2025.2.0 - ci-build

IGTTPFHIRGatewaygICS - Local Development build (v2025.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ConsentTemplate - Detailed Descriptions

Active as of 2025-06-12

Definitions for the ConsentTemplate resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Questionnaire
Definition

A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection.

ShortA structured set of questions
Control0..*
Alternate NamesForm, CRF, Survey
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
que-2: The link ids for groups and questions must be unique within the questionnaire (descendants().linkId.isDistinct())
que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
2. Questionnaire.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
This element is affected by the following invariants: ele-1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Questionnaire.language
Definition

The base language in which the resource is written.

ShortSprache des ModulsLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
This element is affected by the following invariants: ele-1
BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages|4.0.1
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Questionnaire.extension:sourceDocument
Slice NamesourceDocument
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Quelldokument des Questionnaires) (Extension Type: Attachment)
Must Supporttrue
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Questionnaire.extension:sourceDocument.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://fhir.de/ConsentManagement/StructureDefinition/SourceDocument
10. Questionnaire.extension:sourceDocument.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

ShortValue of extension
Control10..1
This element is affected by the following invariants: ele-1
TypeAttachment, date, Meta, Address, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Must Supporttrue
Standard StatusNormative (from Trial Use)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Questionnaire.extension:sourceDocument.value[x].contentType
Definition

Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

ShortMime type of the content, with charset etc.
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Control10..1
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from Mime Typeshttp://hl7.org/fhir/ValueSet/mimetypes|4.0.1
(required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

The mime type of an attachment. Any valid mime type is allowed.

Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Standard StatusNormative (from Trial Use)
Summarytrue
Requirements

Processors of the data need to be able to know how to interpret the data.

ExampleGeneral: text/plain; charset=UTF-8, image/png
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Questionnaire.extension:sourceDocument.value[x].data
Definition

The actual data of the attachment - a sequence of bytes, base64 encoded.

ShortData inline, base64ed
Comments

The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

Control10..1
This element is affected by the following invariants: ele-1
Typebase64Binary
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Standard StatusNormative (from Trial Use)
Requirements

The data needs to able to be transmitted inline.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Questionnaire.extension:signatureRequired
Slice NamesignatureRequired
Definition

Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.

ShortIs signature needed?
Comments

If this appears at the Questionnaire level, then the signature will be gathered for the entire form when it is marked complete. If it appears on a particular item, then it will be gathered on that question or group when it is filled in. (E.g. seeking the user's initials beside certain questions.)

The signature can be captured using the http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature extension.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
Must Supporttrue
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Questionnaire.extension:signatureRequired.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..0*
This element is affected by the following invariants: ele-1
TypeExtension
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Questionnaire.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 20. Questionnaire.extension:signatureRequired.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/questionnaire-signatureRequired
    22. Questionnaire.extension:signatureRequired.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control10..1
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from For codes, see SignatureTypeCodes
    (extensible to http://hl7.org/fhir/ValueSet/signature-type)

    The type of signature needed.

    TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Standard StatusNormative (from Trial Use)
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Questionnaire.extension:signatureRequired.value[x].coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control10..*
    This element is affected by the following invariants: ele-1
    TypeCoding
    Standard StatusNormative (from Trial Use)
    Summarytrue
    Requirements

    Allows for alternative encodings within a code system, and translations to other code systems.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Questionnaire.extension:signatureRequired.value[x].coding.system
    Definition

    The identification of the code system that defines the meaning of the symbol in the code.

    ShortIdentity of the terminology system
    Comments

    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

    Control10..1
    This element is affected by the following invariants: ele-1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Standard StatusNormative (from Trial Use)
    Summarytrue
    Requirements

    Need to be unambiguous about the source of the definition of the symbol.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Questionnaire.extension:signatureRequired.value[x].coding.code
    Definition

    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

    ShortSymbol in syntax defined by the system
    Comments

    Note that FHIR strings SHALL NOT exceed 1MB in size

    Control10..1
    This element is affected by the following invariants: ele-1
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Standard StatusNormative (from Trial Use)
    Summarytrue
    Requirements

    Need to refer to a particular code in the system.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Questionnaire.extension:created
    Slice Namecreated
    Definition

    Erstellungsdatum der Ressource/Information

    ShortCreated
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Created) (Extension Type: instant)
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    32. Questionnaire.extension:externalProperty
    Slice NameexternalProperty
    Definition

    ExternalProperty

    ShortExternalProperty
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(External Property Element) (Complex Extension)
    Must Supporttrue
    Standard StatusNormative (from Trial Use)
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    34. Questionnaire.extension:expirationProperty
    Slice NameexpirationProperty
    Definition

    Expiration Property

    ShortExpiration Property
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Expiration Property) (Complex Extension)
    Must Supporttrue
    Standard StatusNormative (from Trial Use)
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    36. Questionnaire.extension:label
    Slice Namelabel
    Definition

    Label in einem Questionnaire

    ShortQuestionnaire Label
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Questionnaire Label) (Extension Type: string)
    Must Supporttrue
    Standard StatusNormative (from Trial Use)
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    38. Questionnaire.extension:versionLabel
    Slice NameversionLabel
    Definition

    Versions-Label

    ShortVersions-Label
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Version Label) (Extension Type: string)
    Must Supporttrue
    Standard StatusNormative (from Trial Use)
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    40. Questionnaire.extension:versionLabel.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..0*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Questionnaire.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 42. Questionnaire.extension:versionLabel.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuehttps://ths-greifswald.de/fhir/StructureDefinition/gics/VersionLabel
      44. Questionnaire.extension:versionLabel.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      This element is affected by the following invariants: ele-1
      Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Standard StatusNormative (from Trial Use)
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Questionnaire.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Standard StatusNormative (from Trial Use)
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Questionnaire.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 48. Questionnaire.url
        Definition

        Kanonischer, global eindeutiger Name ("Canonical identifier") des Templates Frames. Wird benötigt zur Rückreferenzierung aus dem QuestionnaireComposed.


        An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.

        ShortKanonischer, global eindeutiger Name ("Canonical identifier") des Templates FramesCanonical identifier for this questionnaire, represented as a URI (globally unique)
        Comments

        Beispiel: http://meine-klinik.de/fhir/NamingSystem/ProjektX/FragebogenTemplate12


        The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension.

        Control10..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        … This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Questionnaire.identifier
        Definition

        Identifikator eines Moduls. Dient dem Zweck des systemübergreifen Identifizierens, z.B. beim verteilten Consent Management


        A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance.

        ShortIdentifikator eines Template-FramesAdditional identifier for the questionnaire
        Comments

        Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this questionnaire outside of FHIR, where it is not possible to use the logical URI.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeIdentifier
        Must Supporttrue
        Summarytrue
        Requirements

        Allows externally provided and/or usable business identifiers to be easily associated with the module.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Questionnaire.identifier.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Questionnaire.identifier.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control10..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        ExampleGeneral: http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Questionnaire.identifier.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        This element is affected by the following invariants: ele-1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        ExampleGeneral: 123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Questionnaire.version
        Definition

        The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

        ShortVersionsangabe des Template FramesBusiness version of the questionnaire
        Comments

        There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version].

        NoteThis is a business version Id, not a resource version Id (see discussion)
        Control10..1
        This element is affected by the following invariants: ele-1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Questionnaire.name
        Definition

        A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation.

        ShortName des Template FramesName for this questionnaire (computer friendly)
        Comments

        The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

        Control10..1
        This element is affected by the following invariants: ele-1, inv-0
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Support human navigation and code generation.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Questionnaire.title
        Definition

        Titel des Consent Moduls zur Darstellung auf dem späteren Consent Template


        A short, descriptive, user-friendly title for the questionnaire.

        ShortAnzuzeigender Kurztitel der EinwilligungName for this questionnaire (human friendly)
        Comments

        This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Questionnaire.status
        Definition

        The status of this questionnaire. Enables tracking the life-cycle of the content.

        Shortdraft | active | retired | unknown
        Comments

        Allows filtering of questionnaires that are appropriate for use versus not.

        Control1..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

        The lifecycle status of an artifact.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Questionnaire.contact
        Definition

        Inhaltlicher Ansprechpartner der auf der Einwilligungsvorlage angezeigt werden soll


        Contact details to assist a user in finding and communicating with the publisher.

        ShortAnsprechpartnerContact details for the publisher
        Comments

        May be a web site, an email address, a telephone number, etc.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeContactDetail
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Questionnaire.description
        Definition

        A free text natural language description of the questionnaire from a consumer's perspective.

        ShortZweckbeschreibung des Consent ModulesNatural language description of the questionnaire
        Comments

        This description can be used to capture details such as why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created).

        Control0..1
        This element is affected by the following invariants: ele-1
        Typemarkdown
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. Questionnaire.useContext
        Definition

        The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate questionnaire instances.

        ShortThe context that the content is intended to support
        Comments

        When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

        Control10..*
        This element is affected by the following invariants: ele-1
        TypeUsageContext
        Must Supporttrue
        Summarytrue
        Requirements

        Assist in searching for appropriate content.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Questionnaire.useContext.code
        Definition

        A code that identifies the type of context being specified by this usage context.

        ShortType of context being specified
        Comments

        Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

        Control1..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from ConsentManagementQuestionnaireComponentshttp://hl7.org/fhir/ValueSet/usage-context-type|4.0.1
        (required to http://fhir.de/ConsentManagement/ValueSet/QuestionnaireComponents)

        A code that specifies a type of context being specified by a usage context.

        TypeCoding
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. Questionnaire.useContext.code.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control10..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. Questionnaire.useContext.code.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control10..1
        This element is affected by the following invariants: ele-1
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. Questionnaire.useContext.value[x]
        Definition

        A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

        ShortValue that defines the context
        Control1..1
        This element is affected by the following invariants: ele-1
        TypeReference(Consent Management Domain Research Study, PlanDefinition, ResearchStudy, InsurancePlan, HealthcareService, Group, Location, Organization), Quantity, Range, CodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Must Supporttrue
        Standard StatusNormative (from Trial Use)
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. Questionnaire.useContext.value[x].reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control10..1
        This element is affected by the following invariants: ele-1, ref-1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. Questionnaire.code
        Definition

        An identifier for this question or group of questions in a particular terminology such as LOINC.

        ShortConcept that represents the overall questionnaire
        Comments

        Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

        Control10..1*
        This element is affected by the following invariants: ele-1
        BindingUnless not suitable, these codes SHALL be taken from For example codes, see ConsentManagementTemplateTypehttp://hl7.org/fhir/ValueSet/questionnaire-questions|4.0.1
        (extensible to http://fhir.de/ConsentManagement/ValueSet/TemplateType)

        Codes for questionnaires, groups and individual questions.

        TypeCoding
        Must Supporttrue
        Summarytrue
        Requirements

        Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. Questionnaire.code.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control10..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. Questionnaire.code.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control10..1
        This element is affected by the following invariants: ele-1
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. Questionnaire.item
        Definition

        A particular question, question grouping or display text that is part of the questionnaire.

        ShortQuestions and sections within the Questionnaire
        Comments

        The content of the questionnaire is constructed from an ordered, hierarchical collection of items.

        Control10..*
        This element is affected by the following invariants: ele-1, que-3
        TypeBackboneElement
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        que-9: Read-only can't be specified for "display" items (type!='display' or readOnly.empty())
        que-8: Initial values can't be specified for groups or display items ((type!='group' and type!='display') or initial.empty())
        que-6: Required and repeat aren't permitted for display items (type!='display' or (required.empty() and repeats.empty()))
        que-5: Only 'choice' and 'open-choice' items can have answerValueSet ((type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty()))
        que-4: A question cannot have both answerOption and answerValueSet (answerOption.empty() or answerValueSet.empty())
        que-3: Display items cannot have a "code" asserted (type!='display' or code.empty())
        que-10: Maximum length can only be declared for simple question types ((type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty())
        que-1: Group items must have nested items, display items cannot have nested items ((type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty()))
        que-13: Can only have multiple initial values for repeating items (repeats=true or initial.count() <= 1)
        que-11: If one or more answerOption is present, initial[x] must be missing (answerOption.empty() or initial.empty())
        que-12: If there are more than one enableWhen, enableBehavior must be specified (enableWhen.count() > 2 implies enableBehavior.exists())
        90. Questionnaire.item.extension:designNote
        Slice NamedesignNote
        Definition

        Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

        ShortDesign comments
        Comments

        Allows capture of todos, rationale for design decisions, etc.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Design Note) (Extension Type: markdown)
        Must Supporttrue
        Standard StatusNormative (from Trial Use)
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        92. Questionnaire.item.extension:subQuestionnaire
        Slice NamesubQuestionnaire
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Consent Management Sub-Questionnaire) (Extension Type: Reference(Consent Management Template Module))
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        94. Questionnaire.item.extension:subQuestionnaire.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..0*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Questionnaire.item.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 96. Questionnaire.item.extension:subQuestionnaire.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valuehttp://fhir.de/ConsentManagement/StructureDefinition/SubQuestionnaire
          98. Questionnaire.item.extension:subQuestionnaire.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control10..1
          This element is affected by the following invariants: ele-1
          TypeReference(Consent Management Template Module, Consent Module), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Standard StatusNormative (from Trial Use)
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          100. Questionnaire.item.extension:subQuestionnaire.value[x].reference
          Definition

          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

          ShortLiteral reference, Relative, internal or absolute URL
          Comments

          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

          Control10..1
          This element is affected by the following invariants: ele-1, ref-1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          102. Questionnaire.item.extension:subQuestionnaire.value[x].type
          Definition

          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

          ShortType the reference refers to (e.g. "Patient")
          Comments

          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

          Control0..01
          This element is affected by the following invariants: ele-1
          BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types|4.0.1
          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

          Aa resource (or, for logical models, the URI of the logical model).

          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          104. Questionnaire.item.extension:subQuestionnaire.value[x].identifier
          Definition

          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

          ShortLogical reference, when literal reference is not known
          Comments

          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..01
          This element is affected by the following invariants: ele-1
          TypeIdentifier
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. Questionnaire.item.extension:subQuestionnaire.value[x].display
          Definition

          Plain text narrative that identifies the resource in addition to the resource reference.

          ShortText alternative for the resource
          Comments

          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

          Control0..01
          This element is affected by the following invariants: ele-1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. Questionnaire.item.extension:externalProperty
          Slice NameexternalProperty
          Definition

          ExternalProperty

          ShortExternalProperty
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(External Property Element) (Complex Extension)
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          110. Questionnaire.item.extension:expirationProperty
          Slice NameexpirationProperty
          Definition

          Expiration Property

          ShortExpiration Property
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Expiration Property) (Complex Extension)
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          112. Questionnaire.item.extension:freeTextDefAttributes
          Slice NamefreeTextDefAttributes
          Definition

          ExternalProperty

          ShortExternalProperty
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(FreeTextDef Attributes) (Complex Extension)
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          114. Questionnaire.item.extension:position
          Slice Nameposition
          Definition

          Position (Ordinate) eines Items im Questionnaire. Im Kontext von FHIR ist diese Angabe redundant, wird aber dennoch mitgeführt

          ShortPosition
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Position) (Extension Type: integer)
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          116. Questionnaire.item.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          118. Questionnaire.item.linkId
          Definition

          An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.

          ShortUnique id for item in questionnaire
          Comments

          This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

          Control1..1
          This element is affected by the following invariants: ele-1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Requirements

          QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.


          QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. Questionnaire.item.code
          Definition

          A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers).

          ShortCorresponding concept for this item in a terminology
          Comments

          The value may come from the ElementDefinition referred to by .definition.

          Control0..*
          This element is affected by the following invariants: ele-1, que-3
          BindingFor example codes, see QuestionnaireQuestionCodeshttp://hl7.org/fhir/ValueSet/questionnaire-questions|4.0.1
          (example to http://hl7.org/fhir/ValueSet/questionnaire-questions)

          Codes for questionnaires, groups and individual questions.

          TypeCoding
          Must Supporttrue
          Requirements

          Allows linking of groups of questions to formal terminologies.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          122. Questionnaire.item.code.system
          Definition

          The identification of the code system that defines the meaning of the symbol in the code.

          ShortIdentity of the terminology system
          Comments

          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

          Control10..1
          This element is affected by the following invariants: ele-1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need to be unambiguous about the source of the definition of the symbol.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          124. Questionnaire.item.code.code
          Definition

          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          ShortSymbol in syntax defined by the system
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control10..1
          This element is affected by the following invariants: ele-1
          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need to refer to a particular code in the system.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          126. Questionnaire.item.text
          Definition

          The name of a section, the text of a question or text content for a display item.

          ShortPrimary text for the item
          Comments

          When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading. Group item instructions should be included as a display type item within the group.

          Control0..1
          This element is affected by the following invariants: ele-1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          128. Questionnaire.item.text.extension:renderingMarkdown
          Slice NamerenderingMarkdown
          Definition

          This is an equivalent of the string on which the extension is sent, but includes additional markdown (see documentation about markdown. Note that using HTML xhtml can allow for greater precision of display.

          ShortString equivalent with markdown
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Markdown) (Extension Type: markdown)
          Standard StatusNormative (from Trial Use)
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          130. Questionnaire.item.text.extension:renderingXhtml
          Slice NamerenderingXhtml
          Definition

          This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.

          ShortString equivalent with html markup
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(XHTML Representation) (Extension Type: string)
          Standard StatusNormative (from Trial Use)
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          132. Questionnaire.item.type
          Definition

          The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.).

          Shortgroup | display | boolean | decimal | integer | date | dateTime +
          Comments

          Additional constraints on the type of answer can be conveyed by extensions. The value may come from the ElementDefinition referred to by .definition.

          Control1..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from QuestionnaireItemTypehttp://hl7.org/fhir/ValueSet/item-type|4.0.1
          (required to http://hl7.org/fhir/ValueSet/item-type|4.0.1)

          Distinguishes groups from questions and display text and indicates data type for questions.

          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Requirements

          Defines the format in which the user is to be prompted for the answer.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          134. Questionnaire.item.enableWhen
          Definition

          A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true.

          ShortOnly allow data when
          Comments

          If multiple repetitions of this extension are present, the item should be enabled when the condition for any of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeBackboneElement
          Is Modifiertrue because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
          Must Supporttrue
          Requirements

          Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          que-7: If the operator is 'exists', the value must be a boolean (operator = 'exists' implies (answer is Boolean))
          136. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire
          Slice NamesourceSubQuestionnaire
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Consent Management Sub-Questionnaire) (Extension Type: Reference(Consent Management Template Module))
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          138. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valuehttp://fhir.de/ConsentManagement/StructureDefinition/SubQuestionnaire
          140. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control10..1
          This element is affected by the following invariants: ele-1
          TypeReference(Consent Management Template Module), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          142. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].reference
          Definition

          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

          ShortLiteral reference, Relative, internal or absolute URL
          Comments

          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

          Control10..1
          This element is affected by the following invariants: ele-1, ref-1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          144. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].type
          Definition

          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

          ShortType the reference refers to (e.g. "Patient")
          Comments

          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

          Control0..01
          This element is affected by the following invariants: ele-1
          BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types|4.0.1
          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

          Aa resource (or, for logical models, the URI of the logical model).

          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          146. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].identifier
          Definition

          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

          ShortLogical reference, when literal reference is not known
          Comments

          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..01
          This element is affected by the following invariants: ele-1
          TypeIdentifier
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          148. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].display
          Definition

          Plain text narrative that identifies the resource in addition to the resource reference.

          ShortText alternative for the resource
          Comments

          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

          Control0..01
          This element is affected by the following invariants: ele-1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Standard StatusNormative (from Trial Use)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          150. Questionnaire.item.enableWhen.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          152. Questionnaire.item.enableWhen.question
          Definition

          The linkId for the question whose answer (or lack of answer) governs whether this item is enabled.

          ShortQuestion that determines whether item is enabled
          Comments

          If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the "ancestor" axis and then the "preceding" axis and then the "following" axis.

          Control1..1
          This element is affected by the following invariants: ele-1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          154. Questionnaire.item.enableWhen.operator
          Definition

          Specifies the criteria by which the question is enabled.

          Shortexists | = | != | > | < | >= | <=
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control1..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from QuestionnaireItemOperatorhttp://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1
          (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1)

          The criteria by which a question is enabled.

          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          156. Questionnaire.item.enableWhen.answer[x]
          Definition

          A value that the referenced question is tested using the specified operator in order for the item to be enabled.

          ShortValue for question comparison based on operator
          Control1..1
          This element is affected by the following invariants: ele-1, que-7
          BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1
          (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

          Allowed values to answer questions.

          TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, Coding, Quantity, Reference(Resource, Resource)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          158. Questionnaire.item.enableBehavior
          Definition

          Controls how multiple enableWhen values are interpreted - whether all or any must be true.

          Shortall | any
          Comments

          This element must be specified if more than one enableWhen value is provided.

          Control0..1
          This element is affected by the following invariants: ele-1, que-12
          BindingThe codes SHALL be taken from EnableWhenBehaviorhttp://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1
          (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1)

          Controls how multiple enableWhen values are interpreted - whether all or any must be true.

          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          160. Questionnaire.item.required
          Definition

          An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire.

          ShortWhether the item must be included in data results
          Comments

          Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition.

          Control0..1
          This element is affected by the following invariants: ele-1, que-6
          Typeboolean
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Meaning if MissingItems are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          162. Questionnaire.item.repeats
          Definition

          An indication, if true, that the item may occur multiple times in the response, collecting multiple answers for questions or multiple sets of answers for groups.

          ShortWhether the item may repeat
          Comments

          If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items.

          The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values.

          The value may come from the ElementDefinition referred to by .definition.

          Control0..1
          This element is affected by the following invariants: ele-1, que-6
          Typeboolean
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Requirements

          Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set.

          Meaning if MissingItems are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          164. Questionnaire.item.readOnly
          Definition

          An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.

          ShortDon't allow human editing
          Comments

          The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers.

          Control0..1
          This element is affected by the following invariants: ele-1, que-9
          Typeboolean
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Requirements

          Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          166. Questionnaire.item.maxLength
          Definition

          The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse.

          ShortNo more than this many characters
          Comments

          For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition.

          Control0..1
          This element is affected by the following invariants: ele-1, que-10
          Typeinteger
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          168. Questionnaire.item.answerValueSet
          Definition

          A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" question.

          ShortValueset containing permitted answers
          Comments

          LOINC defines many useful value sets for questionnaire responses. See LOINC Answer Lists. The value may come from the ElementDefinition referred to by .definition.

          Control0..1
          This element is affected by the following invariants: ele-1, que-4, que-5
          Typecanonical(ValueSet, ValueSet)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          170. Questionnaire.item.answerOption
          Definition

          One of the permitted answers for a "choice" or "open-choice" question.

          ShortPermitted answer
          Comments

          This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes.

          Control0..*
          This element is affected by the following invariants: ele-1, que-4, que-5
          TypeBackboneElement
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          172. Questionnaire.item.answerOption.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          174. Questionnaire.item.answerOption.value[x]
          Definition

          A potential answer that's allowed as the answer to this question.

          ShortAnswer value
          Comments

          The data type of the value must agree with the item.type.

          Control1..1
          This element is affected by the following invariants: ele-1
          BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1
          (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

          Allowed values to answer questions.

          TypeChoice of: integer, date, time, string, Coding, Reference(Resource, Resource)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Standard StatusNormative (from Trial Use)
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          176. Questionnaire.item.answerOption.initialSelected
          Definition

          Indicates whether the answer value is selected when the list of possible answers is initially shown.

          ShortWhether option is selected by default
          Comments

          Use this instead of initial[v] if answerValueSet is present.

          Control0..1
          This element is affected by the following invariants: ele-1
          Typeboolean
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Standard StatusNormative (from Trial Use)
          Meaning if MissingOnly selected items explicitly marked to be selected
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          178. Questionnaire.item.initial
          Definition

          One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.

          ShortInitial value(s) when item is first rendered
          Comments

          The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial[x] must agree with the item.type, and only repeating items can have more then one initial value.

          Control0..*
          This element is affected by the following invariants: ele-1, que-8, que-13
          TypeBackboneElement
          Must Supporttrue
          Requirements

          In some workflows, having defaults saves time.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          180. Questionnaire.item.initial.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          182. Questionnaire.item.initial.value[x]
          Definition

          The actual value to for an initial answer.

          ShortActual value for initializing the question
          Comments

          The type of the initial value must be consistent with the type of the item.

          Control1..1
          This element is affected by the following invariants: ele-1
          BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1
          (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

          Allowed values to answer questions.

          TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource, Resource)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Standard StatusNormative (from Trial Use)
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          184. Questionnaire.item.item
          Definition

          Text, questions and other groups to be nested beneath a question or group.

          ShortNested questionnaire items
          Comments

          There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting.

          Control0..*
          This element is affected by the following invariants: que-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
          Must Supporttrue
          Requirements

          Reports can consist of complex nested groups.

          Guidance on how to interpret the contents of this table can be foundhere

          0. Questionnaire
          2. Questionnaire.extension:created
          Slice Namecreated
          Control0..1
          TypeExtension(Created) (Extension Type: instant)
          Must Supporttrue
          4. Questionnaire.extension:externalProperty
          Slice NameexternalProperty
          Control0..*
          TypeExtension(External Property Element) (Complex Extension)
          Must Supporttrue
          Standard StatusNormative (from Normative)
          6. Questionnaire.extension:expirationProperty
          Slice NameexpirationProperty
          Control0..*
          TypeExtension(Expiration Property) (Complex Extension)
          Must Supporttrue
          Standard StatusNormative (from Normative)
          8. Questionnaire.extension:label
          Slice Namelabel
          Control0..*
          TypeExtension(Questionnaire Label) (Extension Type: string)
          Must Supporttrue
          Standard StatusNormative (from Normative)
          10. Questionnaire.extension:versionLabel
          Slice NameversionLabel
          Control0..1
          TypeExtension(Version Label) (Extension Type: string)
          Must Supporttrue
          Standard StatusNormative (from Normative)
          12. Questionnaire.extension:versionLabel.value[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          Standard StatusNormative (from Normative)
          14. Questionnaire.useContext
          16. Questionnaire.useContext.value[x]
          TypeReference(Consent Management Domain Research Study)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Standard StatusNormative (from Normative)
          18. Questionnaire.item
          20. Questionnaire.item.extension:subQuestionnaire
          Slice NamesubQuestionnaire
          22. Questionnaire.item.extension:subQuestionnaire.extension
          Control0..0
          24. Questionnaire.item.extension:subQuestionnaire.value[x]
          TypeReference(Consent Management Template Module, Consent Module)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Standard StatusNormative (from Normative)
          26. Questionnaire.item.extension:externalProperty
          Slice NameexternalProperty
          Control0..*
          TypeExtension(External Property Element) (Complex Extension)
          Must Supporttrue
          Standard StatusNormative (from Normative)
          28. Questionnaire.item.extension:expirationProperty
          Slice NameexpirationProperty
          Control0..*
          TypeExtension(Expiration Property) (Complex Extension)
          Must Supporttrue
          Standard StatusNormative (from Normative)
          30. Questionnaire.item.extension:freeTextDefAttributes
          Slice NamefreeTextDefAttributes
          Control0..1
          TypeExtension(FreeTextDef Attributes) (Complex Extension)
          Must Supporttrue
          Standard StatusNormative (from Normative)
          32. Questionnaire.item.extension:position
          Slice Nameposition
          Control0..1
          TypeExtension(Position) (Extension Type: integer)
          Must Supporttrue
          Standard StatusNormative (from Normative)
          34. Questionnaire.item.answerOption
          36. Questionnaire.item.answerOption.value[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          Standard StatusNormative (from Normative)
          38. Questionnaire.item.answerOption.initialSelected
          Must Supporttrue
          Standard StatusNormative (from Normative)
          40. Questionnaire.item.initial
          42. Questionnaire.item.initial.value[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          Standard StatusNormative (from Normative)

          Guidance on how to interpret the contents of this table can be foundhere

          0. Questionnaire
          Definition

          A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection.

          ShortA structured set of questions
          Control0..*
          Alternate NamesForm, CRF, Survey
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          que-2: The link ids for groups and questions must be unique within the questionnaire (descendants().linkId.isDistinct())
          que-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
          2. Questionnaire.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Control0..1
          Typeid
          Summarytrue
          4. Questionnaire.meta
          Definition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          ShortMetadata about the resource
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeMeta
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Questionnaire.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Control0..1
          This element is affected by the following invariants: ele-1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. Questionnaire.language
          Definition

          The base language in which the resource is written.

          ShortSprache des Moduls
          Comments

          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. Questionnaire.text
          Definition

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          ShortText summary of the resource, for human interpretation
          Comments

          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeNarrative
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Questionnaire.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          ShortContained, inline Resources
          Comments

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Control0..*
          TypeResource
          Alternate Namesinline resources, anonymous resources, contained resources
          14. Questionnaire.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Standard StatusNormative (from Trial Use)
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Questionnaire.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. Questionnaire.extension:sourceDocument
            Slice NamesourceDocument
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(Quelldokument des Questionnaires) (Extension Type: Attachment)
            Must Supporttrue
            Standard StatusNormative (from Trial Use)
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. Questionnaire.extension:sourceDocument.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            XML FormatIn the XML format, this property is represented as an attribute.
            20. Questionnaire.extension:sourceDocument.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Standard StatusNormative (from Trial Use)
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Questionnaire.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 22. Questionnaire.extension:sourceDocument.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttp://fhir.de/ConsentManagement/StructureDefinition/SourceDocument
              24. Questionnaire.extension:sourceDocument.value[x]
              Definition

              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

              ShortValue of extension
              Control1..1
              This element is affected by the following invariants: ele-1
              TypeAttachment
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Must Supporttrue
              Standard StatusNormative (from Trial Use)
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              26. Questionnaire.extension:sourceDocument.value[x].id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              XML FormatIn the XML format, this property is represented as an attribute.
              28. Questionnaire.extension:sourceDocument.value[x].extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Standard StatusNormative (from Trial Use)
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Questionnaire.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 30. Questionnaire.extension:sourceDocument.value[x].contentType
                Definition

                Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

                ShortMime type of the content, with charset etc.
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control1..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from Mime Types
                (required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

                The mime type of an attachment. Any valid mime type is allowed.

                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                Processors of the data need to be able to know how to interpret the data.

                ExampleGeneral: text/plain; charset=UTF-8, image/png
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                32. Questionnaire.extension:sourceDocument.value[x].language
                Definition

                The human language of the content. The value can be any valid value according to BCP 47.

                ShortHuman language of the content (BCP-47)
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHOULD be taken from CommonLanguages
                (preferred to http://hl7.org/fhir/ValueSet/languages)

                A human language.

                Additional BindingsPurpose
                AllLanguagesMax Binding
                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                Users need to be able to choose between the languages in a set of attachments.

                ExampleGeneral: en-AU
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                34. Questionnaire.extension:sourceDocument.value[x].data
                Definition

                The actual data of the attachment - a sequence of bytes, base64 encoded.

                ShortData inline, base64ed
                Comments

                The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

                Control1..1
                This element is affected by the following invariants: ele-1
                Typebase64Binary
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Standard StatusNormative (from Trial Use)
                Requirements

                The data needs to able to be transmitted inline.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. Questionnaire.extension:sourceDocument.value[x].url
                Definition

                A location where the data can be accessed.

                ShortUri where the data can be found
                Comments

                If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

                Control0..1
                This element is affected by the following invariants: ele-1
                Typeurl
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                The data needs to be transmitted by reference.

                ExampleGeneral: http://www.acme.com/logo-small.png
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. Questionnaire.extension:sourceDocument.value[x].size
                Definition

                The number of bytes of data that make up this attachment (before base64 encoding, if that is done).

                ShortNumber of bytes of content (if url provided)
                Comments

                The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeunsignedInt
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. Questionnaire.extension:sourceDocument.value[x].hash
                Definition

                The calculated hash of the data using SHA-1. Represented using base64.

                ShortHash of the data (sha-1, base64ed)
                Comments

                The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.

                Control0..1
                This element is affected by the following invariants: ele-1
                Typebase64Binary
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. Questionnaire.extension:sourceDocument.value[x].title
                Definition

                A label or set of text to display in place of the data.

                ShortLabel to display in place of the data
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                This element is affected by the following invariants: ele-1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

                ExampleGeneral: Official Corporate Logo
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. Questionnaire.extension:sourceDocument.value[x].creation
                Definition

                The date that the attachment was first created.

                ShortDate attachment was first created
                Control0..1
                This element is affected by the following invariants: ele-1
                TypedateTime
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                This is often tracked as an integrity issue for use of the attachment.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. Questionnaire.extension:signatureRequired
                Slice NamesignatureRequired
                Definition

                Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.

                ShortIs signature needed?
                Comments

                If this appears at the Questionnaire level, then the signature will be gathered for the entire form when it is marked complete. If it appears on a particular item, then it will be gathered on that question or group when it is filled in. (E.g. seeking the user's initials beside certain questions.)

                The signature can be captured using the http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature extension.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(Questionnaire Signature Required) (Extension Type: CodeableConcept)
                Must Supporttrue
                Standard StatusNormative (from Trial Use)
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                48. Questionnaire.extension:signatureRequired.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                XML FormatIn the XML format, this property is represented as an attribute.
                50. Questionnaire.extension:signatureRequired.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..0
                This element is affected by the following invariants: ele-1
                TypeExtension
                Standard StatusNormative (from Trial Use)
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Questionnaire.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 52. Questionnaire.extension:signatureRequired.url
                  Definition

                  Source of the definition for the extension code - a logical name or a URL.

                  Shortidentifies the meaning of the extension
                  Comments

                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                  Control1..1
                  Typeuri
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/questionnaire-signatureRequired
                  54. Questionnaire.extension:signatureRequired.value[x]
                  Definition

                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                  ShortValue of extension
                  Control1..1
                  This element is affected by the following invariants: ele-1
                  BindingUnless not suitable, these codes SHALL be taken from SignatureTypeCodes
                  (extensible to http://hl7.org/fhir/ValueSet/signature-type)

                  The type of signature needed.

                  TypeCodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Standard StatusNormative (from Trial Use)
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. Questionnaire.extension:signatureRequired.value[x].id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  XML FormatIn the XML format, this property is represented as an attribute.
                  58. Questionnaire.extension:signatureRequired.value[x].extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Standard StatusNormative (from Trial Use)
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Questionnaire.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 60. Questionnaire.extension:signatureRequired.value[x].coding
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode defined by a terminology system
                    Comments

                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                    Control1..*
                    This element is affected by the following invariants: ele-1
                    TypeCoding
                    Standard StatusNormative (from Trial Use)
                    Summarytrue
                    Requirements

                    Allows for alternative encodings within a code system, and translations to other code systems.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    62. Questionnaire.extension:signatureRequired.value[x].coding.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    XML FormatIn the XML format, this property is represented as an attribute.
                    64. Questionnaire.extension:signatureRequired.value[x].coding.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Standard StatusNormative (from Trial Use)
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Questionnaire.extension.value[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 66. Questionnaire.extension:signatureRequired.value[x].coding.system
                      Definition

                      The identification of the code system that defines the meaning of the symbol in the code.

                      ShortIdentity of the terminology system
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                      Control1..1
                      This element is affected by the following invariants: ele-1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Standard StatusNormative (from Trial Use)
                      Summarytrue
                      Requirements

                      Need to be unambiguous about the source of the definition of the symbol.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      68. Questionnaire.extension:signatureRequired.value[x].coding.version
                      Definition

                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                      ShortVersion of the system - if relevant
                      Comments

                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                      NoteThis is a business version Id, not a resource version Id (see discussion)
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Standard StatusNormative (from Trial Use)
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      70. Questionnaire.extension:signatureRequired.value[x].coding.code
                      Definition

                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                      ShortSymbol in syntax defined by the system
                      Comments

                      Note that FHIR strings SHALL NOT exceed 1MB in size

                      Control1..1
                      This element is affected by the following invariants: ele-1
                      Typecode
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Standard StatusNormative (from Trial Use)
                      Summarytrue
                      Requirements

                      Need to refer to a particular code in the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      72. Questionnaire.extension:signatureRequired.value[x].coding.display
                      Definition

                      A representation of the meaning of the code in the system, following the rules of the system.

                      ShortRepresentation defined by the system
                      Comments

                      Note that FHIR strings SHALL NOT exceed 1MB in size

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Standard StatusNormative (from Trial Use)
                      Summarytrue
                      Requirements

                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      74. Questionnaire.extension:signatureRequired.value[x].coding.userSelected
                      Definition

                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                      ShortIf this coding was chosen directly by the user
                      Comments

                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typeboolean
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Standard StatusNormative (from Trial Use)
                      Summarytrue
                      Requirements

                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      76. Questionnaire.extension:signatureRequired.value[x].text
                      Definition

                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                      ShortPlain text representation of the concept
                      Comments

                      Very often the text is the same as a displayName of one of the codings.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Standard StatusNormative (from Trial Use)
                      Summarytrue
                      Requirements

                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      78. Questionnaire.extension:created
                      Slice Namecreated
                      Definition

                      Erstellungsdatum der Ressource/Information

                      ShortCreated
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Created) (Extension Type: instant)
                      Must Supporttrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      80. Questionnaire.extension:externalProperty
                      Slice NameexternalProperty
                      Definition

                      ExternalProperty

                      ShortExternalProperty
                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension(External Property Element) (Complex Extension)
                      Must Supporttrue
                      Standard StatusNormative (from Trial Use)
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      82. Questionnaire.extension:expirationProperty
                      Slice NameexpirationProperty
                      Definition

                      Expiration Property

                      ShortExpiration Property
                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Expiration Property) (Complex Extension)
                      Must Supporttrue
                      Standard StatusNormative (from Trial Use)
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      84. Questionnaire.extension:label
                      Slice Namelabel
                      Definition

                      Label in einem Questionnaire

                      ShortQuestionnaire Label
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Questionnaire Label) (Extension Type: string)
                      Must Supporttrue
                      Standard StatusNormative (from Trial Use)
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      86. Questionnaire.extension:versionLabel
                      Slice NameversionLabel
                      Definition

                      Versions-Label

                      ShortVersions-Label
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Version Label) (Extension Type: string)
                      Must Supporttrue
                      Standard StatusNormative (from Trial Use)
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      88. Questionnaire.extension:versionLabel.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      XML FormatIn the XML format, this property is represented as an attribute.
                      90. Questionnaire.extension:versionLabel.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control0..0
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Questionnaire.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 92. Questionnaire.extension:versionLabel.url
                        Definition

                        Source of the definition for the extension code - a logical name or a URL.

                        Shortidentifies the meaning of the extension
                        Comments

                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                        Control1..1
                        Typeuri
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed Valuehttps://ths-greifswald.de/fhir/StructureDefinition/gics/VersionLabel
                        94. Questionnaire.extension:versionLabel.value[x]
                        Definition

                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                        ShortValue of extension
                        Control1..1
                        This element is affected by the following invariants: ele-1
                        Typestring
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Standard StatusNormative (from Trial Use)
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        96. Questionnaire.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                        Standard StatusNormative (from Trial Use)
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Questionnaire.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 98. Questionnaire.url
                          Definition

                          Kanonischer, global eindeutiger Name ("Canonical identifier") des Templates Frames. Wird benötigt zur Rückreferenzierung aus dem QuestionnaireComposed.

                          ShortKanonischer, global eindeutiger Name ("Canonical identifier") des Templates Frames
                          Comments

                          Beispiel: http://meine-klinik.de/fhir/NamingSystem/ProjektX/FragebogenTemplate12

                          Control1..1
                          This element is affected by the following invariants: ele-1
                          Typeuri
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          … This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          100. Questionnaire.identifier
                          Definition

                          Identifikator eines Moduls. Dient dem Zweck des systemübergreifen Identifizierens, z.B. beim verteilten Consent Management

                          ShortIdentifikator eines Template-Frames
                          Comments

                          Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this questionnaire outside of FHIR, where it is not possible to use the logical URI.

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeIdentifier
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Allows externally provided and/or usable business identifiers to be easily associated with the module.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          102. Questionnaire.identifier.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          XML FormatIn the XML format, this property is represented as an attribute.
                          104. Questionnaire.identifier.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Standard StatusNormative (from Trial Use)
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Questionnaire.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 106. Questionnaire.identifier.use
                            Definition

                            The purpose of this identifier.

                            Shortusual | official | temp | secondary | old (If known)
                            Comments

                            Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            BindingThe codes SHALL be taken from IdentifierUse
                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                            Identifies the purpose for this identifier, if known .

                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            108. Questionnaire.identifier.type
                            Definition

                            A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                            ShortDescription of identifier
                            Comments

                            This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                            (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                            A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                            TypeCodeableConcept
                            Summarytrue
                            Requirements

                            Allows users to make use of identifiers when the identifier system is not known.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            110. Questionnaire.identifier.system
                            Definition

                            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                            ShortThe namespace for the identifier value
                            Comments

                            Identifier.system is always case sensitive.

                            Control1..1
                            This element is affected by the following invariants: ele-1
                            Typeuri
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                            ExampleGeneral: http://www.acme.com/identifiers/patient
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            112. Questionnaire.identifier.value
                            Definition

                            The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                            ShortThe value that is unique
                            Comments

                            If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                            Control1..1
                            This element is affected by the following invariants: ele-1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            ExampleGeneral: 123456
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            114. Questionnaire.identifier.period
                            Definition

                            Time period during which identifier is/was valid for use.

                            ShortTime period when id is/was valid for use
                            Comments

                            A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                            Period is not used for a duration (a measure of elapsed time). See Duration.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypePeriod
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                            116. Questionnaire.identifier.assigner
                            Definition

                            Organization that issued/manages the identifier.

                            ShortOrganization that issued id (may be just text)
                            Comments

                            The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeReference(Organization)
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                            118. Questionnaire.version
                            Definition

                            The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

                            ShortVersionsangabe des Template Frames
                            Comments

                            There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version].

                            NoteThis is a business version Id, not a resource version Id (see discussion)
                            Control1..1
                            This element is affected by the following invariants: ele-1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            120. Questionnaire.name
                            Definition

                            A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation.

                            ShortName des Template Frames
                            Comments

                            The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

                            Control1..1
                            This element is affected by the following invariants: ele-1, inv-0
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Support human navigation and code generation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            122. Questionnaire.title
                            Definition

                            Titel des Consent Moduls zur Darstellung auf dem späteren Consent Template

                            ShortAnzuzeigender Kurztitel der Einwilligung
                            Comments

                            This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            124. Questionnaire.derivedFrom
                            Definition

                            The URL of a Questionnaire that this Questionnaire is based on.

                            ShortInstantiates protocol or definition
                            Comments

                            see Canonical References

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            Typecanonical(Questionnaire)
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Requirements

                            Allows a Questionnaire to be created based on another Questionnaire.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            126. Questionnaire.status
                            Definition

                            The status of this questionnaire. Enables tracking the life-cycle of the content.

                            Shortdraft | active | retired | unknown
                            Comments

                            Allows filtering of questionnaires that are appropriate for use versus not.

                            Control1..1
                            This element is affected by the following invariants: ele-1
                            BindingThe codes SHALL be taken from PublicationStatus
                            (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

                            The lifecycle status of an artifact.

                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            128. Questionnaire.experimental
                            Definition

                            A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

                            ShortFor testing purposes, not real usage
                            Comments

                            Allows filtering of questionnaires that are appropriate for use versus not.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typeboolean
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            130. Questionnaire.subjectType
                            Definition

                            The types of subjects that can be the subject of responses created for the questionnaire.

                            ShortResource that can be subject of QuestionnaireResponse
                            Comments

                            If none are specified, then the subject is unlimited.

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            BindingThe codes SHALL be taken from ResourceType
                            (required to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                            One of the resource types defined as part of this version of FHIR.

                            Typecode
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            132. Questionnaire.date
                            Definition

                            The date (and optionally time) when the questionnaire was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes.

                            ShortDate last changed
                            Comments

                            Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypedateTime
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate NamesRevision Date
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            134. Questionnaire.publisher
                            Definition

                            The name of the organization or individual that published the questionnaire.

                            ShortName of the publisher (organization or individual)
                            Comments

                            Usually an organization but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Helps establish the "authority/credibility" of the questionnaire. May also allow for contact.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            136. Questionnaire.contact
                            Definition

                            Inhaltlicher Ansprechpartner der auf der Einwilligungsvorlage angezeigt werden soll

                            ShortAnsprechpartner
                            Comments

                            May be a web site, an email address, a telephone number, etc.

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeContactDetail
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            138. Questionnaire.description
                            Definition

                            A free text natural language description of the questionnaire from a consumer's perspective.

                            ShortZweckbeschreibung des Consent Modules
                            Comments

                            This description can be used to capture details such as why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created).

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typemarkdown
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            140. Questionnaire.useContext
                            Definition

                            The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate questionnaire instances.

                            ShortThe context that the content is intended to support
                            Comments

                            When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

                            Control1..*
                            This element is affected by the following invariants: ele-1
                            TypeUsageContext
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Assist in searching for appropriate content.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            142. Questionnaire.useContext.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            XML FormatIn the XML format, this property is represented as an attribute.
                            144. Questionnaire.useContext.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension
                            Standard StatusNormative (from Trial Use)
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Questionnaire.useContext.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 146. Questionnaire.useContext.code
                              Definition

                              A code that identifies the type of context being specified by this usage context.

                              ShortType of context being specified
                              Comments

                              Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

                              Control1..1
                              This element is affected by the following invariants: ele-1
                              BindingThe codes SHALL be taken from ConsentManagementQuestionnaireComponents
                              (required to http://fhir.de/ConsentManagement/ValueSet/QuestionnaireComponents)

                              A code that specifies a type of context being specified by a usage context.

                              TypeCoding
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              148. Questionnaire.useContext.code.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              XML FormatIn the XML format, this property is represented as an attribute.
                              150. Questionnaire.useContext.code.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Standard StatusNormative (from Trial Use)
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Questionnaire.useContext.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 152. Questionnaire.useContext.code.system
                                Definition

                                The identification of the code system that defines the meaning of the symbol in the code.

                                ShortIdentity of the terminology system
                                Comments

                                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                Control1..1
                                This element is affected by the following invariants: ele-1
                                Typeuri
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need to be unambiguous about the source of the definition of the symbol.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                154. Questionnaire.useContext.code.version
                                Definition

                                The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                ShortVersion of the system - if relevant
                                Comments

                                Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                NoteThis is a business version Id, not a resource version Id (see discussion)
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                156. Questionnaire.useContext.code.code
                                Definition

                                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                ShortSymbol in syntax defined by the system
                                Comments

                                Note that FHIR strings SHALL NOT exceed 1MB in size

                                Control1..1
                                This element is affected by the following invariants: ele-1
                                Typecode
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need to refer to a particular code in the system.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                158. Questionnaire.useContext.code.display
                                Definition

                                A representation of the meaning of the code in the system, following the rules of the system.

                                ShortRepresentation defined by the system
                                Comments

                                Note that FHIR strings SHALL NOT exceed 1MB in size

                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                160. Questionnaire.useContext.code.userSelected
                                Definition

                                Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                ShortIf this coding was chosen directly by the user
                                Comments

                                Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typeboolean
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                162. Questionnaire.useContext.value[x]
                                Definition

                                A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

                                ShortValue that defines the context
                                Control1..1
                                This element is affected by the following invariants: ele-1
                                TypeReference(Consent Management Domain Research Study)
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Must Supporttrue
                                Standard StatusNormative (from Trial Use)
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                164. Questionnaire.useContext.value[x].id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                XML FormatIn the XML format, this property is represented as an attribute.
                                166. Questionnaire.useContext.value[x].extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                ShortAdditional content defined by implementations
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension
                                Standard StatusNormative (from Trial Use)
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Questionnaire.useContext.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 168. Questionnaire.useContext.value[x].reference
                                  Definition

                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                  ShortLiteral reference, Relative, internal or absolute URL
                                  Comments

                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                  Control1..1
                                  This element is affected by the following invariants: ele-1, ref-1
                                  Typestring
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  170. Questionnaire.useContext.value[x].type
                                  Definition

                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                  ShortType the reference refers to (e.g. "Patient")
                                  Comments

                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                  Aa resource (or, for logical models, the URI of the logical model).

                                  Typeuri
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  172. Questionnaire.useContext.value[x].identifier
                                  Definition

                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                  ShortLogical reference, when literal reference is not known
                                  Comments

                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeIdentifier
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  174. Questionnaire.useContext.value[x].display
                                  Definition

                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                  ShortText alternative for the resource
                                  Comments

                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  176. Questionnaire.jurisdiction
                                  Definition

                                  A legal or geographic region in which the questionnaire is intended to be used.

                                  ShortIntended jurisdiction for questionnaire (if applicable)
                                  Comments

                                  It may be possible for the questionnaire to be used in jurisdictions other than those for which it was originally designed or intended.

                                  Control0..*
                                  This element is affected by the following invariants: ele-1
                                  BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSet
                                  (extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

                                  Countries and regions within which this artifact is targeted for use.

                                  TypeCodeableConcept
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  178. Questionnaire.purpose
                                  Definition

                                  Explanation of why this questionnaire is needed and why it has been designed as it has.

                                  ShortWhy this questionnaire is defined
                                  Comments

                                  This element does not describe the usage of the questionnaire. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this questionnaire.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typemarkdown
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  180. Questionnaire.copyright
                                  Definition

                                  A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire.

                                  ShortUse and/or publishing restrictions
                                  Comments

                                  Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typemarkdown
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Requirements

                                  Consumers must be able to determine any legal restrictions on the use of the questionnaire and/or its content.

                                  Alternate NamesLicense, Restrictions
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  182. Questionnaire.approvalDate
                                  Definition

                                  The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

                                  ShortWhen the questionnaire was approved by publisher
                                  Comments

                                  The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typedate
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  184. Questionnaire.lastReviewDate
                                  Definition

                                  The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

                                  ShortWhen the questionnaire was last reviewed
                                  Comments

                                  If specified, this date follows the original approval date.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typedate
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Requirements

                                  Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  186. Questionnaire.effectivePeriod
                                  Definition

                                  The period during which the questionnaire content was or is planned to be in active use.

                                  ShortWhen the questionnaire is expected to be used
                                  Comments

                                  The effective period for a questionnaire determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypePeriod
                                  Summarytrue
                                  Requirements

                                  Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the questionnaire are or are expected to be used instead.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                  188. Questionnaire.code
                                  Definition

                                  An identifier for this question or group of questions in a particular terminology such as LOINC.

                                  ShortConcept that represents the overall questionnaire
                                  Comments

                                  Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

                                  Control1..1
                                  This element is affected by the following invariants: ele-1
                                  BindingUnless not suitable, these codes SHALL be taken from ConsentManagementTemplateType
                                  (extensible to http://fhir.de/ConsentManagement/ValueSet/TemplateType)

                                  Codes for questionnaires, groups and individual questions.

                                  TypeCoding
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  190. Questionnaire.code.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  192. Questionnaire.code.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Standard StatusNormative (from Trial Use)
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Questionnaire.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 194. Questionnaire.code.system
                                    Definition

                                    The identification of the code system that defines the meaning of the symbol in the code.

                                    ShortIdentity of the terminology system
                                    Comments

                                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    Typeuri
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

                                    Need to be unambiguous about the source of the definition of the symbol.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    196. Questionnaire.code.version
                                    Definition

                                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                    ShortVersion of the system - if relevant
                                    Comments

                                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                    NoteThis is a business version Id, not a resource version Id (see discussion)
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    198. Questionnaire.code.code
                                    Definition

                                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                    ShortSymbol in syntax defined by the system
                                    Comments

                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    Typecode
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

                                    Need to refer to a particular code in the system.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    200. Questionnaire.code.display
                                    Definition

                                    A representation of the meaning of the code in the system, following the rules of the system.

                                    ShortRepresentation defined by the system
                                    Comments

                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    202. Questionnaire.code.userSelected
                                    Definition

                                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                    ShortIf this coding was chosen directly by the user
                                    Comments

                                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typeboolean
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    204. Questionnaire.item
                                    Definition

                                    A particular question, question grouping or display text that is part of the questionnaire.

                                    ShortQuestions and sections within the Questionnaire
                                    Comments

                                    The content of the questionnaire is constructed from an ordered, hierarchical collection of items.

                                    Control1..*
                                    This element is affected by the following invariants: ele-1, que-3
                                    TypeBackboneElement
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    que-9: Read-only can't be specified for "display" items (type!='display' or readOnly.empty())
                                    que-8: Initial values can't be specified for groups or display items ((type!='group' and type!='display') or initial.empty())
                                    que-6: Required and repeat aren't permitted for display items (type!='display' or (required.empty() and repeats.empty()))
                                    que-5: Only 'choice' and 'open-choice' items can have answerValueSet ((type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty()))
                                    que-4: A question cannot have both answerOption and answerValueSet (answerOption.empty() or answerValueSet.empty())
                                    que-3: Display items cannot have a "code" asserted (type!='display' or code.empty())
                                    que-10: Maximum length can only be declared for simple question types ((type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty())
                                    que-1: Group items must have nested items, display items cannot have nested items ((type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty()))
                                    que-13: Can only have multiple initial values for repeating items (repeats=true or initial.count() <= 1)
                                    que-11: If one or more answerOption is present, initial[x] must be missing (answerOption.empty() or initial.empty())
                                    que-12: If there are more than one enableWhen, enableBehavior must be specified (enableWhen.count() > 2 implies enableBehavior.exists())
                                    206. Questionnaire.item.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    208. Questionnaire.item.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension
                                    Standard StatusNormative (from Trial Use)
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Questionnaire.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 210. Questionnaire.item.extension:designNote
                                      Slice NamedesignNote
                                      Definition

                                      Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

                                      ShortDesign comments
                                      Comments

                                      Allows capture of todos, rationale for design decisions, etc.

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Design Note) (Extension Type: markdown)
                                      Must Supporttrue
                                      Standard StatusNormative (from Trial Use)
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      212. Questionnaire.item.extension:subQuestionnaire
                                      Slice NamesubQuestionnaire
                                      Definition

                                      Optional Extension Element - found in all resources.

                                      ShortOptional Extensions Element
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Consent Management Sub-Questionnaire) (Extension Type: Reference(Consent Management Template Module))
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      214. Questionnaire.item.extension:subQuestionnaire.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      216. Questionnaire.item.extension:subQuestionnaire.extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..0
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Questionnaire.item.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 218. Questionnaire.item.extension:subQuestionnaire.url
                                        Definition

                                        Source of the definition for the extension code - a logical name or a URL.

                                        Shortidentifies the meaning of the extension
                                        Comments

                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                        Control1..1
                                        Typeuri
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Fixed Valuehttp://fhir.de/ConsentManagement/StructureDefinition/SubQuestionnaire
                                        220. Questionnaire.item.extension:subQuestionnaire.value[x]
                                        Definition

                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                        ShortValue of extension
                                        Control1..1
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Consent Management Template Module, Consent Module)
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Standard StatusNormative (from Trial Use)
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        222. Questionnaire.item.extension:subQuestionnaire.value[x].id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        224. Questionnaire.item.extension:subQuestionnaire.value[x].extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension
                                        Standard StatusNormative (from Trial Use)
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Questionnaire.item.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 226. Questionnaire.item.extension:subQuestionnaire.value[x].reference
                                          Definition

                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                          ShortLiteral reference, Relative, internal or absolute URL
                                          Comments

                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                          Control1..1
                                          This element is affected by the following invariants: ele-1, ref-1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          228. Questionnaire.item.extension:subQuestionnaire.value[x].type
                                          Definition

                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                          ShortType the reference refers to (e.g. "Patient")
                                          Comments

                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                          Control0..0
                                          This element is affected by the following invariants: ele-1
                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                          Aa resource (or, for logical models, the URI of the logical model).

                                          Typeuri
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          230. Questionnaire.item.extension:subQuestionnaire.value[x].identifier
                                          Definition

                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                          ShortLogical reference, when literal reference is not known
                                          Comments

                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..0
                                          This element is affected by the following invariants: ele-1
                                          TypeIdentifier
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          232. Questionnaire.item.extension:subQuestionnaire.value[x].display
                                          Definition

                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                          ShortText alternative for the resource
                                          Comments

                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                          Control0..0
                                          This element is affected by the following invariants: ele-1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          234. Questionnaire.item.extension:externalProperty
                                          Slice NameexternalProperty
                                          Definition

                                          ExternalProperty

                                          ShortExternalProperty
                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(External Property Element) (Complex Extension)
                                          Must Supporttrue
                                          Standard StatusNormative (from Trial Use)
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          236. Questionnaire.item.extension:expirationProperty
                                          Slice NameexpirationProperty
                                          Definition

                                          Expiration Property

                                          ShortExpiration Property
                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(Expiration Property) (Complex Extension)
                                          Must Supporttrue
                                          Standard StatusNormative (from Trial Use)
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          238. Questionnaire.item.extension:freeTextDefAttributes
                                          Slice NamefreeTextDefAttributes
                                          Definition

                                          ExternalProperty

                                          ShortExternalProperty
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(FreeTextDef Attributes) (Complex Extension)
                                          Must Supporttrue
                                          Standard StatusNormative (from Trial Use)
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          240. Questionnaire.item.extension:position
                                          Slice Nameposition
                                          Definition

                                          Position (Ordinate) eines Items im Questionnaire. Im Kontext von FHIR ist diese Angabe redundant, wird aber dennoch mitgeführt

                                          ShortPosition
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(Position) (Extension Type: integer)
                                          Must Supporttrue
                                          Standard StatusNormative (from Trial Use)
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          242. Questionnaire.item.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          244. Questionnaire.item.linkId
                                          Definition

                                          An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.

                                          ShortUnique id for item in questionnaire
                                          Comments

                                          This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

                                          Control1..1
                                          This element is affected by the following invariants: ele-1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Requirements

                                          QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          246. Questionnaire.item.definition
                                          Definition

                                          This element is a URI that refers to an ElementDefinition that provides information about this item, including information that might otherwise be included in the instance of the Questionnaire resource. A detailed description of the construction of the URI is shown in Comments, below. If this element is present then the following element values MAY be derived from the Element Definition if the corresponding elements of this Questionnaire resource instance have no value:

                                          • code (ElementDefinition.code)
                                          • type (ElementDefinition.type)
                                          • required (ElementDefinition.min)
                                          • repeats (ElementDefinition.max)
                                          • maxLength (ElementDefinition.maxLength)
                                          • answerValueSet (ElementDefinition.binding)
                                          • options (ElementDefinition.binding).
                                          ShortElementDefinition - details for the item
                                          Comments

                                          The uri refers to an ElementDefinition in a StructureDefinition and always starts with the canonical URL for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id Element.id. E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment identifier, the first/root element definition in the target is the matching element definition.

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typeuri
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Requirements

                                          A common pattern is to define a set of data elements and then build multiple questionnaires for different circumstances to gather the data. This element provides traceability to the common definition and allows the content for the question to come from the underlying definition.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          248. Questionnaire.item.code
                                          Definition

                                          A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers).

                                          ShortCorresponding concept for this item in a terminology
                                          Comments

                                          The value may come from the ElementDefinition referred to by .definition.

                                          Control0..*
                                          This element is affected by the following invariants: ele-1, que-3
                                          BindingFor example codes, see QuestionnaireQuestionCodes
                                          (example to http://hl7.org/fhir/ValueSet/questionnaire-questions)

                                          Codes for questionnaires, groups and individual questions.

                                          TypeCoding
                                          Must Supporttrue
                                          Requirements

                                          Allows linking of groups of questions to formal terminologies.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          250. Questionnaire.item.code.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          252. Questionnaire.item.code.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension
                                          Standard StatusNormative (from Trial Use)
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on Questionnaire.item.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 254. Questionnaire.item.code.system
                                            Definition

                                            The identification of the code system that defines the meaning of the symbol in the code.

                                            ShortIdentity of the terminology system
                                            Comments

                                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            Typeuri
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

                                            Need to be unambiguous about the source of the definition of the symbol.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            256. Questionnaire.item.code.version
                                            Definition

                                            The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                            ShortVersion of the system - if relevant
                                            Comments

                                            Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                            NoteThis is a business version Id, not a resource version Id (see discussion)
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            258. Questionnaire.item.code.code
                                            Definition

                                            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                            ShortSymbol in syntax defined by the system
                                            Comments

                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            Typecode
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

                                            Need to refer to a particular code in the system.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            260. Questionnaire.item.code.display
                                            Definition

                                            A representation of the meaning of the code in the system, following the rules of the system.

                                            ShortRepresentation defined by the system
                                            Comments

                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            262. Questionnaire.item.code.userSelected
                                            Definition

                                            Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                            ShortIf this coding was chosen directly by the user
                                            Comments

                                            Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typeboolean
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            264. Questionnaire.item.prefix
                                            Definition

                                            A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire.

                                            ShortE.g. "1(a)", "2.5.3"
                                            Comments

                                            These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically, these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Requirements

                                            Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used.

                                            Alternate Nameslabel
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            266. Questionnaire.item.text
                                            Definition

                                            The name of a section, the text of a question or text content for a display item.

                                            ShortPrimary text for the item
                                            Comments

                                            When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading. Group item instructions should be included as a display type item within the group.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            268. Questionnaire.item.text.id
                                            Definition

                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            270. Questionnaire.item.text.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Standard StatusNormative (from Trial Use)
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Questionnaire.item.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 272. Questionnaire.item.text.extension:renderingMarkdown
                                              Slice NamerenderingMarkdown
                                              Definition

                                              This is an equivalent of the string on which the extension is sent, but includes additional markdown (see documentation about markdown. Note that using HTML xhtml can allow for greater precision of display.

                                              ShortString equivalent with markdown
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Markdown) (Extension Type: markdown)
                                              Standard StatusNormative (from Trial Use)
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              274. Questionnaire.item.text.extension:renderingXhtml
                                              Slice NamerenderingXhtml
                                              Definition

                                              This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.

                                              ShortString equivalent with html markup
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(XHTML Representation) (Extension Type: string)
                                              Standard StatusNormative (from Trial Use)
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              276. Questionnaire.item.text.value
                                              Definition

                                              Primitive value for string

                                              ShortPrimitive value for string
                                              Control0..1
                                              Typestring
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Max Length:1048576
                                              278. Questionnaire.item.type
                                              Definition

                                              The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.).

                                              Shortgroup | display | boolean | decimal | integer | date | dateTime +
                                              Comments

                                              Additional constraints on the type of answer can be conveyed by extensions. The value may come from the ElementDefinition referred to by .definition.

                                              Control1..1
                                              This element is affected by the following invariants: ele-1
                                              BindingThe codes SHALL be taken from QuestionnaireItemType
                                              (required to http://hl7.org/fhir/ValueSet/item-type|4.0.1)

                                              Distinguishes groups from questions and display text and indicates data type for questions.

                                              Typecode
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Requirements

                                              Defines the format in which the user is to be prompted for the answer.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              280. Questionnaire.item.enableWhen
                                              Definition

                                              A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true.

                                              ShortOnly allow data when
                                              Comments

                                              If multiple repetitions of this extension are present, the item should be enabled when the condition for any of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to.

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeBackboneElement
                                              Is Modifiertrue because If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present
                                              Must Supporttrue
                                              Requirements

                                              Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              que-7: If the operator is 'exists', the value must be a boolean (operator = 'exists' implies (answer is Boolean))
                                              282. Questionnaire.item.enableWhen.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              284. Questionnaire.item.enableWhen.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension
                                              Standard StatusNormative (from Trial Use)
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Questionnaire.item.enableWhen.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 286. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire
                                                Slice NamesourceSubQuestionnaire
                                                Definition

                                                Optional Extension Element - found in all resources.

                                                ShortOptional Extensions Element
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(Consent Management Sub-Questionnaire) (Extension Type: Reference(Consent Management Template Module))
                                                Must Supporttrue
                                                Standard StatusNormative (from Trial Use)
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                288. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.id
                                                Definition

                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                290. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                Standard StatusNormative (from Trial Use)
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on Questionnaire.item.enableWhen.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 292. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.url
                                                  Definition

                                                  Source of the definition for the extension code - a logical name or a URL.

                                                  Shortidentifies the meaning of the extension
                                                  Comments

                                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                  Control1..1
                                                  Typeuri
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Fixed Valuehttp://fhir.de/ConsentManagement/StructureDefinition/SubQuestionnaire
                                                  294. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x]
                                                  Definition

                                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                  ShortValue of extension
                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeReference(Consent Management Template Module)
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Must Supporttrue
                                                  Standard StatusNormative (from Trial Use)
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  296. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].id
                                                  Definition

                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  298. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortAdditional content defined by implementations
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Standard StatusNormative (from Trial Use)
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Questionnaire.item.enableWhen.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 300. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].reference
                                                    Definition

                                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                    ShortLiteral reference, Relative, internal or absolute URL
                                                    Comments

                                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                    Control1..1
                                                    This element is affected by the following invariants: ele-1, ref-1
                                                    Typestring
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Standard StatusNormative (from Trial Use)
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    302. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].type
                                                    Definition

                                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                    ShortType the reference refers to (e.g. "Patient")
                                                    Comments

                                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                    Control0..0
                                                    This element is affected by the following invariants: ele-1
                                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                    Aa resource (or, for logical models, the URI of the logical model).

                                                    Typeuri
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Standard StatusNormative (from Trial Use)
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    304. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].identifier
                                                    Definition

                                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                    ShortLogical reference, when literal reference is not known
                                                    Comments

                                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                    Control0..0
                                                    This element is affected by the following invariants: ele-1
                                                    TypeIdentifier
                                                    Standard StatusNormative (from Trial Use)
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    306. Questionnaire.item.enableWhen.extension:sourceSubQuestionnaire.value[x].display
                                                    Definition

                                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                                    ShortText alternative for the resource
                                                    Comments

                                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                    Control0..0
                                                    This element is affected by the following invariants: ele-1
                                                    Typestring
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Standard StatusNormative (from Trial Use)
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    308. Questionnaire.item.enableWhen.modifierExtension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    310. Questionnaire.item.enableWhen.question
                                                    Definition

                                                    The linkId for the question whose answer (or lack of answer) governs whether this item is enabled.

                                                    ShortQuestion that determines whether item is enabled
                                                    Comments

                                                    If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the "ancestor" axis and then the "preceding" axis and then the "following" axis.

                                                    Control1..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typestring
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    312. Questionnaire.item.enableWhen.operator
                                                    Definition

                                                    Specifies the criteria by which the question is enabled.

                                                    Shortexists | = | != | > | < | >= | <=
                                                    Comments

                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                    Control1..1
                                                    This element is affected by the following invariants: ele-1
                                                    BindingThe codes SHALL be taken from QuestionnaireItemOperator
                                                    (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1)

                                                    The criteria by which a question is enabled.

                                                    Typecode
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    314. Questionnaire.item.enableWhen.answer[x]
                                                    Definition

                                                    A value that the referenced question is tested using the specified operator in order for the item to be enabled.

                                                    ShortValue for question comparison based on operator
                                                    Control1..1
                                                    This element is affected by the following invariants: ele-1, que-7
                                                    BindingFor example codes, see QuestionnaireAnswerCodes
                                                    (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

                                                    Allowed values to answer questions.

                                                    TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, Coding, Quantity, Reference(Resource)
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    316. Questionnaire.item.enableBehavior
                                                    Definition

                                                    Controls how multiple enableWhen values are interpreted - whether all or any must be true.

                                                    Shortall | any
                                                    Comments

                                                    This element must be specified if more than one enableWhen value is provided.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1, que-12
                                                    BindingThe codes SHALL be taken from EnableWhenBehavior
                                                    (required to http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1)

                                                    Controls how multiple enableWhen values are interpreted - whether all or any must be true.

                                                    Typecode
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    318. Questionnaire.item.required
                                                    Definition

                                                    An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire.

                                                    ShortWhether the item must be included in data results
                                                    Comments

                                                    Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1, que-6
                                                    Typeboolean
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Meaning if MissingItems are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    320. Questionnaire.item.repeats
                                                    Definition

                                                    An indication, if true, that the item may occur multiple times in the response, collecting multiple answers for questions or multiple sets of answers for groups.

                                                    ShortWhether the item may repeat
                                                    Comments

                                                    If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items.

                                                    The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values.

                                                    The value may come from the ElementDefinition referred to by .definition.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1, que-6
                                                    Typeboolean
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Requirements

                                                    Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set.

                                                    Meaning if MissingItems are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    322. Questionnaire.item.readOnly
                                                    Definition

                                                    An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.

                                                    ShortDon't allow human editing
                                                    Comments

                                                    The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1, que-9
                                                    Typeboolean
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Requirements

                                                    Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    324. Questionnaire.item.maxLength
                                                    Definition

                                                    The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse.

                                                    ShortNo more than this many characters
                                                    Comments

                                                    For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1, que-10
                                                    Typeinteger
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    326. Questionnaire.item.answerValueSet
                                                    Definition

                                                    A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" question.

                                                    ShortValueset containing permitted answers
                                                    Comments

                                                    LOINC defines many useful value sets for questionnaire responses. See LOINC Answer Lists. The value may come from the ElementDefinition referred to by .definition.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1, que-4, que-5
                                                    Typecanonical(ValueSet)
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    328. Questionnaire.item.answerOption
                                                    Definition

                                                    One of the permitted answers for a "choice" or "open-choice" question.

                                                    ShortPermitted answer
                                                    Comments

                                                    This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes.

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1, que-4, que-5
                                                    TypeBackboneElement
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    330. Questionnaire.item.answerOption.id
                                                    Definition

                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    332. Questionnaire.item.answerOption.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension
                                                    Standard StatusNormative (from Trial Use)
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on Questionnaire.item.answerOption.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 334. Questionnaire.item.answerOption.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      336. Questionnaire.item.answerOption.value[x]
                                                      Definition

                                                      A potential answer that's allowed as the answer to this question.

                                                      ShortAnswer value
                                                      Comments

                                                      The data type of the value must agree with the item.type.

                                                      Control1..1
                                                      This element is affected by the following invariants: ele-1
                                                      BindingFor example codes, see QuestionnaireAnswerCodes
                                                      (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

                                                      Allowed values to answer questions.

                                                      TypeChoice of: integer, date, time, string, Coding, Reference(Resource)
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                                      Standard StatusNormative (from Trial Use)
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      338. Questionnaire.item.answerOption.initialSelected
                                                      Definition

                                                      Indicates whether the answer value is selected when the list of possible answers is initially shown.

                                                      ShortWhether option is selected by default
                                                      Comments

                                                      Use this instead of initial[v] if answerValueSet is present.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typeboolean
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Standard StatusNormative (from Trial Use)
                                                      Meaning if MissingOnly selected items explicitly marked to be selected
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      340. Questionnaire.item.initial
                                                      Definition

                                                      One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.

                                                      ShortInitial value(s) when item is first rendered
                                                      Comments

                                                      The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial[x] must agree with the item.type, and only repeating items can have more then one initial value.

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1, que-8, que-13
                                                      TypeBackboneElement
                                                      Must Supporttrue
                                                      Requirements

                                                      In some workflows, having defaults saves time.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      342. Questionnaire.item.initial.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      344. Questionnaire.item.initial.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Standard StatusNormative (from Trial Use)
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on Questionnaire.item.initial.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 346. Questionnaire.item.initial.modifierExtension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..*
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        Requirements

                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                        Alternate Namesextensions, user content, modifiers
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        348. Questionnaire.item.initial.value[x]
                                                        Definition

                                                        The actual value to for an initial answer.

                                                        ShortActual value for initializing the question
                                                        Comments

                                                        The type of the initial value must be consistent with the type of the item.

                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1
                                                        BindingFor example codes, see QuestionnaireAnswerCodes
                                                        (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

                                                        Allowed values to answer questions.

                                                        TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                                        Standard StatusNormative (from Trial Use)
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        350. Questionnaire.item.item
                                                        Definition

                                                        Text, questions and other groups to be nested beneath a question or group.

                                                        ShortNested questionnaire items
                                                        Comments

                                                        There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting.

                                                        Control0..*
                                                        This element is affected by the following invariants: que-1
                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item
                                                        Must Supporttrue
                                                        Requirements

                                                        Reports can consist of complex nested groups.