A form definition. Three things distinguish it from a bare R4 Questionnaire, and all three come from
what a medical form system actually has to do rather than from FHIR:
1. It has canonical identity.url is required. A form is versioned, cached and referenced by
every response to it.
2. It declares what it produces. Contained prototypes plus SDC template extraction, in the
same contained transaction Bundle NexusTemplate uses for letters and Task uses for a
suggested chart entry. One container, three wrappers.
3. It says where answers land.item.definition names the element an answer populates and
item.code names the concept, so a "do you smoke" question is not free text that happens to
be about smoking.
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.
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 it's narrative along with other profiles, value sets, etc.
Cardinality
0..1
Type
uri
Modifier
yes — This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
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).
Text summary of the resource, for human interpretation
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 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.
Prototypes of the resources this form produces, and the transaction Bundle that may carry them -- valid base R4, NOT required to satisfy their eventual Nexus profile
Definition
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Comments
The same rule the Templates page states for NexusTemplate, and for the same reasons: a prototype
is valid base R4; the extracted resource is valid Nexus.
A prototype has no patient, because a form is about no one until it is answered. Where base R4 does
require a value, supply a truthful one -- the form's own date, its author -- and expect it to be
overwritten. Do NOT invent sentinel values: a placeholder like 1900-01-01 is syntactically valid,
which is exactly the problem, because if the step that was meant to replace it is missing it
survives into a real chart indistinguishable from a value someone meant.
dom-3 and dom-4 supply two guarantees from base FHIR rather than from rules invented here: a
stray prototype nothing points at is already invalid, and a prototype cannot carry repository
identity it has no right to.
One place a prototype sits: as an entry of the contained transaction Bundle, with its own
entry.request, entry.fullUrl and templateExtractContext. So contained on a conformant form
is normally a single Bundle. A prototype loose in contained is the shape 1.20.0 shipped and this
profile no longer admits -- see questionnaire-extract-is-bundle-only and the profile description
for why.
dom-2 is why the graph travels as a Bundle rather than as some other container -- a contained
resource may not contain nested resources, and Bundle is the one exempt, because it derives from
Resource rather than DomainResource. The Templates page states that once, for all three wrappers.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
The contained transaction Bundle whose entries are the prototypes this form produces
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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments
A local reference to a contained transaction Bundle whose entries are the prototypes -- the SAME container NexusTemplate names with List.entry.item and a suggested-resource Task names with input[suggestion]. Each entry carries a templateExtractContext expression naming the part of the response that fills it: an entry is instantiated once per match and removed when the expression finds nothing, which is how a form whose output depends on the answers is expressed without leaving the Bundle. 0..1 because a form has one output Bundle; a form producing several resources gives it several entries. Optional rather than required because a form need not write to the chart at all.
NOT USED -- prototypes are Bundle entries in this specification
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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments
Prohibited here, though SDC blesses it, and prohibited twice over: by this slice and by questionnaire-extract-is-bundle-only, which states the same rule once for the whole resource. Prototypes are entries of the Bundle that templateExtractBundle names.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
Cardinality
0..*
Type
Extension
Modifier
yes — Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.
Requirements
… This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.
Comments
Required here though 0..1 in R4. This is the target of QuestionnaireResponse.questionnaire; a response to a form with no canonical cannot be interpreted beyond its own display text.
Business identifier from the authoring system, where one exists
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 module.
Comments
Distinct from url. A form translated inward from an external system SHOULD carry the source system's identifier here, so the translation can be traced back. url is what this form IS in Nexus; identifier is what it was called where it came from. A source system's own identifier SHOULD be carried alongside this one, flagged use = secondary. See Carrying the raw code.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Requirements
Allows users to make use of identifiers when the identifier system is not known.
Comments
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comments
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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
Required here though 0..1 in R4. Forms change, and a response is only interpretable against the version that was answered. Form authoring systems already version their definitions; nothing is being asked for that they do not already track.
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
Support human navigation and code generation.
Comments
The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.
The status of this questionnaire. Enables tracking the life-cycle of the content.
Comments
retired is how a form stops being offered. As with templates, retiring is a status change and not a delete -- responses to a retired form must stay interpretable.
Cardinality
1..1
Type
code
Must Support
yes
Modifier
yes — This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.
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.
The date (and optionally time) when the questionnaire was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes.
Comments
Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
Name of the publisher (organization or individual)
Definition
The name of the organization or individual that published 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.
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 why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created).
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 questionnaire instances.
Requirements
Assist in searching for appropriate content.
Comments
When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
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.
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 must be able to determine any legal restrictions on the use of the questionnaire and/or its content.
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.
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 measure intended to be used for the year 2016 might be published in 2015.
A particular question, question grouping or display text that is part of the questionnaire.
Comments
Constrained here, unlike QuestionnaireResponse.item, and the difference is deliberate. A RESPONSE
may arrive from an external instrument whose tree we do not govern, so constraining it would make
conformant partner data non-conformant. A form DEFINITION in Nexus is one we authored or one we
translated inward, so it is held to this shape.
Item trees nest arbitrarily deep -- a real intake form in production reaches six levels -- so
consumers MUST recurse rather than index positionally.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
A uuid allocated before extraction, for an entry whose fullUrl cannot be authored
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments
The answer to a REPEATING entry's identity, and the one place a form needs something a template does not. A Bundle.entry whose templateExtractContext selects a repeating item is instantiated once per repeat, but entry.fullUrl is a single authored value -- so a repeating entry cannot carry an authored urn:uuid and stay distinguishable. extractAllocateId on the repeating item names a fresh uuid per iteration, and the entry writes its fullUrl as an expression over it: templateExtractValue carrying %episodeId, on _fullUrl. That is legal because templateExtractValue is declared with context Element and fullUrl is a uri, so it takes the primitive-extension form. NOTE that this is a READING of SDC rather than a pattern SDC demonstrates -- extract-complex-template2 leaves one authored urn:uuid on an entry whose context is a repeating group, which is under-specified rather than wrong. A non-repeating entry needs none of this: it authors its urn:uuid and its siblings cite it, exactly as a template's prototypes do.
NOT USED -- prototypes are Bundle entries in this specification
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extensions that cannot be ignored even if unrecognized
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
Cardinality
0..*
Type
Extension
Modifier
yes — Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
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.
The element an answer populates -- the form-to-chart binding
Definition
This element is a URI that refers to an ElementDefinition that provides information about this item, including information that might otherwise be included in the instance of the Questionnaire resource. A detailed description of the construction of the URI is shown in Comments, below. If this element is present then the following element values MAY be derived from the Element Definition if the corresponding elements of this Questionnaire resource instance have no value:
* code (ElementDefinition.code)
* type (ElementDefinition.type)
* required (ElementDefinition.min)
* repeats (ElementDefinition.max)
* maxLength (ElementDefinition.maxLength)
* answerValueSet (ElementDefinition.binding)
* options (ElementDefinition.binding).
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 generic replacement for a flat EMR-field enum, and the reason this profile does not mint one.
The source model names seventy EMR fields an answer can be bound to -- demographics,
problem list, allergies, medications, social history, and a granular tobacco and substance
vocabulary. Every one of them is an element of a resource we already profile, so the binding is a
path, not a code: Patient.birthDate, Observation.value[x] on a smoking-status prototype,
Condition.code. Expressed this way the model's flattening compromises dissolve -- a parallel addr2*
enum is just Patient.address[1].
R4 defines this element as a reference to an ElementDefinition, so a binding may name a Nexus
profile's element and inherit that profile's constraints rather than restating them.
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
What the answer MEANS, as distinct from where it goes. A question coded with the LOINC tobacco-smoking-status concept is recognisable as that question whichever form it appears on, which is what makes an answer promotable to a clinical fact rather than form-specific text.
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.
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.
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, coded choice, 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.
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 item should be enabled when the condition for any of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to.
Cardinality
0..*
Type
BackboneElement
Must Support
yes
Modifier
yes — If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extensions that cannot be ignored even if unrecognized
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
Cardinality
0..*
Type
Extension
Modifier
yes — Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
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.
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
Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition.
An indication, if true, that the item may occur multiple times in the response, collecting multiple answers for questions or multiple sets of answers for groups.
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.
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
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.
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.
A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" 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.
One of the permitted answers for a "choice" or "open-choice" 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.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extensions that cannot be ignored even if unrecognized
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
Cardinality
0..*
Type
Extension
Modifier
yes — Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
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[x] must agree with the item.type, and only repeating items can have more then one initial value.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Extensions that cannot be ignored even if unrecognized
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
Cardinality
0..*
Type
Extension
Modifier
yes — Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
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.