Da Vinci - Documentation Templates and Rules
2.1.0 - STU 2.1

Publication Build: This will be filled in by the publication tooling

## Resource Profile: DTRQuestionnaireAdapt - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 2

Definitions for the dtr-questionnaire-adapt resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be found here

0. Questionnaire
Definition | Defines the metadata that should be present when embedding a adaptive Questionnaire as part of a QuestionnaireResponse. A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection.
Short | Adaptive QuestionnaireA structured set of questions
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Form, CRF, Survey
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (`name.matches('[A-Z]([A-Za-z0-9_]){0,254}')`) que-2: The link ids for groups and questions must be unique within the questionnaire (`descendants().linkId.isDistinct()`) que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}')) que-2: The link ids for groups and questions must be unique within the questionnaire (descendants().linkId.isDistinct())
2. Questionnaire.implicitRules
Definition | 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.
Short | A set of rules under which this content was created
Comments | 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.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Questionnaire.text
Definition | 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.
Short | Text summary of the resource, for human interpretation
Comments | 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 information is added later.
Control | 10..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Questionnaire.text.status
Definition | The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.
Short | generated | extensions | additional | empty
Control | 1..1
Binding | The codes SHALL be taken from NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/narrative-status|4.0.1` ) The status of a resource narrative.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Questionnaire.text.div
Definition | The actual narrative content, a stripped down version of XHTML.
Short | Limited xhtml content
Comments | The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, 'anchor' elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects. The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.
Control | 1..1
Type | xhtml
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (`htmlChecks()`) txt-2: The narrative SHALL have some non-whitespace content (`htmlChecks()`) txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks()) txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
10. Questionnaire.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | 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.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Questionnaire.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
12. Questionnaire.extension:questionnaireAdaptive
Slice Name | questionnaireAdaptive
Definition | Marks a questionnaire as being adaptive. Value can either be a boolean (if true, indicates adaptive) or a URL for the base URL of a server that can perform the nextQuestion operation for this particular questionnaire.
Short | Marks a questionnaire as being adaptive.
Comments | There can only be one in a questionnaire if the value used is boolean.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Questionnaire adaptive) (Extension Type: Choice of: boolean, url)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. Questionnaire.extension:questionnaireAdaptive.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Questionnaire.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Questionnaire.extension:questionnaireAdaptive.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive`
18. Questionnaire.extension:questionnaireAdaptive.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Type | url, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Questionnaire.extension:styleSensitive
Slice Name | styleSensitive
Definition | Indicates that the style extensions (style, markdown and xhtml) in this resource instance are essential to the interpretation of the instance and that systems that are not capable of rendering using those extensions should not be used to render the resource.
Short | Are styles important for processing?
Comments | If set to true, all systems that claim to support this extension and that render elements from the resource SHALL either render the content as required by the style extensions (style, xhtml and markdown or shall indicate to the user that the resource (or specific elements in the resource) cannot be appropriately rendered by the system.
Control | 0..1
Type | Extension(Style sensitive) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. Questionnaire.extension:styleSensitive.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Questionnaire.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
24. Questionnaire.extension:styleSensitive.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/rendering-styleSensitive`
26. Questionnaire.extension:styleSensitive.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1 This element is affected by the following invariants: ext-1
Type | boolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Pattern Value | `false`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Questionnaire.extension:cqf-library
Slice Name | cqf-library
Definition | A reference to a Library containing the formal logic used by the artifact.
Short | The library can contain CQL, FHIRPath or x-fhir-query. The implementers must handle any of the above.
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..*
Type | Extension(CQF Library) (Extension Type: canonical(Library))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. Questionnaire.extension:cqf-library.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Questionnaire.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. Questionnaire.extension:cqf-library.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/cqf-library`
34. Questionnaire.extension:cqf-library.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1 This element is affected by the following invariants: ext-1
Type | canonical(SDCLibrary), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Questionnaire.extension:itemPopulationContext
Slice Name | itemPopulationContext
Definition | Specifies a query or other expression that identifies the resource (or set of resources for a repeating item) that should be used to support the population of this Questionnaire or Questionnaire.item on initial population. When populating the questionnaire, it will set the specified variable name to that resource repetition for use in processing items within the group.
Short | Establishes mapping context for a Questionnaire item
Control | 0..*
Type | Extension(Item population context) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
38. Questionnaire.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
40. Questionnaire.url
Definition | An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.
Short | Canonical identifier for this questionnaire, represented as a URI (globally unique)
Comments | The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension.
Control | 0..01
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | We prohibit URL because this Questionnaire is a one-off for a specific response and therefore does not have its own canonical URL. The URL of the base questionnaire is captured using Questionnaire.derivedFrom … This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Questionnaire.version
Definition | The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.
Short | Business version of the questionnaire
Comments | There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version].
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Questionnaire.title
Definition | A short, descriptive, user-friendly title for the questionnaire.
Short | Name for this questionnaire (human friendly)
Comments | This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Questionnaire.title.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Questionnaire.title.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
48. Questionnaire.title.extension:titleRenderingStyle
Slice Name | titleRenderingStyle
Definition | Identifies how the specified element should be rendered when displayed.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
50. Questionnaire.title.extension:titleRenderingXhtml
Slice Name | titleRenderingXhtml
Definition | This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.
Short | String equivalent with html markup
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
52. Questionnaire.derivedFrom
Definition | The URL of a Questionnaire that this Questionnaire is based on.
Short | Base Questionnaire this adaptive instance is drivenen fromInstantiates protocol or definition
Comments | For this profile, there must be exactly one Questionnaire which is the base Questionnaire the 'adaptive' QuestionnaireResponse completion was executed against.
Control | 10..1*
Type | canonical(Questionnaire)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Allows a Questionnaire to be created based on another Questionnaire.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Questionnaire.status
Definition | The status of this questionnaire. Enables tracking the life-cycle of the content.
Short | draft | active | retired | unknown
Comments | Allows filtering of questionnaires that are appropriate for use versus not.
Control | 1..1
Binding | The codes SHALL be taken from PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/publication-status|4.0.1` ) The lifecycle status of an artifact.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. Questionnaire.effectivePeriod
Definition | The period during which the questionnaire content was or is planned to be in active use.
Short | Validity period for the QuestionnaireWhen the questionnaire is expected to be used
Comments | The effective period for a questionnaire determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the questionnaire are or are expected to be used instead.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Questionnaire.item
Definition | A particular question, question grouping or display text that is part of the questionnaire.
Short | Questions and sections within the Questionnaire
Comments | The content of the questionnaire is constructed from an ordered, hierarchical collection of items.
Control | 0..* This element is affected by the following invariants: que-3
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) que-1: Group items must have nested items, display items cannot have nested items (`(type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty())`) que-3: Display items cannot have a "code" asserted (`type!='display' or code.empty()`) que-4: A question cannot have both answerOption and answerValueSet (`answerOption.empty() or answerValueSet.empty()`) que-5: Only 'choice' and 'open-choice' items can have answerValueSet (`(type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty())`) que-6: Required and repeat aren't permitted for display items (`type!='display' or (required.empty() and repeats.empty())`) que-8: Initial values can't be specified for groups or display items (`(type!='group' and type!='display') or initial.empty()`) que-9: Read-only can't be specified for "display" items (`type!='display' or readOnly.empty()`) que-10: Maximum length can only be declared for simple question types (`(type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty()`) que-11: If one or more answerOption is present, initial[x] must be missing (`answerOption.empty() or initial.empty()`) que-12: If there are more than one enableWhen, enableBehavior must be specified (`enableWhen.count() > 2 implies enableBehavior.exists()`) que-13: Can only have multiple initial values for repeating items (`repeats=true or initial.count() <= 1`) que-1: Group items must have nested items, display items cannot have nested items ((type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty())) que-3: Display items cannot have a "code" asserted (type!='display' or code.empty()) que-4: A question cannot have both answerOption and answerValueSet (answerOption.empty() or answerValueSet.empty()) que-5: Only 'choice' and 'open-choice' items can have answerValueSet ((type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty())) que-6: Required and repeat aren't permitted for display items (type!='display' or (required.empty() and repeats.empty())) que-8: Initial values can't be specified for groups or display items ((type!='group' and type!='display') or initial.empty()) que-9: Read-only can't be specified for "display" items (type!='display' or readOnly.empty()) que-10: Maximum length can only be declared for simple question types ((type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty()) que-11: If one or more answerOption is present, initial[x] must be missing (answerOption.empty() or initial.empty()) que-12: If there are more than one enableWhen, enableBehavior must be specified (enableWhen.count() > 2 implies enableBehavior.exists()) que-13: Can only have multiple initial values for repeating items (repeats=true or initial.count() <= 1)
60. Questionnaire.item.extension:hidden
Slice Name | hidden
Definition | If true, indicates that the extended item should not be displayed to the user.
Short | Don't display to user
Comments | If an item is hidden, all descendant items are hidden as well.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Questionnaire Hidden) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
62. Questionnaire.item.extension:itemMedia
Slice Name | itemMedia
Definition | Media to render/make available as an accompaniment to the question being asked
Short | Media to display
Control | 0..1
Type | Extension(Item Media) (Extension Type: Attachment)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
64. Questionnaire.item.extension:itemOptionalDisplay
Slice Name | itemOptionalDisplay
Definition | This extension is used when defining high-level questionnaires that will then be used as a basis for 'derived' Questionnaires that are further refined for use in specific organizations or contexts. If the extension is present and set to 'true', it means that this item should be considered to be 'optional' from an adaptation perspective and that the question can be removed (i.e. not displayed) in derived questionnaires without impacting the validity of the instrument. Alternatively, the element can be marked as 'hidden' and 'readOnly' and have a value or descendant item values declared using initialValue or initialExpression. If the element with 'optionalDisplay=true' is marked as 'required=true', then this second approach is the only means to exclude the element from display.
Short | Can suppress from display to user
Comments | If a group or question that contains other groups or questions is marked as "optional", all of its contents are automatically also treated as optional.
Control | 0..0
Type | Extension(Optional Display?) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
66. Questionnaire.item.extension:shortText
Slice Name | shortText
Definition | The short text for the item.
Short | Short text for the item.
Comments | This element is useful for an item that require a shorter text when rendered (e.g. when displaying the item on a mobile phone).
Control | 0..1
Type | Extension(Short text) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
68. Questionnaire.item.extension:openLabel
Slice Name | openLabel
Definition | The label text to display beside free-text and/or unrestricted type values for an 'open' choice element. E.g. 'Other, please specify', or 'Additional condition', or 'More reason(s)', etc.
Short | Image to display
Control | 0..1
Type | Extension(Label for 'open' items) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
70. Questionnaire.item.extension:itemControl
Slice Name | itemControl
Definition | The type of data entry control or structure that should be used to render the item.
Short | E.g. Fly-over, Table, Checkbox, Combo-box, Lookup, etc.
Comments | Different controls may be appropriate for different item types. It is up to the system rendering a questionnaire as to what controls it will support and for which data types. See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Item Control) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
72. Questionnaire.item.extension:choiceOrientation
Slice Name | choiceOrientation
Definition | Identifies the desired orientation when rendering a list of choices (typically radio-box or check-box lists).
Short | horizontal | vertical
Comments | Systems may choose to wrap answers rather than attempting to display them all in one row or column. Language conventions may determine the order in which the choices are listed (left-to-right or right-to-left, etc.). See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire ChoiceOrientation) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
74. Questionnaire.item.extension:displayCategory
Slice Name | displayCategory
Definition | Describes the intended purpose of the rendered text. For example - instructions, guidance on access control, maintenance information, etc.
Short | Purpose of rendered text
Comments | See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Display Category) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
76. Questionnaire.item.extension:supportLink
Slice Name | supportLink
Definition | A URL that resolves to additional supporting information or guidance related to the question. See additional guidance and examples in the SDC implementation guide.
Short | Supporting information
Control | 0..*
Type | Extension(Questionnaire Support Link) (Extension Type: uri)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
78. Questionnaire.item.extension:choiceColumn
Slice Name | choiceColumn
Definition | Provides guidelines for rendering multi-column choices. I.e. when displaying a list of codes (for `choice` or `open-choice` items) or a list of resources (for `reference` items), this extension allows the drop-down to have multiple columns. For codes, the author can pick additional code system properties to display - such as alternate display names strength or form for drug codes, etc. For references, the author can choose particular columns from the resource (e.g. first name, last name, specialty, address).
Short | Guide for rendering multi-column choices
Comments | Each repetition represents a column to display.
Control | 0..*
Type | Extension(Choice column) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
80. Questionnaire.item.extension:width
Slice Name | width
Definition | When used with an item control that causes the question to appear as a column in a table, indicates the width to give to the column for this question.
Short | Width of column for question
Comments | code missing = pixels; code = % = percentage.
Control | 0..1
Type | Extension(Width of column) (Extension Type: Quantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
82. Questionnaire.item.extension:sliderStepValue
Slice Name | sliderStepValue
Definition | For slider-based controls, indicates the step size to use when toggling the control up or down.
Short | Increment value for slider
Comments | See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Slider Step Value) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
84. Questionnaire.item.extension:entryFormat
Slice Name | entryFormat
Definition | Additional instructions for the user to guide their input (i.e. a human readable version of a regular expression like "nnn-nnn-nnn"). In most UIs this is the placeholder (or 'ghost') text placed directly inside the edit controls and that disappear when the control gets the focus.
Short | User prompt for format
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Entry format) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
86. Questionnaire.item.extension:collapsible
Slice Name | collapsible
Definition | Indicates whether the child items of a group or question item is displayed in collapsible form.
Short | Indicates whether the child items of a group or question item is displayed in collapsible form.
Control | 0..1
Type | Extension(Collapsible) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
88. Questionnaire.item.extension:initialExpression
Slice Name | initialExpression
Definition | Initial value for a question answer as determined by an evaluated expression.
Short | Expression-determined initial value
Comments | Initial value is only calculated at the time the QuestionnaireResponse is first generated.
Control | 0..1
Type | Extension(initial.exists().not()) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
90. Questionnaire.item.extension:unit
Slice Name | unit
Definition | Provides a computable unit of measure associated with numeric questions to support subsequent computation on responses. This is for use on items of type integer and decimal, and it's purpose is to support converting the integer or decimal answer into a Quantity when extracting the data into a resource.
Short | Unit for numeric answer
Comments | The human-readable unit is conveyed as a display element. This element is for computation purposes.
Control | 0..1
Type | Extension(Questionnaire Unit) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
92. Questionnaire.item.extension:candidateExpression
Slice Name | candidateExpression
Definition | A FHIRPath or CQL expression, or FHIR Query that resolves to a list of candidate answers for the question item or that establishes context for a group item. The user may select from among the candidates to choose answers for the question.
Short | Expression for possible answers
Comments | The results of the expression must correspond to the item type of the question the element appears on or must correspond to a resource, backbone element or complex data type for a group item. Resources are considered a match for the Reference item type. Quantity can be a match for decimal and integer items so long as a questionnaire-unit extension is present.
Control | 0..1
Type | Extension(Candidate Answers Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
94. Questionnaire.item.extension:contextExpression
Slice Name | contextExpression
Definition | A FHIR Query that resolves to one or more resources that can be displayed to the user to help provide context for answering a question. For example, if the question is "Has the patient discussed this issue on any visits in the past year?", the contextExpression might return the set of patient's encounters for the prior 12 month period to help jog the practitioner's memory.
Short | Expression for information to guide answers
Control | 0..*
Type | Extension(Answer Context Expression) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
96. Questionnaire.item.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
98. Questionnaire.item.linkId
Definition | An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.
Short | Unique id for item in questionnaire
Comments | This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient. QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Questionnaire.item.prefix
Definition | A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire.
Short | E.g. "1(a)", "2.5.3"
Comments | These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically, these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used.
Alternate Names | label
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. Questionnaire.item.prefix.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Questionnaire.item.prefix.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
104. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
Slice Name | itemPrefixRenderingStyle
Definition | Identifies how the specified element should be rendered when displayed.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
106. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
Slice Name | itemPrefixRenderingXhtml
Definition | This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.
Short | String equivalent with html markup
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
108. Questionnaire.item.text
Definition | The name of a section, the text of a question or text content for a display item.
Short | Primary text for the item
Comments | When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading. Group item instructions should be included as a display type item within the group.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. Questionnaire.item.text.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Questionnaire.item.text.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
112. Questionnaire.item.text.extension:itemTextRenderingStyle
Slice Name | itemTextRenderingStyle
Definition | Identifies how the specified element should be rendered when displayed.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
114. Questionnaire.item.text.extension:itemTextRenderingXhtml
Slice Name | itemTextRenderingXhtml
Definition | This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.
Short | String equivalent with html markup
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
116. Questionnaire.item.type
Definition | The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.).
Short | group | display | boolean | decimal | integer | date | dateTime +
Comments | Additional constraints on the type of answer can be conveyed by extensions. The value may come from the ElementDefinition referred to by .definition.
Control | 1..1
Binding | The codes SHALL be taken from QuestionnaireItemType http://hl7.org/fhir/ValueSet/item-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/item-type|4.0.1` ) Distinguishes groups from questions and display text and indicates data type for questions.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Defines the format in which the user is to be prompted for the answer.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. Questionnaire.item.enableWhen
Definition | A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true.
Short | Only allow data when
Comments | If multiple repetitions of this extension are present, the item should be enabled when the condition for any of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to.
Control | 0..0*
Type | BackboneElement
Is Modifier | true because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
Summary | false
Requirements | Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) que-7: If the operator is 'exists', the value must be a boolean (`operator = 'exists' implies (answer is Boolean)`) que-7: If the operator is 'exists', the value must be a boolean (operator = 'exists' implies (answer is Boolean))
124. Questionnaire.item.enableBehavior
Definition | Controls how multiple enableWhen values are interpreted - whether all or any must be true.
Short | all | any
Comments | This element must be specified if more than one enableWhen value is provided.
Control | 0..01 This element is affected by the following invariants: que-12
Binding | The codes SHALL be taken from EnableWhenBehavior http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1 (required to `http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1` ) Controls how multiple enableWhen values are interpreted - whether all or any must be true.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
126. Questionnaire.item.required
Definition | An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire.
Short | Whether the item must be included in data results
Comments | Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition.
Control | 0..1 This element is affected by the following invariants: que-6
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Meaning if Missing | Items are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. Questionnaire.item.repeats
Definition | An indication, if true, that the item may occur multiple times in the response, collecting multiple answers for questions or multiple sets of answers for groups.
Short | Whether the item may repeat
Comments | If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items. The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values. The value may come from the ElementDefinition referred to by .definition.
Control | 0..1 This element is affected by the following invariants: que-6
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set.
Meaning if Missing | Items are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. Questionnaire.item.readOnly
Definition | An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.
Short | Don't allow human editing
Comments | The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers.
Control | 0..1 This element is affected by the following invariants: que-9
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. Questionnaire.item.answerValueSet
Definition | A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" question.
Short | Valueset containing permitted answers
Comments | LOINC defines many useful value sets for questionnaire responses. See LOINC Answer Lists. The value may come from the ElementDefinition referred to by .definition.
Control | 0..1 This element is affected by the following invariants: que-4, que-5
Type | canonical(ValueSet)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Questionnaire.item.answerOption
Definition | One of the permitted answers for a "choice" or "open-choice" question.
Short | Permitted answer
Comments | This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes.
Control | 0..* This element is affected by the following invariants: que-4, que-5
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. Questionnaire.item.answerOption.extension
Definition | An Extension 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.
Short | ExtensionAdditional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Questionnaire.item.answerOption.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
138. Questionnaire.item.answerOption.extension:itemAnswerMedia
Slice Name | itemAnswerMedia
Definition | Media to render/make available as an accompaniment to a specific answer option
Short | Answer Media to display
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Item Answer Media) (Extension Type: Attachment)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
140. Questionnaire.item.answerOption.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
142. Questionnaire.item.answerOption.value[x]
Definition | A potential answer that's allowed as the answer to this question.
Short | Answer value
Comments | The data type of the value must agree with the item.type.
Control | 1..1
Binding | For example codes, see QuestionnaireAnswerCodes http://hl7.org/fhir/ValueSet/questionnaire-answers (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers` ) Allowed values to answer questions.
Type | Choice of: integer, date, time, string, Coding, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. Questionnaire.item.initial
Definition | One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.
Short | Initial value(s) when item is first rendered
Comments | The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial[x] must agree with the item.type, and only repeating items can have more then one initial value.
Control | 0..* This element is affected by the following invariants: que-8, que-13
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | In some workflows, having defaults saves time.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Questionnaire.item.initial.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
148. Questionnaire.item.initial.value[x]
Definition | The actual value to for an initial answer.
Short | Actual value for initializing the question
Comments | The type of the initial value must be consistent with the type of the item.
Control | 1..1
Binding | For example codes, see QuestionnaireAnswerCodes http://hl7.org/fhir/ValueSet/questionnaire-answers (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers` ) Allowed values to answer questions.
Type | Choice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Questionnaire.item.item
Definition | Text, questions and other groups to be nested beneath a question or group.
Short | Nested questionnaire items
Comments | There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting.
Control | 0..* This element is affected by the following invariants: que-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
Is Modifier | false
Must Support | true
Summary | false
Requirements | Reports can consist of complex nested groups.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. Questionnaire
2. Questionnaire.text
Control | 1..?
4. Questionnaire.text.div
Comments | The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, 'anchor' elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.
6. Questionnaire.extension
Control | 1..?
8. Questionnaire.extension:questionnaireAdaptive
Slice Name | questionnaireAdaptive
10. Questionnaire.extension:questionnaireAdaptive.extension
Control | 0..0
12. Questionnaire.extension:questionnaireAdaptive.value[x]
Type | url
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
14. Questionnaire.extension:styleSensitive
Slice Name | styleSensitive
Comments | If set to true, all systems that claim to support this extension and that render elements from the resource SHALL either render the content as required by the style extensions (style, xhtml and markdown or shall indicate to the user that the resource (or specific elements in the resource) cannot be appropriately rendered by the system.
Control | 0..1
Type | Extension(Style sensitive) (Extension Type: boolean)
16. Questionnaire.extension:styleSensitive.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Pattern Value | `false`
18. Questionnaire.extension:cqf-library
Slice Name | cqf-library
Short | The library can contain CQL, FHIRPath or x-fhir-query. The implementers must handle any of the above.
Control | 0..*
Type | Extension(CQF Library) (Extension Type: canonical(Library))
Must Support | true
20. Questionnaire.extension:cqf-library.value[x]
Type | canonical(SDCLibrary)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
22. Questionnaire.extension:itemPopulationContext
Slice Name | itemPopulationContext
Control | 0..*
Type | Extension(Item population context) (Extension Type: Expression)
Must Support | true
24. Questionnaire.title
26. Questionnaire.title.extension
Slicing | This element introduces a set of slices on `Questionnaire.title.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
28. Questionnaire.title.extension:titleRenderingStyle
Slice Name | titleRenderingStyle
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
30. Questionnaire.title.extension:titleRenderingXhtml
Slice Name | titleRenderingXhtml
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
32. Questionnaire.effectivePeriod
Short | Validity period for the Questionnaire
Must Support | true
34. Questionnaire.item
36. Questionnaire.item.extension:itemMedia
Slice Name | itemMedia
Control | 0..1
Type | Extension(Item Media) (Extension Type: Attachment)
38. Questionnaire.item.extension:itemOptionalDisplay
Slice Name | itemOptionalDisplay
Control | 0..0
Type | Extension(Optional Display?) (Extension Type: boolean)
40. Questionnaire.item.extension:shortText
Slice Name | shortText
Control | 0..1
Type | Extension(Short text) (Extension Type: string)
42. Questionnaire.item.extension:openLabel
Slice Name | openLabel
Control | 0..1
Type | Extension(Label for 'open' items) (Extension Type: string)
44. Questionnaire.item.extension:itemControl
Slice Name | itemControl
Control | 0..1
Type | Extension(Questionnaire Item Control) (Extension Type: CodeableConcept)
Must Support | true
46. Questionnaire.item.extension:choiceOrientation
Slice Name | choiceOrientation
Control | 0..1
Type | Extension(Questionnaire ChoiceOrientation) (Extension Type: code)
48. Questionnaire.item.extension:displayCategory
Slice Name | displayCategory
Control | 0..1
Type | Extension(Questionnaire Display Category) (Extension Type: CodeableConcept)
50. Questionnaire.item.extension:supportLink
Slice Name | supportLink
Control | 0..*
Type | Extension(Questionnaire Support Link) (Extension Type: uri)
Must Support | true
52. Questionnaire.item.extension:choiceColumn
Slice Name | choiceColumn
Control | 0..*
Type | Extension(Choice column) (Complex Extension)
54. Questionnaire.item.extension:width
Slice Name | width
Control | 0..1
Type | Extension(Width of column) (Extension Type: Quantity)
56. Questionnaire.item.extension:sliderStepValue
Slice Name | sliderStepValue
Control | 0..1
Type | Extension(Questionnaire Slider Step Value) (Extension Type: integer)
58. Questionnaire.item.extension:entryFormat
Slice Name | entryFormat
Control | 0..1
Type | Extension(Entry format) (Extension Type: string)
60. Questionnaire.item.extension:collapsible
Slice Name | collapsible
Control | 0..1
Type | Extension(Collapsible) (Extension Type: code)
62. Questionnaire.item.extension:initialExpression
Slice Name | initialExpression
Control | 0..1
Type | Extension(initial.exists().not()) (Extension Type: Expression)
Must Support | true
64. Questionnaire.item.extension:unit
Slice Name | unit
Control | 0..1
Type | Extension(Questionnaire Unit) (Extension Type: Coding)
66. Questionnaire.item.extension:candidateExpression
Slice Name | candidateExpression
Control | 0..1
Type | Extension(Candidate Answers Expression) (Extension Type: Expression)
Must Support | true
68. Questionnaire.item.extension:contextExpression
Slice Name | contextExpression
Control | 0..*
Type | Extension(Answer Context Expression) (Complex Extension)
Must Support | true
70. Questionnaire.item.prefix
72. Questionnaire.item.prefix.extension
Slicing | This element introduces a set of slices on `Questionnaire.item.prefix.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
74. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
Slice Name | itemPrefixRenderingStyle
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
76. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
Slice Name | itemPrefixRenderingXhtml
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
78. Questionnaire.item.text
80. Questionnaire.item.text.extension
Slicing | This element introduces a set of slices on `Questionnaire.item.text.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
82. Questionnaire.item.text.extension:itemTextRenderingStyle
Slice Name | itemTextRenderingStyle
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
84. Questionnaire.item.text.extension:itemTextRenderingXhtml
Slice Name | itemTextRenderingXhtml
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Must Support | true
86. Questionnaire.item.enableWhen
Control | 0..0
88. Questionnaire.item.enableBehavior
Control | 0..0
90. Questionnaire.item.answerOption
92. Questionnaire.item.answerOption.extension
Slicing | This element introduces a set of slices on `Questionnaire.item.answerOption.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
94. Questionnaire.item.answerOption.extension:itemAnswerMedia
Slice Name | itemAnswerMedia
Control | 0..1
Type | Extension(Item Answer Media) (Extension Type: Attachment)

Guidance on how to interpret the contents of this table can be found here

0. Questionnaire
Definition | Defines the metadata that should be present when embedding a adaptive Questionnaire as part of a QuestionnaireResponse.
Short | Adaptive Questionnaire
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Form, CRF, Survey
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (`name.matches('[A-Z]([A-Za-z0-9_]){0,254}')`) que-2: The link ids for groups and questions must be unique within the questionnaire (`descendants().linkId.isDistinct()`)
2. Questionnaire.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Questionnaire.meta
Definition | 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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Questionnaire.implicitRules
Definition | 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.
Short | A set of rules under which this content was created
Comments | 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.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Questionnaire.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Questionnaire.text
Definition | 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.
Short | Text summary of the resource, for human interpretation
Comments | 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 information is added later.
Control | 1..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Questionnaire.text.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
14. Questionnaire.text.extension
Definition | 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.
Short | Additional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.text.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Questionnaire.text.status
Definition | The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.
Short | generated | extensions | additional | empty
Control | 1..1
Binding | The codes SHALL be taken from NarrativeStatus (required to `http://hl7.org/fhir/ValueSet/narrative-status|4.0.1` ) The status of a resource narrative.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
18. Questionnaire.text.div
Definition | The actual narrative content, a stripped down version of XHTML.
Short | Limited xhtml content
Comments | The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, 'anchor' elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.
Control | 1..1
Type | xhtml
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (`htmlChecks()`) txt-2: The narrative SHALL have some non-whitespace content (`htmlChecks()`)
20. Questionnaire.contained
Definition | 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.
Short | Contained, inline Resources
Comments | 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
22. Questionnaire.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
24. Questionnaire.extension:questionnaireAdaptive
Slice Name | questionnaireAdaptive
Definition | Marks a questionnaire as being adaptive. Value can either be a boolean (if true, indicates adaptive) or a URL for the base URL of a server that can perform the nextQuestion operation for this particular questionnaire.
Short | Marks a questionnaire as being adaptive.
Comments | There can only be one in a questionnaire if the value used is boolean.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Questionnaire adaptive) (Extension Type: Choice of: boolean, url)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
26. Questionnaire.extension:questionnaireAdaptive.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
28. Questionnaire.extension:questionnaireAdaptive.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
30. Questionnaire.extension:questionnaireAdaptive.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive`
32. Questionnaire.extension:questionnaireAdaptive.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Type | url
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. Questionnaire.extension:styleSensitive
Slice Name | styleSensitive
Definition | Indicates that the style extensions (style, markdown and xhtml) in this resource instance are essential to the interpretation of the instance and that systems that are not capable of rendering using those extensions should not be used to render the resource.
Short | Are styles important for processing?
Comments | If set to true, all systems that claim to support this extension and that render elements from the resource SHALL either render the content as required by the style extensions (style, xhtml and markdown or shall indicate to the user that the resource (or specific elements in the resource) cannot be appropriately rendered by the system.
Control | 0..1
Type | Extension(Style sensitive) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
36. Questionnaire.extension:styleSensitive.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | id
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
38. Questionnaire.extension:styleSensitive.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
40. Questionnaire.extension:styleSensitive.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/rendering-styleSensitive`
42. Questionnaire.extension:styleSensitive.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1 This element is affected by the following invariants: ext-1
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Pattern Value | `false`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. Questionnaire.extension:cqf-library
Slice Name | cqf-library
Definition | A reference to a Library containing the formal logic used by the artifact.
Short | The library can contain CQL, FHIRPath or x-fhir-query. The implementers must handle any of the above.
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..*
Type | Extension(CQF Library) (Extension Type: canonical(Library))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
46. Questionnaire.extension:cqf-library.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | id
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
48. Questionnaire.extension:cqf-library.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
50. Questionnaire.extension:cqf-library.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/cqf-library`
52. Questionnaire.extension:cqf-library.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1 This element is affected by the following invariants: ext-1
Type | canonical(SDCLibrary)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Questionnaire.extension:itemPopulationContext
Slice Name | itemPopulationContext
Definition | Specifies a query or other expression that identifies the resource (or set of resources for a repeating item) that should be used to support the population of this Questionnaire or Questionnaire.item on initial population. When populating the questionnaire, it will set the specified variable name to that resource repetition for use in processing items within the group.
Short | Establishes mapping context for a Questionnaire item
Control | 0..*
Type | Extension(Item population context) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
56. Questionnaire.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
58. Questionnaire.url
Definition | An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.
Short | Canonical identifier for this questionnaire, represented as a URI (globally unique)
Comments | The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension.
Control | 0..0
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | We prohibit URL because this Questionnaire is a one-off for a specific response and therefore does not have its own canonical URL. The URL of the base questionnaire is captured using Questionnaire.derivedFrom
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. Questionnaire.identifier
Definition | A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance.
Short | Additional identifier for the questionnaire
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this questionnaire outside of FHIR, where it is not possible to use the logical URI.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Questionnaire.version
Definition | The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.
Short | Business version of the questionnaire
Comments | There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version].
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. Questionnaire.name
Definition | A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation.
Short | Name for this questionnaire (computer friendly)
Comments | The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.
Control | 0..1 This element is affected by the following invariants: inv-0
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Support human navigation and code generation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Questionnaire.title
Definition | A short, descriptive, user-friendly title for the questionnaire.
Short | Name for this questionnaire (human friendly)
Comments | This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Questionnaire.title.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
70. Questionnaire.title.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.title.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
72. Questionnaire.title.extension:titleRenderingStyle
Slice Name | titleRenderingStyle
Definition | Identifies how the specified element should be rendered when displayed.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
74. Questionnaire.title.extension:titleRenderingXhtml
Slice Name | titleRenderingXhtml
Definition | This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.
Short | String equivalent with html markup
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
76. Questionnaire.title.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Max Length: | 1048576
78. Questionnaire.derivedFrom
Definition | The URL of a Questionnaire that this Questionnaire is based on.
Short | Base Questionnaire this adaptive instance is drivenen from
Comments | For this profile, there must be exactly one Questionnaire which is the base Questionnaire the 'adaptive' QuestionnaireResponse completion was executed against.
Control | 1..1
Type | canonical(Questionnaire)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Allows a Questionnaire to be created based on another Questionnaire.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. Questionnaire.status
Definition | The status of this questionnaire. Enables tracking the life-cycle of the content.
Short | draft | active | retired | unknown
Comments | Allows filtering of questionnaires that are appropriate for use versus not.
Control | 1..1
Binding | The codes SHALL be taken from PublicationStatus (required to `http://hl7.org/fhir/ValueSet/publication-status|4.0.1` ) The lifecycle status of an artifact.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Questionnaire.experimental
Definition | A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.
Short | For testing purposes, not real usage
Comments | Allows filtering of questionnaires that are appropriate for use versus not.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Questionnaire.subjectType
Definition | The types of subjects that can be the subject of responses created for the questionnaire.
Short | Resource that can be subject of QuestionnaireResponse
Comments | If none are specified, then the subject is unlimited.
Control | 0..*
Binding | The codes SHALL be taken from ResourceType (required to `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` ) One of the resource types defined as part of this version of FHIR.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. Questionnaire.date
Definition | The date (and optionally time) when the questionnaire was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes.
Short | Date last changed
Comments | Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | Revision Date
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. Questionnaire.publisher
Definition | The name of the organization or individual that published the questionnaire.
Short | Name of the publisher (organization or individual)
Comments | Usually an organization but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Helps establish the "authority/credibility" of the questionnaire. May also allow for contact.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. Questionnaire.contact
Definition | Contact details to assist a user in finding and communicating with the publisher.
Short | Contact details for the publisher
Comments | May be a web site, an email address, a telephone number, etc.
Control | 0..*
Type | ContactDetail
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. Questionnaire.description
Definition | A free text natural language description of the questionnaire from a consumer's perspective.
Short | Natural language description of the questionnaire
Comments | This description can be used to capture details such as why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created).
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Questionnaire.useContext
Definition | The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate questionnaire instances.
Short | The context that the content is intended to support
Comments | When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Control | 0..*
Type | UsageContext
Is Modifier | false
Summary | true
Requirements | Assist in searching for appropriate content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Questionnaire.jurisdiction
Definition | A legal or geographic region in which the questionnaire is intended to be used.
Short | Intended jurisdiction for questionnaire (if applicable)
Comments | It may be possible for the questionnaire to be used in jurisdictions other than those for which it was originally designed or intended.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from Jurisdiction ValueSet (extensible to `http://hl7.org/fhir/ValueSet/jurisdiction` ) Countries and regions within which this artifact is targeted for use.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. Questionnaire.purpose
Definition | Explanation of why this questionnaire is needed and why it has been designed as it has.
Short | Why this questionnaire is defined
Comments | This element does not describe the usage of the questionnaire. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this questionnaire.
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Questionnaire.copyright
Definition | A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire.
Short | Use and/or publishing restrictions
Control | 0..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Consumers must be able to determine any legal restrictions on the use of the questionnaire and/or its content.
Alternate Names | License, Restrictions
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Questionnaire.approvalDate
Definition | The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.
Short | When the questionnaire was approved by publisher
Comments | The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. Questionnaire.lastReviewDate
Definition | The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.
Short | When the questionnaire was last reviewed
Comments | If specified, this date follows the original approval date.
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. Questionnaire.effectivePeriod
Definition | The period during which the questionnaire content was or is planned to be in active use.
Short | Validity period for the Questionnaire
Comments | The effective period for a questionnaire determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the questionnaire are or are expected to be used instead.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. Questionnaire.code
Definition | An identifier for this question or group of questions in a particular terminology such as LOINC.
Short | Concept that represents the overall questionnaire
Control | 0..*
Binding | For example codes, see QuestionnaireQuestionCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-questions` ) Codes for questionnaires, groups and individual questions.
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
110. Questionnaire.item
Definition | A particular question, question grouping or display text that is part of the questionnaire.
Short | Questions and sections within the Questionnaire
Comments | The content of the questionnaire is constructed from an ordered, hierarchical collection of items.
Control | 0..* This element is affected by the following invariants: que-3
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) que-1: Group items must have nested items, display items cannot have nested items (`(type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty())`) que-3: Display items cannot have a "code" asserted (`type!='display' or code.empty()`) que-4: A question cannot have both answerOption and answerValueSet (`answerOption.empty() or answerValueSet.empty()`) que-5: Only 'choice' and 'open-choice' items can have answerValueSet (`(type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty())`) que-6: Required and repeat aren't permitted for display items (`type!='display' or (required.empty() and repeats.empty())`) que-8: Initial values can't be specified for groups or display items (`(type!='group' and type!='display') or initial.empty()`) que-9: Read-only can't be specified for "display" items (`type!='display' or readOnly.empty()`) que-10: Maximum length can only be declared for simple question types (`(type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty()`) que-11: If one or more answerOption is present, initial[x] must be missing (`answerOption.empty() or initial.empty()`) que-12: If there are more than one enableWhen, enableBehavior must be specified (`enableWhen.count() > 2 implies enableBehavior.exists()`) que-13: Can only have multiple initial values for repeating items (`repeats=true or initial.count() <= 1`)
112. Questionnaire.item.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
114. Questionnaire.item.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
116. Questionnaire.item.extension:hidden
Slice Name | hidden
Definition | If true, indicates that the extended item should not be displayed to the user.
Short | Don't display to user
Comments | If an item is hidden, all descendant items are hidden as well.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Questionnaire Hidden) (Extension Type: boolean)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
118. Questionnaire.item.extension:itemMedia
Slice Name | itemMedia
Definition | Media to render/make available as an accompaniment to the question being asked
Short | Media to display
Control | 0..1
Type | Extension(Item Media) (Extension Type: Attachment)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
120. Questionnaire.item.extension:itemOptionalDisplay
Slice Name | itemOptionalDisplay
Definition | This extension is used when defining high-level questionnaires that will then be used as a basis for 'derived' Questionnaires that are further refined for use in specific organizations or contexts. If the extension is present and set to 'true', it means that this item should be considered to be 'optional' from an adaptation perspective and that the question can be removed (i.e. not displayed) in derived questionnaires without impacting the validity of the instrument. Alternatively, the element can be marked as 'hidden' and 'readOnly' and have a value or descendant item values declared using initialValue or initialExpression. If the element with 'optionalDisplay=true' is marked as 'required=true', then this second approach is the only means to exclude the element from display.
Short | Can suppress from display to user
Comments | If a group or question that contains other groups or questions is marked as "optional", all of its contents are automatically also treated as optional.
Control | 0..0
Type | Extension(Optional Display?) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
122. Questionnaire.item.extension:shortText
Slice Name | shortText
Definition | The short text for the item.
Short | Short text for the item.
Comments | This element is useful for an item that require a shorter text when rendered (e.g. when displaying the item on a mobile phone).
Control | 0..1
Type | Extension(Short text) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
124. Questionnaire.item.extension:openLabel
Slice Name | openLabel
Definition | The label text to display beside free-text and/or unrestricted type values for an 'open' choice element. E.g. 'Other, please specify', or 'Additional condition', or 'More reason(s)', etc.
Short | Image to display
Control | 0..1
Type | Extension(Label for 'open' items) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
126. Questionnaire.item.extension:itemControl
Slice Name | itemControl
Definition | The type of data entry control or structure that should be used to render the item.
Short | E.g. Fly-over, Table, Checkbox, Combo-box, Lookup, etc.
Comments | Different controls may be appropriate for different item types. It is up to the system rendering a questionnaire as to what controls it will support and for which data types. See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Item Control) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
128. Questionnaire.item.extension:choiceOrientation
Slice Name | choiceOrientation
Definition | Identifies the desired orientation when rendering a list of choices (typically radio-box or check-box lists).
Short | horizontal | vertical
Comments | Systems may choose to wrap answers rather than attempting to display them all in one row or column. Language conventions may determine the order in which the choices are listed (left-to-right or right-to-left, etc.). See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire ChoiceOrientation) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
130. Questionnaire.item.extension:displayCategory
Slice Name | displayCategory
Definition | Describes the intended purpose of the rendered text. For example - instructions, guidance on access control, maintenance information, etc.
Short | Purpose of rendered text
Comments | See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Display Category) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
132. Questionnaire.item.extension:supportLink
Slice Name | supportLink
Definition | A URL that resolves to additional supporting information or guidance related to the question. See additional guidance and examples in the SDC implementation guide.
Short | Supporting information
Control | 0..*
Type | Extension(Questionnaire Support Link) (Extension Type: uri)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
134. Questionnaire.item.extension:choiceColumn
Slice Name | choiceColumn
Definition | Provides guidelines for rendering multi-column choices. I.e. when displaying a list of codes (for `choice` or `open-choice` items) or a list of resources (for `reference` items), this extension allows the drop-down to have multiple columns. For codes, the author can pick additional code system properties to display - such as alternate display names strength or form for drug codes, etc. For references, the author can choose particular columns from the resource (e.g. first name, last name, specialty, address).
Short | Guide for rendering multi-column choices
Comments | Each repetition represents a column to display.
Control | 0..*
Type | Extension(Choice column) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
136. Questionnaire.item.extension:width
Slice Name | width
Definition | When used with an item control that causes the question to appear as a column in a table, indicates the width to give to the column for this question.
Short | Width of column for question
Comments | code missing = pixels; code = % = percentage.
Control | 0..1
Type | Extension(Width of column) (Extension Type: Quantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
138. Questionnaire.item.extension:sliderStepValue
Slice Name | sliderStepValue
Definition | For slider-based controls, indicates the step size to use when toggling the control up or down.
Short | Increment value for slider
Comments | See additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Questionnaire Slider Step Value) (Extension Type: integer)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
140. Questionnaire.item.extension:entryFormat
Slice Name | entryFormat
Definition | Additional instructions for the user to guide their input (i.e. a human readable version of a regular expression like "nnn-nnn-nnn"). In most UIs this is the placeholder (or 'ghost') text placed directly inside the edit controls and that disappear when the control gets the focus.
Short | User prompt for format
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Entry format) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
142. Questionnaire.item.extension:collapsible
Slice Name | collapsible
Definition | Indicates whether the child items of a group or question item is displayed in collapsible form.
Short | Indicates whether the child items of a group or question item is displayed in collapsible form.
Control | 0..1
Type | Extension(Collapsible) (Extension Type: code)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
144. Questionnaire.item.extension:initialExpression
Slice Name | initialExpression
Definition | Initial value for a question answer as determined by an evaluated expression.
Short | Expression-determined initial value
Comments | Initial value is only calculated at the time the QuestionnaireResponse is first generated.
Control | 0..1
Type | Extension(initial.exists().not()) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
146. Questionnaire.item.extension:unit
Slice Name | unit
Definition | Provides a computable unit of measure associated with numeric questions to support subsequent computation on responses. This is for use on items of type integer and decimal, and it's purpose is to support converting the integer or decimal answer into a Quantity when extracting the data into a resource.
Short | Unit for numeric answer
Comments | The human-readable unit is conveyed as a display element. This element is for computation purposes.
Control | 0..1
Type | Extension(Questionnaire Unit) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
148. Questionnaire.item.extension:candidateExpression
Slice Name | candidateExpression
Definition | A FHIRPath or CQL expression, or FHIR Query that resolves to a list of candidate answers for the question item or that establishes context for a group item. The user may select from among the candidates to choose answers for the question.
Short | Expression for possible answers
Comments | The results of the expression must correspond to the item type of the question the element appears on or must correspond to a resource, backbone element or complex data type for a group item. Resources are considered a match for the Reference item type. Quantity can be a match for decimal and integer items so long as a questionnaire-unit extension is present.
Control | 0..1
Type | Extension(Candidate Answers Expression) (Extension Type: Expression)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
150. Questionnaire.item.extension:contextExpression
Slice Name | contextExpression
Definition | A FHIR Query that resolves to one or more resources that can be displayed to the user to help provide context for answering a question. For example, if the question is "Has the patient discussed this issue on any visits in the past year?", the contextExpression might return the set of patient's encounters for the prior 12 month period to help jog the practitioner's memory.
Short | Expression for information to guide answers
Control | 0..*
Type | Extension(Answer Context Expression) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
152. Questionnaire.item.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
154. Questionnaire.item.linkId
Definition | An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.
Short | Unique id for item in questionnaire
Comments | This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Questionnaire.item.definition
Definition | This element is a URI that refers to an ElementDefinition that provides information about this item, including information that might otherwise be included in the instance of the Questionnaire resource. A detailed description of the construction of the URI is shown in Comments, below. If this element is present then the following element values MAY be derived from the Element Definition if the corresponding elements of this Questionnaire resource instance have no value: code (ElementDefinition.code) type (ElementDefinition.type) required (ElementDefinition.min) repeats (ElementDefinition.max) maxLength (ElementDefinition.maxLength) answerValueSet (ElementDefinition.binding) options (ElementDefinition.binding).
Short | ElementDefinition - details for the item
Comments | The uri refers to an ElementDefinition in a StructureDefinition and always starts with the canonical URL for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id Element.id. E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment identifier, the first/root element definition in the target is the matching element definition.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | A common pattern is to define a set of data elements and then build multiple questionnaires for different circumstances to gather the data. This element provides traceability to the common definition and allows the content for the question to come from the underlying definition.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Questionnaire.item.code
Definition | A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers).
Short | Corresponding concept for this item in a terminology
Comments | The value may come from the ElementDefinition referred to by .definition.
Control | 0..* This element is affected by the following invariants: que-3
Binding | For example codes, see QuestionnaireQuestionCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-questions` ) Codes for questionnaires, groups and individual questions.
Type | Coding
Is Modifier | false
Summary | false
Requirements | Allows linking of groups of questions to formal terminologies.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. Questionnaire.item.prefix
Definition | A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire.
Short | E.g. "1(a)", "2.5.3"
Comments | These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically, these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used.
Alternate Names | label
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
162. Questionnaire.item.prefix.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
164. Questionnaire.item.prefix.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.prefix.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
166. Questionnaire.item.prefix.extension:itemPrefixRenderingStyle
Slice Name | itemPrefixRenderingStyle
Definition | Identifies how the specified element should be rendered when displayed.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
168. Questionnaire.item.prefix.extension:itemPrefixRenderingXhtml
Slice Name | itemPrefixRenderingXhtml
Definition | This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.
Short | String equivalent with html markup
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
170. Questionnaire.item.prefix.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Max Length: | 1048576
172. Questionnaire.item.text
Definition | The name of a section, the text of a question or text content for a display item.
Short | Primary text for the item
Comments | When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading. Group item instructions should be included as a display type item within the group.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. Questionnaire.item.text.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
176. Questionnaire.item.text.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.text.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
178. Questionnaire.item.text.extension:itemTextRenderingStyle
Slice Name | itemTextRenderingStyle
Definition | Identifies how the specified element should be rendered when displayed.
Short | Html style value
Comments | This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension. For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(Rendering Style) (Extension Type: string)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
180. Questionnaire.item.text.extension:itemTextRenderingXhtml
Slice Name | itemTextRenderingXhtml
Definition | This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.
Short | String equivalent with html markup
Comments | For questionnaires, see additional guidance and examples in the SDC implementation guide.
Control | 0..1
Type | Extension(XHTML Representation) (Extension Type: string)
Is Modifier | false
Must Support | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
182. Questionnaire.item.text.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Max Length: | 1048576
184. Questionnaire.item.type
Definition | The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.).
Short | group | display | boolean | decimal | integer | date | dateTime +
Comments | Additional constraints on the type of answer can be conveyed by extensions. The value may come from the ElementDefinition referred to by .definition.
Control | 1..1
Binding | The codes SHALL be taken from QuestionnaireItemType (required to `http://hl7.org/fhir/ValueSet/item-type|4.0.1` ) Distinguishes groups from questions and display text and indicates data type for questions.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Defines the format in which the user is to be prompted for the answer.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
186. Questionnaire.item.enableWhen
Definition | A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true.
Short | Only allow data when
Comments | If multiple repetitions of this extension are present, the item should be enabled when the condition for any of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to.
Control | 0..0
Type | BackboneElement
Is Modifier | true because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
Summary | false
Requirements | Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) que-7: If the operator is 'exists', the value must be a boolean (`operator = 'exists' implies (answer is Boolean)`)
194. Questionnaire.item.enableBehavior
Definition | Controls how multiple enableWhen values are interpreted - whether all or any must be true.
Short | all | any
Comments | This element must be specified if more than one enableWhen value is provided.
Control | 0..0 This element is affected by the following invariants: que-12
Binding | The codes SHALL be taken from EnableWhenBehavior (required to `http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1` ) Controls how multiple enableWhen values are interpreted - whether all or any must be true.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
196. Questionnaire.item.required
Definition | An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire.
Short | Whether the item must be included in data results
Comments | Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition.
Control | 0..1 This element is affected by the following invariants: que-6
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Meaning if Missing | Items are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
198. Questionnaire.item.repeats
Definition | An indication, if true, that the item may occur multiple times in the response, collecting multiple answers for questions or multiple sets of answers for groups.
Short | Whether the item may repeat
Comments | If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items. The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values. The value may come from the ElementDefinition referred to by .definition.
Control | 0..1 This element is affected by the following invariants: que-6
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set.
Meaning if Missing | Items are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
200. Questionnaire.item.readOnly
Definition | An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.
Short | Don't allow human editing
Comments | The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers.
Control | 0..1 This element is affected by the following invariants: que-9
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
202. Questionnaire.item.maxLength
Definition | The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse.
Short | No more than this many characters
Comments | For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition.
Control | 0..1 This element is affected by the following invariants: que-10
Type | integer
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
204. Questionnaire.item.answerValueSet
Definition | A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" question.
Short | Valueset containing permitted answers
Comments | LOINC defines many useful value sets for questionnaire responses. See LOINC Answer Lists. The value may come from the ElementDefinition referred to by .definition.
Control | 0..1 This element is affected by the following invariants: que-4, que-5
Type | canonical(ValueSet)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
206. Questionnaire.item.answerOption
Definition | One of the permitted answers for a "choice" or "open-choice" question.
Short | Permitted answer
Comments | This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes.
Control | 0..* This element is affected by the following invariants: que-4, que-5
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
208. Questionnaire.item.answerOption.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
210. Questionnaire.item.answerOption.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Questionnaire.item.answerOption.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
212. Questionnaire.item.answerOption.extension:itemAnswerMedia
Slice Name | itemAnswerMedia
Definition | Media to render/make available as an accompaniment to a specific answer option
Short | Answer Media to display
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Item Answer Media) (Extension Type: Attachment)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
214. Questionnaire.item.answerOption.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
216. Questionnaire.item.answerOption.value[x]
Definition | A potential answer that's allowed as the answer to this question.
Short | Answer value
Comments | The data type of the value must agree with the item.type.
Control | 1..1
Binding | For example codes, see QuestionnaireAnswerCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers` ) Allowed values to answer questions.
Type | Choice of: integer, date, time, string, Coding, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. Questionnaire.item.answerOption.initialSelected
Definition | Indicates whether the answer value is selected when the list of possible answers is initially shown.
Short | Whether option is selected by default
Comments | Use this instead of initial[v] if answerValueSet is present.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Meaning if Missing | Only selected items explicitly marked to be selected
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. Questionnaire.item.initial
Definition | One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.
Short | Initial value(s) when item is first rendered
Comments | The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial[x] must agree with the item.type, and only repeating items can have more then one initial value.
Control | 0..* This element is affected by the following invariants: que-8, que-13
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | In some workflows, having defaults saves time.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
222. Questionnaire.item.initial.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
224. Questionnaire.item.initial.extension
Definition | 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.
Short | Additional content defined by implementations
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
226. Questionnaire.item.initial.modifierExtension
Definition | 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 and/or the understanding of the containing element's descendants. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
228. Questionnaire.item.initial.value[x]
Definition | The actual value to for an initial answer.
Short | Actual value for initializing the question
Comments | The type of the initial value must be consistent with the type of the item.
Control | 1..1
Binding | For example codes, see QuestionnaireAnswerCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers` ) Allowed values to answer questions.
Type | Choice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
230. Questionnaire.item.item
Definition | Text, questions and other groups to be nested beneath a question or group.
Short | Nested questionnaire items
Comments | There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting.
Control | 0..* This element is affected by the following invariants: que-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
Is Modifier | false
Must Support | true
Summary | false
Requirements | Reports can consist of complex nested groups.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)