HL7.FHIR.BE.MANZANA\Questionnaire - FINDRISC screening questionnaire instance - XML Representation

This page is part of the Manzana Project FHIR Specifications (v1.0.0: Release) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Questionnaire: rs-findRisc-questionnaire - XML Profile

XML representation of the rs-findRisc-questionnaire questionnaire.
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<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="rs-findRisc-questionnaire"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkId for the item">LinkId</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the itemcan appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> rs-findRisc-questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://hl7belgium.org/profiles/fhir/manzana/Questionnaire/rs-findRisc-questionnaire#1.0.0</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.patientAge" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> patientAge</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Please specify the patient's age?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-open-choice">open-choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: PatientAge<br/>Value Set: <a href="ValueSet-vs-findRisc-screening-age.html">Value Set - FINDRISC screening age</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.bmi" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> bmi</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Please specify the patient's BMI (Kg/m²)?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-open-choice">open-choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: PatientBMI<br/>Value Set: <a href="ValueSet-vs-findRisc-screening-bmi.html">Value Set - FINDRISC screening BMI</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.waistCircumference" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> waistCircumference</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Please specify the patient's waist circumference?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-open-choice">open-choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: PatientWaistCircumference<br/>Value Set: <a href="ValueSet-vs-findRisc-screening-waistCircumference.html">Value Set - FINDRISC screening waist circumference</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.medication-highBloodPressure" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> medication-highBloodPressure</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Has the patient ever used drugs for high blood pressure?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-open-choice">open-choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: MedicationHighBloodPressure<br/>Value Set: <a href="ValueSet-vs-findRisc-screening-medicationHBP.html">Value Set - FINDRISC screening medication high blood pressure</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.history-highBloodGlucose" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> history-highBloodGlucose</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Does the customer have a history of high blood glucose??</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-open-choice">open-choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: HistoryHighBloodGlucose<br/>Value Set: <a href="ValueSet-vs-findRisc-screening-hyperglycemia.html">Value Set - FINDRISC screening hyperglycemia</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.physical-activity" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> physical-activity</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How much physical activity does the patient do?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-open-choice">open-choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: PhysicalActivity<br/>Value Set: <a href="ValueSet-vs-findRisc-screening-physicalActivity.html">Value Set - FINDRISC screening physical activity</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.daily-consume-veg-fruit" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> daily-consume-veg-fruit</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Does the patient consume daily vegetables, fruits, or berries?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-open-choice">open-choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: ConsumeVegetablesFruitsBarries<br/>Value Set: <a href="ValueSet-vs-findRisc-screening-consumeVegFrBa.html">Value Set - FINDRISC screening daily consume of vegetabes, fruits and barries</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.family-history-diabetes" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> family-history-diabetes</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Does the patient's family have a history of diabetes?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-open-choice">open-choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Definition: FamilyHistoryDiabetes<br/>Value Set: <a href="ValueSet-vs-findRisc-screening-familyHistoryDiabetes.html">Value Set - FINDRISC screening family history diabetes</a></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="http://hl7belgium.org/profiles/fhir/manzana/Questionnaire/rs-findRisc-questionnaire"/>
  <version value="1.0.0"/>
  <name value="rs-findRisc-questionnaire"/>
  <status value="draft"/>
  <date value="2020-09-23T02:57:56+00:00"/>
  <publisher value="HL7 Belgium"/>
  <contact>
    <name value="HL7 Belgium"/>
    <telecom>
      <system value="url"/>
      <value value="https://hl7belgium.org"/>
    </telecom>
  </contact>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7belgium.org"/>
    </telecom>
  </contact>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="BE"/>
    </coding>
  </jurisdiction>
  <item>
    <linkId value="patientAge"/>
    <definition value="PatientAge"/>
    <code>
      <system value="http://snomed.info/sct"/>
      <code value="105727008"/>
    </code>
    <text value="Please specify the patient's age?"/>
    <type value="open-choice"/>
    <required value="true"/>
    <answerValueSet
                    value="http://hl7belgium.org/profiles/fhir/manzana/ValueSet/vs-findRisc-screening-age"/>
  </item>
  <item>
    <linkId value="bmi"/>
    <definition value="PatientBMI"/>
    <code>
      <system value="http://snomed.info/sct"/>
      <code value="60621009"/>
    </code>
    <text value="Please specify the patient's BMI (Kg/m²)?"/>
    <type value="open-choice"/>
    <required value="true"/>
    <answerValueSet
                    value="http://hl7belgium.org/profiles/fhir/manzana/ValueSet/vs-findRisc-screening-bmi"/>
  </item>
  <item>
    <linkId value="waistCircumference"/>
    <definition value="PatientWaistCircumference"/>
    <code>
      <system value="http://snomed.info/sct"/>
      <code value="276361009"/>
    </code>
    <text value="Please specify the patient's waist circumference?"/>
    <type value="open-choice"/>
    <required value="true"/>
    <answerValueSet
                    value="http://hl7belgium.org/profiles/fhir/manzana/ValueSet/vs-findRisc-screening-waistCircumference"/>
  </item>
  <item>
    <linkId value="medication-highBloodPressure"/>
    <definition value="MedicationHighBloodPressure"/>
    <code>
      <system value="http://snomed.info/sct"/>
      <code value="276361009"/>
    </code>
    <text value="Has the patient ever used drugs for high blood pressure?"/>
    <type value="open-choice"/>
    <required value="true"/>
    <answerValueSet
                    value="http://hl7belgium.org/profiles/fhir/manzana/ValueSet/vs-findRisc-screening-medicationHBP"/>
  </item>
  <item>
    <linkId value="history-highBloodGlucose"/>
    <definition value="HistoryHighBloodGlucose"/>
    <code>
      <system value="http://snomed.info/sct"/>
      <code value="80394007"/>
    </code>
    <text value="Does the customer have a history of high blood glucose??"/>
    <type value="open-choice"/>
    <required value="true"/>
    <answerValueSet
                    value="http://hl7belgium.org/profiles/fhir/manzana/ValueSet/vs-findRisc-screening-hyperglycemia"/>
  </item>
  <item>
    <linkId value="physical-activity"/>
    <definition value="PhysicalActivity"/>
    <code>
      <system value="http://snomed.info/sct"/>
      <code value="68130003"/>
    </code>
    <text value="How much physical activity does the patient do?"/>
    <type value="open-choice"/>
    <required value="true"/>
    <answerValueSet
                    value="http://hl7belgium.org/profiles/fhir/manzana/ValueSet/vs-findRisc-screening-physicalActivity"/>
  </item>
  <item>
    <linkId value="daily-consume-veg-fruit"/>
    <definition value="ConsumeVegetablesFruitsBarries"/>
    <code>
      <system value="http://snomed.info/sct"/>
      <code value="391129005"/>
    </code>
    <text
          value="Does the patient consume daily vegetables, fruits, or berries?"/>
    <type value="open-choice"/>
    <required value="true"/>
    <answerValueSet
                    value="http://hl7belgium.org/profiles/fhir/manzana/ValueSet/vs-findRisc-screening-consumeVegFrBa"/>
  </item>
  <item>
    <linkId value="family-history-diabetes"/>
    <definition value="FamilyHistoryDiabetes"/>
    <code>
      <system value="http://snomed.info/sct"/>
      <code value="160303001"/>
    </code>
    <text value="Does the patient's family have a history of diabetes?"/>
    <type value="open-choice"/>
    <required value="true"/>
    <answerValueSet
                    value="http://hl7belgium.org/profiles/fhir/manzana/ValueSet/vs-findRisc-screening-familyHistoryDiabetes"/>
  </item>
</Questionnaire>