| Package | csiro.fhir.au.smartforms |
| Resource Type | Questionnaire |
| Id | AllergiesAdverseReactions |
| FHIR Version | R4 |
| Source | https://smartforms.csiro.au/ig/https://build.fhir.org/ig/aehrc/smart-forms-ig/Questionnaire-AllergiesAdverseReactions.html |
| URL | http://www.health.gov.au/assessments/mbs/715/AllergiesAdverseReactions |
| Version | 0.3.0 |
| Status | draft |
| Date | 2025-03-14 |
| Name | AllergiesAdverseReactions |
| Title | Aboriginal and Torres Strait Islander Health Check - Allergies/Adverse Reactions |
| Realm | au |
| Copyright | Copyright © 2022+ Australian Government Department of Health and Aged Care - All rights reserved. This content is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. See https://creativecommons.org/licenses/by-sa/4.0/. |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire AllergiesAdverseReactions
Profiles: Advanced Rendering Questionnaire, SDC Modular Questionnaire, Populatable Questionnaire - Expression, Extractable Questionnaire - Template
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  AllergiesAdverseReactions | Questionnaire | http://www.health.gov.au/assessments/mbs/715/AllergiesAdverseReactions#0.3.0 | |||
  allergy | Allergies/adverse reactions | 0..1 | group | ||
   CD-in-progress-3 | In progress | 0..1 | display | Enable When: MarkComplete-3 != | |
| CD-complete-3 | Complete | 0..1 | display | Enable When: MarkComplete-3 = | |
| allergyinstruction | Adverse reaction risk summary | 0..1 | group | ||
 allergysummary | Adverse reaction risk summary | 0..* | group | ||
 allergyIntoleranceId | null | 0..1 | string |  | |
 allergysummary-substance | Substance | 0..1 | open-choice |  | Value Set: Adverse Reaction Agent |
| allergysummary-status | Status | 0..1 | choice | Options: 2 options | |
| allergysummary-manifestation | Manifestation | 0..* | open-choice | | Value Set: Clinical Finding |
 allergysummary-comment | Comment | 0..1 | text | ||
| allergynew | New adverse reaction risks | 0..* | group | ||
| allergynew-substance | Substance | 1..1 | open-choice | Value Set: Adverse Reaction Agent | |
| allergynew-manifestation | Manifestation | 0..* | open-choice | Value Set: Clinical Finding | |
| allergynew-comment | Comment | 0..1 | text | ||
| 3e689aeb-69a1-4a9b-93bd-50377511dd9b | Health priorities, actions and follow-up | 0..1 | text | ||
 MarkComplete-3 | Mark section as complete | 0..1 | boolean | ||
| Documentation for this format | |||||
Options Sets
Answer options for allergysummary-status
AllergyIntolerance #AllergyIntoleranceTemplate
clinicalStatus: Active
code:
patient: ?rref?
note:
reaction
manifestation: No display for AllergyIntolerance.reaction.manifestation (concept: null), No display for AllergyIntolerance.reaction.manifestation (concept: )
Parameters #AllergyIntolerancePatchTemplate
| operation | |
| type | replace |
| path | AllergyIntolerance.clinicalStatus |
| name | clinicalStatus |
| value | |
| pathLabel | Clinical status |
| operation | |
| type | replace |
| path | AllergyIntolerance.note[0].text |
| name | text |
| value | |
| pathLabel | Comment |
FHIR{
"resourceType": "Questionnaire",
"id": "AllergiesAdverseReactions",
"meta": {
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-render",
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-modular",
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-pop-exp",
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-template"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"contained": [
{
"resourceType": "AllergyIntolerance",
"id": "AllergyIntoleranceTemplate",
"clinicalStatus": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active"
}
]
},
"code": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractContext",
"valueString": "item.where(linkId='allergynew-substance').answer.value"
}
],
"coding": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "ofType(Coding)"
}
]
}
],
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "ofType(string)"
}
]
}
},
"patient": {
"_reference": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "%resource.subject.reference"
}
]
}
},
"note": [
{
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "item.where(linkId='allergynew-comment').answer.value"
}
]
}
}
],
"reaction": [
{
"manifestation": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractContext",
"valueString": "item.where(linkId='allergynew-manifestation').answer.value.ofType(Coding)"
}
],
"coding": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "$this"
}
]
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractContext",
"valueString": "item.where(linkId='allergynew-manifestation').answer.value.ofType(string)"
}
],
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "$this"
}
]
}
}
]
}
]
},
{
"resourceType": "Parameters",
"id": "AllergyIntolerancePatchTemplate",
"parameter": [
{
"name": "operation",
"part": [
{
"name": "type",
"valueCode": "replace"
},
{
"name": "path",
"valueString": "AllergyIntolerance.clinicalStatus"
},
{
"name": "name",
"valueString": "clinicalStatus"
},
{
"name": "value",
"valueCodeableConcept": {
"coding": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "item.where(linkId='allergysummary-status').answer.value.first()"
}
]
}
]
}
},
{
"name": "pathLabel",
"valueString": "Clinical status"
}
]
},
{
"name": "operation",
"part": [
{
"name": "type",
"valueCode": "replace"
},
{
"name": "path",
"valueString": "AllergyIntolerance.note[0].text"
},
{
"name": "name",
"valueString": "text"
},
{
"name": "value",
"_valueMarkdown": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "item.where(linkId='allergysummary-comment').answer.value.first()"
}
]
}
},
{
"name": "pathLabel",
"valueString": "Comment"
}
]
}
]
}
],
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assemble-expectation",
"valueCode": "assemble-child"
},
{
"extension": [
{
"url": "name",
"valueCoding": {
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
"code": "patient"
}
},
{
"url": "type",
"valueCode": "Patient"
},
{
"url": "description",
"valueString": "The patient that is to be used to pre-populate the form"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
},
{
"extension": [
{
"url": "name",
"valueCoding": {
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
"code": "user"
}
},
{
"url": "type",
"valueCode": "Practitioner"
},
{
"url": "description",
"valueString": "The practitioner user that is to be used to pre-populate the form"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
},
{
"extension": [
{
"url": "name",
"valueCoding": {
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
"code": "encounter"
}
},
{
"url": "type",
"valueCode": "Encounter"
},
{
"url": "description",
"valueString": "The encounter that is to be used to pre-populate the form"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembleContext",
"valueString": "age"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "AllergyIntolerance",
"language": "application/x-fhir-query",
"expression": "AllergyIntolerance?patient={{%patient.id}}"
}
},
{
"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]",
"valueCoding": {
"system": "http://hl7.org/fhir/version-algorithm",
"code": "semver"
}
}
],
"url": "http://www.health.gov.au/assessments/mbs/715/AllergiesAdverseReactions",
"version": "0.3.0",
"name": "AllergiesAdverseReactions",
"title": "Aboriginal and Torres Strait Islander Health Check - Allergies/Adverse Reactions",
"status": "draft",
"experimental": false,
"subjectType": [
"Patient"
],
"date": "2025-03-14",
"publisher": "AEHRC CSIRO",
"contact": [
{
"name": "AEHRC CSIRO",
"telecom": [
{
"system": "url",
"value": "https://confluence.csiro.au/display/PCDQFPhase2/Primary+Care+Data+Quality+Foundations+-+Phase+2"
}
]
}
],
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "AU",
"display": "Australia"
}
]
}
],
"copyright": "Copyright © 2022+ Australian Government Department of Health and Aged Care - All rights reserved.\nThis content is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.\nSee https://creativecommons.org/licenses/by-sa/4.0/.\n",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%age.exists()"
}
}
],
"linkId": "allergy",
"text": "Allergies/adverse reactions",
"type": "group",
"repeats": false,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "https://smartforms.csiro.au/ig/CodeSystem/QuestionnaireItemControlExtended",
"code": "context-display"
}
]
}
}
],
"linkId": "CD-in-progress-3",
"text": "In progress",
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString": "<div title=\"In progress\" xmlns=\"http://www.w3.org/1999/xhtml\">\r\n\t<div style=\"display: flex; flex-direction: row;\">\r\n\t\t<img width='24' height='24' src='data:image/svg+xml;base64,\r\n\t\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' \r\n\t\tstyle=\"align-self: center;\"/>\r\n\t</div>\r\n</div>"
}
]
},
"type": "display",
"enableWhen": [
{
"question": "MarkComplete-3",
"operator": "!=",
"answerBoolean": true
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "https://smartforms.csiro.au/ig/CodeSystem/QuestionnaireItemControlExtended",
"code": "context-display"
}
]
}
}
],
"linkId": "CD-complete-3",
"text": "Complete",
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString": "<div title=\"Section completed\" xmlns=\"http://www.w3.org/1999/xhtml\">\r\n\t<div style=\"display: flex; flex-direction: row;\">\r\n\t\t<img width='24' height='24' src='data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHdpZHRoPSIxZW0iIGhlaWdodD0iMWVtIiB2aWV3Qm94PSIwIDAgMjQgMjQiPjxwYXRoIGZpbGw9IiMyZTdkMzIiIGQ9Ik0yMCAxMmE4IDggMCAwIDEtOCA4YTggOCAwIDAgMS04LThhOCA4IDAgMCAxIDgtOGMuNzYgMCAxLjUuMTEgMi4yLjMxbDEuNTctMS41N0E5LjgyMiA5LjgyMiAwIDAgMCAxMiAyQTEwIDEwIDAgMCAwIDIgMTJhMTAgMTAgMCAwIDAgMTAgMTBhMTAgMTAgMCAwIDAgMTAtMTBNNy45MSAxMC4wOEw2LjUgMTEuNUwxMSAxNkwyMSA2bC0xLjQxLTEuNDJMMTEgMTMuMTdsLTMuMDktMy4wOVoiLz48L3N2Zz4='\r\n\t\tstyle=\"align-self: center;\"/>\r\n\t</div>\r\n</div>"
}
]
},
"type": "display",
"enableWhen": [
{
"question": "MarkComplete-3",
"operator": "=",
"answerBoolean": true
}
]
},
{
"linkId": "allergyinstruction",
"text": "Adverse reaction risk summary",
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>Adverse reaction risk summary</p>\n <p style=\"font-size:0.9em; font-weight:normal\"><em>This section includes a list of existing items from the patient record. <br />Update these items here or update the patient record and repopulate the form. <br />Add new items at the bottom.</em></p>\n </div>"
}
]
},
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemPopulationContext",
"valueExpression": {
"name": "AllergyIntoleranceRepeat",
"language": "text/fhirpath",
"expression": "%AllergyIntolerance.entry.resource.where(clinicalStatus.coding.exists(code='active')).where(verificationStatus.coding.all(code.empty() or code='confirmed'))"
}
},
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#AllergyIntolerancePatchTemplate"
}
},
{
"url": "resourceId",
"valueString": "item.where(linkId='allergyIntoleranceId').answer.value"
},
{
"url": "type",
"valueCode": "AllergyIntolerance"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "allergysummary",
"text": "Adverse reaction risk summary",
"_text": {
"extension": [
{
"url": "https://smartforms.csiro.au/ig/StructureDefinition/QuestionnaireItemTextHidden",
"valueBoolean": true
}
]
},
"type": "group",
"repeats": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%AllergyIntoleranceRepeat.id"
}
}
],
"linkId": "allergyIntoleranceId",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%AllergyIntoleranceRepeat.code.select((coding.where(system='http://snomed.info/sct') | coding.where(system!='http://snomed.info/sct').first() | text ).first())"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "autocomplete"
}
]
}
}
],
"linkId": "allergysummary-substance",
"text": "Substance",
"type": "open-choice",
"repeats": false,
"readOnly": true,
"answerValueSet": "https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%AllergyIntoleranceRepeat.clinicalStatus.coding"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down"
}
]
}
}
],
"linkId": "allergysummary-status",
"text": "Status",
"type": "choice",
"repeats": false,
"answerOption": [
{
"valueCoding": {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active",
"display": "Active"
}
},
{
"valueCoding": {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "inactive",
"display": "Inactive"
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%AllergyIntoleranceRepeat.reaction.manifestation.coding"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "autocomplete"
}
]
}
}
],
"linkId": "allergysummary-manifestation",
"text": "Manifestation",
"type": "open-choice",
"repeats": true,
"readOnly": true,
"answerValueSet": "https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%AllergyIntoleranceRepeat.note[0].text"
}
}
],
"linkId": "allergysummary-comment",
"text": "Comment",
"type": "text",
"repeats": false
}
]
},
{
"extension": [
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#AllergyIntoleranceTemplate"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "allergynew",
"text": "New adverse reaction risks",
"_text": {
"extension": [
{
"url": "https://smartforms.csiro.au/ig/StructureDefinition/QuestionnaireItemTextHidden",
"valueBoolean": true
}
]
},
"type": "group",
"repeats": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "autocomplete"
}
]
}
}
],
"linkId": "allergynew-substance",
"text": "Substance",
"type": "open-choice",
"required": true,
"repeats": false,
"answerValueSet": "https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "autocomplete"
}
]
}
}
],
"linkId": "allergynew-manifestation",
"text": "Manifestation",
"type": "open-choice",
"repeats": true,
"answerValueSet": "https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1"
},
{
"linkId": "allergynew-comment",
"text": "Comment",
"type": "text",
"repeats": false
}
]
}
]
},
{
"linkId": "3e689aeb-69a1-4a9b-93bd-50377511dd9b",
"text": "Health priorities, actions and follow-up",
"type": "text",
"repeats": false
},
{
"linkId": "MarkComplete-3",
"text": "Mark section as complete",
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\r\n<head>\r\n <style type=\"text/css\">\r\n .alert {\r\n padding: 0.875rem;\r\n margin-bottom: 1rem;\r\n font-size: 0.875rem;\r\n color: #29712D;\r\n border-radius: 0.5rem;\r\n background-color: #D9E8DA;\r\n font-weight: 700;\r\n max-width: 205px;\r\n }\r\n </style>\r\n</head>\r\n<body>\r\n<div class=\"alert\">Mark section as complete</div>\r\n</body>\r\n</div>"
}
]
},
"type": "boolean",
"repeats": false
}
]
}
]
}