CMS ACCESS Model API
0.9.8 - draft US

This page is part of the ACCESS Model IG v0.9.8 DRAFT (v0.9.8: Releases Draft) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions

Questionnaire:

Computable Name:

Profile: SDCBaseQuestionnaire version: 3.0.0

Structure
LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. Questionnaire http://example.org/Questionnaire/HOOSJRQuestionnaire#0.9.7
... hoosjr-1 Going up or down stairs 0..1 choice Value Set:
Options: 5 options
... hoosjr-2 Walking on an uneven surface 0..1 choice Value Set:
Options: 5 options
... hoosjr-3 Rising from sitting 0..1 choice Value Set:
Options: 5 options
... hoosjr-5 Lying in bed 0..1 choice Value Set:
Options: 5 options
... hoosjr-6 Sitting 0..1 choice Value Set:
Options: 5 options
... total-interval-score Total interval score [HOOSJR] 0..1 decimal iconicon Value Set:

doco Documentation for this format

Options Sets

Answer options for hoosjr-1

  • http://loinc.org#LA137-2 ("None")
  • http://loinc.org#LA6752-5 ("Mild")
  • http://loinc.org#LA6751-7 ("Moderate")
  • http://loinc.org#LA6750-9 ("Severe")
  • http://loinc.org#LA11912-5 ("Extreme")

Answer options for hoosjr-2

  • http://loinc.org#LA137-2 ("None")
  • http://loinc.org#LA6752-5 ("Mild")
  • http://loinc.org#LA6751-7 ("Moderate")
  • http://loinc.org#LA6750-9 ("Severe")
  • http://loinc.org#LA11912-5 ("Extreme")

Answer options for hoosjr-3

  • http://loinc.org#LA137-2 ("None")
  • http://loinc.org#LA6752-5 ("Mild")
  • http://loinc.org#LA6751-7 ("Moderate")
  • http://loinc.org#LA6750-9 ("Severe")
  • http://loinc.org#LA11912-5 ("Extreme")

Answer options for hoosjr-4

  • http://loinc.org#LA137-2 ("None")
  • http://loinc.org#LA6752-5 ("Mild")
  • http://loinc.org#LA6751-7 ("Moderate")
  • http://loinc.org#LA6750-9 ("Severe")
  • http://loinc.org#LA11912-5 ("Extreme")

Answer options for hoosjr-5

  • http://loinc.org#LA137-2 ("None")
  • http://loinc.org#LA6752-5 ("Mild")
  • http://loinc.org#LA6751-7 ("Moderate")
  • http://loinc.org#LA6750-9 ("Severe")
  • http://loinc.org#LA11912-5 ("Extreme")

Answer options for hoosjr-6

  • http://loinc.org#LA137-2 ("None")
  • http://loinc.org#LA6752-5 ("Mild")
  • http://loinc.org#LA6751-7 ("Moderate")
  • http://loinc.org#LA6750-9 ("Severe")
  • http://loinc.org#LA11912-5 ("Extreme")

Profile: SDCBaseQuestionnaire version: 3.0.0

Going up or down stairs

Walking on an uneven surface

Rising from sitting

Bending to the floor/picking up an object

Lying in bed

Sitting

Total interval score [HOOSJR]

  • linkId: total-interval-score
  • Answers:

Profile: SDCBaseQuestionnaire version: 3.0.0

LinkIDDescription & Constraintsdoco
.. hoosjr-1 Value Set:
Options: 5 options
.. hoosjr-2 Value Set:
Options: 5 options
.. hoosjr-3 Value Set:
Options: 5 options
.. hoosjr-4 Value Set:
Options: 5 options
.. hoosjr-5 Value Set:
Options: 5 options
.. hoosjr-6 Value Set:
Options: 5 options
.. total-interval-score Value Set:

doco Documentation for this format

Test this Questionnaire

Try this questionnaire out:

Responses for this Questionnaire