| Package | hl7.fhir.uv.sdc.r4b |
| Type | Questionnaire |
| Id | questionnaire-sdc-profile-example-ussg-fht |
| FHIR Version | R4B |
| Source | http://hl7.org/fhir/uv/sdc/http://hl7.org/fhir/uv/sdc/STU3/Questionnaire-questionnaire-sdc-profile-example-ussg-fht.html |
| URL | http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-ussg-fht |
| Version | 3.0.0 |
| Status | active |
| Date | 2015 |
| Name | USSurgeonGeneralFamilyHealthPortrait |
| Title | US Surgeon General - Family Health Portrait |
| Realm | uv |
| Authority | hl7 |
| Description | This represents an implementation of the "US Surgeon General family health portrait" form found at https://lforms-demo.nlm.nih.gov |
| Purpose | Captures basic family history information |
| Copyright | (c) 2015 Regenstrief Institute |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
| LinkId | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  USSurgeonGeneralFamilyHealthPortrait | This represents an implementation of the "US Surgeon General family health portrait" form found at https://lforms-demo.nlm.nih.gov | Questionnaire | http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-ussg-fht#3.0.0 | ||
  0 | null | 0..1 | group | ||
  0.1 | Date Done | 0..1 | date | ||
 0.2 | Time Done | 0..1 | time | ||
 0.3 | Where Done | 0..1 | string | ||
 0.4 | Comment | 0..1 | string | ||
| 1 | Your health information | 1..1 | group | Definition: http://loinc.org/fhir/DataElement/54126-8 | |
| 1.1 | null | 0..1 | group | ||
| 1.1.1 | Name | 0..1 | string |  | Max Length: 200 Definition: http://loinc.org/fhir/DataElement/54125-0 |
 1.1.2 | Gender | 1..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54131-8 Value Set: http://loinc.org/vs/LL1-9 |
| 1.1.2.1.1 | Please specify | 1..1 | string | Enable When: 1.1.2 = Other (LOINC#LA46-8) | |
| 1.1.3 | Date of Birth | 0..1 | date | | Definition: http://loinc.org/fhir/DataElement/21112-8 |
| 1.1.4 | Were you born a twin? | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54132-6 Value Set: http://loinc.org/vs/LL623-0 Initial Value: Coding = LOINC#LA32-8 "No" |
| 1.1.5 | Were you adopted? | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54128-4 Value Set: http://loinc.org/vs/LL361-7 |
| 1.1.6 | Are your parents related to each other in any way other than marriage? | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54135-9 Value Set: http://loinc.org/vs/LL361-7 |
 1.1.7 | Height | 1..1 | decimal | | Definition: http://loinc.org/fhir/DataElement/8302-2 |
| 1.1.7.1.1 | Units | 0..1 | choice | Value Set: Length Units | |
| 1.1.8 | Weight | 0..1 | decimal | | Definition: http://loinc.org/fhir/DataElement/29463-7 |
| 1.1.8.1.1 | Units | 0..1 | choice | Value Set: Weight Units | |
| 1.1.9 | Body mass index (BMI) [Ratio] | 0..1 | decimal |  | Definition: http://loinc.org/fhir/DataElement/39156-5 |
| 1.1.10 | Race | 1..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54134-2 Value Set: http://loinc.org/vs/LL629-7 |
| 1.1.11 | Ethnicity | 0..* | choice | | Definition: http://loinc.org/fhir/DataElement/54133-4 Value Set: http://loinc.org/vs/LL628-9 |
| 1.2 | Your diseases history | 0..* | group | Definition: http://loinc.org/fhir/DataElement/54137-5 | |
 1.2.1 | Disease or Condition | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54140-9 Value Set: http://loinc.org/vs/LL626-3 |
| 1.2.2 | Age at Diagnosis | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54130-0 Value Set: http://loinc.org/vs/LL619-8 |
| 2 | Family member health information | 0..* | group | Definition: http://loinc.org/fhir/DataElement/54114-4 | |
| 2.1.1 | null | 0..1 | group | ||
| 2.1.1.1 | Relationship to you | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54136-7 Value Set: http://loinc.org/vs/LL621-4 |
| 2.1.1.2 | Name | 0..1 | string | | Definition: http://loinc.org/fhir/DataElement/54138-3 |
| 2.1.1.3 | Gender | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54123-5 Value Set: http://loinc.org/vs/LL1-9 |
| 2.1.1.3.1.1 | Please specify | 1..1 | string | Enable When: 2.1.1.3 = Other (LOINC#LA46-8) | |
| 2.1.1.4 | Living? | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54139-1 Value Set: http://loinc.org/vs/LL361-7 |
| 2.1.1.4.1 | null | 0..1 | group | ||
| 2.1.1.4.1.1 | Cause of Death | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54112-8 Value Set: http://loinc.org/vs/LL627-1 |
| 2.1.1.4.1.1.1 | Please specify | 0..1 | string | Enable When: 2.1.1.4.1.1 = Other/Unexpected (LOINC#LA10589-2) | |
| 2.1.1.4.1.2 | Age at Death | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54113-6 Value Set: http://loinc.org/vs/LL619-8 |
| 2.1.1.4.2 | null | 0..1 | group | ||
| 2.1.1.4.2.1 | Date of Birth | 0..1 | date | | Definition: http://loinc.org/fhir/DataElement/54124-3 |
| 2.1.1.4.2.2 | Age | 0..1 | decimal | | Definition: http://loinc.org/fhir/DataElement/54141-7 |
| 2.1.1.5 | Was this person born a twin? | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54121-9 Value Set: http://loinc.org/vs/LL623-0 |
| 2.1.1.6 | Was this person adopted? | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54122-7 Value Set: http://loinc.org/vs/LL623-0 |
| 2.1.1.7 | Race | 0..* | choice | | Definition: http://loinc.org/fhir/DataElement/54119-3 Value Set: http://loinc.org/vs/LL629-7 |
| 2.1.1.8 | Ethnicity | 0..* | choice | | Definition: http://loinc.org/fhir/DataElement/54120-1 Value Set: http://loinc.org/vs/LL628-9 |
| 2.1.2 | This family member's history of disease | 0..* | group | Definition: http://loinc.org/fhir/DataElement/54117-7 | |
| 2.1.2.1 | Disease or Condition | 1..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54116-9 Value Set: http://loinc.org/vs/LL626-3 |
| 2.1.2.2 | Age at Diagnosis | 0..1 | choice | | Definition: http://loinc.org/fhir/DataElement/54115-1 Value Set: http://loinc.org/vs/LL619-8 |
| 2.1.2.3 | Mock-up item: Height | 0..1 | decimal | ||
| 2.1.2.4 | Mock-up item: Weight | 0..1 | decimal | ||
| 2.1.2.5 | Mock-up item: BMI | 0..1 | decimal | ||
| Documentation for this format | |||||
FHIR{
"resourceType": "Questionnaire",
"id": "questionnaire-sdc-profile-example-ussg-fht",
"meta": {
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-pop-obsn",
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-search"
]
},
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"contained": [
{
"resourceType": "ValueSet",
"id": "length",
"meta": {
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-valueset"
]
},
"name": "LengthUnits",
"title": "Length Units",
"status": "active",
"description": "Length units",
"immutable": true,
"compose": {
"include": [
{
"system": "http://unitsofmeasure.org",
"concept": [
{
"code": "[in_i]",
"display": "inch (international)"
},
{
"code": "cm",
"display": "centimeters"
}
]
}
]
}
},
{
"resourceType": "ValueSet",
"id": "weight",
"meta": {
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-valueset"
]
},
"name": "WeightUnits",
"title": "Weight Units",
"status": "active",
"description": "Weight units",
"immutable": true,
"compose": {
"include": [
{
"system": "http://unitsofmeasure.org",
"concept": [
{
"code": "[lb_av]",
"display": "pound (US and British)"
},
{
"code": "kg",
"display": "kilograms"
}
]
}
]
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-ussg-fht",
"identifier": [
{
"system": "http://example.org/panel-id",
"value": "54127-6"
}
],
"version": "3.0.0",
"name": "USSurgeonGeneralFamilyHealthPortrait",
"title": "US Surgeon General - Family Health Portrait",
"status": "active",
"experimental": true,
"subjectType": [
"Patient"
],
"date": "2015",
"publisher": "HL7 International - FHIR Infrastructure Work Group",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://hl7.org/Special/committees/fiwg"
}
]
}
],
"description": "This represents an implementation of the \"US Surgeon General family health portrait\" form found at https://lforms-demo.nlm.nih.gov",
"useContext": [
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "species"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "337915000",
"display": "Homo sapiens"
}
]
}
}
],
"jurisdiction": [
{
"coding": [
{
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code": "001"
}
]
}
],
"purpose": "Captures basic family history information",
"copyright": "(c) 2015 Regenstrief Institute",
"approvalDate": "2015-10-31",
"lastReviewDate": "2017-03-15",
"code": [
{
"system": "http://loinc.org",
"code": "54127-6",
"display": "US Surgeon General family health portrait [USSG-FHT]"
}
],
"item": [
{
"linkId": "0",
"type": "group",
"item": [
{
"linkId": "0.1",
"text": "Date Done",
"type": "date"
},
{
"linkId": "0.2",
"text": "Time Done",
"type": "time"
},
{
"linkId": "0.3",
"text": "Where Done",
"type": "string"
},
{
"linkId": "0.4",
"text": "Comment",
"type": "string"
}
]
},
{
"linkId": "1",
"definition": "http://loinc.org/fhir/DataElement/54126-8",
"code": [
{
"system": "http://loinc.org",
"code": "54126-8"
}
],
"text": "Your health information",
"type": "group",
"required": true,
"item": [
{
"linkId": "1.1",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54125-0",
"code": [
{
"system": "http://loinc.org",
"code": "54125-0"
}
],
"text": "Name",
"type": "string",
"maxLength": 200
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54131-8",
"code": [
{
"system": "http://loinc.org",
"code": "54131-8"
}
],
"text": "Gender",
"type": "choice",
"required": true,
"answerValueSet": "http://loinc.org/vs/LL1-9",
"item": [
{
"linkId": "1.1.2.1.1",
"text": "Please specify",
"type": "string",
"enableWhen": [
{
"question": "1.1.2",
"operator": "=",
"answerCoding": {
"system": "http://loinc.org",
"code": "LA46-8"
}
}
],
"required": true
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.3",
"definition": "http://loinc.org/fhir/DataElement/21112-8",
"code": [
{
"system": "http://loinc.org",
"code": "21112-8"
}
],
"text": "Date of Birth",
"type": "date"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54132-6",
"code": [
{
"system": "http://loinc.org",
"code": "54132-6"
}
],
"text": "Were you born a twin?",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL623-0",
"initial": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54128-4",
"code": [
{
"system": "http://loinc.org",
"code": "54128-4"
}
],
"text": "Were you adopted?",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL361-7"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54135-9",
"code": [
{
"system": "http://loinc.org",
"code": "54135-9"
}
],
"text": "Are your parents related to each other in any way other than marriage?",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL361-7"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.7",
"definition": "http://loinc.org/fhir/DataElement/8302-2",
"code": [
{
"system": "http://loinc.org",
"code": "8302-2"
}
],
"text": "Height",
"type": "decimal",
"required": true,
"item": [
{
"linkId": "1.1.7.1.1",
"text": "Units",
"type": "choice",
"answerValueSet": "#length"
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.8",
"definition": "http://loinc.org/fhir/DataElement/29463-7",
"code": [
{
"system": "http://loinc.org",
"code": "29463-7"
}
],
"text": "Weight",
"type": "decimal",
"item": [
{
"linkId": "1.1.8.1.1",
"text": "Units",
"type": "choice",
"answerValueSet": "#weight"
}
]
},
{
"linkId": "1.1.9",
"definition": "http://loinc.org/fhir/DataElement/39156-5",
"code": [
{
"system": "http://loinc.org",
"code": "39156-5"
}
],
"text": "Body mass index (BMI) [Ratio]",
"type": "decimal",
"readOnly": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.10",
"definition": "http://loinc.org/fhir/DataElement/54134-2",
"code": [
{
"system": "http://loinc.org",
"code": "54134-2"
}
],
"text": "Race",
"type": "choice",
"required": true,
"answerValueSet": "http://loinc.org/vs/LL629-7"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.1.11",
"definition": "http://loinc.org/fhir/DataElement/54133-4",
"code": [
{
"system": "http://loinc.org",
"code": "54133-4"
}
],
"text": "Ethnicity",
"type": "choice",
"repeats": true,
"answerValueSet": "http://loinc.org/vs/LL628-9"
}
]
},
{
"linkId": "1.2",
"definition": "http://loinc.org/fhir/DataElement/54137-5",
"code": [
{
"system": "http://loinc.org",
"code": "54137-5"
}
],
"text": "Your diseases history",
"type": "group",
"repeats": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.2.1",
"definition": "http://loinc.org/fhir/DataElement/54140-9",
"code": [
{
"system": "http://loinc.org",
"code": "54140-9"
}
],
"text": "Disease or Condition",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL626-3"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "1.2.2",
"definition": "http://loinc.org/fhir/DataElement/54130-0",
"code": [
{
"system": "http://loinc.org",
"code": "54130-0"
}
],
"text": "Age at Diagnosis",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL619-8"
}
]
}
]
},
{
"linkId": "2",
"definition": "http://loinc.org/fhir/DataElement/54114-4",
"code": [
{
"system": "http://loinc.org",
"code": "54114-4"
}
],
"text": "Family member health information",
"type": "group",
"repeats": true,
"item": [
{
"linkId": "2.1.1",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.1",
"definition": "http://loinc.org/fhir/DataElement/54136-7",
"code": [
{
"system": "http://loinc.org",
"code": "54136-7"
}
],
"text": "Relationship to you",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL621-4"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.2",
"definition": "http://loinc.org/fhir/DataElement/54138-3",
"code": [
{
"system": "http://loinc.org",
"code": "54138-3"
}
],
"text": "Name",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.3",
"definition": "http://loinc.org/fhir/DataElement/54123-5",
"code": [
{
"system": "http://loinc.org",
"code": "54123-5"
}
],
"text": "Gender",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL1-9",
"item": [
{
"linkId": "2.1.1.3.1.1",
"text": "Please specify",
"type": "string",
"enableWhen": [
{
"question": "2.1.1.3",
"operator": "=",
"answerCoding": {
"system": "http://loinc.org",
"code": "LA46-8"
}
}
],
"required": true
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.4",
"definition": "http://loinc.org/fhir/DataElement/54139-1",
"code": [
{
"system": "http://loinc.org",
"code": "54139-1"
}
],
"text": "Living?",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL361-7",
"item": [
{
"linkId": "2.1.1.4.1",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.4.1.1",
"definition": "http://loinc.org/fhir/DataElement/54112-8",
"code": [
{
"system": "http://loinc.org",
"code": "54112-8"
}
],
"text": "Cause of Death",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL627-1",
"item": [
{
"linkId": "2.1.1.4.1.1.1",
"text": "Please specify",
"type": "string",
"enableWhen": [
{
"question": "2.1.1.4.1.1",
"operator": "=",
"answerCoding": {
"system": "http://loinc.org",
"code": "LA10589-2"
}
}
]
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.4.1.2",
"definition": "http://loinc.org/fhir/DataElement/54113-6",
"code": [
{
"system": "http://loinc.org",
"code": "54113-6"
}
],
"text": "Age at Death",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL619-8"
}
]
},
{
"linkId": "2.1.1.4.2",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.4.2.1",
"definition": "http://loinc.org/fhir/DataElement/54124-3",
"code": [
{
"system": "http://loinc.org",
"code": "54124-3"
}
],
"text": "Date of Birth",
"type": "date"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.4.2.2",
"definition": "http://loinc.org/fhir/DataElement/54141-7",
"code": [
{
"system": "http://loinc.org",
"code": "54141-7"
}
],
"text": "Age",
"type": "decimal"
}
]
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.5",
"definition": "http://loinc.org/fhir/DataElement/54121-9",
"code": [
{
"system": "http://loinc.org",
"code": "54121-9"
}
],
"text": "Was this person born a twin?",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL623-0"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.6",
"definition": "http://loinc.org/fhir/DataElement/54122-7",
"code": [
{
"system": "http://loinc.org",
"code": "54122-7"
}
],
"text": "Was this person adopted?",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL623-0"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.7",
"definition": "http://loinc.org/fhir/DataElement/54119-3",
"code": [
{
"system": "http://loinc.org",
"code": "54119-3"
}
],
"text": "Race",
"type": "choice",
"repeats": true,
"answerValueSet": "http://loinc.org/vs/LL629-7"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.1.8",
"definition": "http://loinc.org/fhir/DataElement/54120-1",
"code": [
{
"system": "http://loinc.org",
"code": "54120-1"
}
],
"text": "Ethnicity",
"type": "choice",
"repeats": true,
"answerValueSet": "http://loinc.org/vs/LL628-9"
}
]
},
{
"linkId": "2.1.2",
"definition": "http://loinc.org/fhir/DataElement/54117-7",
"code": [
{
"system": "http://loinc.org",
"code": "54117-7"
}
],
"text": "This family member's history of disease",
"type": "group",
"repeats": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.2.1",
"definition": "http://loinc.org/fhir/DataElement/54116-9",
"code": [
{
"system": "http://loinc.org",
"code": "54116-9"
}
],
"text": "Disease or Condition",
"type": "choice",
"required": true,
"answerValueSet": "http://loinc.org/vs/LL626-3"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
"valueDuration": {
"value": 200,
"system": "http://unitsofmeasure.org",
"code": "a"
}
}
],
"linkId": "2.1.2.2",
"definition": "http://loinc.org/fhir/DataElement/54115-1",
"code": [
{
"system": "http://loinc.org",
"code": "54115-1"
}
],
"text": "Age at Diagnosis",
"type": "choice",
"answerValueSet": "http://loinc.org/vs/LL619-8"
},
{
"linkId": "2.1.2.3",
"text": "Mock-up item: Height",
"type": "decimal"
},
{
"linkId": "2.1.2.4",
"text": "Mock-up item: Weight",
"type": "decimal"
},
{
"linkId": "2.1.2.5",
"text": "Mock-up item: BMI",
"type": "decimal"
}
]
}
]
}
]
}