<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="QuestionnaireResponse" />
  <url value="https://fhir.centraxx.de/StructureDefinition/QuestionnaireResponse" />
  <version value="2025.4.0" />
  <name value="QuestionnaireResponse" />
  <status value="active" />
  <publisher value="Kairos an IQVIA business" />
  <description value="Represents a CentraXX crf. CentraXX crfs can be updated but not created." />
  <fhirVersion value="4.0.1" />
  <kind value="resource" />
  <abstract value="false" />
  <type value="QuestionnaireResponse" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
  <derivation value="constraint" />
  <snapshot>
    <element id="QuestionnaireResponse">
      <path value="QuestionnaireResponse" />
      <short value="A structured set of questions and their answers" />
      <definition value="A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to." />
      <comment value="The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on.  I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse." />
      <alias value="Form" />
      <alias value="QuestionnaireAnswers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="QuestionnaireResponse" />
        <min value="0" />
        <max value="*" />
      </base>
      <constraint>
        <key value="dom-2" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
        <expression value="contained.contained.empty()" />
        <xpath value="not(parent::f:contained and f:contained)" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-4" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-3" />
        <severity value="error" />
        <human value="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" />
        <expression value="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()" />
        <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
        </extension>
        <key value="dom-6" />
        <severity value="warning" />
        <human value="A resource should have narrative for robust management" />
        <expression value="text.`div`.exists()" />
        <xpath value="exists(f:text/h:div)" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-5" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
        <expression value="contained.meta.security.empty()" />
        <xpath value="not(exists(f:contained/*/f:meta/f:security))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Observation[moodCode=EVN]" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.id">
      <path value="QuestionnaireResponse.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
      <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <isSummary value="true" />
    </element>
    <element id="QuestionnaireResponse.meta">
      <path value="QuestionnaireResponse.meta" />
      <short value="Metadata about the resource" />
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.meta" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Meta" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.implicitRules">
      <path value="QuestionnaireResponse.implicitRules" />
      <short value="A set of rules under which this content was created" />
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
      <comment value="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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="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" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.language">
      <path value="QuestionnaireResponse.language" />
      <short value="Language of the resource content" />
      <definition value="The base language in which the resource is written." />
      <comment value="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)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.language" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language" />
        </extension>
        <strength value="preferred" />
        <description value="A human language." />
        <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.text">
      <path value="QuestionnaireResponse.text" />
      <short value="Text summary of the resource, for human interpretation" />
      <definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
      <comment value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later." />
      <alias value="narrative" />
      <alias value="html" />
      <alias value="xhtml" />
      <alias value="display" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Narrative" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Act.text?" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.contained">
      <path value="QuestionnaireResponse.contained" />
      <short value="Contained, inline Resources" />
      <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
      <comment value="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." />
      <alias value="inline resources" />
      <alias value="anonymous resources" />
      <alias value="contained resources" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.contained" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Resource" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.extension">
      <path value="QuestionnaireResponse.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="5" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.extension:updateWithOverwrite">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="updateWithOverwrite" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/updateWithOverwrite" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.extension:studyVisit">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="studyVisit" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/study/visits/visit" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.extension:studyPhase">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="studyPhase" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/study/phases/phase" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.extension:crfCreationDate">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="crfCreationDate" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/crf/creationDate" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.extension:approvalState">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="approvalState" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/studyVisitItem/approvalState" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.extension:surveyDueDate">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="surveyDueDate" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/survey/dueDate" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.modifierExtension">
      <path value="QuestionnaireResponse.modifierExtension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="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." />
      <requirements value="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](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier">
      <path value="QuestionnaireResponse.identifier" />
      <short value="Unique id for this set of answers" />
      <definition value="A business identifier assigned to a particular completed (or partially completed) questionnaire." />
      <requirements value="Used for tracking, registration and other business purposes." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.identifier" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.identifier" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".id" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier.id">
      <path value="QuestionnaireResponse.identifier.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier.extension">
      <path value="QuestionnaireResponse.identifier.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier.use">
      <path value="QuestionnaireResponse.identifier.use" />
      <short value="usual | official | temp | secondary | old (If known)" />
      <definition value="The purpose of this identifier." />
      <comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
      <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.use" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one." />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse" />
        </extension>
        <strength value="required" />
        <description value="Identifies the purpose for this identifier, if known ." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier.type">
      <path value="QuestionnaireResponse.identifier.type" />
      <short value="Description of identifier" />
      <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
      <comment value="This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type." />
      <requirements value="Allows users to make use of identifiers when the identifier system is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType" />
        </extension>
        <strength value="extensible" />
        <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier.system">
      <path value="QuestionnaireResponse.identifier.system" />
      <short value="The namespace for the identifier value" />
      <definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
      <comment value="Identifier.system is always case sensitive." />
      <requirements value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <example>
        <label value="General" />
        <valueUri value="http://www.acme.com/identifiers/patient" />
      </example>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / EI-2-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.root or Role.id.root" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierType" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier.value">
      <path value="QuestionnaireResponse.identifier.value" />
      <short value="The value that is unique" />
      <definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
      <comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <example>
        <label value="General" />
        <valueString value="123456" />
      </example>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.1 / EI.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./Value" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier.period">
      <path value="QuestionnaireResponse.identifier.period" />
      <short value="Time period when id is/was valid for use" />
      <definition value="Time period during which identifier is/was valid for use." />
      <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. &quot;the patient was an inpatient of the hospital for this time range&quot;) or one value from the range applies (e.g. &quot;give to the patient between these two times&quot;).&#xA;&#xA;Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="per-1" />
        <severity value="error" />
        <human value="If present, start SHALL have a lower value than end" />
        <expression value="start.hasValue().not() or end.hasValue().not() or (start &lt;= end)" />
        <xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) &lt;= xs:dateTime(f:end/@value))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Period" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.7 + CX.8" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.effectiveTime or implied by context" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./StartDate and ./EndDate" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier.assigner">
      <path value="QuestionnaireResponse.identifier.assigner" />
      <short value="Organization that issued id (may be just text)" />
      <definition value="Organization that issued/manages the identifier." />
      <comment value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.assigner" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / (CX.4,CX.9,CX.10)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierIssuingAuthority" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.basedOn">
      <path value="QuestionnaireResponse.basedOn" />
      <short value="Request fulfilled by this QuestionnaireResponse" />
      <definition value="The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse.  For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <requirements value="Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon." />
      <alias value="order" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="QuestionnaireResponse.basedOn" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.basedOn" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=FLFS].target" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.partOf">
      <path value="QuestionnaireResponse.partOf" />
      <short value="Part of this action" />
      <definition value="A procedure or observation that this questionnaire was performed as part of the execution of.  For example, the surgery a checklist was executed as part of." />
      <comment value="Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire.  For relationships to referrals, and other types of requests, use basedOn." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="QuestionnaireResponse.partOf" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.partOf" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.questionnaire">
      <path value="QuestionnaireResponse.questionnaire" />
      <short value="Form being answered" />
      <definition value="The Questionnaire that defines and organizes the questions for which answers are being provided." />
      <comment value="If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.)." />
      <requirements value="Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form." />
      <alias value="Form" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.questionnaire" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="canonical" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.instantiates" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.status">
      <path value="QuestionnaireResponse.status" />
      <short value="in-progress | completed | amended | entered-in-error | stopped" />
      <definition value="The position of the questionnaire response within its overall lifecycle." />
      <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
      <requirements value="The information on Questionnaire resources  may possibly be gathered during multiple sessions and altered after considered being finished." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isModifier value="true" />
      <isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireResponseStatus" />
        </extension>
        <strength value="required" />
        <description value="Lifecycle status of the questionnaire response." />
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.status" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.status" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish &quot;in-progress&quot; from &quot;published)" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.subject">
      <path value="QuestionnaireResponse.subject" />
      <short value="The subject of the questions" />
      <definition value="The subject of the questionnaire response.  This could be a patient, organization, practitioner, device, etc.  This is who/what the answers apply to, but is not necessarily the source of information." />
      <comment value="If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types." />
      <requirements value="Allows linking the answers to the individual the answers describe.  May also affect access control." />
      <alias value="Patient" />
      <alias value="Focus" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.subject" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.centraxx.de/StructureDefinition/StudyMember" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.subject" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject[x]" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=SBJ].role" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.encounter">
      <path value="QuestionnaireResponse.encounter" />
      <short value="Encounter created as part of" />
      <definition value="The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated." />
      <comment value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter." />
      <requirements value="Provides context for the information that was captured.  May also affect access control." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.encounter" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.encounter" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.context" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship(typeCode=COMP].source[classCode&lt;=PCPR, moodCode=EVN]" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.authored">
      <path value="QuestionnaireResponse.authored" />
      <short value="Date the answers were gathered" />
      <definition value="The date and/or time that this set of answers were last changed." />
      <comment value="May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.&#xA;&#xA;This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible." />
      <requirements value="Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers." />
      <alias value="Date Created" />
      <alias value="Date published" />
      <alias value="Date Issued" />
      <alias value="Date updated" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.authored" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.occurrence[x]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.recorded" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=AUT].time" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.author">
      <path value="QuestionnaireResponse.author" />
      <short value="Person who received and recorded the answers" />
      <definition value="Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system." />
      <comment value="Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation.  Authoring by device would indicate that some portion of the questionnaire had been auto-populated." />
      <requirements value="Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers." />
      <alias value="Laboratory" />
      <alias value="Service" />
      <alias value="Practitioner" />
      <alias value="Department" />
      <alias value="Company" />
      <alias value="Performer" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.author" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.centraxx.de/StructureDefinition/Person" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.performer" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.author" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=AUT].role" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.source">
      <path value="QuestionnaireResponse.source" />
      <short value="The person who answered the questions" />
      <definition value="The person who answered the questions about the subject." />
      <comment value="If not specified, no inference can be made about who provided the data." />
      <requirements value="When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.source" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.source" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=INF].role" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item">
      <path value="QuestionnaireResponse.item" />
      <short value="Groups and questions" />
      <definition value="A group or question item from the original questionnaire for which answers are provided." />
      <comment value="Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer)." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="QuestionnaireResponse.item" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="qrs-1" />
        <severity value="error" />
        <human value="Nested item can't be beneath both item and answer" />
        <expression value="(answer.exists() and item.exists()).not()" />
        <xpath value="not(exists(f:answer) and exists(f:item))" />
        <source value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.id">
      <path value="QuestionnaireResponse.item.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.extension">
      <path value="QuestionnaireResponse.item.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.extension:valueIndex">
      <path value="QuestionnaireResponse.item.extension" />
      <sliceName value="valueIndex" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/crf/item/valueIndex" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.modifierExtension">
      <path value="QuestionnaireResponse.item.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="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." />
      <requirements value="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](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.linkId">
      <path value="QuestionnaireResponse.item.linkId" />
      <short value="Pointer to specific item from Questionnaire" />
      <definition value="The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource." />
      <comment value="The id of the corresponding CrfTemplateField" />
      <requirements value="Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.linkId" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.definition">
      <path value="QuestionnaireResponse.item.definition" />
      <short value="ElementDefinition - details for the item" />
      <definition value="A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item." />
      <comment value="The ElementDefinition must be in a [StructureDefinition](structuredefinition.html#), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].&#xA;&#xA;There is no need for this element if the item pointed to by the linkId has a definition listed." />
      <requirements value="A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.definition" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.text">
      <path value="QuestionnaireResponse.item.text" />
      <short value="Name for group or question text" />
      <definition value="Text that is displayed above the contents of the group or as the text of the question being answered." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
      <requirements value="Allows the questionnaire response to be read without access to the questionnaire." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".text" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer">
      <path value="QuestionnaireResponse.item.answer" />
      <short value="The response(s) to the question" />
      <definition value="The respondent's answer(s) to the question." />
      <comment value="The value is nested because we cannot have a repeating structure that has variable type." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="QuestionnaireResponse.item.answer" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".value[type=LIST_ANY]" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.id">
      <path value="QuestionnaireResponse.item.answer.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.extension">
      <path value="QuestionnaireResponse.item.answer.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.modifierExtension">
      <path value="QuestionnaireResponse.item.answer.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="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." />
      <requirements value="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](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <type>
        <code value="decimal" />
      </type>
      <type>
        <code value="integer" />
      </type>
      <type>
        <code value="date" />
      </type>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="time" />
      </type>
      <type>
        <code value="string" />
      </type>
      <type>
        <code value="uri" />
      </type>
      <type>
        <code value="Attachment" />
      </type>
      <type>
        <code value="Coding" />
      </type>
      <type>
        <code value="Quantity" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireAnswer" />
        </extension>
        <strength value="example" />
        <description value="Code indicating the response provided for a question." />
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueBoolean" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <representation value="xmlAttr" />
      <short value="Primitive value for boolean" />
      <definition value="Primitive value for boolean" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="boolean.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="boolean" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/regex">
          <valueString value="true|false" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.Boolean" />
      </type>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueAttachment" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Attachment" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.contentType">
      <path value="QuestionnaireResponse.item.answer.value[x].contentType" />
      <short value="Mime type of the content, with charset etc." />
      <definition value="Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
      <requirements value="Processors of the data need to be able to know how to interpret the data." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Attachment.contentType" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <example>
        <label value="General" />
        <valueCode value="text/plain; charset=UTF-8, image/png" />
      </example>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MimeType" />
        </extension>
        <strength value="required" />
        <description value="The mime type of an attachment. Any valid mime type is allowed." />
        <valueSet value="http://hl7.org/fhir/ValueSet/mimetypes|4.0.1" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="ED.2+ED.3/RP.2+RP.3. Note conversion may be needed if old style values are being used" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./mediaType, ./charset" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.language">
      <path value="QuestionnaireResponse.item.answer.value[x].language" />
      <short value="Human language of the content (BCP-47)" />
      <definition value="The human language of the content. The value can be any valid value according to BCP 47." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
      <requirements value="Users need to be able to choose between the languages in a set of attachments." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Attachment.language" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <example>
        <label value="General" />
        <valueCode value="en-AU" />
      </example>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language" />
        </extension>
        <strength value="preferred" />
        <description value="A human language." />
        <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./language" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.data">
      <path value="QuestionnaireResponse.item.answer.value[x].data" />
      <short value="Data inline, base64ed" />
      <definition value="The actual data of the attachment - a sequence of bytes, base64 encoded." />
      <comment value="The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON." />
      <requirements value="The data needs to able to be transmitted inline." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Attachment.data" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="base64Binary" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="ED.5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./data" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.url">
      <path value="QuestionnaireResponse.item.answer.value[x].url" />
      <short value="Uri where the data can be found" />
      <definition value="A location where the data can be accessed." />
      <comment value="If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data." />
      <requirements value="The data needs to be transmitted by reference." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Attachment.url" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="url" />
      </type>
      <example>
        <label value="General" />
        <valueUrl value="http://www.acme.com/logo-small.png" />
      </example>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="RP.1+RP.2 - if they refer to a URL (see v2.6)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./reference/literal" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.size">
      <path value="QuestionnaireResponse.item.answer.value[x].size" />
      <short value="Number of bytes of content (if url provided)" />
      <definition value="The number of bytes of data that make up this attachment (before base64 encoding, if that is done)." />
      <comment value="The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference." />
      <requirements value="Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Attachment.size" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="unsignedInt" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A (needs data type R3 proposal)" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.hash">
      <path value="QuestionnaireResponse.item.answer.value[x].hash" />
      <short value="Hash of the data (sha-1, base64ed)" />
      <definition value="The calculated hash of the data using SHA-1. Represented using base64." />
      <comment value="The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see [Provenance.signature](provenance-definitions.html#Provenance.signature) for mechanism to protect a resource with a digital signature." />
      <requirements value="Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Attachment.hash" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="base64Binary" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".integrityCheck[parent::ED/integrityCheckAlgorithm=&quot;SHA-1&quot;]" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.title">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="QuestionnaireResponse.item.answer.value[x].title" />
      <short value="Label to display in place of the data" />
      <definition value="A label or set of text to display in place of the data." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
      <requirements value="Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Attachment.title" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <example>
        <label value="General" />
        <valueString value="Official Corporate Logo" />
      </example>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./title/data" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.creation">
      <path value="QuestionnaireResponse.item.answer.value[x].creation" />
      <short value="Date attachment was first created" />
      <definition value="The date that the attachment was first created." />
      <requirements value="This is often tracked as an integrity issue for use of the attachment." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Attachment.creation" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A (needs data type R3 proposal)" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueDecimal" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <representation value="xmlAttr" />
      <short value="Primitive value for decimal" />
      <definition value="Primitive value for decimal" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="decimal.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="decimal" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/regex">
          <valueString value="-?(0|[1-9][0-9]*)(\.[0-9]+)?([eE][+-]?[0-9]+)?" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.Decimal" />
      </type>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueInteger" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <representation value="xmlAttr" />
      <short value="Primitive value for integer" />
      <definition value="Primitive value for integer" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="integer.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="integer" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/regex">
          <valueString value="-?([0]|([1-9][0-9]*))" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.Integer" />
      </type>
      <minValueInteger value="-2147483648" />
      <maxValueInteger value="2147483647" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueCoding" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <example>
        <label value="Icd Entry" />
        <valueCoding>
          <system value="urn:centraxx:CodeSystem/IcdCatalog-18" />
          <version value="code" />
          <code value="A32.1" />
        </valueCoding>
      </example>
      <example>
        <label value="Ops entry" />
        <valueCoding>
          <system value="urn:centraxx:CodeSystem/OpsCatalog-3" />
          <code value="1-100" />
        </valueCoding>
      </example>
      <example>
        <label value="custom catalog entry" />
        <valueCoding>
          <system value="urn:centraxx:CodeSystem/Catalog-4" />
          <code value="the custom code" />
        </valueCoding>
      </example>
      <example>
        <label value="usage entry (controlled vocabulary)" />
        <valueCoding>
          <system value="urn:centraxx:CodeSystem/UsageEntry-3" />
          <code value="THE_CODE" />
        </valueCoding>
      </example>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="qre-cxx-1" />
        <severity value="error" />
        <human value="If the catalog is an IcdCatalog, a version must be given." />
        <expression value="system.startsWith('urn:centraxx:CodeSystem/IcdCatalog-') implies version.exists()" />
        <source value="https://fhir.centraxx.de/StructureDefinition/QuestionnaireResponse" />
      </constraint>
      <constraint>
        <key value="qre-cxx-2" />
        <severity value="error" />
        <human value="The catalog system must be supported by CentraXX. The system url must start with 'urn:centraxx:CodeSystem/&lt;catalog&gt;' where &lt;catalog&gt; must be one of: IcdCatalog, OpsCatalog, Catalog, MasterDataCatalog, UsageEntry" />
        <expression value="system.startsWith('urn:centraxx:CodeSystem/IcdCatalog') or system.startsWith('urn:centraxx:CodeSystem/OpsCatalog') or system.startsWith('urn:centraxx:CodeSystem/Catalog') or system.startsWith('urn:centraxx:CodeSystem/MasterDataCatalog') or system.startsWith('urn:centraxx:CodeSystem/UsageEntry') or system.startsWith('urn:centraxx:CodeSystem/ValueList')" />
        <source value="https://fhir.centraxx.de/StructureDefinition/QuestionnaireResponse" />
      </constraint>
      <mustSupport value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireAnswer" />
        </extension>
        <strength value="example" />
        <description value="Code indicating the response provided for a question." />
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.system">
      <path value="QuestionnaireResponse.item.answer.value[x].system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
      <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.version">
      <path value="QuestionnaireResponse.item.answer.value[x].version" />
      <short value="Version of the system - if relevant" />
      <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
      <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.code">
      <path value="QuestionnaireResponse.item.answer.value[x].code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
      <requirements value="Need to refer to a particular code in the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.display">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="QuestionnaireResponse.item.answer.value[x].display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.userSelected">
      <path value="QuestionnaireResponse.item.answer.value[x].userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
      <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
      <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueDate" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="date" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <representation value="xmlAttr" />
      <short value="Primitive value for date" />
      <definition value="Primitive value for date" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="date.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="date" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/regex">
          <valueString value="([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1]))?)?" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.Date" />
      </type>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueDateTime" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <representation value="xmlAttr" />
      <short value="Primitive value for dateTime" />
      <definition value="Primitive value for dateTime" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="dateTime.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="dateTime" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/regex">
          <valueString value="([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\.[0-9]+)?(Z|(\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?)?)?" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.DateTime" />
      </type>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueQuantity" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireAnswer" />
        </extension>
        <strength value="example" />
        <description value="Code indicating the response provided for a question." />
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <short value="Numerical value (with implicit precision)" />
      <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." />
      <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." />
      <requirements value="Precision is handled implicitly in almost all cases of measurement." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Quantity.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="SN.2  / CQ - N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.comparator">
      <path value="QuestionnaireResponse.item.answer.value[x].comparator" />
      <short value="&lt; | &lt;= | &gt;= | &gt; - how to understand the value" />
      <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is &quot;&lt;&quot; , then the real value is &lt; stated value." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
      <requirements value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;400mg/L due to the limitations of measuring methodology." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.comparator" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" />
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuantityComparator" />
        </extension>
        <strength value="required" />
        <description value="How the Quantity should be understood and represented." />
        <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="SN.1  / CQ.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL properties" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.unit">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="QuestionnaireResponse.item.answer.value[x].unit" />
      <short value="Unit representation" />
      <definition value="A human-readable form of the unit." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
      <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Quantity.unit" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="(see OBX.6 etc.) / CQ.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ.unit" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.system">
      <path value="QuestionnaireResponse.item.answer.value[x].system" />
      <short value="System that defines coded unit form" />
      <definition value="The identification of the system that provides the coded form of the unit." />
      <comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" />
      <requirements value="Need to know the system that defines the coded form of the unit." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <condition value="qty-3" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="(see OBX.6 etc.) / CQ.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CO.codeSystem, PQ.translation.codeSystem" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.code">
      <path value="QuestionnaireResponse.item.answer.value[x].code" />
      <short value="Coded form of the unit" />
      <definition value="A computer processable form of the unit in some unit representation system." />
      <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system." />
      <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="(see OBX.6 etc.) / CQ.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ.code, MO.currency, PQ.translation.code" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueString" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireAnswer" />
        </extension>
        <strength value="example" />
        <description value="Code indicating the response provided for a question." />
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <representation value="xmlAttr" />
      <short value="Primitive value for string" />
      <definition value="Primitive value for string" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="string.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/regex">
          <valueString value="[ \r\n\t\S]+" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <maxLength value="1048576" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueTime" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="time" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <representation value="xmlAttr" />
      <short value="Primitive value for time" />
      <definition value="Primitive value for time" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="time.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="time" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/regex">
          <valueString value="([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\.[0-9]+)?" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.Time" />
      </type>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueUri" />
      <short value="Single-valued answer to the question" />
      <definition value="The answer (or one of the answers) provided by the respondent to the question." />
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
      <requirements value="Ability to retain a single-valued answer to a question." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mustSupport value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireAnswer" />
        </extension>
        <strength value="example" />
        <description value="Code indicating the response provided for a question." />
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".item" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri.id">
      <path value="QuestionnaireResponse.item.answer.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="closed" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="2" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mustSupport value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <representation value="xmlAttr" />
      <short value="Primitive value for uri" />
      <definition value="Primitive value for uri" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="uri.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/regex">
          <valueString value="\S*" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
    </element>
    <element id="QuestionnaireResponse.item.answer.item">
      <path value="QuestionnaireResponse.item.answer.item" />
      <short value="Nested groups and questions" />
      <definition value="Nested groups and/or questions found within this particular answer." />
      <requirements value="It is useful to have &quot;sub-questions&quot;, questions which normally appear when certain answers are given and which collect additional details." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="QuestionnaireResponse.item.answer.item" />
        <min value="0" />
        <max value="*" />
      </base>
      <contentReference value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item" />
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]" />
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.item">
      <path value="QuestionnaireResponse.item.item" />
      <short value="Nested questionnaire response items" />
      <definition value="Questions or sub-groups nested beneath a question or group." />
      <requirements value="Reports can consist of complex nested groups." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="QuestionnaireResponse.item.item" />
        <min value="0" />
        <max value="*" />
      </base>
      <contentReference value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item" />
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="QuestionnaireResponse.extension">
      <path value="QuestionnaireResponse.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="5" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.extension:updateWithOverwrite">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="updateWithOverwrite" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/updateWithOverwrite" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.extension:studyVisit">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="studyVisit" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/study/visits/visit" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.extension:studyPhase">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="studyPhase" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/study/phases/phase" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.extension:crfCreationDate">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="crfCreationDate" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/crf/creationDate" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.extension:approvalState">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="approvalState" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/studyVisitItem/approvalState" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.extension:surveyDueDate">
      <path value="QuestionnaireResponse.extension" />
      <sliceName value="surveyDueDate" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/survey/dueDate" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.identifier">
      <path value="QuestionnaireResponse.identifier" />
      <min value="0" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.identifier.value">
      <path value="QuestionnaireResponse.identifier.value" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.questionnaire">
      <path value="QuestionnaireResponse.questionnaire" />
      <min value="0" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.status">
      <path value="QuestionnaireResponse.status" />
      <min value="0" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.subject">
      <path value="QuestionnaireResponse.subject" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.centraxx.de/StructureDefinition/StudyMember" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.authored">
      <path value="QuestionnaireResponse.authored" />
      <min value="0" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.author">
      <path value="QuestionnaireResponse.author" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.centraxx.de/StructureDefinition/Person" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item">
      <path value="QuestionnaireResponse.item" />
      <min value="0" />
      <max value="*" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.extension">
      <path value="QuestionnaireResponse.item.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.extension:valueIndex">
      <path value="QuestionnaireResponse.item.extension" />
      <sliceName value="valueIndex" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/crf/item/valueIndex" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.linkId">
      <path value="QuestionnaireResponse.item.linkId" />
      <comment value="The id of the corresponding CrfTemplateField" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.text">
      <path value="QuestionnaireResponse.item.text" />
      <min value="0" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer">
      <path value="QuestionnaireResponse.item.answer" />
      <min value="0" />
      <max value="*" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueBoolean" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="boolean" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueAttachment" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Attachment" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.contentType">
      <path value="QuestionnaireResponse.item.answer.value[x].contentType" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.data">
      <path value="QuestionnaireResponse.item.answer.value[x].data" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.size">
      <path value="QuestionnaireResponse.item.answer.value[x].size" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.title">
      <path value="QuestionnaireResponse.item.answer.value[x].title" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueAttachment.creation">
      <path value="QuestionnaireResponse.item.answer.value[x].creation" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueDecimal" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="decimal" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueInteger" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="integer" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueCoding" />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Coding" />
      </type>
      <example>
        <label value="Icd Entry" />
        <valueCoding>
          <system value="urn:centraxx:CodeSystem/IcdCatalog-18" />
          <version value="code" />
          <code value="A32.1" />
        </valueCoding>
      </example>
      <example>
        <label value="Ops entry" />
        <valueCoding>
          <system value="urn:centraxx:CodeSystem/OpsCatalog-3" />
          <code value="1-100" />
        </valueCoding>
      </example>
      <example>
        <label value="custom catalog entry" />
        <valueCoding>
          <system value="urn:centraxx:CodeSystem/Catalog-4" />
          <code value="the custom code" />
        </valueCoding>
      </example>
      <example>
        <label value="usage entry (controlled vocabulary)" />
        <valueCoding>
          <system value="urn:centraxx:CodeSystem/UsageEntry-3" />
          <code value="THE_CODE" />
        </valueCoding>
      </example>
      <constraint>
        <key value="qre-cxx-1" />
        <severity value="error" />
        <human value="If the catalog is an IcdCatalog, a version must be given." />
        <expression value="system.startsWith('urn:centraxx:CodeSystem/IcdCatalog-') implies version.exists()" />
        <source value="https://fhir.centraxx.de/StructureDefinition/QuestionnaireResponse" />
      </constraint>
      <constraint>
        <key value="qre-cxx-2" />
        <severity value="error" />
        <human value="The catalog system must be supported by CentraXX. The system url must start with 'urn:centraxx:CodeSystem/&lt;catalog&gt;' where &lt;catalog&gt; must be one of: IcdCatalog, OpsCatalog, Catalog, MasterDataCatalog, UsageEntry" />
        <expression value="system.startsWith('urn:centraxx:CodeSystem/IcdCatalog') or system.startsWith('urn:centraxx:CodeSystem/OpsCatalog') or system.startsWith('urn:centraxx:CodeSystem/Catalog') or system.startsWith('urn:centraxx:CodeSystem/MasterDataCatalog') or system.startsWith('urn:centraxx:CodeSystem/UsageEntry') or system.startsWith('urn:centraxx:CodeSystem/ValueList')" />
        <source value="https://fhir.centraxx.de/StructureDefinition/QuestionnaireResponse" />
      </constraint>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.system">
      <path value="QuestionnaireResponse.item.answer.value[x].system" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.version">
      <path value="QuestionnaireResponse.item.answer.value[x].version" />
      <min value="0" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.code">
      <path value="QuestionnaireResponse.item.answer.value[x].code" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueDate" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="date" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDate.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueDateTime" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="dateTime" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueQuantity" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Quantity" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.value">
      <path value="QuestionnaireResponse.item.answer.value[x].value" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity.unit">
      <path value="QuestionnaireResponse.item.answer.value[x].unit" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueString" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueString.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueTime" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="time" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueTime.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri">
      <path value="QuestionnaireResponse.item.answer.value[x]" />
      <sliceName value="valueUri" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="uri" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri.extension">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="closed" />
      </slicing>
      <min value="0" />
      <max value="2" />
      <type>
        <code value="Extension" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri.extension:lowerValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="lowerValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/lowerValue" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]:valueUri.extension:upperValue">
      <path value="QuestionnaireResponse.item.answer.value[x].extension" />
      <sliceName value="upperValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.centraxx.de/extension/laborValue/upperValue" />
      </type>
      <mustSupport value="true" />
    </element>
  </differential>
</StructureDefinition>