{
  "description": "Pre-session treatment questionnaire",
  "_filename": "back-pain-pre-session-en.questionnaire.json",
  "package_name": "smart4health.eu.core",
  "subjectType": [ "Patient" ],
  "date": "2021-01-28",
  "publisher": "D4L data4life gGmbH",
  "name": "Smart4Health_pre-session_pain_questionnaire",
  "item": [ {
    "code": [ {
      "code": "72514-3",
      "system": "http://loinc.org",
      "display": "Pain severity 0-10 Score Reported"
    } ],
    "text": "Please indicate your current pain level",
    "type": "choice",
    "linkId": "current_back_pain_level",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
      "valueCodeableConcept": {
        "coding": [ {
          "code": "painscalewithlabels",
          "system": "http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes"
        } ]
      }
    } ],
    "answerValueSet": "http://loinc.org/vs/LL2335-9",
    "enableBehavior": "any"
  }, {
    "code": [ {
      "code": "72514-3",
      "system": "http://loinc.org",
      "display": "Pain severity 0-10 Score Reported"
    } ],
    "text": "Please indicate your average pain level during the past four weeks",
    "type": "choice",
    "linkId": "average_back_pain_level",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
      "valueCodeableConcept": {
        "coding": [ {
          "code": "painscalewithlabels",
          "system": "http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes"
        } ]
      }
    } ],
    "answerValueSet": "http://loinc.org/vs/LL2335-9",
    "enableBehavior": "any"
  }, {
    "code": [ {
      "code": "72514-3",
      "system": "http://loinc.org",
      "display": "Pain severity 0-10 Score Reported"
    } ],
    "text": "Please indicate your maximum pain level during the past four weeks",
    "type": "choice",
    "linkId": "max_back_pain_level_4w",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
      "valueCodeableConcept": {
        "coding": [ {
          "code": "painscalewithlabels",
          "system": "http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes"
        } ]
      }
    } ],
    "answerValueSet": "http://loinc.org/vs/LL2335-9",
    "enableBehavior": "any"
  }, {
    "text": "Are you taking painkillers at the moment?",
    "type": "choice",
    "linkId": "taking_painkillers",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/yesno",
    "enableBehavior": "any"
  } ],
  "type": null,
  "experimental": null,
  "resourceType": "Questionnaire",
  "title": "Pre-session treatment questionnaire",
  "package_version": "0.5.2",
  "status": "draft",
  "language": "en",
  "id": "2a350e5a-6499-48e5-829c-e8b0b1fd215f",
  "kind": null,
  "url": "http://fhir.smart4health.eu/Questionnaire/pre-session-questionnaire",
  "version": "1.0.0",
  "contact": [ {
    "name": "ITTM Solutions",
    "telecom": [ {
      "value": "https://www.ittm-solutions.com/",
      "system": "url"
    } ]
  }, {
    "name": "D4L data4life gGmbH",
    "telecom": [ {
      "value": "https://www.data4life.care",
      "system": "url"
    } ]
  } ]
}