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

: HOOS JR QuestionnaireResponse - May 2026 - XML Representation

Raw xml | Download


<QuestionnaireResponse xmlns="http://hl7.org/fhir">
  <id value="HOOSJRExample5"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xml:lang="en" xmlns="http://www.w3.org/1999/xhtml" lang="en"><p>HOOS JR - May 2026. Total interval score: 65.082.</p></div>
  </text>
  <questionnaire
                 value="http://example.org/fhir/Questionnaire/HOOSJRQuestionnaire"/>
  <status value="completed"/>
  <subject>🔗 
    <reference value="Patient/patient-john-doe-01"/>
  </subject>
  <authored value="2026-05-15T10:30:00Z"/>
  <author>🔗 
    <reference value="Patient/patient-john-doe-01"/>
  </author>
  <item>
    <linkId value="hoosjr-1"/>
    <text value="Going up or down stairs"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="1"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6752-5"/>
        <display value="Mild"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="hoosjr-2"/>
    <text value="Walking on an uneven surface"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="1"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6752-5"/>
        <display value="Mild"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="hoosjr-3"/>
    <text value="Rising from sitting"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="2"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6751-7"/>
        <display value="Moderate"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="hoosjr-4"/>
    <text value="Bending to the floor/picking up an object"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="2"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6751-7"/>
        <display value="Moderate"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="hoosjr-5"/>
    <text value="Lying in bed"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="1"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6752-5"/>
        <display value="Mild"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="hoosjr-6"/>
    <text value="Sitting"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="1"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6752-5"/>
        <display value="Mild"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="total-interval-score"/>
    <answer>
      <valueDecimal value="65.082"/>
    </answer>
  </item>
</QuestionnaireResponse>