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

• Narrative Content
• XML
• JSON

: PROMIS Physical Function SF 6b QuestionnaireResponse - February 2026 - XML Representation

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<QuestionnaireResponse xmlns="http://hl7.org/fhir">
  <id value="PROMISPhysicalFunctionExample2"/>
  <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 (Short Form 6b) - February 2026. T-score: 50.8.</p></div>
  </text>
  <questionnaire
                 value="http://example.org/fhir/Questionnaire/PROMISPhysicalFunctionQuestionnaire"/>
  <status value="completed"/>
  <subject>🔗 
    <reference value="Patient/patient-john-doe-01"/>
  </subject>
  <authored value="2026-02-15T10:30:00Z"/>
  <author>🔗 
    <reference value="Patient/patient-john-doe-01"/>
  </author>
  <item>
    <linkId value="pf6b-1"/>
    <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="pf6b-2"/>
    <text value="Are you able to go up and down stairs at a normal pace?"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="3"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA13920-6"/>
        <display value="With some difficulty"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="pf6b-3"/>
    <text value="Are you able to go for a walk of at least 15 minutes?"/>
    <answer>
      <valueCoding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
          <valueDecimal value="3"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA13920-6"/>
        <display value="With some difficulty"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="pf6b-4"/>
    <text value="Are you able to run errands and shop?"/>
    <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="pf6b-5"/>
    <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="pf6b-6"/>
    <text
          value="Does your health now limit you in doing moderate work around the house like vacuuming, sweeping floors or carrying in groceries?"/>
    <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="raw_score"/>
    <answer>
      <valueDecimal value="18"/>
    </answer>
  </item>
  <item>
    <linkId value="tscore"/>
    <answer>
      <valueDecimal value="50.8"/>
    </answer>
  </item>
</QuestionnaireResponse>