" alt="icon"/></a><img src="icon-qi-readonly.png" alt="icon"/></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="6" class="hierarchy"><br/><a href="https://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>Options Sets</b></p><a name="opt-item.health"> </a><p><b>Answer options for health </b></p><ul><li style="font-size: 11px">http://loinc.org#LA9206-9 ("Excellent")</li><li style="font-size: 11px">http://loinc.org#LA13913-1 ("Very Good")</li><li style="font-size: 11px">http://loinc.org#LA8967-7 ("Good")</li><li style="font-size: 11px">http://loinc.org#LA8968-5 ("Fair")</li><li style="font-size: 11px">http://loinc.org#LA8969-3 ("Poor")</li></ul><a name="opt-item.quality_of_life"> </a><p><b>Answer options for quality_of_life </b></p><ul><li style="font-size: 11px">http://loinc.org#LA9206-9 ("Excellent")</li><li style="font-size: 11px">http://loinc.org#LA13913-1 ("Very Good")</li><li style="font-size: 11px">http://loinc.org#LA8967-7 ("Good")</li><li style="font-size: 11px">http://loinc.org#LA8968-5 ("Fair")</li><li style="font-size: 11px">http://loinc.org#LA8969-3 ("Poor")</li></ul><a name="opt-item.physical_health"> </a><p><b>Answer options for physical_health </b></p><ul><li style="font-size: 11px">http://loinc.org#LA9206-9 ("Excellent")</li><li style="font-size: 11px">http://loinc.org#LA13913-1 ("Very Good")</li><li style="font-size: 11px">http://loinc.org#LA8967-7 ("Good")</li><li style="font-size: 11px">http://loinc.org#LA8968-5 ("Fair")</li><li style="font-size: 11px">http://loinc.org#LA8969-3 ("Poor")</li></ul><a name="opt-item.mental_health"> </a><p><b>Answer options for mental_health </b></p><ul><li style="font-size: 11px">http://loinc.org#LA9206-9 ("Excellent")</li><li style="font-size: 11px">http://loinc.org#LA13913-1 ("Very Good")</li><li style="font-size: 11px">http://loinc.org#LA8967-7 ("Good")</li><li style="font-size: 11px">http://loinc.org#LA8968-5 ("Fair")</li><li style="font-size: 11px">http://loinc.org#LA8969-3 ("Poor")</li></ul><a name="opt-item.satisfaction_social"> </a><p><b>Answer options for satisfaction_social </b></p><ul><li style="font-size: 11px">http://loinc.org#LA9206-9 ("Excellent")</li><li style="font-size: 11px">http://loinc.org#LA13913-1 ("Very Good")</li><li style="font-size: 11px">http://loinc.org#LA8967-7 ("Good")</li><li style="font-size: 11px">http://loinc.org#LA8968-5 ("Fair")</li><li style="font-size: 11px">http://loinc.org#LA8969-3 ("Poor")</li></ul><a name="opt-item.social_activities"> </a><p><b>Answer options for social_activities </b></p><ul><li style="font-size: 11px">http://loinc.org#LA9206-9 ("Excellent")</li><li style="font-size: 11px">http://loinc.org#LA13913-1 ("Very Good")</li><li style="font-size: 11px">http://loinc.org#LA8967-7 ("Good")</li><li style="font-size: 11px">http://loinc.org#LA8968-5 ("Fair")</li><li style="font-size: 11px">http://loinc.org#LA8969-3 ("Poor")</li></ul><a name="opt-item.physical_activities"> </a><p><b>Answer options for physical_activities </b></p><ul><li style="font-size: 11px">http://loinc.org#LA13937-0 ("Completely")</li><li style="font-size: 11px">http://loinc.org#LA13938-8 ("Mostly")</li><li style="font-size: 11px">http://loinc.org#LA13939-6 ("Moderately")</li><li style="font-size: 11px">http://loinc.org#LA13940-4 ("A little")</li><li style="font-size: 11px">http://loinc.org#LA6568-5 ("Not at all")</li></ul><a name="opt-item.emotional"> </a><p><b>Answer options for emotional </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6270-8 ("Never")</li><li style="font-size: 11px">http://loinc.org#LA10066-1 ("Rarely")</li><li style="font-size: 11px">http://loinc.org#LA10082-8 ("Sometimes")</li><li style="font-size: 11px">http://loinc.org#LA10044-8 ("Often")</li><li style="font-size: 11px">http://loinc.org#LA9933-8 ("Always")</li></ul><a name="opt-item.fatigue"> </a><p><b>Answer options for fatigue </b></p><ul><li style="font-size: 11px">http://loinc.org#LA137-2 ("None")</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.pain"> </a><p><b>Answer options for pain </b></p><ul><li style="font-size: 11px">http://loinc.org#LA26951-6 ("0 - No Pain")</li><li style="font-size: 11px">http://loinc.org#LA6112-2 ("1")</li><li style="font-size: 11px">http://loinc.org#LA6113-0 ("2")</li><li style="font-size: 11px">http://loinc.org#LA6114-8 ("3")</li><li style="font-size: 11px">http://loinc.org#LA6115-5 ("4")</li><li style="font-size: 11px">http://loinc.org#LA10137-0 ("5")</li><li style="font-size: 11px">http://loinc.org#LA10138-8 ("6")</li><li style="font-size: 11px">http://loinc.org#LA10139-6 ("7")</li><li style="font-size: 11px">http://loinc.org#LA10140-4 ("8")</li><li style="font-size: 11px">http://loinc.org#LA10141-2 ("9")</li><li style="font-size: 11px">http://loinc.org#LA26952-4 ("10 - Worst Pain Imaginable")</li></ul></div>
</text>
<url
value="https://globalalliantinc.com/fhir/Questionnaire/questionnaire-PROMIS10"/>
<version value="0.1.0"/>
<title value="PROMIS-10"/>
<status value="draft"/>
<date value="2026-03-26T20:08:48+00:00"/>
<publisher value="MITRE"/>
<contact>
<name value="MITRE"/>
<telecom>
<system value="url"/>
<value value="http://www.mitre.org"/>
</telecom>
</contact>
<contact>
<name value="May Terry"/>
<telecom>
<system value="email"/>
<value value="mayT@mitre.org"/>
<use value="work"/>
</telecom>
</contact>
<description value="PROMIS Global-10"/>
<purpose
value="The PROMIS Global-10 is a 10-item patient-reported questionnaire used to gauge the patient's overall physical and mental health."/>
<code>
<system value="http://loinc.org"/>
<code value="85524-7"/>
<display value="PROMIS short form - global - version 1.2"/>
</code>
<item>
<extension url="http://hl7.org/fhir/StructureDefinition/regex">
<valueString
value="^[1-9]((?![SLOIBZ])[A-Z])((?![SLOIBZ])[0-9A-Z])[0-9]((?![SLOIBZ])[A-Z])((?![SLOIBZ])[0-9A-Z])[0-9]((?![SLOIBZ])[A-Z])((?![SLOIBZ])[A-Z])[0-9][0-9]$"/>
</extension>
<linkId value="mbi"/>
<text
value="What is this patient's Medicare Beneficiary Identifier (MBI)?"/>
<type value="string"/>
<required value="true"/>
</item>
<item>
<linkId value="assessment_date"/>
<text value="Please report the date this assessment was complete."/>
<type value="date"/>
<required value="true"/>
</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>
<linkId value="health"/>
<code>
<system value="http://loinc.org"/>
<code value="61577-3"/>
<display value="In general, would you say your health is..."/>
</code>
<text value="In general, would you say your health is..."/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA9206-9"/>
<display value="Excellent"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13913-1"/>
<display value="Very Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8967-7"/>
<display value="Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8968-5"/>
<display value="Fair"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8969-3"/>
<display value="Poor"/>
</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>
<linkId value="quality_of_life"/>
<code>
<system value="http://loinc.org"/>
<code value="61578-1"/>
<display value="In general, would you say your quality of life is..."/>
</code>
<text value="In general, would you say your quality of life is..."/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA9206-9"/>
<display value="Excellent"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13913-1"/>
<display value="Very Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8967-7"/>
<display value="Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8968-5"/>
<display value="Fair"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8969-3"/>
<display value="Poor"/>
</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>
<linkId value="physical_health"/>
<code>
<system value="http://loinc.org"/>
<code value="61579-9"/>
<display value="In general, how would you rate your physical health?"/>
</code>
<text value="In general, how would you rate your physical health?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA9206-9"/>
<display value="Excellent"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13913-1"/>
<display value="Very Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8967-7"/>
<display value="Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8968-5"/>
<display value="Fair"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8969-3"/>
<display value="Poor"/>
</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>
<linkId value="mental_health"/>
<code>
<system value="http://loinc.org"/>
<code value="61580-7"/>
<display
value="In general, how would you rate your mental health, including your mood and your ability to think?"/>
</code>
<text
value="In general, how would you rate your mental health, including your mood and your ability to think?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA9206-9"/>
<display value="Excellent"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13913-1"/>
<display value="Very Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8967-7"/>
<display value="Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8968-5"/>
<display value="Fair"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8969-3"/>
<display value="Poor"/>
</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>
<linkId value="satisfaction_social"/>
<code>
<system value="http://loinc.org"/>
<code value="61581-5"/>
<display
value="In general, how would you rate your satisfaction with your social activities and relationships?"/>
</code>
<text
value="In general, how would you rate your satisfaction with your social activities and relationships?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA9206-9"/>
<display value="Excellent"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13913-1"/>
<display value="Very Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8967-7"/>
<display value="Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8968-5"/>
<display value="Fair"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8969-3"/>
<display value="Poor"/>
</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>
<linkId value="social_activities"/>
<code>
<system value="http://loinc.org"/>
<code value="61585-6"/>
<display
value="In 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.)"/>
</code>
<text
value="In 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.)"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA9206-9"/>
<display value="Excellent"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13913-1"/>
<display value="Very Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8967-7"/>
<display value="Good"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8968-5"/>
<display value="Fair"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA8969-3"/>
<display value="Poor"/>
</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>
<linkId value="physical_activities"/>
<code>
<system value="http://loinc.org"/>
<code value="61582-3"/>
<display
value="In 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?"/>
</code>
<text
value="In 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?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13937-0"/>
<display value="Completely"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13938-8"/>
<display value="Mostly"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13939-6"/>
<display value="Moderately"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA13940-4"/>
<display value="A little"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</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>
<linkId value="emotional"/>
<code>
<system value="http://loinc.org"/>
<code value="61586-4"/>
<display
value="In the past 7 days, how often have you been bothered by emotional problems such as feeling anxious, depressed or irritable?"/>
</code>
<text
value="In the past 7 days, how often have you been bothered by emotional problems such as feeling anxious, depressed or irritable?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6270-8"/>
<display value="Never"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10066-1"/>
<display value="Rarely"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10082-8"/>
<display value="Sometimes"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10044-8"/>
<display value="Often"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA9933-8"/>
<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>
<linkId value="fatigue"/>
<code>
<system value="http://loinc.org"/>
<code value="61584-9"/>
<display
value="In the past 7 days, how would you rate your fatigue on average?"/>
</code>
<text
value="In the past 7 days, how would you rate your fatigue on average?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA137-2"/>
<display value="None"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6752-5"/>
<display value="Mild"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6751-7"/>
<display value="Moderate"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6750-9"/>
<display value="Severe"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<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>
<linkId value="pain"/>
<code>
<system value="http://loinc.org"/>
<code value="61583-1"/>
<display
value="On 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?"/>
</code>
<text
value="On 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?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA26951-6"/>
<display value="0 - No Pain"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6112-2"/>
<display value="1"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6113-0"/>
<display value="2"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6114-8"/>
<display value="3"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="4"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6115-5"/>
<display value="4"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="5"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10137-0"/>
<display value="5"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="6"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10138-8"/>
<display value="6"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="7"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10139-6"/>
<display value="7"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="8"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10140-4"/>
<display value="8"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="9"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10141-2"/>
<display value="9"/>
</valueCoding>
</answerOption>
<answerOption>
<extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="10"/>
</extension>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA26952-4"/>
<display value="10 - Worst Pain Imaginable"/>
</valueCoding>
</answerOption>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression
value="%resource.item.where(linkId='physical_health').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value + %resource.item.where(linkId='physical_activities').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value + iif(%resource.item.where(linkId='pain').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value = 0, 5, iif(%resource.item.where(linkId='pain').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value <= 3, 4, iif(%resource.item.where(linkId='pain').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value <= 6, 3, iif(%resource.item.where(linkId='pain').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value <= 9, 2, 1)))) + %resource.item.where(linkId='fatigue').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value"/>
</valueExpression>
</extension>
<linkId value="physical_health_score"/>
<code>
<system value="http://loinc.org"/>
<code value="71972-4"/>
<display value="PROMIS-10 Global Physical Health (GPH) score"/>
</code>
<text value="PROMIS-10 Global Health, GPH, raw score"/>
<type value="decimal"/>
<readOnly value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression
value="%resource.item.where(linkId='quality_of_life').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value + %resource.item.where(linkId='mental_health').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value + %resource.item.where(linkId='satisfaction_social').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value + %resource.item.where(linkId='emotional').answer.value.extension.where(url='http://hl7.org/fhir/StructureDefinition/ordinalValue').value"/>
</valueExpression>
</extension>
<linkId value="mental_health_score"/>
<code>
<system value="http://loinc.org"/>
<code value="71970-8"/>
<display value="PROMIS-10 Global Mental Health (GMH) score"/>
</code>
<text value="PROMIS-10 Global Health, GMH raw score"/>
<type value="decimal"/>
<readOnly value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression
value="iif(%resource.item.where(linkId='physical_health_score').answer.value = 4, 16.2, iif(%resource.item.where(linkId='physical_health_score').answer.value = 5, 19.9, iif(%resource.item.where(linkId='physical_health_score').answer.value = 6, 23.5, iif(%resource.item.where(linkId='physical_health_score').answer.value = 7, 26.7, iif(%resource.item.where(linkId='physical_health_score').answer.value = 8, 29.6, iif(%resource.item.where(linkId='physical_health_score').answer.value = 9, 32.4, iif(%resource.item.where(linkId='physical_health_score').answer.value = 10, 34.9, iif(%resource.item.where(linkId='physical_health_score').answer.value = 11, 37.4, iif(%resource.item.where(linkId='physical_health_score').answer.value = 12, 39.8, iif(%resource.item.where(linkId='physical_health_score').answer.value = 13, 42.3, iif(%resource.item.where(linkId='physical_health_score').answer.value = 14, 44.9, iif(%resource.item.where(linkId='physical_health_score').answer.value = 15, 47.7, iif(%resource.item.where(linkId='physical_health_score').answer.value = 16, 50.8, iif(%resource.item.where(linkId='physical_health_score').answer.value = 17, 54.1, iif(%resource.item.where(linkId='physical_health_score').answer.value = 18, 57.7, iif(%resource.item.where(linkId='physical_health_score').answer.value = 19, 61.9, iif(%resource.item.where(linkId='physical_health_score').answer.value = 20, 67.7, {})))))))))))))))))"/>
</valueExpression>
</extension>
<linkId value="physical_health_tscore"/>
<code>
<system value="http://loinc.org"/>
<code value="71971-6"/>
<display value="PROMIS-10 Global Physical Health (GPH) score T-score"/>
</code>
<text value="PROMIS Global Physical Health v1.2 T-Score"/>
<type value="decimal"/>
<readOnly value="true"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression
value="iif(%resource.item.where(linkId='mental_health_score').answer.value = 4, 21.2, iif(%resource.item.where(linkId='mental_health_score').answer.value = 5, 25.1, iif(%resource.item.where(linkId='mental_health_score').answer.value = 6, 28.4, iif(%resource.item.where(linkId='mental_health_score').answer.value = 7, 31.3, iif(%resource.item.where(linkId='mental_health_score').answer.value = 8, 33.8, iif(%resource.item.where(linkId='mental_health_score').answer.value = 9, 36.3, iif(%resource.item.where(linkId='mental_health_score').answer.value = 10, 38.8, iif(%resource.item.where(linkId='mental_health_score').answer.value = 11, 41.1, iif(%resource.item.where(linkId='mental_health_score').answer.value = 12, 43.5, iif(%resource.item.where(linkId='mental_health_score').answer.value = 13, 45.8, iif(%resource.item.where(linkId='mental_health_score').answer.value = 14, 48.3, iif(%resource.item.where(linkId='mental_health_score').answer.value = 15, 50.8, iif(%resource.item.where(linkId='mental_health_score').answer.value = 16, 53.3, iif(%resource.item.where(linkId='mental_health_score').answer.value = 17, 56.0, iif(%resource.item.where(linkId='mental_health_score').answer.value = 18, 59.0, iif(%resource.item.where(linkId='mental_health_score').answer.value = 19, 62.5, iif(%resource.item.where(linkId='mental_health_score').answer.value = 20, 67.6, {})))))))))))))))))"/>
</valueExpression>
</extension>
<linkId value="mental_health_tscore"/>
<code>
<system value="http://loinc.org"/>
<code value="71969-0"/>
<display value="PROMIS-10 Global Mental Health (GMH) score T-score"/>
</code>
<text value="PROMIS Global Mental Health v1.2 T-Score"/>
<type value="decimal"/>
<readOnly value="true"/>
</item>
</Questionnaire>