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:

Official URL: http://example.org/Questionnaire/OswestryDisabilityIndexQuestionnaire Version: 0.9.8
Active as of 2026-05-20 Computable Name:

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. Questionnaire http://example.org/Questionnaire/OswestryDisabilityIndexQuestionnaire#0.9.8
... odi-1 Pain intensity 0..1 choice Value Set:
Options: 6 options
... odi-2 Personal care (washing, dressing, etc.) 0..1 choice Value Set:
Options: 6 options
... odi-3 Lifting 0..1 choice Value Set:
Options: 6 options
... odi-5 Sitting 0..1 choice Value Set:
Options: 6 options
... odi-6 Standing 0..1 choice Value Set:
Options: 6 options
... odi-7 Sleeping 0..1 choice Value Set:
Options: 6 options
... odi-8 Sex life (if applicable) 0..1 choice Value Set:
Options: 6 options
... odi-9 Social life 0..1 choice Value Set:
Options: 6 options
... odi-10 Traveling 0..1 choice Value Set:
Options: 6 options
... score Oswestry disability index score ODI 0..1 decimal Value Set:

doco Documentation for this format

Options Sets

Answer options for odi-1

  • null#null ("I have no pain at the moment.")
  • null#null ("The pain is very mild at the moment.")
  • null#null ("The pain is moderate at the moment.")
  • null#null ("The pain is fairly severe at the moment.")
  • null#null ("The pain is very severe at the moment.")
  • null#null ("The pain is the worst imaginable at the moment.")

Answer options for odi-2

  • null#null ("I can look after myself normally without causing extra pain.")
  • null#null ("I can look after myself normally but it is very painful.")
  • null#null ("It is painful to look after myself and I am slow and careful.")
  • null#null ("I need some help but can manage most of my personal care.")
  • null#null ("I need help every day in most aspects of my personal care.")
  • null#null ("I do not get dressed, I wash with difficulty and stay in bed.")

Answer options for odi-3

  • null#null ("I can lift heavy weights without additional pain.")
  • null#null ("I can lift heavy weights but it gives additional pain.")
  • null#null ("Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently placed e.g. on a table.")
  • null#null ("Pain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positioned.")
  • null#null ("I can lift very light weights.")
  • null#null ("I cannot lift or carry anything at all.")

Answer options for odi-4

  • null#null ("Pain does not prevent me walking any distance.")
  • null#null ("Pain prevents me from walking more than one mile.")
  • null#null ("Pain prevents me from walking more than a quarter of a mile.")
  • null#null ("Pain prevents me from walking more than 100 yards.")
  • null#null ("I can only walk using a stick or crutches.")
  • null#null ("I am in bed most of the time and have to crawl to the toilet.")

Answer options for odi-5

  • null#null ("I can sit in any chair as long as I like.")
  • null#null ("I can only sit in my favorite chair as long as I like.")
  • null#null ("Pain prevents me from sitting for more than one hour.")
  • null#null ("Pain prevents me from sitting for more than half an hour.")
  • null#null ("Pain prevents me from sitting for more than 10 minutes.")
  • null#null ("Pain prevents me from sitting at all.")

Answer options for odi-6

  • null#null ("I can stand as long as I want without additional pain.")
  • null#null ("I can stand as long as I want but it gives me additional pain.")
  • null#null ("Pain prevents me from standing for more than 1 hour.")
  • null#null ("Pain prevents me from standing for more than half an hour.")
  • null#null ("Pain prevents me from standing for more than 10 minutes.")
  • null#null ("Pain prevents me from standing at all.")

Answer options for odi-7

  • null#null ("My sleep is never interrupted by pain.")
  • null#null ("My sleep is occasionally interrupted by pain.")
  • null#null ("Because of pain I have less than 6 hours sleep.")
  • null#null ("Because of pain I have less than 4 hours sleep.")
  • null#null ("Because of pain I have less than 2 hours sleep.")
  • null#null ("Pain prevents me from sleeping at all.")

Answer options for odi-8

  • null#null ("My sex life is normal and causes no additional pain.")
  • null#null ("My sex life is normal but causes some additional pain.")
  • null#null ("My sex life is nearly normal but is very painful.")
  • null#null ("My sex life is severely restricted by pain.")
  • null#null ("My sex life is non existent because of pain.")
  • null#null ("Pain prevents me from having any sex life at all.")

Answer options for odi-9

  • null#null ("My social life is normal and causes me no additional pain.")
  • null#null ("My social life is normal but increases the degree of pain.")
  • null#null ("Pain has no significant effect on social life apart from limiting my more energetic interests e.g. sports, etc.")
  • null#null ("Pain has restricted my social life and I do not go out as often.")
  • null#null ("Pain has restricted social life to my home.")
  • null#null ("I have no social life because of pain.")

Answer options for odi-10

  • null#null ("I can travel anywhere without pain.")
  • null#null ("I can travel anywhere but it gives me additional pain.")
  • null#null ("Pain is bad but I am able to manage trips over two hours.")
  • null#null ("Pain restricts me to trips of less than one hour.")
  • null#null ("Pain restricts trips to short necessary journeys under 30 minutes.")
  • null#null ("Pain prevents traveling except to receive treatment.")

Pain intensity

Personal care (washing, dressing, etc.)

Lifting

Walking

Sitting

Standing

Sleeping

Sex life (if applicable)

Social life

Traveling

Oswestry disability index score ODI

  • linkId: score
  • Answers:

LinkIDDescription & Constraintsdoco
.. odi-1 Value Set:
Options: 6 options
.. odi-2 Value Set:
Options: 6 options
.. odi-3 Value Set:
Options: 6 options
.. odi-4 Value Set:
Options: 6 options
.. odi-5 Value Set:
Options: 6 options
.. odi-6 Value Set:
Options: 6 options
.. odi-7 Value Set:
Options: 6 options
.. odi-8 Value Set:
Options: 6 options
.. odi-9 Value Set:
Options: 6 options
.. odi-10 Value Set:
Options: 6 options
.. score Value Set:

doco Documentation for this format

Test this Questionnaire

Try this questionnaire out:

Responses for this Questionnaire