API Name: put-screening

This API creates the Project Silver Screen (PSS) questionnaire response.

Specification

Endpoint	[baseurl]/QuestionnaireResponse/$put-screening
Protocol	HTTPS
HTTP Method	Post
HTTP Header	Content-Type: application/fhir+json

Request Body

Remarks:

(All Slices) is an automatically generated section and should be ignored. Do not pass this as an input parameter. It will also not be part of response.

QuestionnaireResponse

QuestionnaireResponse	C		QuestionnaireResponse	There are no (further) constraints on this element Element id QuestionnaireResponse Short description A structured set of questions and their answers Alternate names Form, QuestionnaireAnswers Definition 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. Comments 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. Data type QuestionnaireResponse Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().ofType(canonical) \| %resource.descendants().ofType(uri) \| %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity, Role, or Act,Observation[moodCode=EVN] workflow: Event w5: infrastructure.information
id	Σ	0..1	id	There are no (further) constraints on this element Element id QuestionnaireResponse.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id QuestionnaireResponse.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id QuestionnaireResponse.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id QuestionnaireResponse.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text	C	0..1	Narrative	There are no (further) constraints on this element Element id QuestionnaireResponse.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: dom-6 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained	C	0..*	Resource	There are no (further) constraints on this element Element id QuestionnaireResponse.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Data type Resource Conditions The cardinality or value of this element may be affected by these constraints: dom-2, dom-4, dom-3, dom-5 Mappings rim: N/A
extension	C	0..*	Extension	Element id QuestionnaireResponse.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
code	C	0..1	Extension(Coding)	Element id QuestionnaireResponse.extension:code Short description identify the assessment type Alternate names extensions, user content Definition identify the assessment type Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Coding) Extension URL https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentType Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a,N/A
id		0..1	id	There are no (further) constraints on this element Element id QuestionnaireResponse.extension:code.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.extension:code.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id QuestionnaireResponse.extension:code.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentType Mappings rim: N/A
value[x]	C	1..1	Binding	Element id QuestionnaireResponse.extension:code.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding AssessmentTypeValueSet (required) Conditions The cardinality or value of this element may be affected by these constraints: ext-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCoding			Coding	There are no (further) constraints on this element Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id QuestionnaireResponse.extension:code.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.extension:code.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id QuestionnaireResponse.extension:code.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/assessment-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.extension:code.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	Element id QuestionnaireResponse.extension:code.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples Project Silver Screen pss-screen Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.extension:code.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.extension:code.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	1..1	Identifier	There are no (further) constraints on this element Element id QuestionnaireResponse.identifier Short description Business identifier for this set of answers Definition Business identifiers assigned to this questionnaire response by the performer and/or other systems. These identifiers remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the questionnaire response as it is known by various participating systems and in a way that remains consistent across servers. Comments Note: This is a business identifier, not a resource identifier (see discussion). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id
basedOn	Σ	0..0	Reference(CarePlan \| ServiceRequest)	There are no (further) constraints on this element Element id QuestionnaireResponse.basedOn Short description Request fulfilled by this QuestionnaireResponse Alternate names order Definition A plan, proposal or order that is fulfilled in whole or in part by this questionnaire response. For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression. Requirements Supports traceability of responsibility for the questionnaire response and allows linkage of the response to the proposals/recommendations acted upon. Data type Reference(CarePlan \| ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target
partOf	Σ	0..0	Reference(Observation \| Procedure)	There are no (further) constraints on this element Element id QuestionnaireResponse.partOf Short description Part of referenced event Definition 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. Comments Not to be used to link an questionnaire response to an Encounter - use 'context' for that. Composition of questionnaire responses will be handled using the Assemble operation defined in the SDC IG. For relationships to referrals, and other types of requests, use basedOn. Data type Reference(Observation \| Procedure) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf rim: .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
questionnaire	Σ	1..1	canonical(Questionnaire)	There are no (further) constraints on this element Element id QuestionnaireResponse.questionnaire Short description Canonical URL of Questionnaire being answered Alternate names Form Definition The Questionnaire that defines and organizes the questions for which answers are being provided. Requirements Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form. Comments If a QuestionnaireResponse references a Questionnaire that can be resolved, 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.). It is possible to have a QuestionnaireResponse whose 'questionnaire' element does not resolve. It is also possible for the questionnaire element to not have a value but only extensions (e.g. conveying the title or identifier for the questionnaire). This may happen for legacy data. If there is no formally defined Questionnaire, it is undefined what the 'correct' values for the linkId elements should be and it is possible that linkIds might be inconsistent for QuestionnaireResponses for the same form if captured by distinct systems. Data type canonical(Questionnaire) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: ./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id QuestionnaireResponse.status Short description in-progress \| completed \| amended \| entered-in-error \| stopped Definition The current state of the questionnaire response. Requirements The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished. Comments Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. Data type code Binding Lifecycle status of the questionnaire response. QuestionnaireResponseStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status rim: .statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish "in-progress" from "published)
subject	Σ	1..1	Reference(Patient)	Element id QuestionnaireResponse.subject Short description The subject of the questions Alternate names Patient, Focus Definition 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. Requirements Links the questionnaire response to the Patient context. May also affect access control. Comments If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. Data type Reference(Patient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=SBJ].role
encounter	Σ	0..1	Reference(Encounter)	Element id QuestionnaireResponse.encounter Short description Encounter the questionnaire response is part of Definition The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated. Requirements Links the questionnaire response to the Encounter context. May also affect access control. Comments This will typically be the encounter the questionnaire response was created during, but some questionnaire responses may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission forms). A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.encounter w5: FiveWs.context rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
authored	Σ	1..1	dateTime	There are no (further) constraints on this element Element id QuestionnaireResponse.authored Short description Date the answers were gathered Alternate names Date Created, Date published, Date Issued, Date updated Definition The date and/or time that this questionnaire response was last modified by the user - e.g. changing answers or revising status. Requirements Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers. Comments 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. This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.recorded w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
author	Σ	0..0	Reference(Practitioner \| Patient \| Organization)	Element id QuestionnaireResponse.author Short description The individual or device that received and recorded the answers Alternate names Laboratory, Service, Practitioner, Department, Company, Performer Definition The individual or device that received the answers to the questions in the QuestionnaireResponse and recorded them in the system. Requirements Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers. Comments 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. Device should only be used if it directly determined the answers, not if it was merely used as a capture tool to record answers provided by others. In the latter case, information about the physical device, software, etc. would be captured using Provenance. Data type Reference(Practitioner \| Patient \| Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.actor w5: FiveWs.author rim: .participation[typeCode=AUT].role
source	Σ	0..0	Reference(Patient \| Practitioner \| Organization)	Element id QuestionnaireResponse.source Short description The individual or device that answered the questions Definition The individual or device that answered the questions about the subject. Requirements When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions. Comments If not specified, no inference can be made about who provided the data. Device should only be used if it directly determined the answers, not if it was merely used as a capture tool to record answers provided by others. In the latter case, information about the physical device, software, etc. would be captured using Provenance. Data type Reference(Patient \| Practitioner \| Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.source rim: .participation[typeCode=INF].role
item	C	1..*	BackboneElement	There are no (further) constraints on this element Element id QuestionnaireResponse.item Short description Groups and questions Definition A group or question item from the original questionnaire for which answers are provided. Comments 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).\nWhen dealing with repeating items, each group repetition will be handled by a separate item. However, repeating questions are handled with a single question item and potentially multiple answers. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qrs-1: Item cannot contain both item and answer `(answer.exists() and item.exists()).not()` qrs-2: Repeated answers are combined in the answers array of a single item `repeat(answer\|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
id		0..0	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	Element id QuestionnaireResponse.item.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
assessmentItemType	C	0..1	Extension(Coding)	Element id QuestionnaireResponse.item.extension:assessmentItemType Short description Identify the assessment item type Alternate names extensions, user content Definition Identify the assessment item type Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Coding) Extension URL https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: n/a,N/A
id		0..0	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:assessmentItemType.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:assessmentItemType.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:assessmentItemType.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType Mappings rim: N/A
value[x]	C	1..1	Binding	Element id QuestionnaireResponse.item.extension:assessmentItemType.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding AssessmentItemTypeValueSet (required) Conditions The cardinality or value of this element may be affected by these constraints: ext-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCoding			Coding	There are no (further) constraints on this element Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:assessmentItemType.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:assessmentItemType.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id QuestionnaireResponse.item.extension:assessmentItemType.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/assessment-item-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:assessmentItemType.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	Element id QuestionnaireResponse.item.extension:assessmentItemType.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples Oral Screening oral Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:assessmentItemType.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:assessmentItemType.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
testType	C	0..1	Extension(Coding)	Element id QuestionnaireResponse.item.extension:testType Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Coding) Extension URL https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: n/a,N/A
id		0..0	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:testType.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:testType.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:testType.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType Mappings rim: N/A
value[x]	C	1..1	Binding	Element id QuestionnaireResponse.item.extension:testType.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding TestTypeValueSet (required) Conditions The cardinality or value of this element may be affected by these constraints: ext-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCoding			Coding	There are no (further) constraints on this element Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:testType.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:testType.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id QuestionnaireResponse.item.extension:testType.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/test-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:testType.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:testType.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:testType.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension:testType.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
linkId	C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.linkId Short description Pointer to specific item from Questionnaire Definition The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource. Requirements Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier. Data type string Conditions The cardinality or value of this element may be affected by these constraints: qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id
definition		0..0	uri	There are no (further) constraints on this element Element id QuestionnaireResponse.item.definition Short description ElementDefinition - details for the item Definition A reference to an ElementDefinition that provides the details for the item. Requirements 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. Comments The ElementDefinition must be in a StructureDefinition, 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]. There is no need for this element if the item pointed to by the linkId has a definition listed. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code
text		1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.text Short description Name for group or question text Definition Text that is displayed above the contents of the group or as the text of the question being answered. Requirements Allows the questionnaire response to be read without access to the questionnaire. Comments The text for an item SHOULD be identical to the text from the corresponding Questionnaire.item. This can't be strictly enforced because it's possible for the Questionnaire to be updated subsequent to the QuestionnaireResponse having been created, however the intention is that the text in the QuestionnaireResponse reflects what the user saw when completing the Questionnaire. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .text
answer	C	1..*	BackboneElement	Element id QuestionnaireResponse.item.answer Short description The response(s) to the question Definition The respondent's answer(s) to the question. Comments The value is nested because we cannot have a repeating structure that has variable type. Data type BackboneElement Slicing Unordered, Open, by $this(Value) Conditions The cardinality or value of this element may be affected by these constraints: qrs-1, qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .value[type=LIST_ANY]
(All Slices)				The requirements in this element apply to all slices
id		0..0	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]	C	1..1		There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.value[x] Short description Single-valued answer to the question Definition The answer (or one of the answers) provided by the respondent to the question. Requirements Ability to retain a single-valued answer to a question. Comments 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. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse SHOULD match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) SHALL NOT pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc.). Systems MAY enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match. Binding Binding this is problematic because one value set can't apply to both codes and quantities. QuestionnaireAnswerCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item
valueString			string	Data type string
valueCoding			Coding	Data type Coding
item		0..0	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.item Short description Child items of question Definition Nested groups and/or questions found within this particular answer. Requirements It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Comments Only used when nesting beneath a question - see item.item for nesting beneath groups Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
answerYesNo	C	1..*	BackboneElement	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo Short description The response(s) to the question Definition The respondent's answer(s) to the question. Comments The value is nested because we cannot have a repeating structure that has variable type. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: qrs-1, qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .value[type=LIST_ANY]
id		0..0	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]	C	1..1	Binding	Element id QuestionnaireResponse.item.answer:answerYesNo.value[x] Short description Single-valued answer to the question Definition The answer (or one of the answers) provided by the respondent to the question. Requirements Ability to retain a single-valued answer to a question. Comments 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. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse SHOULD match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) SHALL NOT pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc.). Systems MAY enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match. Binding Binding this is problematic because one value set can't apply to both codes and quantities. AssessmentAnswerTypeCodeSystem (required) Conditions The cardinality or value of this element may be affected by these constraints: qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item
valueCoding			Coding	Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id QuestionnaireResponse.item.answer:answerYesNo.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/assessment-answer-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
item		0..0	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerYesNo.item Short description Child items of question Definition Nested groups and/or questions found within this particular answer. Requirements It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Comments Only used when nesting beneath a question - see item.item for nesting beneath groups Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
answerPassRefer	C	1..*	BackboneElement	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer Short description The response(s) to the question Definition The respondent's answer(s) to the question. Comments The value is nested because we cannot have a repeating structure that has variable type. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: qrs-1, qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .value[type=LIST_ANY]
id		0..0	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]	C	1..1		There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.value[x] Short description Single-valued answer to the question Definition The answer (or one of the answers) provided by the respondent to the question. Requirements Ability to retain a single-valued answer to a question. Comments 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. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse SHOULD match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) SHALL NOT pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc.). Systems MAY enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match. Binding Binding this is problematic because one value set can't apply to both codes and quantities. QuestionnaireAnswerCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item
valueCoding			Coding	Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id QuestionnaireResponse.item.answer:answerPassRefer.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/assessment-answer-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
item		0..0	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerPassRefer.item Short description Child items of question Definition Nested groups and/or questions found within this particular answer. Requirements It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Comments Only used when nesting beneath a question - see item.item for nesting beneath groups Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
answerVisualTest	C	1..*	BackboneElement	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest Short description The response(s) to the question Definition The respondent's answer(s) to the question. Comments The value is nested because we cannot have a repeating structure that has variable type. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: qrs-1, qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .value[type=LIST_ANY]
id		0..0	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]	C	1..1	Binding	Element id QuestionnaireResponse.item.answer:answerVisualTest.value[x] Short description Single-valued answer to the question Definition The answer (or one of the answers) provided by the respondent to the question. Requirements Ability to retain a single-valued answer to a question. Comments 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. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse SHOULD match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) SHALL NOT pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc.). Systems MAY enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match. Binding Binding this is problematic because one value set can't apply to both codes and quantities. TestVisualCodeValueSet (required) Conditions The cardinality or value of this element may be affected by these constraints: qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item
valueCoding			Coding	Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id QuestionnaireResponse.item.answer:answerVisualTest.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value http://loinc.org Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
item		0..0	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerVisualTest.item Short description Child items of question Definition Nested groups and/or questions found within this particular answer. Requirements It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Comments Only used when nesting beneath a question - see item.item for nesting beneath groups Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
answerHearingTest	C	1..*	BackboneElement	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest Short description The response(s) to the question Definition The respondent's answer(s) to the question. Comments The value is nested because we cannot have a repeating structure that has variable type. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: qrs-1, qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .value[type=LIST_ANY]
id		0..0	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]	C	1..1	Binding	Element id QuestionnaireResponse.item.answer:answerHearingTest.value[x] Short description Single-valued answer to the question Definition The answer (or one of the answers) provided by the respondent to the question. Requirements Ability to retain a single-valued answer to a question. Comments 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. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse SHOULD match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) SHALL NOT pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc.). Systems MAY enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match. Binding Binding this is problematic because one value set can't apply to both codes and quantities. TestHearingCodeValueSet (required) Conditions The cardinality or value of this element may be affected by these constraints: qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item
valueCoding			Coding	Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id QuestionnaireResponse.item.answer:answerHearingTest.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value http://loinc.org Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
item		0..0	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerHearingTest.item Short description Child items of question Definition Nested groups and/or questions found within this particular answer. Requirements It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Comments Only used when nesting beneath a question - see item.item for nesting beneath groups Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
answerOralTestDenture	C	1..*	BackboneElement	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture Short description The response(s) to the question Definition The respondent's answer(s) to the question. Comments The value is nested because we cannot have a repeating structure that has variable type. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: qrs-1, qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .value[type=LIST_ANY]
id		0..0	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]	C	1..1	Binding	Element id QuestionnaireResponse.item.answer:answerOralTestDenture.value[x] Short description Single-valued answer to the question Definition The answer (or one of the answers) provided by the respondent to the question. Requirements Ability to retain a single-valued answer to a question. Comments 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. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse SHOULD match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) SHALL NOT pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc.). Systems MAY enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match. Binding Binding this is problematic because one value set can't apply to both codes and quantities. PlacementOfDentureValueSet (required) Conditions The cardinality or value of this element may be affected by these constraints: qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item
valueCoding			Coding	Data type Coding
id		0..1	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id QuestionnaireResponse.item.answer:answerOralTestDenture.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/placement-of-denture Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
item		0..0	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestDenture.item Short description Child items of question Definition Nested groups and/or questions found within this particular answer. Requirements It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Comments Only used when nesting beneath a question - see item.item for nesting beneath groups Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
answerOralTestOHATStatus	C	1..*	BackboneElement	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus Short description The response(s) to the question Definition The respondent's answer(s) to the question. Comments The value is nested because we cannot have a repeating structure that has variable type. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: qrs-1, qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .value[type=LIST_ANY]
id		0..0	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]	C	1..1	Binding	Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.value[x] Short description Single-valued answer to the question Definition The answer (or one of the answers) provided by the respondent to the question. Requirements Ability to retain a single-valued answer to a question. Comments 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. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse SHOULD match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) SHALL NOT pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc.). Systems MAY enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match. Binding Binding this is problematic because one value set can't apply to both codes and quantities. OHATStatusValueSet (required) Conditions The cardinality or value of this element may be affected by these constraints: qrs-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item
valueCoding			Coding	Data type Coding
id		0..1	id	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/ohat-status Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
item		0..0	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer:answerOralTestOHATStatus.item Short description Child items of question Definition Nested groups and/or questions found within this particular answer. Requirements It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Comments Only used when nesting beneath a question - see item.item for nesting beneath groups Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
item		0..0	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.item Short description Child items of group item Definition Sub-questions, sub-groups or display items nested beneath a group. Requirements Reports can consist of complex nested groups. Comments Only used when nesting beneath a group - see item.answer.item for nesting beneath questions Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]

{

"resourceType": "QuestionnaireResponse",

"questionnaire": "https://fhir.synapxe.sg/Questionnaire/pss-screen",

"status": "completed",

"identifier": [

{

"system": "https://fhir.synapxe.sg/NamingSystem/questionnaireResponseId",

"value": "QR-00001"

}

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-type",
"code": "pss-screen",
"display": "Project Silver Screen"

}

"subject": {

"reference": "Patient/54321"

"encounter": {

"reference": "Encounter/12345"

"authored": "2025-09-16T10:00:00+08:00",

"item": [

{

"linkId": "1",

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "oral",
"display": "Oral Screening"

}

"item": [

{

"linkId": "1.1",

"text": "Are there any oral health issues?",

"answer": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "N",
"display": "No"

}

]

}

]

{

"linkId": "2",

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "vision",
"display": "Vision Screening"

}

"item": [

{

"linkId": "2.1",

"text": "Snellen Test Result",

"answer": [

{

"valueCoding": {

"system": "http://loinc.org",
"code": "6-6",
"display": "6/6"

}

]

}

]

{

"linkId": "3",

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "hearing",
"display": "Hearing Screening"

}

"item": [

{

"linkId": "3.1",

"text": "Is the participant wearing hearing aids?",

"answer": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "no",
"display": "No"

}

]

{

"linkId": "3.3",

"text": "Proceed with hearing screening?",

"answer": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "yes",
"display": "Yes"

}

]

{

"linkId": "3.4",

"text": "Visual Examination (Left Ear)",

"answer": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "pass",
"display": "Pass"

}

]

{

"linkId": "3.5",

"text": "Pure Tone Test Result (Left Ear)",

"answer": [

{

"valueCoding": {

"system": "http://loinc.org",
"code": "0-25",
"display": "0-25 dB"

}

]

}

]

}

]

}

{

"resourceType": "QuestionnaireResponse",

"questionnaire": "https://fhir.synapxe.sg/Questionnaire/pss-screen",

"status": "completed",

"identifier": [

{

"system": "https://fhir.synapxe.sg/NamingSystem/questionnaireResponseId",

"value": "QR-00001"

}

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-type",
"code": "pss-screen",
"display": "Project Silver Screen"

}

"subject": {

"reference": "Patient/54321"

"encounter": {

"reference": "Encounter/12345"

"authored": "2025-09-16T10:00:00+08:00",

"item": [

{

"linkId": "1.1",

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "oral",
"display": "Oral Screening"

}

"text": "Are there any oral health issues?",

"answer": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "no",
"display": "No"

}

]

{

"linkId": "2.1",

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "vision",
"display": "Vision Screening"

}

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/test-type",
"code": "snellen-test-right-eye",
"display": "Snellen Test (Right Eye)"

}

"text": "Snellen Test Result",

"answer": [

{

"valueCoding": {

"system": "http://loinc.org",
"code": "6-6",
"display": "6/6"

}

]

{

"linkId": "3.1",

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "hearing",
"display": "Hearing Screening"

}

"text": "Is the participant wearing hearing aids?",

"answer": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "no",
"display": "No"

}

]

{

"linkId": "3.3",

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "hearing",
"display": "Hearing Screening"

}

"text": "Proceed with hearing screening?",

"answer": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "yes",
"display": "Yes"

}

]

{

"linkId": "3.4",

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "hearing",
"display": "Hearing Screening"

}

"text": "Visual Examination (Left Ear)",

"answer": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "pass",
"display": "Pass"

}

]

{

"linkId": "3.5",

"extension": [

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "hearing",
"display": "Hearing Screening"

}

{

"url": "https://fhir.synapxe.sg/StructureDefinition/ExtensionAssessmentItemType",

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/test-type",
"code": "pure-tone-test-left-ear",
"display": "Pure Tone Test (Left Ear)"

}

"text": "Pure Tone Test Result (Left Ear)",

"answer": [

{

"valueCoding": {

"system": "http://loinc.org",
"code": "0-25",
"display": "0-25 dB"

}

]

}

]

}

Terminologies

Path	Binding Strength	Value Set (Code System)
QuestionnaireResponse.extension.value[x]	required	https://fhir.synapxe.sg/ValueSet/assessment-type
QuestionnaireResponse.item.extension.value[x]	required	https://fhir.synapxe.sg/ValueSet/assessment-item-type
QuestionnaireResponse.item.extension.value[x]	required	https://fhir.synapxe.sg/ValueSet/test-type
QuestionnaireResponse.item.answer.value[x]	required	https://fhir.synapxe.sg/CodeSystem/assessment-answer-type
QuestionnaireResponse.item.answer.value[x]	required	https://fhir.synapxe.sg/ValueSet/test-visual-code
QuestionnaireResponse.item.answer.value[x]	required	https://fhir.synapxe.sg/ValueSet/test-hearing-code
QuestionnaireResponse.item.answer.value[x]	required	https://fhir.synapxe.sg/ValueSet/placement-of-denture
QuestionnaireResponse.item.answer.value[x]	required	https://fhir.synapxe.sg/ValueSet/ohat-status

Questionnaire	C		Questionnaire	There are no (further) constraints on this element Element id Questionnaire Short description A structured set of questions Alternate names Form, CRF, Survey Definition A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection. Data type Questionnaire Constraints cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation `name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')` que-2: The link ids for groups and questions must be unique within the questionnaire `descendants().linkId.isDistinct()` Mappings w5: conformance.behavior,infrastructure.information workflow: Definition rim: Observation[moodCode=DEF]
id	Σ	0..1	id	There are no (further) constraints on this element Element id Questionnaire.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Questionnaire.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Questionnaire.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Questionnaire.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding IETF language tag for a human language AllLanguages (required) Additional bindings CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text	C	0..1	Narrative	There are no (further) constraints on this element Element id Questionnaire.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Conditions The cardinality or value of this element may be affected by these constraints: dom-6 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained	C	0..*	Resource	There are no (further) constraints on this element Element id Questionnaire.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Data type Resource Conditions The cardinality or value of this element may be affected by these constraints: dom-2, dom-4, dom-3, dom-5 Mappings rim: N/A
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Questionnaire.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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 managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	Σ ?! C	0..*	Extension	There are no (further) constraints on this element Element id Questionnaire.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
url	Σ C	1..1	uri	There are no (further) constraints on this element Element id Questionnaire.url Short description Canonical identifier for this questionnaire, represented as an absolute URI (globally unique) Definition An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers. Requirements Allows the questionnaire to be referenced by a single globally unique identifier. This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for. Comments Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions. In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found. The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension. Data type uri Constraints cnl-1: URL should not contain \| or # - these characters make processing canonical references problematic `exists() implies matches('^[^\|# ]+$')` ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.url w5: FiveWs.identifier rim: .identifier[scope=BUSN;reliability=ISS]
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Questionnaire.identifier Short description Business identifier for questionnaire Definition A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance. Requirements Allows externally provided and/or usable business identifiers to be easily associated with the questionnaire. Comments Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this questionnaire outside of FHIR, where it is not possible to use the logical URI. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.identifier w5: FiveWs.identifier rim: .identifier objimpl: no-gen-base
version	Σ	1..1	string	There are no (further) constraints on this element Element id Questionnaire.version Short description Business version of the questionnaire Definition The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. Comments There may be different questionnaires that have the same url but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format. The version SHOULD NOT contain a '#' - see Business Version. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.version w5: FiveWs.version rim: N/A (to add?)
versionAlgorithm[x]	Σ	0..1	Binding	There are no (further) constraints on this element Element id Questionnaire.versionAlgorithm[x] Short description How to compare versions Definition Indicates the mechanism used to compare versions to determine which is more current. Comments If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined. Binding VersionAlgorithm (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.versionAlgorithm
versionAlgorithmString			string	There are no (further) constraints on this element Data type string
versionAlgorithmCoding			Coding	There are no (further) constraints on this element Data type Coding
name	Σ C	0..1	string	There are no (further) constraints on this element Element id Questionnaire.name Short description Name for this questionnaire (computer friendly) Definition A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation. Requirements Supports code generation. Comments The name is not expected to be globally unique. The name should be a simple alphanumeric type no-whitespace name to ensure that it is machine-processing friendly. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cnl-0 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.name rim: N/A
title	Σ	1..1	string	There are no (further) constraints on this element Element id Questionnaire.title Short description Name for this questionnaire (human friendly) Definition A short, descriptive, user-friendly title for the questionnaire. Comments This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.title rim: .title
derivedFrom	Σ	0..*	canonical(Questionnaire)	There are no (further) constraints on this element Element id Questionnaire.derivedFrom Short description Based on Questionnaire Definition The URL of a Questionnaire that this Questionnaire is based on. Requirements Allows a Questionnaire to be created based on another Questionnaire. Comments This element covers a broad range of relationships, from 'somewhat inspired by' to 'fully compliant with'. There is a standard extensionthat allows clearer differentiation between the specifics of the derivation relationship where this is needed - e.g. to determine substitutability and validation expectations - http://hl7.org/fhir/StructureDefinition/questionnaire-derivationType. Data type canonical(Questionnaire) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.derivedFromCanonical rim: .outboundRelationship[typeCode=DRIV].target[classCode=OBS, moodCode=DEFN]
status	Σ ?! C	1..1	codeBinding	There are no (further) constraints on this element Element id Questionnaire.status Short description draft \| active \| retired \| unknown Definition The current state of this questionnaire. Requirements Enables tracking the lifecycle of the content and filtering of questionnaires that are appropriate for use versus not. Comments A nominal state-transition diagram can be found in the] documentation Unknown does not represent 'other' - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. See guidance around (not) making local changes to elements here. Data type code Binding The lifecycle status of an artifact. PublicationStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: que-1a Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.status w5: FiveWs.status rim: .status
experimental	Σ	0..1	boolean	There are no (further) constraints on this element Element id Questionnaire.experimental Short description For testing purposes, not real usage Definition A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended for genuine usage. Requirements Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire. Comments Allows filtering of questionnaires that are appropriate for use versus not. Meaning when missing If absent, this resource is treated as though it is not experimental. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.experimental w5: FiveWs.class rim: N/A
subjectType	Σ	0..0	codeBinding	There are no (further) constraints on this element Element id Questionnaire.subjectType Short description Resource that can be subject of QuestionnaireResponse Definition The types of subjects that can be the subject of responses created for the questionnaire. Requirements Allows enforcing that a QuestionnaireResponse only has a .subject element of the appropriate type. Comments If none are specified, then the subject is unlimited. Data type code Binding One of the resource types defined as part of this version of FHIR. ResourceType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.subject[x] rim: .outboundRelationship[typeCode=META].target[classCode=OBS, moodCode=DEFN, isCriterion=true].participation.role.classCode w5: FiveWs.who
date	Σ	0..0	dateTime	There are no (further) constraints on this element Element id Questionnaire.date Short description Date last changed Alternate names Revision Date Definition The date (and optionally time) when the questionnaire was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes. Comments The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource. See guidance around (not) making local changes to elements here. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.date w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
publisher	Σ	0..0	string	There are no (further) constraints on this element Element id Questionnaire.publisher Short description Name of the publisher/steward (organization or individual) Definition The name of the organization or individual responsible for the release and ongoing maintenance of the questionnaire. Requirements Helps establish the "authority/credibility" of the questionnaire. May also allow for contact. Comments Usually an organization but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.publisher w5: FiveWs.author rim: .participation[typeCode=AUT].role
contact	Σ	0..0	ContactDetail	There are no (further) constraints on this element Element id Questionnaire.contact Short description Contact details for the publisher Definition Contact details to assist a user in finding and communicating with the publisher. Comments May be a web site, an email address, a telephone number, etc. See guidance around (not) making local changes to elements here. Data type ContactDetail Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.contact rim: .participation[typeCode=CALLBCK].role
description	Σ	0..0	markdown	There are no (further) constraints on this element Element id Questionnaire.description Short description Natural language description of the questionnaire Definition A free text natural language description of the questionnaire from a consumer's perspective. Comments This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context. (E.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created). Data type markdown Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.description rim: .text
useContext	Σ	0..0	UsageContext	There are no (further) constraints on this element Element id Questionnaire.useContext Short description The context that the content is intended to support Definition The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate questionnaires. Requirements Assist in searching for appropriate content. Comments When multiple useContexts are specified, there is no expectation that all or even any of the contexts apply. Data type UsageContext Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.useContext rim: N/A (to add?)
jurisdiction	Σ	0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Questionnaire.jurisdiction Short description Intended jurisdiction for questionnaire (if applicable) Definition A legal or geographic region in which the questionnaire is intended to be used. Comments It may be possible for the questionnaire to be used in jurisdictions other than those for which it was originally designed or intended. DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.) Data type CodeableConcept Binding Countries and regions within which this artifact is targeted for use. JurisdictionValueSet (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.jurisdiction rim: N/A (to add?)
purpose		0..0	markdown	There are no (further) constraints on this element Element id Questionnaire.purpose Short description Why this questionnaire is defined Definition Explanation of why this questionnaire is needed and why it has been designed as it has. Comments This element does not describe the usage of the questionnaire. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this questionnaire. Data type markdown Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.purpose w5: FiveWs.why[x] rim: .reasonCode.text objimpl: no-gen-base
copyright		0..0	markdown	There are no (further) constraints on this element Element id Questionnaire.copyright Short description Use and/or publishing restrictions Alternate names License, Restrictions Definition A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire. Requirements Consumers of the questionnaire must be able to determine any legal restrictions on the use of the artifact and/or its content. Data type markdown Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.copyright rim: N/A (to add?) objimpl: no-gen-base
copyrightLabel		0..0	string	There are no (further) constraints on this element Element id Questionnaire.copyrightLabel Short description Copyright holder and year(s) Definition A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved'). Requirements Defines the content expected to be rendered in all representations of the artifact. Comments The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.copyrightLabel
approvalDate		0..0	date	There are no (further) constraints on this element Element id Questionnaire.approvalDate Short description When the questionnaire was approved by publisher Definition The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage. Comments The 'date' element may be more recent than the approval date because of minor changes or editorial corrections. See guidance around (not) making local changes to elements here. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.approvalDate rim: .outboundRelationship[typeCode="SUBJ"].act[classCode=CACT;moodCode=EVN;code="approval"].effectiveTime objimpl: no-gen-base
lastReviewDate		0..0	date	There are no (further) constraints on this element Element id Questionnaire.lastReviewDate Short description When the questionnaire was last reviewed by the publisher Definition The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date. Requirements Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant. Comments If specified, this date follows the original approval date. See guidance around (not) making local changes to elements here. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.lastReviewDate rim: .outboundRelationship[typeCode="SUBJ"; subsetCode="RECENT"].act[classCode=CACT;moodCode=EVN;code="review"].effectiveTime objimpl: no-gen-base
effectivePeriod	Σ	1..1	Period	There are no (further) constraints on this element Element id Questionnaire.effectivePeriod Short description When the questionnaire is expected to be used Definition The period during which the questionnaire content was or is planned to be in active use. Requirements Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the questionnaire are or are expected to be used instead. Comments The effective period for a questionnaire determines when the content is applicable for usage and is independent of publication and review dates. For example, a questionnaire intended to be used for the year 2016 might be published in 2015. See guidance around (not) making local changes to elements here. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.effectivePeriod rim: N/A (to add?) objimpl: no-gen-base
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.effectivePeriod.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.effectivePeriod.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
start	Σ C	1..1	dateTime	There are no (further) constraints on this element Element id Questionnaire.effectivePeriod.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: per-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low
end	Σ C	1..1	dateTime	There are no (further) constraints on this element Element id Questionnaire.effectivePeriod.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Conditions The cardinality or value of this element may be affected by these constraints: per-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high
code	Σ	0..1	CodingBinding	Element id Questionnaire.code Short description Concept that represents the overall questionnaire Definition An identifier for this collection of questions in a particular terminology such as LOINC. Requirements Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code. Data type Coding Binding Codes for questionnaires, groups and individual questions. AssessmentTypeValueSet (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Definition.code rim: .code
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.code.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.code.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.code.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/assessment-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.code.version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	Element id Questionnaire.code.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples Project Silver Screen pss-screen Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.code.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.code.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
item	C	1..*	BackboneElement	There are no (further) constraints on this element Element id Questionnaire.item Short description Questions and sections within the Questionnaire Definition A particular question, question grouping or display text that is part of the questionnaire. Comments The content of the questionnaire is constructed from an ordered, hierarchical collection of items. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` que-1a: Group items must have nested items when Questionanire is complete `(type='group' and %resource.status='complete') implies item.empty().not()` que-1b: Groups should have items `type='group' implies item.empty().not()` que-1c: Display items cannot have child items `type='display' implies item.empty()` que-3: Display items cannot have a "code" asserted `type!='display' or code.empty()` que-4: A question cannot have both answerOption and answerValueSet `answerOption.empty() or answerValueSet.empty()` que-5: Only coding, decimal, integer, date, dateTime, time, string or quantity items can have answerOption or answerValueSet `(type='coding' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty())` que-6: Required and repeat aren't permitted for display items `type!='display' or (required.empty() and repeats.empty())` que-8: Initial values can't be specified for groups or display items `(type!='group' and type!='display') or initial.empty()` que-9: Read-only can't be specified for "display" items `type!='display' or readOnly.empty()` que-10: Maximum length can only be declared for simple question types `(type in ('boolean' \| 'decimal' \| 'integer' \| 'string' \| 'text' \| 'url')) or answerConstraint='optionOrString' or maxLength.empty()` que-11: If one or more answerOption is present, initial cannot be present. Use answerOption.initialSelected instead `answerOption.empty() or initial.empty()` que-12: If there are more than one enableWhen, enableBehavior must be specified `enableWhen.count() > 1 implies enableBehavior.exists()` que-13: Can only have multiple initial values for repeating items `repeats=true or initial.count() <= 1` que-14: Can only have answerConstraint if answerOption or answerValueSet are present. (This is a warning because extensions may serve the same purpose) `answerConstraint.exists() implies answerOption.exists() or answerValueSet.exists()` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=DEF]
id		0..0	string	There are no (further) constraints on this element Element id Questionnaire.item.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
linkId	C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.linkId Short description Unique id for item in questionnaire Definition An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource. Requirements QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient. Comments This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here. LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such Data type string Conditions The cardinality or value of this element may be affected by these constraints: que-2 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` que-15: Link ids should be 255 characters or less `$this.length() <= 255` Mappings rim: .id
definition		0..0	uri	There are no (further) constraints on this element Element id Questionnaire.item.definition Short description ElementDefinition - details for the item Definition This element is a URI that refers to an ElementDefinition or to an ObservationDefinition that provides information about this item, including information that might otherwise be included in the instance of the Questionnaire resource. A detailed description of the construction of the URI is shown in Comments, below. Requirements A common pattern is to define a set of data elements and then build multiple questionnaires for different circumstances to gather the data. This element provides traceability to the common definition and allows the content for the question to come from the underlying definition. Comments The uri refers to an ElementDefinition in a StructureDefinition or to an ObservationDefinition and always starts with the canonical URL for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id Element.id. E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment identifier, the first/root element definition in the target is the matching element definition. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=INST].target[classCode=OBS, moodCode=DEF]
code	C	0..*	CodingBinding	Element id Questionnaire.item.code Short description Corresponding concept for this item in a terminology Definition A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers). Requirements Allows linking of groups of questions to formal terminologies. Comments The value may come from the ElementDefinition referred to by .definition. Data type Coding Slicing Unordered, Open, by $this(Value) Binding Codes for questionnaires, groups and individual questions. AssessmentItemTypeValueSet (required) Conditions The cardinality or value of this element may be affected by these constraints: que-3 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .code
(All Slices)				The requirements in this element apply to all slices
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.item.code.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.code.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.item.code.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/assessment-item-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.code.version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id Questionnaire.item.code.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.code.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.code.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
assessmentItemType	C	0..1	CodingBinding	Element id Questionnaire.item.code:assessmentItemType Short description Corresponding concept for this item in a terminology Definition A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers). Requirements Allows linking of groups of questions to formal terminologies. Comments The value may come from the ElementDefinition referred to by .definition. Data type Coding Binding Codes for questionnaires, groups and individual questions. AssessmentItemTypeCodeSystem (required) Conditions The cardinality or value of this element may be affected by these constraints: que-3 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .code
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.item.code:assessmentItemType.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.code:assessmentItemType.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.item.code:assessmentItemType.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/assessment-item-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.code:assessmentItemType.version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id Questionnaire.item.code:assessmentItemType.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.code:assessmentItemType.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.code:assessmentItemType.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
testType	C	0..1	CodingBinding	Element id Questionnaire.item.code:testType Short description Corresponding concept for this item in a terminology Definition A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers). Requirements Allows linking of groups of questions to formal terminologies. Comments The value may come from the ElementDefinition referred to by .definition. Data type Coding Binding observation codes for tests like Snellen, Pinhole, etc TestTypeValueSet (required) Conditions The cardinality or value of this element may be affected by these constraints: que-3 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .code
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.item.code:testType.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.code:testType.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.item.code:testType.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value http://loinc.org Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.code:testType.version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	Element id Questionnaire.item.code:testType.code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples Snellen Test (Right eye) snellen-test-right-eye Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.code:testType.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.code:testType.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
prefix		0..0	string	There are no (further) constraints on this element Element id Questionnaire.item.prefix Short description E.g. "1(a)", "2.5.3" Alternate names label Definition A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire. Requirements Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used. Comments These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically, these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Not supported
text		0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.text Short description Primary text for the item Definition The name of a section, the text of a question or text content for a display item. Comments When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading. Group item instructions should be included as a display type item within the group. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .text
type	C	1..1	codeBinding	There are no (further) constraints on this element Element id Questionnaire.item.type Short description group \| display \| boolean \| decimal \| integer \| date \| dateTime + Definition The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, Coding, etc.). Requirements Defines the format in which the user is to be prompted for the answer. Comments Additional constraints on the type of answer can be conveyed by extensions. The value may come from the ElementDefinition referred to by .definition. Data type code Binding Distinguishes groups from questions and display text and indicates data type for questions. QuestionnaireItemType (required) Conditions The cardinality or value of this element may be affected by these constraints: que-9, que-8, que-6, que-5, que-3, que-10, que-1a, que-1b, que-1c Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
enableWhen	?! C	0..1	BackboneElement	There are no (further) constraints on this element Element id Questionnaire.item.enableWhen Short description Only allow data when Definition A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true. Requirements Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions. Comments If multiple repetitions of this extension are present, the interpretation is driven by enableBehavior (either all repetitions must evaluate to true for this item to be enabled, or only one must evaluate to true for the item to be enabled). If the enableWhen.question has multiple answers, the condition evaluates to true if any of the answers for the referenced item match the enableWhen condition. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to. If enableWhen logic depends on an item that is disabled, the logic should proceed as though the item is not valued - even if a default value or other value might be retained in memory in the event of the item being re-enabled. In some cases, the comparison between the indicated answer and the specified value may differ only by precision. For example, the enableWhen might be Q1 > 1970, but the answer to Q1 is 1970-10-15. There is not a clear answer as to whether 1970-10-15 should be considered 'greater' than 1970, given that it is an imprecise value. In these indeterminate situations, the form filler has the option of refusing to render the form. If the form is displayed, items where enableWhen is indeterminate SHOULD be treated as enabled with a warning indicating that the questionnaire logic was faulty and it is possible that the item should not be enabled. Questionnaires SHOULD be designed to take into account challenges around varying precision to minimize non-deterministic situations by setting constraints around expected precision, etc. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: que-12 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` que-7: If the operator is 'exists', the value must be a boolean `operator = 'exists' implies (answer is boolean)` Mappings rim: N/A - MIF rather than RIM level
id		0..0	string	There are no (further) constraints on this element Element id Questionnaire.item.enableWhen.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.enableWhen.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.enableWhen.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
question		1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.enableWhen.question Short description The linkId of question that determines whether item is enabled/disabled Definition The linkId for the question whose answer (or lack of answer) governs whether this item is enabled. Comments If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the "ancestor" axis and then the "preceding" axis and then the "following" axis. If there are multiple items with the same linkId and all are equadistant (e.g. a question references a question that appears in a separate repeating group), that is an error. (Consider using the enableWhenExpression extension to define logic to handle such a situation.) Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
operator	C	1..1	codeBinding	There are no (further) constraints on this element Element id Questionnaire.item.enableWhen.operator Short description exists \| = \| != \| > \| < \| >= \| <= Definition Specifies the criteria by which the question is enabled. Data type code Binding The criteria by which a question is enabled. QuestionnaireItemOperator (required) Conditions The cardinality or value of this element may be affected by these constraints: que-7 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answer[x]	C	1..1		There are no (further) constraints on this element Element id Questionnaire.item.enableWhen.answer[x] Short description Value for question comparison based on operator Definition A value that the referenced question is tested using the specified operator in order for the item to be enabled. If there are multiple answers, a match on any of the answers suffices. If different behavior is desired (all must match, at least 2 must match, etc.), consider using the enableWhenExpression extension. Binding Allowed values to answer questions. QuestionnaireAnswerCodes (example) Conditions The cardinality or value of this element may be affected by these constraints: que-7 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answerCoding			Coding	Data type Coding
enableBehavior	C	0..0	codeBinding	There are no (further) constraints on this element Element id Questionnaire.item.enableBehavior Short description all \| any Definition Controls how multiple enableWhen values are interpreted - whether all or any must be true. Comments This element must be specified if more than one enableWhen value is provided. Data type code Binding Controls how multiple enableWhen values are interpreted - whether all or any must be true. EnableWhenBehavior (required) Conditions The cardinality or value of this element may be affected by these constraints: que-12 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
disabledDisplay		0..0	codeBinding	There are no (further) constraints on this element Element id Questionnaire.item.disabledDisplay Short description hidden \| protected Definition Indicates if and how items that are disabled (because enableWhen evaluates to 'false') should be displayed. Comments If not specified, rendering behavior is up to the client. This element is only meaningful if enableWhen or an equivalent extension is present Data type code Binding Defines how disabled elements should be rendered QuestionnaireItemDisabledDisplay (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
required	C	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.required Short description Whether the item must be included in data results Definition An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire. Comments If the required item is a question, it must have a direct answer (i.e. an answer to the question itself, not merely answers to child questions) in order for the QuestionnaireResponse to be complete. If the required item is a group, it must have at least one descendant question which has an answer Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. It also only has meaning if the parent element is present. If a non-required 'group' item contains a 'required' question item, it's completely fine to omit the group (because it's not required) despite it having a required child. Similarly, if an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one descendant item with a populated answer). The value for 'required' may come from the ElementDefinition referred to by .definition. Meaning when missing Items are assumed not to be required unless explicitly specified, though extensions may impose additional expectations Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: que-6 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
repeats	C	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.repeats Short description Whether the item may repeat Definition An indication, if true, that a QuestionnaireResponse for this item may include multiple answers associated with a single instance of this item (for question-type items) or multiple repetitions of the item (for group-type items). Requirements Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set. Comments If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items. The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values. The value may come from the ElementDefinition referred to by .definition. When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers. Meaning when missing Items are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: que-6, que-13 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
readOnly	C	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.readOnly Short description Don't allow human editing Definition An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire. Requirements Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc. Comments If specified on a 'group', then all items beneath the specified group are read only. For questions, this only marks the answer associated with the specific item read only. Descendant questions are not impacted. The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers. Data type boolean Conditions The cardinality or value of this element may be affected by these constraints: que-9 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
maxLength	C	0..0	integer	There are no (further) constraints on this element Element id Questionnaire.item.maxLength Short description No more than these many characters Definition The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse. Comments For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition. Data type integer Conditions The cardinality or value of this element may be affected by these constraints: que-10 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: N/A - MIF rather than RIM level
answerConstraint	C	0..0	codeBinding	There are no (further) constraints on this element Element id Questionnaire.item.answerConstraint Short description optionsOnly \| optionsOrType \| optionsOrString Definition For items that have a defined set of allowed answers (via answerOption or answerValueSet), indicates whether values other than those specified can be selected. Requirements Introduces the ability for questions to have 'other' answers Meaning when missing If not specified, answerConstraint is presumed to be 'optionsOnly' Data type code Binding Indicates differnt modes for restricting values when options or valueset are specified QuestionnaireAnswerConstraint (required) Conditions The cardinality or value of this element may be affected by these constraints: que-10, que-14 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answerValueSet	C	0..0	canonical(ValueSet)	There are no (further) constraints on this element Element id Questionnaire.item.answerValueSet Short description ValueSet containing permitted answers Definition A reference to a value set containing a list of values representing permitted answers for a question. Comments LOINC defines many useful value sets for questionnaire responses. See LOINC Answer Lists. The value may come from the ElementDefinition referred to by .definition. Data type canonical(ValueSet) Conditions The cardinality or value of this element may be affected by these constraints: que-5, que-4, que-14 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answerOption	C	1..*	BackboneElement	Element id Questionnaire.item.answerOption Short description Permitted answer Definition One of the permitted answers for the question. Comments This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes. Data type BackboneElement Slicing Unordered, Open, by $this(Value) Conditions The cardinality or value of this element may be affected by these constraints: que-5, que-4, que-11, que-14 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
(All Slices)				The requirements in this element apply to all slices
id		0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]		1..1	Binding	Element id Questionnaire.item.answerOption.value[x] Short description Answer value Definition A potential answer that's allowed as the answer to this question. Comments The data type of the value must agree with the item.type. Binding Allowed values to answer questions. QuestionnaireAnswerCodes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
valueString			string	Data type string
valueCoding			Coding	Data type Coding
initialSelected		0..1	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption.initialSelected Short description Whether option is selected by default Definition Indicates whether the answer value is selected when the list of possible answers is initially shown. Meaning when missing Only selected items explicitly marked to be selected Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answerYesNoOption	C	1..*	BackboneElement	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption Short description Permitted answer Definition One of the permitted answers for the question. Comments This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: que-5, que-4, que-11, que-14 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
id		0..0	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]		1..1	Binding	Element id Questionnaire.item.answerOption:answerYesNoOption.value[x] Short description Answer value Definition A potential answer that's allowed as the answer to this question. Comments The data type of the value must agree with the item.type. Binding Allowed values to answer questions. AssessmentAnswerYesNoValueSet (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
valueCoding			Coding	Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.item.answerOption:answerYesNoOption.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/assessment-answer-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
initialSelected		0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerYesNoOption.initialSelected Short description Whether option is selected by default Definition Indicates whether the answer value is selected when the list of possible answers is initially shown. Meaning when missing Only selected items explicitly marked to be selected Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answerVisualTestOption	C	1..*	BackboneElement	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption Short description Permitted answer Definition One of the permitted answers for the question. Comments This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: que-5, que-4, que-11, que-14 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
id		0..0	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]		1..1	Binding	Element id Questionnaire.item.answerOption:answerVisualTestOption.value[x] Short description Answer value Definition A potential answer that's allowed as the answer to this question. Comments The data type of the value must agree with the item.type. Binding Allowed values to answer questions. TestVisualCodeValueSet (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
valueCoding			Coding	Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.item.answerOption:answerVisualTestOption.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value http://loinc.org Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
initialSelected		0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerVisualTestOption.initialSelected Short description Whether option is selected by default Definition Indicates whether the answer value is selected when the list of possible answers is initially shown. Meaning when missing Only selected items explicitly marked to be selected Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answerHearingTestOption	C	1..*	BackboneElement	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption Short description Permitted answer Definition One of the permitted answers for the question. Comments This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: que-5, que-4, que-11, que-14 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
id		0..0	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]		1..1	Binding	Element id Questionnaire.item.answerOption:answerHearingTestOption.value[x] Short description Answer value Definition A potential answer that's allowed as the answer to this question. Comments The data type of the value must agree with the item.type. Binding Allowed values to answer questions. TestHearingCodeValueSet (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
valueCoding			Coding	Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.item.answerOption:answerHearingTestOption.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value http://loinc.org Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
initialSelected		0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerHearingTestOption.initialSelected Short description Whether option is selected by default Definition Indicates whether the answer value is selected when the list of possible answers is initially shown. Meaning when missing Only selected items explicitly marked to be selected Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answerPassReferOption	C	1..*	BackboneElement	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption Short description Permitted answer Definition One of the permitted answers for the question. Comments This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: que-5, que-4, que-11, que-14 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
id		0..0	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]		1..1	Binding	Element id Questionnaire.item.answerOption:answerPassReferOption.value[x] Short description Answer value Definition A potential answer that's allowed as the answer to this question. Comments The data type of the value must agree with the item.type. Binding Allowed values to answer questions. AssessmentAnswerPassReferValueSet (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
valueCoding			Coding	Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.item.answerOption:answerPassReferOption.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/assessment-answer-type Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
initialSelected		0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerPassReferOption.initialSelected Short description Whether option is selected by default Definition Indicates whether the answer value is selected when the list of possible answers is initially shown. Meaning when missing Only selected items explicitly marked to be selected Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answerOralTestOptionDenture	C	1..*	BackboneElement	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture Short description Permitted answer Definition One of the permitted answers for the question. Comments This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: que-5, que-4, que-11, que-14 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
id		0..0	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]		1..1	Binding	Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.value[x] Short description Answer value Definition A potential answer that's allowed as the answer to this question. Comments The data type of the value must agree with the item.type. Binding Allowed values to answer questions. PlacementOfDentureValueSet (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
valueCoding			Coding	Data type Coding
id		0..0	id	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/placement-of-denture Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples Upper (partial) upper-partial Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
initialSelected		0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionDenture.initialSelected Short description Whether option is selected by default Definition Indicates whether the answer value is selected when the list of possible answers is initially shown. Meaning when missing Only selected items explicitly marked to be selected Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
answerOralTestOptionOHATStatus	C	1..*	BackboneElement	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus Short description Permitted answer Definition One of the permitted answers for the question. Comments This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: que-5, que-4, que-11, que-14 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
id		0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! C	0..0	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]		1..1	Binding	Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.value[x] Short description Answer value Definition A potential answer that's allowed as the answer to this question. Comments The data type of the value must agree with the item.type. Binding Allowed values to answer questions. OHATStatusValueSet (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
valueCoding			Coding	Data type Coding
id		0..1	id	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Conditions The cardinality or value of this element may be affected by these constraints: ele-1 Mappings rim: n/a
extension	C	0..*	Extension	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uriFixed Value	Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://fhir.synapxe.sg/CodeSystem/ohat-status Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.value[x].version Short description Version of the system - if relevant Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ C	1..1	code	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.value[x].code Short description Symbol in syntax defined by the system Definition 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). Requirements Need to refer to a particular code in the system. Data type code Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ C	1..1	string	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Conditions The cardinality or value of this element may be affected by these constraints: cod-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements 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. Comments 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: 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 "true"; fhir:target dt:CDCoding.codingRationale\#O ]
initialSelected		0..0	boolean	There are no (further) constraints on this element Element id Questionnaire.item.answerOption:answerOralTestOptionOHATStatus.initialSelected Short description Whether option is selected by default Definition Indicates whether the answer value is selected when the list of possible answers is initially shown. Meaning when missing Only selected items explicitly marked to be selected Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
initial	C	0..0	BackboneElement	There are no (further) constraints on this element Element id Questionnaire.item.initial Short description Initial value(s) when item is first rendered Definition One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input. Requirements In some workflows, having defaults saves time. Comments The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial.answer[x] must agree with the item.type, and only repeating items can have more then one initial value. Data type BackboneElement Conditions The cardinality or value of this element may be affected by these constraints: que-8, que-13, que-11 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A - MIF rather than RIM level
item		0..*	see (item)	There are no (further) constraints on this element Element id Questionnaire.item.item Short description Nested questionnaire items Definition Text, questions and other groups to be nested beneath a question or group. Requirements Reports can consist of complex nested groups. Comments There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target

{

"resourceType": "Questionnaire",

"url": "https://fhir.synapxe.sg/Questionnaire/pss-screen",

"version": "1.0.0",

"title": "Project Silver Screen Assessment",

"status": "active",

"effectivePeriod": {

"start": "2025-09-16",

"end": "2025-12-31"

"code": [

{

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-type",
"code": "pss-screen",
"display": "Project Silver Screen"

}

"item": [

{

"linkId": "1",

"type": "group",

"code": [

{

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "oral",
"display": "Oral Screening"

}

"item": [

{

"linkId": "1.1",
"text": "Is the participant currently wearing dentures or has dentures?",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "no",
"display": "No"
}
}
]

}

]

{

"linkId": "2",

"type": "group",

"code": [

{

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "vision",
"display": "Vision Screening"

}

"item": [

{

"linkId": "2.1",

"text": "Snellen Test Result",

"type": "choice",

"code": [

{

"system": "http://loinc.org",
"code": "29271-4",
"display": "Visual acuity left eye"

}

"answerOption": [

{

"valueCoding": {

"system": "http://loinc.org",
"code": "6-6",
"display": "6/6"

}

{

"valueCoding": {

"system": "http://loinc.org",
"code": "6-12",
"display": "6/12"

}

]

}

]

{

"linkId": "3",

"type": "group",

"code": [

{

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-item-type",
"code": "hearing",
"display": "Hearing Screening"

}

"item": [

{

"linkId": "3.1",
"text": "Is the participant wearing hearing aids?",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "no",
"display": "No"
}
}
]

{

"linkId": "3.2",

"text": "Does the participant need to change the hearing aids?",

"type": "choice",

"answerOption": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "yes",
"display": "Yes"

}

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "no",
"display": "No"

}

"enableWhen": [

{

"question": "3.1",

"operator": "=",

"answerCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "yes",
"display": "Yes"

}

]

{

"linkId": "3.3",

"text": "Proceed with hearing screening?",

"type": "choice",

"answerOption": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "yes",
"display": "Yes"

}

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "no",
"display": "No"

}

"enableWhen": [

{

"question": "3.1",

"operator": "=",

"answerCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "no",
"display": "No"

}

]

{

"linkId": "3.4",

"text": "Visual Examination (Left Ear)",

"type": "choice",

"answerOption": [

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "pass",
"display": "Pass"

}

{

"valueCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "refer",
"display": "Refer"

}

"enableWhen": [

{

"question": "3.3",

"operator": "=",

"answerCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "yes",
"display": "Yes"

}

]

{

"linkId": "3.5",

"text": "Pure Tone Test Result (Left Ear)",

"type": "choice",

"code": [

{

"system": "http://loinc.org",
"code": "91375-6",
"display": "Hearing threshold 250 Hz Ear-L"

}

"answerOption": [

{

"valueCoding": {

"system": "http://loinc.org",
"code": "0-25",
"display": "0-25 dB"

}

{

"valueCoding": {

"system": "http://loinc.org",
"code": ">25",
"display": ">25 dB"

}

"enableWhen": [

{

"question": "3.3",

"operator": "=",

"answerCoding": {

"system": "https://fhir.synapxe.sg/CodeSystem/assessment-answer-type",
"code": "yes",
"display": "Yes"

}

]

}

]

}

]

}

Terminologies

Path	Binding Strength	Value Set (Code System)	Description
Questionnaire.code	required	https://fhir.synapxe.sg/ValueSet/assessment-type
Questionnaire.item.code	required	https://fhir.synapxe.sg/ValueSet/assessment-item-type
Questionnaire.item.code	required	https://fhir.synapxe.sg/CodeSystem/assessment-item-type
Questionnaire.item.code	required	https://fhir.synapxe.sg/ValueSet/test-type	observation codes for tests like Snellen, Pinhole, etc
Questionnaire.item.answerOption.value[x]	required	https://fhir.synapxe.sg/ValueSet/assessment-answer-yesno
Questionnaire.item.answerOption.value[x]	required	https://fhir.synapxe.sg/ValueSet/test-visual-code
Questionnaire.item.answerOption.value[x]	required	https://fhir.synapxe.sg/ValueSet/test-hearing-code
Questionnaire.item.answerOption.value[x]	required	https://fhir.synapxe.sg/ValueSet/assessment-answer-passrefer
Questionnaire.item.answerOption.value[x]	required	https://fhir.synapxe.sg/ValueSet/placement-of-denture
Questionnaire.item.answerOption.value[x]	required	https://fhir.synapxe.sg/ValueSet/ohat-status