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 Physical Function CAT QuestionnaireResponse - May 2026 - XML Representation

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<QuestionnaireResponse xmlns="http://hl7.org/fhir">
  <id value="PROMISPhysicalFunctionCATExample5"/>
  <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>PROMIS Physical Function (CAT) - May 2026. T-score: 47.7.</p></div>
  </text>
  <questionnaire
                 value="http://example.org/fhir/Questionnaire/PROMISPhysicalFunctionCATQuestionnaire"/>
  <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="pf-cat-1"/>
    <text
          value="Does your health now limit you in doing two hours of physical labor?"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="2"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA11911-7"/>
        <display value="Quite a lot"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="pf-cat-2"/>
    <text value="Are you able to do chores such as vacuuming or yard work?"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="4"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA13918-0"/>
        <display value="With a little difficulty"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="pf-cat-3"/>
    <text
          value="To what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair?"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="3"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA13939-6"/>
        <display value="Moderately"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="pf-cat-4"/>
    <text
          value="Does your health now limit you in walking more than a mile?"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="2"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA11911-7"/>
        <display value="Quite a lot"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="tscore"/>
    <answer>
      <valueDecimal value="47.7"/>
    </answer>
  </item>
</QuestionnaireResponse>