This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 4.0.1. For a full list of available versions, see the Directory of published versions
Patient Care Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Patient, Practitioner, RelatedPerson |
Generated Questionnaire for AdverseEvent
<?xml version="1.0" encoding="UTF-8"?> <Questionnaire xmlns="http://hl7.org/fhir"> <id value="qs1"/> <identifier> <system value="urn:ietf:rfc:3986"/> </identifier> <status value="draft"/> <date value="2018-04-03T12:05:46+10:00"/> <publisher value="Health Level Seven International (Patient Care)"/> <item> <linkId value="AdverseEvent"/> <text value="Medical care, research study or other healthcare event causing physical injury"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Actual or potential/avoided event causing unintended physical injury resulting from or contributed to by medical care, a research study or other healthcare setting factors that requires additional monitoring, treatment, or hospitalization, or that results in death."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="string"/> </extension> <linkId value="AdverseEvent.id"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.id.value"/> <text value="Logical id of this artifact"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <linkId value="AdverseEvent.meta"/> <text value="Metadata about the resource"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/> <type value="display"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="uri"/> </extension> <linkId value="AdverseEvent.implicitRules"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.implicitRules.value"/> <text value="A set of rules under which this content was created"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="code"/> </extension> <linkId value="AdverseEvent.language"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.language.value"/> <text value="language"/> <type value="choice"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <linkId value="AdverseEvent.text"/> <text value="Text summary of the resource, for human interpretation"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later."/> <type value="display"/> </item> </item> <item> <linkId value="AdverseEvent.contained"/> <text value="Contained, inline Resources"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/> <type value="display"/> </item> </item> <item> <linkId value="AdverseEvent.extension"/> <text value="Additional Content defined by implementations"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <linkId value="AdverseEvent.modifierExtension"/> <text value="Extensions that cannot be ignored"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Identifier"/> </extension> <linkId value="AdverseEvent.identifier"/> <text value="Business identifier for the event"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Business identifiers assigned to this adverse event by the performer or other systems which remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)).  It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types.  For example, multiple Patient and a Person resource instance might share the same social insurance number."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.identifier.label"/> <text value="label:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="AdverseEvent.identifier.system"/> <text value="system:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="AdverseEvent.identifier.value"/> <text value="value:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="code"/> </extension> <linkId value="AdverseEvent.actuality"/> <type value="group"/> <required value="true"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Whether the event actually happened, or just had the potential to. Note that this is independent of whether anyone was affected or harmed or how severely."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.actuality.value"/> <text value="actuality"/> <type value="choice"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="AdverseEvent.category"/> <text value="ProductProblem | ProductQuality | ProductUseError | WrongDose | IncorrectPrescribingInformation | WrongTechnique | WrongRouteOfAdministration | WrongRate | WrongDuration | WrongTime | ExpiredDrug | MedicalDeviceUseError | ProblemDifferentManufacturer | UnsafePhysicalEnvironment"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The overall type of event, intended for search and filtering purposes."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.category.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="AdverseEvent.category.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="AdverseEvent.event"/> <text value="Type of the event itself in relation to the subject"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="This element defines the specific type of event that occurred or that was prevented from occurring."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.event.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="AdverseEvent.event.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.subject"/> <type value="group"/> <required value="true"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="This subject or group impacted by the event. If AdverseEvent.resultingCondition differs among members of the group, then use Patient as the subject."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Patient, Group, Practitioner, RelatedPerson"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.subject.value"/> <text value="Subject impacted by event"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.context"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The encounter or episode of care that establishes the context for this AdverseEvent. This will typically be the encounter the AdverseEvent occurred within. For example, if a medication administration was considered an adverse event because it resulted in a rash, then the encounter when the medication administration was given is the context. If the patient reports the AdverseEvent during a second encounter, that second encounter is not the context."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Encounter, EpisodeOfCare"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.context.value"/> <text value="Encounter or episode of care that establishes the context for this AdverseEvent"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="datetime"/> </extension> <linkId value="AdverseEvent.date"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The date (and perhaps time) when the adverse event occurred."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.date.value"/> <text value="When the event occurred"/> <type value="dateTime"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.resultingCondition"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Includes information about the reaction that occurred as a result of exposure to a substance (for example, a drug or a chemical)."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Condition"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.resultingCondition.value"/> <text value="Effect on the subject due to this event"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.location"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The information about where the adverse event occurred."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Location"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.location.value"/> <text value="Location where adverse event occurred"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="AdverseEvent.seriousness"/> <text value="Seriousness of the event"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Assessment whether this event was of real importance."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.seriousness.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="AdverseEvent.seriousness.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="AdverseEvent.severity"/> <text value="Mild | Moderate | Severe"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Describes the severity of the adverse event, in relation to the subject. Contrast to AdverseEvent.serious - a severe rash might not be serious, but a mild heart problem is."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.severity.coding"/> <text value="code:"/> <type value="choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="AdverseEvent.severity.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="AdverseEvent.outcome"/> <text value="resolved | recovering | ongoing | resolvedWithSequelae | fatal | unknown"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Describes the type of outcome from the adverse event."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.outcome.coding"/> <text value="code:"/> <type value="choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="AdverseEvent.outcome.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.recorder"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Information on who recorded the adverse event. May be the patient or a practitioner."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Patient, Practitioner, RelatedPerson"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.recorder.value"/> <text value="Who recorded the adverse event"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.contributor"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Parties that may or should contribute or have contributed information to the adverse event, which can consist of one or more activities. Such information includes information leading to the decision to perform the activity and how to perform the activity (e.g. consultant), information that the activity itself seeks to reveal (e.g. informant of clinical history), or information about what activity was performed (e.g. informant witness)."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Practitioner, Device"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.contributor.value"/> <text value="Who was involved in the adverse event or the potential adverse event"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <linkId value="AdverseEvent.suspectEntity"/> <text value="The suspected agent causing the adverse event"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Describes the entity that is suspected to have caused the adverse event."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="string"/> </extension> <linkId value="AdverseEvent.suspectEntity.id"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.suspectEntity.id.value"/> <text value="xml:id (or equivalent in JSON)"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <linkId value="AdverseEvent.suspectEntity.extension"/> <text value="Additional content defined by implementations"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <linkId value="AdverseEvent.suspectEntity.modifierExtension"/> <text value="Extensions that cannot be ignored"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.suspectEntity.instance"/> <type value="group"/> <required value="true"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Identifies the actual instance of what caused the adverse event. May be a substance, medication, medication administration, medication statement or a device."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Immunization, Procedure, Substance, Medication, MedicationAdministration, MedicationStatement, Device"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.suspectEntity.instance.value"/> <text value="Refers to the specific entity that caused the adverse event"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <linkId value="AdverseEvent.suspectEntity.causality"/> <text value="Information on the possible cause of the event"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Information on the possible cause of the event."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="string"/> </extension> <linkId value="AdverseEvent.suspectEntity.causality.id"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.suspectEntity.causality.id.value"/> <text value="xml:id (or equivalent in JSON)"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <linkId value="AdverseEvent.suspectEntity.causality.extension"/> <text value="Additional content defined by implementations"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <linkId value="AdverseEvent.suspectEntity.causality.modifierExtension"/> <text value="Extensions that cannot be ignored"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="AdverseEvent.suspectEntity.causality.assessment"/> <text value="Assessment of if the entity caused the event"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Assessment of if the entity caused the event."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.suspectEntity.causality.assessment.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="AdverseEvent.suspectEntity.causality.assessment.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="string"/> </extension> <linkId value="AdverseEvent.suspectEntity.causality.productRelatedness"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="AdverseEvent.suspectEntity.causalityProductRelatedness."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.suspectEntity.causality.productRelatedness.value"/> <text value="AdverseEvent.suspectEntity.causalityProductRelatedness"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.suspectEntity.causality.author"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="AdverseEvent.suspectEntity.causalityAuthor."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Practitioner, PractitionerRole"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.suspectEntity.causality.author.value"/> <text value="AdverseEvent.suspectEntity.causalityAuthor"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="AdverseEvent.suspectEntity.causality.method"/> <text value="ProbabilityScale | Bayesian | Checklist"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="ProbabilityScale | Bayesian | Checklist."/> <type value="display"/> </item> <item> <linkId value="AdverseEvent.suspectEntity.causality.method.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="AdverseEvent.suspectEntity.causality.method.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.subjectMedicalHistory"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="AdverseEvent.subjectMedicalHistory."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Condition, Observation, AllergyIntolerance, FamilyMemberHistory, Immunization, Procedure, Media, DocumentReference"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.subjectMedicalHistory.value"/> <text value="AdverseEvent.subjectMedicalHistory"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.referenceDocument"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="AdverseEvent.referenceDocument."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="DocumentReference"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.referenceDocument.value"/> <text value="AdverseEvent.referenceDocument"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="AdverseEvent.study"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="AdverseEvent.study."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="ResearchStudy"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="AdverseEvent.study.value"/> <text value="AdverseEvent.study"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> </item> </Questionnaire>
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.