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StructureDefinition: ehealth-questionnaire

Introduction

A Questionnaire is 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.

Scope and Usage

In the eHealth Infrastructure the Questionnaire resource is used in line with this. Questionnaires are built and maintained by Practitioners and presented to Patients by client applications in order to gather input and answers from Patients in the form of QuestionnaireResponse resources.

Setting minimal and maximal number of permitted choices

A question where possible answers are given as a list of options (of item.type set to choice) can allow multiple choices by setting item.repeats to true. When no further constraints are set, item.repeats set to true means that any number of the options can be provided as answer to the question in a QuestionnaireResponse. The standard extensions item.questionnaire-minOccurs and item.questionnaire-maxOccurs can be used to set such further constraints.

• item.questionnaire-minOccurs sets the minimum number of answers allowed, for instance 2 (of the number of options, say, 5). The element shall be set only when its value is greater than one.
• item.questionnaire-maxOccurs sets the maximum number of answers allowed, for instance 3 (of the number of options, say 5). The element shall be set only when its value is greater than one.

When exactly one answer shall be required, item.requied shall be set to true and item.repeats shall be set to false. When exactly one answer is permitted, item.requied shall be set to false and item.repeats shall be set to false. In these cases, the minOCcurs and maxOccurs shall not be used.

Feedback to the Patient

The Questionnaire resource supports the Question Feedback Pattern from DK QFDD questionnaires. This enables immediate feedback to the patient upon answering a question.

The feedback is pre-defined in the Questionnaire resource using the item.feedback element, so that for each item a patient feedback can be prepared. The feedback will be shown to the patient if the patient’s answer to an item lies within a given interval. The mechanism only works for questions which can be answered with a numeric value. The interval is defined by the min and a max elements of the feedback extension. If the Patient answers the item with a numeric value in the interval given by min-max then the value of the feedback extension is intended to be shown to the Patient.

Recommendation

In the recommendation element, a questionnaire can optionally hold a “degree of recommendation” intended to aid the Practitioner in deciding whether or not the Questionnaire should be applied to the Patient.

Formal Views of Profile Content

The official URL for this profile is:

http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-questionnaire

This profile builds on Questionnaire.

This profile was published on Tue Oct 27 14:11:48 UTC 2020 as a draft by ehealth.sundhed.dk.

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

 

Terminology Bindings

Path	Conformance	ValueSet
Questionnaire.language	extensible	Common Languages Max Binding: All Languages
Questionnaire.status	required	PublicationStatus
Questionnaire.jurisdiction	extensible	Jurisdiction
Questionnaire.code	example	Questionnaire Question Codes
Questionnaire.subjectType	required	ResourceType
Questionnaire.item.code	example	Questionnaire Question Codes
Questionnaire.item.type	required	QuestionnaireItemType
Questionnaire.item.enableWhen.answer[x]	example	Questionnaire Answer Codes
Questionnaire.item.option.value[x]	example	Questionnaire Answer Codes
Questionnaire.item.initial[x]	example	Questionnaire Answer Codes

Constraints

Id	Path	Details	Requirements
dom-2	Questionnaire	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-1	Questionnaire	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-4	Questionnaire	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-3	Questionnaire	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
que-2	Questionnaire	The link ids for groups and questions must be unique within the questionnaire : descendants().linkId.isDistinct()
ele-1	Questionnaire.extension:recommendation	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.extension:recommendation	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.extension:intendedOrganization	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.extension:intendedOrganization	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.extension:revision	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.extension:revision	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.extension:modifierRole	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.extension:modifierRole	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.extension:type	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.extension:type	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.item	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
que-9	Questionnaire.item	Read-only can't be specified for "display" items : type!='display' or readOnly.empty()
que-8	Questionnaire.item	Default values can't be specified for groups or display items : (type!='group' and type!='display') or initial.empty()
que-6	Questionnaire.item	Required and repeat aren't permitted for display items : type!='display' or (required.empty() and repeats.empty())
que-5	Questionnaire.item	Only 'choice' items can have options : (type ='choice' or type = 'open-choice') or (options.empty() and option.empty())
que-4	Questionnaire.item	A question cannot have both option and options : option.empty() or options.empty()
que-3	Questionnaire.item	Display items cannot have a "code" asserted : type!='display' or code.empty()
que-10	Questionnaire.item	Maximum length can only be declared for simple question types : (type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url')) or maxLength.empty()
que-1	Questionnaire.item	Group items must have nested items, display items cannot have nested items : (type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty())
ele-1	Questionnaire.item.extension:minOccurs	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.item.extension:minOccurs	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.item.extension:feedback	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.item.extension:feedback	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.item.extension:maxOccurs	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.item.extension:maxOccurs	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.item.extension:minValue	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.item.extension:minValue	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.item.extension:maxValue	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.item.extension:maxValue	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.item.extension:slidingStepValue	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.item.extension:slidingStepValue	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.item.extension:overviewUsageMode	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Questionnaire.item.extension:overviewUsageMode	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Questionnaire.item.enableWhen	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
que-7	Questionnaire.item.enableWhen	enableWhen must contain either a 'answer' or a 'hasAnswer' element : hasAnswer.exists() xor answer.exists()
ele-1	Questionnaire.item.option	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())

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