Argonaut Questionnaire Implementation Guide (Release 1.0.0 )

This page is part of the Argonaut Questionnaire Implementation Guide (v1.0.0: Release) based on FHIR R3. This is the current published version. For a full list of available versions, see the Directory of published versions

XML Format: QuestionnaireResponse-adaptive-questionnaireresponse-example-dast

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<QuestionnaireResponse xmlns="http://hl7.org/fhir">
  <id value="adaptive-questionnaireresponse-example-dast"/>
  <meta>
    <profile
             value="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-adap-questionnaireresponse"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
    <h3>Drug Abuse Screening Test-10 [DAST-10] Adaptive View</h3>
    <p><em>NOTE: These examples are for educational and testing purposes,
     see the form copyright statement and do not redistribute without expressed
     permission from the form author.</em></p>
    <p>This simulates is a simple adaptive questionnaire implementation.
     After answering and submitting the first question another question is randomly
     returned from the selected questionnaire. This is repeated two more times and
     then the adaptive questionnaire will finish by changing the status to completed
     and returning a score. Note that although these questionnaires are designed as forms and
     are not really appropriate for the adaptive questionnaire use case,  they are used here to
      demonstrate a proof of concept implementation.<br />
    <strong>Questionnaire URL:</strong> http://fhir.org/guides/argonaut/questionnaire/Questionnaire/questionnaire-example-dast<br />
    <strong>Date Completed:</strong> 2018-07-26<br /><br />
    <em>Copyright: Center for Addiction and Mental Health
Copyright 982 Center for Addiction and Mental Health. Used with permission.
URL: http://www.camh.ca/en/hospital/Pages/home.aspx</em></p>
    <hr /><hr /><br /> <strong>Question:</strong> (linkID=score) Cumulative Score is ... (this is hidden text/should not be displayed to the user)<br /><strong>Response:</strong> 0<br /><br /> <strong>Question:</strong> (linkID=std_dev) Standard Deviation is ... (this is hidden text/should not be displayed to the user)<br /><strong>Response:</strong> 0.0<br /><br /> <strong>Question:</strong> (linkID=g1.q1) Have you used drugs other than those required for medical reasons?<br /><strong>Response:</strong>  No ( code = LA32-8 , codesystem = http://loinc.org)<br /><br /> <strong>Question:</strong> (linkID=g1.q4) Have you ever had blackouts or flashbacks as a result of drug use?<br /><strong>Response:</strong>  No ( code = LA32-8 , codesystem = http://loinc.org)<br /><br /> <strong>Question:</strong> (linkID=g1.q8) Have you engaged in illegal activities in order to obtain drugs?<br /><strong>Response:</strong>  No ( code = LA32-8 , codesystem = http://loinc.org)<br /></div>
  </text>
  <contained>
    <Questionnaire>
      <id value="contained-adaptive-questionnaire-example-dast"/>
      <meta>
        <profile
                 value="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-questionnaire"/>
      </meta>
      <extension
                 url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-timeLimit">
        <valueDuration>
          <value value="2"/>
          <unit value="day"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="d"/>
        </valueDuration>
      </extension>
      <url
           value="http://fhir.org/guides/argonaut/questionnaire/Questionnaire/questionnaire-example-dast"/>
      <title value="Contained Adaptive Drug Abuse Screening Test-10 [DAST-10]"/>
      <status value="active"/>
      <date value="2019-02-13T00:35:13.638711Z"/>
      <copyright
                 value="Center for Addiction and Mental Health
Copyright 982 Center for Addiction and Mental Health. Used with permission.
URL: http://www.camh.ca/en/hospital/Pages/home.aspx"/>
      <item>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/questionnaire-hidden">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
          <valueInteger value="1"/>
        </extension>
        <linkId value="score"/>
        <text value="Cumulative Score is ..."/>
        <type value="integer"/>
        <repeats value="false"/>
        <readOnly value="true"/>
      </item>
      <item>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/questionnaire-hidden">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
          <valueInteger value="2"/>
        </extension>
        <linkId value="std_dev"/>
        <text value="Standard Deviation is ..."/>
        <type value="decimal"/>
        <repeats value="false"/>
        <readOnly value="true"/>
      </item>
      <item>
        <extension
                   url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
          <valueInteger value="3"/>
        </extension>
        <linkId value="g1.q1"/>
        <definition
                    value="http://fhir.org/guides/argonaut/questionnaire/Questionnaire/questionnaire-example-dast-g1.q1"/>
        <code>
          <system value="http://loinc.org"/>
          <code value="68525-5"/>
        </code>
        <prefix value="1."/>
        <text
              value="Have you used drugs other than those required for medical reasons?"/>
        <type value="choice"/>
        <required value="true"/>
        <repeats value="false"/>
        <option>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-ordinalValue">
            <valueDecimal value="0"/>
          </extension>
          <extension
                     url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
            <valueInteger value="0"/>
          </extension>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA32-8"/>
            <display value="No"/>
          </valueCoding>
        </option>
        <option>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-ordinalValue">
            <valueDecimal value="1"/>
          </extension>
          <extension
                     url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
            <valueInteger value="1"/>
          </extension>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA33-6"/>
            <display value="Yes"/>
          </valueCoding>
        </option>
      </item>
      <item>
        <extension
                   url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
          <valueInteger value="4"/>
        </extension>
        <linkId value="g1.q4"/>
        <definition
                    value="http://fhir.org/guides/argonaut/questionnaire/Questionnaire/questionnaire-example-dast-g1.q4"/>
        <code>
          <system value="http://loinc.org"/>
          <code value="68528-9"/>
        </code>
        <prefix value="4."/>
        <text
              value="Have you ever had blackouts or flashbacks as a result of drug use?"/>
        <type value="choice"/>
        <required value="true"/>
        <repeats value="false"/>
        <option>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-ordinalValue">
            <valueDecimal value="0"/>
          </extension>
          <extension
                     url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
            <valueInteger value="0"/>
          </extension>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA32-8"/>
            <display value="No"/>
          </valueCoding>
        </option>
        <option>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-ordinalValue">
            <valueDecimal value="1"/>
          </extension>
          <extension
                     url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
            <valueInteger value="1"/>
          </extension>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA33-6"/>
            <display value="Yes"/>
          </valueCoding>
        </option>
      </item>
      <item>
        <extension
                   url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
          <valueInteger value="5"/>
        </extension>
        <linkId value="g1.q8"/>
        <definition
                    value="http://fhir.org/guides/argonaut/questionnaire/Questionnaire/questionnaire-example-dast-g1.q8"/>
        <code>
          <system value="http://loinc.org"/>
          <code value="68532-1"/>
        </code>
        <prefix value="8."/>
        <text
              value="Have you engaged in illegal activities in order to obtain drugs?"/>
        <type value="choice"/>
        <required value="true"/>
        <repeats value="false"/>
        <option>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-ordinalValue">
            <valueDecimal value="0"/>
          </extension>
          <extension
                     url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
            <valueInteger value="0"/>
          </extension>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA32-8"/>
            <display value="No"/>
          </valueCoding>
        </option>
        <option>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-ordinalValue">
            <valueDecimal value="1"/>
          </extension>
          <extension
                     url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-itemOrder">
            <valueInteger value="1"/>
          </extension>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA33-6"/>
            <display value="Yes"/>
          </valueCoding>
        </option>
      </item>
    </Questionnaire>
  </contained>
  <extension
             url="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-responsePeriod">
    <valuePeriod>
      <start value="2019-02-13T00:35:12.073629Z"/>
      <end value="2019-02-13T00:35:33.341374Z"/>
    </valuePeriod>
  </extension>
  <identifier>
    <value value="adaptive-questionnaireresponse-example-dast"/>
  </identifier>
  <questionnaire>
    <reference value="#contained-adaptive-questionnaire-example-dast"/>
  </questionnaire>
  <status value="completed"/>
  <subject>
    <reference value="Patient/subject1"/>
  </subject>
  <context>
    <reference value="Encounter/encounter1"/>
  </context>
  <authored value="2019-02-13T00:35:12.073629Z"/>
  <author>
    <reference value="Practitioner/prov-admin1"/>
  </author>
  <source>
    <reference value="Patient/subject1"/>
  </source>
  <item>
    <linkId value="score"/>
    <text value="Cumulative Score is ..."/>
    <answer>
      <valueInteger value="0"/>
    </answer>
  </item>
  <item>
    <linkId value="std_dev"/>
    <text value="Standard Deviation is ..."/>
    <answer>
      <valueDecimal value="0.0"/>
    </answer>
  </item>
  <item>
    <linkId value="g1.q1"/>
    <definition
                value="http://fhir.org/guides/argonaut/questionnaire/Questionnaire/questionnaire-example-dast-g1.q1"/>
    <text
          value="Have you used drugs other than those required for medical reasons?"/>
    <answer>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA32-8"/>
        <display value="No"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="g1.q4"/>
    <definition
                value="http://fhir.org/guides/argonaut/questionnaire/Questionnaire/questionnaire-example-dast-g1.q4"/>
    <text
          value="Have you ever had blackouts or flashbacks as a result of drug use?"/>
    <answer>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA32-8"/>
        <display value="No"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="g1.q8"/>
    <definition
                value="http://fhir.org/guides/argonaut/questionnaire/Questionnaire/questionnaire-example-dast-g1.q8"/>
    <text
          value="Have you engaged in illegal activities in order to obtain drugs?"/>
    <answer>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA32-8"/>
        <display value="No"/>
      </valueCoding>
    </answer>
  </item>
</QuestionnaireResponse>