{ "description": "Pre-session treatment questionnaire", "_filename": "examples/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": "0.5.1", "status": "draft", "language": "en", "id": "82983f05-c4c7-47eb-841a-b920407b7067", "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" } ] } ] }