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

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• XML
• JSON

: PROMIS Pain Interference SF 6a QuestionnaireResponse - May 2026 - JSON Representation

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{
  "resourceType" : "QuestionnaireResponse",
  "id" : "PROMISPainInterferenceSFExample5",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p>PROMIS Pain Interference (Short Form 6a) - May 2026. T-score: 52.3.</p></div>"
  },
  "questionnaire" : "http://example.org/fhir/Questionnaire/PROMISPainInterferenceSFQuestionnaire",
  "status" : "completed",
  "subject" : {
    🔗 "reference" : "Patient/patient-john-doe-01"
  },
  "authored" : "2026-05-15T10:30:00Z",
  "author" : {
    🔗 "reference" : "Patient/patient-john-doe-01"
  },
  "item" : [
    {
      "linkId" : "pi6a-1",
      "text" : "In the past 7 days: How much did pain interfere with your day to day activities?",
      "answer" : [
        {
          "valueCoding" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal" : 2
              }
            ],
            "system" : "http://loinc.org",
            "code" : "LA13863-8",
            "display" : "A little bit"
          }
        }
      ]
    },
    {
      "linkId" : "pi6a-2",
      "text" : "In the past 7 days: How much did pain interfere with work around the home?",
      "answer" : [
        {
          "valueCoding" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal" : 2
              }
            ],
            "system" : "http://loinc.org",
            "code" : "LA13863-8",
            "display" : "A little bit"
          }
        }
      ]
    },
    {
      "linkId" : "pi6a-3",
      "text" : "In the past 7 days: How much did pain interfere with your ability to participate in social activities?",
      "answer" : [
        {
          "valueCoding" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal" : 2
              }
            ],
            "system" : "http://loinc.org",
            "code" : "LA13863-8",
            "display" : "A little bit"
          }
        }
      ]
    },
    {
      "linkId" : "pi6a-4",
      "text" : "In the past 7 days: How much did pain interfere with your household chores?",
      "answer" : [
        {
          "valueCoding" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal" : 2
              }
            ],
            "system" : "http://loinc.org",
            "code" : "LA13863-8",
            "display" : "A little bit"
          }
        }
      ]
    },
    {
      "linkId" : "pi6a-5",
      "text" : "In the past 7 days: How much did pain interfere with the things you usually do for fun?",
      "answer" : [
        {
          "valueCoding" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal" : 2
              }
            ],
            "system" : "http://loinc.org",
            "code" : "LA13863-8",
            "display" : "A little bit"
          }
        }
      ]
    },
    {
      "linkId" : "pi6a-6",
      "text" : "In the past 7 days: How much did pain interfere with your enjoyment of social activities?",
      "answer" : [
        {
          "valueCoding" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                "valueDecimal" : 2
              }
            ],
            "system" : "http://loinc.org",
            "code" : "LA13863-8",
            "display" : "A little bit"
          }
        }
      ]
    },
    {
      "linkId" : "raw_score",
      "answer" : [
        {
          "valueDecimal" : 12
        }
      ]
    },
    {
      "linkId" : "tscore",
      "answer" : [
        {
          "valueDecimal" : 52.3
        }
      ]
    }
  ]
}