{
  "description": null,
  "_filename": "back-pain-pre-training-en.questionnaire.json",
  "package_name": "smart4health.eu.core",
  "subjectType": [ "Patient" ],
  "date": "2021-04-13",
  "publisher": "D4L data4life gGmbH",
  "name": null,
  "item": [ {
    "text": "Training Number",
    "type": "integer",
    "linkId": "training_no",
    "required": true
  }, {
    "code": [ {
      "code": "72514-3",
      "system": "http://loinc.org"
    } ],
    "item": [ {
      "text": "In the following, please provide your pain level (Visual Analog Scale for Pain - VAS Pain). Please select how you experience your pain (under your usual medication dose) from the given scale (0-10). The VAS pain level describes the scale between '0' ('no pain') and '10' ('worst imaginable pain').",
      "type": "display",
      "linkId": "back_pain_level_before.explanation",
      "enableBehavior": "any"
    } ],
    "text": "Lower back pain level before training",
    "type": "choice",
    "linkId": "back_pain_level_before",
    "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"
  }, {
    "item": [ {
      "text": "0: All well, 10: All bad",
      "type": "display",
      "linkId": "well_being.explanation"
    } ],
    "text": "Well being",
    "type": "choice",
    "linkId": "well_being",
    "required": true,
    "extension": [ {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
      "valueCodeableConcept": {
        "coding": [ {
          "code": "wellbeingscalewithlabels",
          "system": "http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes"
        } ]
      }
    } ],
    "answerValueSet": "http://loinc.org/vs/LL2335-9"
  }, {
    "text": "Summary of your health, general well-being and activities in the last days/weeks",
    "type": "choice",
    "linkId": "well-being_summary",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-pre-training-well-being-summary"
  }, {
    "text": "Extraordinary circumstances",
    "type": "choice",
    "linkId": "extraordinary_circumstances",
    "repeats": true,
    "required": true,
    "enableWhen": [ {
      "operator": "=",
      "question": "well-being_summary",
      "answerCoding": {
        "code": "extraordinary",
        "system": "http://fhir.smart4health.eu/CodeSystem/s4h-pre-training-well-being-summary"
      }
    } ],
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-backpain-extraordinary-circumstances"
  } ],
  "type": null,
  "experimental": null,
  "resourceType": "Questionnaire",
  "title": "Smart4Health pre-training questionnaire",
  "package_version": "0.5.0",
  "status": "draft",
  "id": "343fce1b-637e-414c-9d7e-46b20874023d",
  "kind": null,
  "url": "http://fhir.smart4health.eu/Questionnaire/pre-training-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"
    } ]
  } ]
}