{
"description": null,
"_filename": "example/Questionnaire-AUDIT-C.json",
"package_name": "hl7.fhir.us.core",
"subjectType": [ "Patient" ],
"date": "2023-08-14",
"meta": {
"profile": [ "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire" ]
},
"publisher": "HL7 International / Cross-Group Projects",
"jurisdiction": [ {
"coding": [ {
"code": "US",
"system": "urn:iso:std:iso:3166"
} ]
} ],
"name": "AUDIT_C",
"item": [ {
"code": [ {
"code": "68517-2",
"system": "http://loinc.org",
"display": "How many times in the past year have you have X or more drinks in a day?"
} ],
"item": [ {
"text": "Where X is 5 for men and 4 for women, and a response of greater than, or equal to, 1 is positive.",
"type": "display",
"linkId": "/68517-2-help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "How many times in the past year have you have X or more drinks in a day?",
"type": "decimal",
"linkId": "/68517-2",
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"code": "{#}/a",
"system": "http://unitsofmeasure.org",
"display": "{#}/a"
}
} ]
}, {
"code": [ {
"code": "68519-8",
"system": "http://loinc.org",
"display": "How many standard drinks containing alcohol do you have on a typical day?"
} ],
"text": "How many standard drinks containing alcohol do you have on a typical day?",
"type": "choice",
"linkId": "/68519-8",
"required": false,
"extension": [ {
"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": [ {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "0"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 0
} ],
"valueCoding": {
"code": "LA15694-5",
"system": "http://loinc.org",
"display": "1 or 2"
}
}, {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "1"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 1
} ],
"valueCoding": {
"code": "LA15695-2",
"system": "http://loinc.org",
"display": "3 or 4"
}
}, {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "2"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 2
} ],
"valueCoding": {
"code": "LA18930-0",
"system": "http://loinc.org",
"display": "5 or 6"
}
}, {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "3"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 3
} ],
"valueCoding": {
"code": "LA18931-8",
"system": "http://loinc.org",
"display": "7 to 9"
}
}, {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "4"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 4
} ],
"valueCoding": {
"code": "LA18932-6",
"system": "http://loinc.org",
"display": "10 or more"
}
} ]
}, {
"code": [ {
"code": "68520-6",
"system": "http://loinc.org",
"display": "How often do you have 6 or more drinks on 1 occasion?"
} ],
"text": "How often do you have 6 or more drinks on 1 occasion?",
"type": "choice",
"linkId": "/68520-6",
"required": false,
"extension": [ {
"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": [ {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "0"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 0
} ],
"valueCoding": {
"code": "LA6270-8",
"system": "http://loinc.org",
"display": "Never"
}
}, {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "1"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 1
} ],
"valueCoding": {
"code": "LA18933-4",
"system": "http://loinc.org",
"display": "Less than monthly"
}
}, {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "2"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 2
} ],
"valueCoding": {
"code": "LA18876-5",
"system": "http://loinc.org",
"display": "Monthly"
}
}, {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "3"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 3
} ],
"valueCoding": {
"code": "LA18891-4",
"system": "http://loinc.org",
"display": "Weekly"
}
}, {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString": "4"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
"valueDecimal": 4
} ],
"valueCoding": {
"code": "LA18934-2",
"system": "http://loinc.org",
"display": "Daily or almost daily"
}
} ]
}, {
"code": [ {
"code": "75626-2",
"system": "http://loinc.org",
"display": "Total score [AUDIT-C]"
} ],
"item": [ {
"text": "The Alcohol Use Disorders Identification Test C (AUDIT-C) is scored on a scale of 0-12 where the higher the score, the more likely the patient's drinking is hazardous. A score of 4 or more for men and 3 or more for women is considered positive for hazardous drinking or active alcohol use disorders. If the points are all from Question 1 alone where 2 and 3 are 0, it is likely the patient is drinking below recommended limits. The care provider may review the patients alcohol intake over that past few months to confirm accuracy. [PMID: 12695273]",
"type": "display",
"linkId": "/75626-2-help",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"text": "Help-Button",
"coding": [ {
"code": "help",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Help-Button"
} ]
}
} ]
} ],
"text": "Total score [AUDIT-C]",
"type": "decimal",
"linkId": "/75626-2",
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"code": "{score}",
"system": "http://unitsofmeasure.org",
"display": "{score}"
}
} ]
} ],
"copyright": "Used by permission of HL7 International, all rights reserved Creative Commons License",
"type": null,
"experimental": "true",
"resourceType": "Questionnaire",
"title": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]",
"package_version": "7.0.0",
"status": "active",
"id": "6a82c7dd-14c1-4394-bc5a-3f474dea3f55",
"kind": null,
"url": "http://hl7.org/fhir/us/core/Questionnaire/AUDIT-C",
"code": [ {
"code": "72109-2",
"system": "http://loinc.org",
"display": "Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]"
} ],
"identifier": [ {
"value": "urn:oid:2.16.840.1.113883.4.642.40.2.35.1",
"system": "urn:ietf:rfc:3986"
} ],
"version": "7.0.0",
"contact": [ {
"name": "HL7 International / Cross-Group Projects",
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/cgp",
"system": "url"
}, {
"value": "cgp@lists.HL7.org",
"system": "email"
} ]
} ]
}