{
  "description": "A form for calculating the 10-year-risk of Hard Coronary Heart Disease.  The constants used in the formula match those in https://www.framinghamheartstudy.org/fhs-risk-functions/hard-coronary-heart-disease-10-year-risk/, but the actual formulas are not listed there, and so we have not been able to verify them.  However, the output of this form matches the output of a perl program (from which the formulas were taken) which matched the output of a calculator on a website, which regrettably no longer exists.  So, while this form is good enough or a demo, it should not be relied on for real purposes without first verifying its formulas or its output against some other source.",
  "_filename": "example/Questionnaire-questionnaire-sdc-profile-example-framingham-hchd-lhc.json",
  "package_name": "hl7.fhir.uv.sdc",
  "subjectType": [ "Patient" ],
  "date": "2024-12-17T01:55:34+00:00",
  "meta": {
    "profile": [ "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire" ]
  },
  "publisher": "HL7 International / FHIR Infrastructure",
  "jurisdiction": [ {
    "coding": [ {
      "code": "001",
      "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "display": "World"
    } ]
  } ],
  "name": "FraminghamHCHD",
  "item": [ {
    "code": [ {
      "code": "30525-0",
      "system": "http://loinc.org",
      "display": "Age"
    } ],
    "text": "Age (in years)",
    "type": "decimal",
    "linkId": "/age",
    "required": true
  }, {
    "text": "Sorry, but the formulas are only valid for ages in the range 30 to 79.",
    "type": "display",
    "linkId": "/age_requirement_notice",
    "enableWhen": [ {
      "operator": "<",
      "question": "/age",
      "answerDecimal": 30
    }, {
      "operator": ">",
      "question": "/age",
      "answerDecimal": 79
    } ],
    "enableBehavior": "any"
  }, {
    "code": [ {
      "code": "46098-0",
      "system": "http://loinc.org",
      "display": "Sex"
    } ],
    "text": "Gender",
    "type": "choice",
    "linkId": "/46098-0",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
      "valueInteger": 1
    }, {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
      "valueCodeableConcept": {
        "text": "Drop down",
        "coding": [ {
          "code": "drop-down",
          "system": "http://hl7.org/fhir/questionnaire-item-control",
          "display": "Drop down"
        } ]
      }
    } ],
    "answerOption": [ {
      "valueCoding": {
        "code": "LA2-8",
        "system": "http://loinc.org",
        "display": "Male"
      }
    }, {
      "valueCoding": {
        "code": "LA3-6",
        "system": "http://loinc.org",
        "display": "Female"
      }
    } ]
  }, {
    "text": "Do you smoke?",
    "type": "choice",
    "linkId": "/smokes",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
      "valueInteger": 1
    }, {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
      "valueCodeableConcept": {
        "text": "Radio Button",
        "coding": [ {
          "code": "radio-button",
          "system": "http://hl7.org/fhir/questionnaire-item-control",
          "display": "Radio Button"
        } ]
      }
    } ],
    "answerOption": [ {
      "valueCoding": {
        "code": "Y",
        "system": "http://example.org",
        "display": "Yes"
      }
    }, {
      "valueCoding": {
        "code": "N",
        "system": "http://example.org",
        "display": "No"
      }
    } ]
  }, {
    "code": [ {
      "code": "8480-6",
      "system": "http://loinc.org",
      "display": "Systolic blood pressure"
    } ],
    "text": "Systolic blood pressure",
    "type": "decimal",
    "linkId": "/8480-6",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
      "valueInteger": 1
    }, {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
      "valueCoding": {
        "display": "mm[Hg]"
      }
    } ]
  }, {
    "code": [ {
      "code": "2093-3",
      "system": "http://loinc.org",
      "display": "Cholesterol [Mass/volume] in Serum or Plasma"
    } ],
    "text": "Cholesterol [Mass/Vol]",
    "type": "decimal",
    "linkId": "/2093-3",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
      "valueInteger": 1
    }, {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
      "valueCoding": {
        "display": "mg/dL"
      }
    } ]
  }, {
    "code": [ {
      "code": "2085-9",
      "system": "http://loinc.org",
      "display": "Cholesterol in HDL [Mass/volume] in Serum or Plasma"
    } ],
    "text": "Cholesterol in HDL [Mass/Vol]",
    "type": "decimal",
    "linkId": "/2085-9",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
      "valueInteger": 1
    }, {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
      "valueCoding": {
        "display": "mg/dL"
      }
    } ]
  }, {
    "text": "Are you taking medication for high blood pressure?",
    "type": "choice",
    "linkId": "/antihypertensive",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
      "valueInteger": 1
    }, {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
      "valueCodeableConcept": {
        "text": "Radio Button",
        "coding": [ {
          "code": "radio-button",
          "system": "http://hl7.org/fhir/questionnaire-item-control",
          "display": "Radio Button"
        } ]
      }
    } ],
    "answerOption": [ {
      "valueCoding": {
        "code": "Y",
        "system": "http://example.org",
        "display": "Yes"
      }
    }, {
      "valueCoding": {
        "code": "N",
        "system": "http://example.org",
        "display": "No"
      }
    } ]
  }, {
    "text": "All answers are required before the risk probability can be computed.",
    "type": "display",
    "linkId": "/all_answers_required_notice"
  }, {
    "text": "10-year HCHD Risk Probabilily as a decimal (0 to 1)",
    "type": "decimal",
    "linkId": "riskDecimal",
    "required": false,
    "extension": [ {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression",
      "valueExpression": {
        "language": "text/fhirpath",
        "expression": "%risk",
        "description": "HCHD risk as decimal"
      }
    }, {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
      "valueBoolean": true
    } ]
  }, {
    "text": "10-year HCHD Risk Probabilily",
    "type": "string",
    "linkId": "riskPercentage",
    "required": false,
    "extension": [ {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression",
      "valueExpression": {
        "language": "text/fhirpath",
        "expression": "iif(%risk.exists(), (%risk * 100).round(2).toString() & '%', {})",
        "description": "HCHD risk as percentage"
      }
    } ]
  } ],
  "type": null,
  "experimental": "true",
  "resourceType": "Questionnaire",
  "title": "Hard Coronary Heart Disease (10-year risk)",
  "package_version": "4.0.0-ballot",
  "extension": [ {
    "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]",
    "valueCoding": {
      "code": "semver",
      "system": "http://hl7.org/fhir/version-algorithm"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "age",
      "language": "text/fhirpath",
      "expression": "item.where(linkId='/age').answer.value"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "gender",
      "language": "text/fhirpath",
      "expression": "item.where(linkId='/46098-0').answer.value.display"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "smokesCode",
      "language": "text/fhirpath",
      "expression": "item.where(linkId='/smokes').answer.value.code"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "smokes",
      "language": "text/fhirpath",
      "expression": "iif(%smokesCode.exists(), iif(%smokesCode = 'Y', 1, 0), {})"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "systolic",
      "language": "text/fhirpath",
      "expression": "item.where(linkId='/8480-6').answer.value"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "tChol",
      "language": "text/fhirpath",
      "expression": "item.where(linkId='/2093-3').answer.value"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "hdl",
      "language": "text/fhirpath",
      "expression": "item.where(linkId='/2085-9').answer.value"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "antihypertCode",
      "language": "text/fhirpath",
      "expression": "item.where(linkId='/antihypertensive').answer.value.code"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "antihypert",
      "language": "text/fhirpath",
      "expression": "iif(%antihypertCode.exists(), iif(%systolic >= 120, iif(%antihypertCode = 'Y', 1, 0), 0), {})"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "allQuestionsAnswered",
      "language": "text/fhirpath",
      "expression": "%age.exists() and %gender.exists() and %smokes.exists() and %systolic.exists() and %tChol.exists() and %hdl.exists() and %antihypert.exists()"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "femaleOver78",
      "language": "text/fhirpath",
      "expression": "iif(%allQuestionsAnswered, iif(%gender = 'Female', iif(%age>78, 1 - (0.98767).power((31.764001 * (%age.ln() - 3.9213204) + 22.465206 * (%tChol.ln() - 5.3628984) - 1.187731 * (%hdl.ln() - 4.0146369) + 2.552905 * (%systolic.ln() - 4.8376494) + 0.420251 * (%antihypert - 0.142802) + 13.07543 * (%smokes - 0.3236202) - 5.060998 * (%age.ln() * %tChol.ln() - 21.0557746) - 2.996945 * (78.ln() * %smokes - 1.2519882)).exp()), {}), {}), {})"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "femaleNotOver78",
      "language": "text/fhirpath",
      "expression": "iif(%allQuestionsAnswered, iif(%gender = 'Female', iif(%age<=78, 1 - (0.98767).power((31.764001 * (%age.ln() - 3.9213204) + 22.465206 * (%tChol.ln() - 5.3628984) - 1.187731  * (%hdl.ln() - 4.0146369) + 2.552905  * (%systolic.ln() - 4.8376494) + 0.420251  * (%antihypert - 0.142802) + 13.07543  * (%smokes - 0.3236202) - 5.060998  * (%age.ln() * %tChol.ln() - 21.0557746) - 2.996945  * (%age.ln() * %smokes  - 1.2519882)).exp()), {}), {}), {})"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "maleOver70",
      "language": "text/fhirpath",
      "expression": "iif(%allQuestionsAnswered, iif(%gender = 'Male', iif(%age>70, 1 - (0.9402).power((52.00961  * (%age.ln() - 3.8926095) + 20.014077 * (%tChol.ln() - 5.3441475) - 0.905964  * (%hdl.ln() - 3.7731132) + 1.305784  * (%systolic.ln() - 4.8618212) + 0.241549  * (%antihypert - 0.1180474) + 12.096316 * (%smokes - 0.335602) - 4.605038  * (%age.ln() * %tChol.ln() - 20.8111562) - 2.84367   * (70.ln() * %smokes  - 1.2890301) - 2.93323   * (%age.ln() * %age.ln() - 15.2144965)).exp()), {}), {}), {})"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "maleNotOver70",
      "language": "text/fhirpath",
      "expression": "iif(%allQuestionsAnswered, iif(%gender = 'Male', iif(%age<=70, 1 - (0.9402).power((52.00961  * (%age.ln() - 3.8926095) + 20.014077 * (%tChol.ln() - 5.3441475) - 0.905964  * (%hdl.ln() - 3.7731132) + 1.305784  * (%systolic.ln() - 4.8618212) + 0.241549  * (%antihypert - 0.1180474) + 12.096316 * (%smokes - 0.335602) - 4.605038  * (%age.ln() * %tChol.ln() - 20.8111562) - 2.84367   * (%age.ln() * %smokes  - 1.2890301) - 2.93323   * (%age.ln() * %age.ln() - 15.2144965)).exp()), {}), {}), {})"
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/variable",
    "valueExpression": {
      "name": "risk",
      "language": "text/fhirpath",
      "expression": "%femaleOver78 | %femaleNotOver78 | %maleOver70 | %maleNotOver70"
    }
  } ],
  "status": "active",
  "id": "2fac1842-4023-4780-92a8-1ef0a0002193",
  "kind": null,
  "url": "http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-framingham-hchd-lhc",
  "identifier": [ {
    "value": "urn:oid:2.16.840.1.113883.4.642.40.17.35.10",
    "system": "urn:ietf:rfc:3986"
  } ],
  "version": "4.0.0-ballot",
  "contact": [ {
    "name": "HL7 International / FHIR Infrastructure",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fiwg",
      "system": "url"
    } ]
  }, {
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fiwg",
      "system": "url"
    } ]
  } ]
}