FHIR IG analytics| Package | fhir.paciosampledata |
| Resource Type | QuestionnaireResponse |
| Id | QuestionnaireResponse-promis-10-assessment-betsy-january.json |
| FHIR Version | R4 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: QuestionnaireResponse promis-10-assessment-betsy-january
version: 1; Last updated: 2026-01-20 13:45:20+0000
| LinkID | Text | Definition | Answer |
|---|---|---|---|
  promis-10-assessment-betsy-january | Questionnaire:PROMIS-10 | ||
  mbi | What is this patient's Medicare Beneficiary Identifier (MBI)? | 1PA3D58WH16 | |
| assessment_date | Please report the date this assessment was completed. | 2026-01-20 | |
| health | In general, would you say your health is... | LOINC: LA13913-1 (Very Good) | |
| quality_of_life | In general, would you say your quality of life is... | LOINC: LA13913-1 (Very Good) | |
| physical_health | In general, how would you rate your physical health? | LOINC: LA13913-1 (Very Good) | |
| mental_health | In general, how would you rate your mental health, including your mood and your ability to think? | LOINC: LA13913-1 (Very Good) | |
| satisfaction_social | In general, how would you rate your satisfaction with your social activities and relationships? | LOINC: LA8967-7 (Good) | |
| social_activities | In general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.) | LOINC: LA13913-1 (Very Good) | |
| physical_activities | In the past 7 days, to what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair? | LOINC: LA13937-0 (Completely) | |
| emotional | In the past 7 days, how often have you been bothered by emotional problems such as feeling anxious, depressed or irritable? | LOINC: LA10066-1 (Rarely) | |
| fatigue | In the past 7 days, how would you rate your fatigue on average? | LOINC: LA137-2 (None) | |
| pain | On a scale of 0-10, with 10 being the worst pain imaginable and 0 being no pain, how would you rate your pain on average? | LOINC: LA6114-8 (3) | |
| physical_health_score | PROMIS-10 Global Physical Health (Raw Score) | 18 | |
| mental_health_score | PROMIS-10 Global Mental Health (Raw Score) | 15 | |
| physical_health_tscore | PROMIS Global Physical Health v1.2 T-Score | 57.7 | |
 mental_health_tscore | PROMIS Global Mental Health v1.2 T-Score | 50.8 | |
| Documentation for this format | |||
FHIR
FHIRsmith{
"resourceType": "QuestionnaireResponse",
"id": "promis-10-assessment-betsy-january",
"meta": {
"versionId": "1",
"lastUpdated": "2026-01-20T13:45:20.789Z"
},
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"questionnaire": "https://globalalliantinc.com/fhir/Questionnaire/questionnaire-PROMIS10",
"status": "completed",
"subject": {
"reference": "Patient/patient-betsysmith-johnson01",
"display": "Betsy Smith-Johnson"
},
"authored": "2026-01-20T13:45:20.789Z",
"author": {
"reference": "Patient/patient-betsysmith-johnson01",
"display": "Betsy Smith-Johnson"
},
"item": [
{
"linkId": "mbi",
"text": "What is this patient's Medicare Beneficiary Identifier (MBI)?",
"answer": [
{
"valueString": "1PA3D58WH16"
}
]
},
{
"linkId": "assessment_date",
"text": "Please report the date this assessment was completed.",
"answer": [
{
"valueDate": "2026-01-20"
}
]
},
{
"linkId": "health",
"text": "In general, would you say your health is...",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 4
}
],
"system": "http://loinc.org",
"code": "LA13913-1",
"display": "Very Good"
}
}
]
},
{
"linkId": "quality_of_life",
"text": "In general, would you say your quality of life is...",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 4
}
],
"system": "http://loinc.org",
"code": "LA13913-1",
"display": "Very Good"
}
}
]
},
{
"linkId": "physical_health",
"text": "In general, how would you rate your physical health?",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 4
}
],
"system": "http://loinc.org",
"code": "LA13913-1",
"display": "Very Good"
}
}
]
},
{
"linkId": "mental_health",
"text": "In general, how would you rate your mental health, including your mood and your ability to think?",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 4
}
],
"system": "http://loinc.org",
"code": "LA13913-1",
"display": "Very Good"
}
}
]
},
{
"linkId": "satisfaction_social",
"text": "In general, how would you rate your satisfaction with your social activities and relationships?",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 3
}
],
"system": "http://loinc.org",
"code": "LA8967-7",
"display": "Good"
}
}
]
},
{
"linkId": "social_activities",
"text": "In general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.)",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 4
}
],
"system": "http://loinc.org",
"code": "LA13913-1",
"display": "Very Good"
}
}
]
},
{
"linkId": "physical_activities",
"text": "In the past 7 days, to what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair?",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 5
}
],
"system": "http://loinc.org",
"code": "LA13937-0",
"display": "Completely"
}
}
]
},
{
"linkId": "emotional",
"text": "In the past 7 days, how often have you been bothered by emotional problems such as feeling anxious, depressed or irritable?",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 4
}
],
"system": "http://loinc.org",
"code": "LA10066-1",
"display": "Rarely"
}
}
]
},
{
"linkId": "fatigue",
"text": "In the past 7 days, how would you rate your fatigue on average?",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 5
}
],
"system": "http://loinc.org",
"code": "LA137-2",
"display": "None"
}
}
]
},
{
"linkId": "pain",
"text": "On a scale of 0-10, with 10 being the worst pain imaginable and 0 being no pain, how would you rate your pain on average?",
"answer": [
{
"valueCoding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 3
}
],
"system": "http://loinc.org",
"code": "LA6114-8",
"display": "3"
}
}
]
},
{
"linkId": "physical_health_score",
"text": "PROMIS-10 Global Physical Health (Raw Score)",
"answer": [
{
"valueDecimal": 18
}
]
},
{
"linkId": "mental_health_score",
"text": "PROMIS-10 Global Mental Health (Raw Score)",
"answer": [
{
"valueDecimal": 15
}
]
},
{
"linkId": "physical_health_tscore",
"text": "PROMIS Global Physical Health v1.2 T-Score",
"answer": [
{
"valueDecimal": 57.7
}
]
},
{
"linkId": "mental_health_tscore",
"text": "PROMIS Global Mental Health v1.2 T-Score",
"answer": [
{
"valueDecimal": 50.8
}
]
}
]
}