Madeira Pilot Implementation Guide
0.1.0 - R1

Madeira Pilot Implementation Guide - Local Development build (v0.1.0). See the Directory of published versions

: PreSessionQuestionnaire - XML Representation

Draft as of 2021-01-28

Raw xml | Download



<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="PreSessionQuestionnaire"/>
  <language value="en"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><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 : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/formats.html#table" title="The linkId for the item">LinkId</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/formats.html#table" title="Minimum and Maximum # of times the the itemcan appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="http://build.fhir.org/formats.html#table" title="Legend for this format"><img src="http://build.fhir.org/help16.png" 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 : 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"/> Smart4Health_pre-session_pain_questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Pre-session treatment questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://fhir.smart4health.eu/Questionnaire/pre-session-questionnaire#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 : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.current_back_pain_level" 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"/> current_back_pain_level</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Please indicate your current pain level</td><td style="vertical-align: top; text-align : 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 : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: http://loinc.org/vs/LL2335-9</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.average_back_pain_level" 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"/> average_back_pain_level</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Please indicate your average pain level during the past four weeks</td><td style="vertical-align: top; text-align : 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 : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: http://loinc.org/vs/LL2335-9</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.max_back_pain_level_4w" 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"/> max_back_pain_level_4w</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Please indicate your maximum pain level during the past four weeks</td><td style="vertical-align: top; text-align : 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 : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: http://loinc.org/vs/LL2335-9</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.taking_painkillers" 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-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> taking_painkillers</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Are you taking painkillers at the moment?</td><td style="vertical-align: top; text-align : 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 : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: http://fhir.smart4health.eu/ValueSet/yesno</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://build.fhir.org/formats.html#table" title="Legend for this format"><img src="http://build.fhir.org/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="http://fhir.smart4health.eu/Questionnaire/pre-session-questionnaire"/>
  <version value="0.1.0"/>
  <name value="Smart4Health_pre-session_pain_questionnaire"/>
  <title value="Pre-session treatment questionnaire"/>
  <status value="draft"/>
  <subjectType value="Patient"/>
  <date value="2021-01-28"/>
  <publisher value="UNINOVA"/>
  <contact>
    <name value="UNINOVA"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.uninova.pt"/>
    </telecom>
  </contact>
  <description value="Pre-session treatment questionnaire"/>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes"/>
          <code value="painscalewithlabels"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <linkId value="current_back_pain_level"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="72514-3"/>
      <display value="Pain severity 0-10 Score Reported"/>
    </code>
    <text value="Please indicate your current pain level"/>
    <type value="choice"/>
    <enableBehavior value="any"/>
    <required value="true"/>
    <answerValueSet value="http://loinc.org/vs/LL2335-9"/>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes"/>
          <code value="painscalewithlabels"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <linkId value="average_back_pain_level"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="72514-3"/>
      <display value="Pain severity 0-10 Score Reported"/>
    </code>
    <text
          value="Please indicate your average pain level during the past four weeks"/>
    <type value="choice"/>
    <enableBehavior value="any"/>
    <required value="true"/>
    <answerValueSet value="http://loinc.org/vs/LL2335-9"/>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes"/>
          <code value="painscalewithlabels"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <linkId value="max_back_pain_level_4w"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="72514-3"/>
      <display value="Pain severity 0-10 Score Reported"/>
    </code>
    <text
          value="Please indicate your maximum pain level during the past four weeks"/>
    <type value="choice"/>
    <enableBehavior value="any"/>
    <required value="true"/>
    <answerValueSet value="http://loinc.org/vs/LL2335-9"/>
  </item>
  <item>
    <linkId value="taking_painkillers"/>
    <text value="Are you taking painkillers at the moment?"/>
    <type value="choice"/>
    <enableBehavior value="any"/>
    <required value="true"/>
    <answerValueSet value="http://fhir.smart4health.eu/ValueSet/yesno"/>
  </item>
</Questionnaire>