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Questionnaireresponse-example.json

FHIR Infrastructure Work Group
Maturity Level : N/A
Ballot Status : Informative
Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson
Raw JSON ( canonical form )
General questionnaire response example
{
  "resourceType": "QuestionnaireResponse",
  "id": "3141",
  "text": {
    "status": "generated",
    "div": "<div>\n      \n      \n      <pre>\n            Comorbidity? YES\n              Cardial Comorbidity? YES\n                Angina? YES\n                MI? NO\n              Vascular Comorbidity?\n                (no answers)\n              ...\n            Histopathology\n              Abdominal\n                pT category: 1a\n              ...\n          </pre>\n    \n    \n    </div>"

    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      <pre>\n            Comorbidity? YES\n              Cardial Comorbidity? YES\n                Angina? YES\n                MI? NO\n              Vascular Comorbidity?\n                (no answers)\n              ...\n            Histopathology\n              Abdominal\n                pT category: 1a\n              ...\n          </pre>\n    </div>"

  },
  "contained": [
    {
      "resourceType": "Patient",
      "id": "patsub",
      "identifier": [
        {
          "system": "http://cancer.questionnaire.org/systems/id/patientnr",
          "value": "A34442332"
        },
        {
          "type": {
            "text": "Dutch BSN"
          },
          "system": "urn:oid:2.16.840.1.113883.2.4.6.3",
          "value": "188912345"
        }
      ],
      "gender": "male",
      "birthDate": "1972-11-30"
    },
    {
      "resourceType": "ReferralRequest",
      "id": "order",
      "status": "unknown",
      "intent": "order",
      "subject": {
        "reference": "#patsub"
      },
      "requester": {
        "agent": {
          "reference": "Practitioner/example"
        }
      }
    },
    {

      "resourceType": "Practitioner",
      "id": "questauth",
      "identifier": [
        {
          "type": {
            "text": "AUMC, Den Helder"
          },
          "system": "http://cancer.questionnaire.org/systems/id/org",
          "value": "AUMC"
        }
      ]
    },

    }
  ],
  "identifier": {
    "system": "http://example.org/fhir/NamingSystem/questionnaire-ids",
    "value": "Q12349876"
  },
  "basedOn": [

    {
      "resourceType": "Observation",
      "id": "obs.pt-category",
      "status": "final",
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "53786006",
            "display": "pT1 category"
          }
        ]
      },
      "subject": {
        "reference": "#patsub"
      },
      "performer": [
        {
          "reference": "#questauth"
        }
      ],
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "443357004",
            "display": "pT1a category"
          }
        ]
      }

      "reference": "#order"
    }
  ],
  "parent": [
    {
      "reference": "Procedure/f201"

    }
  ],
  "status": "completed",
  "subject": {
    "reference": "#patsub"
  },
  "context": {
    "reference": "Encounter/example"
  },
  "authored": "2013-02-19T14:15:00-05:00",

  "author": {
    "reference": "#questauth"
  },
  "authored": "2013-02-19T14:15:00-05:00",
  "group": {
    "fhir_comments": [
      "    HISTOPATHOLOGY    ",
      "    TODO: decide how to do this\n    <group>\n\n      <group>\n        <question>\n         <dataResource>\n            <reference value=\"#obs.pt-category\"/>\n          </dataResource>\n        </question>\n      </group>\n    </group>    "
    ],
    "title": "Cancer Quality Forum Questionnaire 2012",
    "group": [
      {
        "question": [
          {
            "fhir_comments": [
              "    COMORBIDITY    ",
              "    First main section of the form, questions about comorbidity    ",
              "    section contains one question: whether there is comorbidity    "
            ],
            "answer": [
              {
                "valueCoding": {
                  "system": "http://cancer.questionnaire.org/system/code/yesno",
                  "code": "1",
                  "display": "Yes"
                },
                "group": [
                  {
                    "question": [
                      {
                        "fhir_comments": [
                          "    COMORBIDITY/CARDIAL    ",
                          "    Subsection about specific comorbidity: cardial    "
                        ],
                        "answer": [
                          {
                            "valueCoding": {
                              "system": "http://cancer.questionnaire.org/system/code/yesno",
                              "code": "1"
                            }

  "item": [
    {
      "linkId": "1",
      "item": [
        {
          "linkId": "1.1",
          "answer": [
            {
              "valueCoding": {
                "system": "http://cancer.questionnaire.org/system/code/yesno",
                "code": "1",
                "display": "Yes"
              },
              "item": [
                {
                  "linkId": "1.1.1",
                  "item": [
                    {
                      "linkId": "1.1.1.1",
                      "answer": [
                        {
                          "valueCoding": {
                            "system": "http://cancer.questionnaire.org/system/code/yesno",
                            "code": "1"

                          }
                        ]
                      },
                      {
                        "answer": [
                          {
                            "fhir_comments": [
                              "    This answer carries both the questionnaire-specific name and an equivalent SNOMED CT code    "
                            ],
                            "valueCoding": {
                              "system": "http://cancer.questionnaire.org/system/code/yesno",
                              "code": "1"
                            }

                        }
                      ]
                    },
                    {
                      "linkId": "1.1.1.2",
                      "answer": [
                        {
                          "valueCoding": {
                            "system": "http://cancer.questionnaire.org/system/code/yesno",
                            "code": "1"

                          }
                        ]
                      },
                      {
                        "answer": [
                          {
                            "valueCoding": {
                              "system": "http://cancer.questionnaire.org/system/code/yesno",
                              "code": "0"
                            }

                        }
                      ]
                    },
                    {
                      "linkId": "1.1.1.3",
                      "answer": [
                        {
                          "valueCoding": {
                            "system": "http://cancer.questionnaire.org/system/code/yesno",
                            "code": "0"

                          }
                        ]
                      }
                    ]
                  }
                ]
              }
            ]
          }
        ]
      }
    ]
  }

                        }
                      ]
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ]

}
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.