Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU 2.1

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## : CDex Questionnaire Example1 - XML Representation

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    <Questionnaire xmlns="http://hl7.org/fhir">
      <id value="cdex-questionnaire-example1"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire cdex-questionnaire-example1</b></p><a name="cdex-questionnaire-example1"> </a><a name="hccdex-questionnaire-example1"> </a><a name="cdex-questionnaire-example1-en-US"> </a><b>Structure</b><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; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="http://hl7.org/fhir/R4/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; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="http://hl7.org/fhir/R4/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; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can 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; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="http://hl7.org/fhir/R4/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; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " 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"/> HomeOxygenTherapyQuestionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><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://example.org/cdex-questionnaire-example1#2.1.0</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.1" 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-text.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="text" class="hierarchy"/> 1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)</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://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></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.2" 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"/> 2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Order Reason</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://hl7.org/fhir/R4/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">Options: <a href="#opt-item.2">4 options</a></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item.2"> </a><p><b>Answer options for 2 </b></p><ul><li style="font-size: 11px">http://example.org#1 (&quot;Initial or original order for certification&quot;)</li><li style="font-size: 11px">http://example.org#2 (&quot;Change in status&quot;)</li><li style="font-size: 11px">http://example.org#3 (&quot;Revision or change in equipment&quot;)</li><li style="font-size: 11px">http://example.org#4 (&quot;Replacement&quot;)</li></ul></div>
      </text>
      <url value="http://example.org/cdex-questionnaire-example1"/>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:2.16.840.1.113883.4.642.40.21.35.1"/>
      </identifier>
      <version value="2.1.0"/>
      <name value="HomeOxygenTherapyQuestionnaire"/>
      <title value="Home Oxygen Therapy Questionnaire"/>
      <status value="active"/>
      <subjectType value="Patient"/>
      <date value="2022-01-17"/>
      <publisher
                 value="HL7 International / Payer/Provider Information Exchange Work Group"/>
      <contact>
        <name
              value="HL7 International / Payer/Provider Information Exchange Work Group"/>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/claims"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="pie@lists.hl7.org"/>
        </telecom>
      </contact>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
        </coding>
      </jurisdiction>
      <copyright
                 value="Used by permission of HL7 International all rights reserved Creative Commons License"/>
      <item>
        <linkId value="1"/>
        <text
              value="Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)"/>
        <type value="text"/>
        <required value="true"/>
      </item>
      <item>
        <linkId value="2"/>
        <text value="Order Reason"/>
        <type value="choice"/>
        <required value="true"/>
        <answerOption>
          <valueCoding>
            <system value="http://example.org"/>
            <code value="1"/>
            <display value="Initial or original order for certification"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://example.org"/>
            <code value="2"/>
            <display value="Change in status"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://example.org"/>
            <code value="3"/>
            <display value="Revision or change in equipment"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://example.org"/>
            <code value="4"/>
            <display value="Replacement"/>
          </valueCoding>
        </answerOption>
      </item>
    </Questionnaire>