{ "resourceType" : "Questionnaire", "id" : "OswestryDisabilityIndexQuestionnaireExample", "meta" : { "profile" : ["http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire|3.0.0"] }, "language" : "en", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire OswestryDisabilityIndexQuestionnaireExample

Profile: SDCBaseQuestionnaireversion: null3.0.0)

Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\".\"\".\" Questionnairehttp://example.org/Questionnaire/OswestryDisabilityIndexQuestionnaire#0.9.8
\".\"\".\"\".\" odi-1Pain intensity0..1choiceOptions: 6 options
\".\"\".\"\".\" odi-2Personal care (washing, dressing, etc.)0..1choiceOptions: 6 options
\".\"\".\"\".\" odi-3Lifting0..1choiceOptions: 6 options
\".\"\".\"\".\" odi-4Walking0..1choiceOptions: 6 options
\".\"\".\"\".\" odi-5Sitting0..1choiceOptions: 6 options
\".\"\".\"\".\" odi-6Standing0..1choiceOptions: 6 options
\".\"\".\"\".\" odi-7Sleeping0..1choiceOptions: 6 options
\".\"\".\"\".\" odi-8Sex life (if applicable)0..1choiceOptions: 6 options
\".\"\".\"\".\" odi-9Social life0..1choiceOptions: 6 options
\".\"\".\"\".\" odi-10Traveling0..1choiceOptions: 6 options
\".\"\".\"\".\" scoreOswestry disability index score ODI0..1decimal

\"doco\" Documentation for this format

Options Sets

Answer options for odi-1

Answer options for odi-2

Answer options for odi-3

Answer options for odi-4

Answer options for odi-5

Answer options for odi-6

Answer options for odi-7

Answer options for odi-8

Answer options for odi-9

Answer options for odi-10

" }, "url" : "http://example.org/Questionnaire/OswestryDisabilityIndexQuestionnaire", "version" : "0.9.8", "status" : "active", "subjectType" : ["Patient"], "date" : "2026-05-20T09:30:43-04:00", "publisher" : "Global Alliant, Inc.", "contact" : [{ "name" : "Global Alliant, Inc.", "telecom" : [{ "system" : "url", "value" : "https://globalalliantinc.com" }, { "system" : "email", "value" : "david.h@globalalliantinc.org" }] }], "jurisdiction" : [{ "coding" : [{ "system" : "urn:iso:std:iso:3166", "code" : "US", "display" : "United States of America" }] }], "code" : [{ "system" : "http://loinc.org", "code" : "97908-8", "display" : "Oswestry Disability Index" }], "item" : [{ "linkId" : "odi-1", "text" : "Pain intensity", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "I have no pain at the moment." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "The pain is very mild at the moment." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "The pain is moderate at the moment." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "The pain is fairly severe at the moment." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "The pain is very severe at the moment." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "The pain is the worst imaginable at the moment." } }] }, { "linkId" : "odi-2", "text" : "Personal care (washing, dressing, etc.)", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "I can look after myself normally without causing extra pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "I can look after myself normally but it is very painful." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "It is painful to look after myself and I am slow and careful." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "I need some help but can manage most of my personal care." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "I need help every day in most aspects of my personal care." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "I do not get dressed, I wash with difficulty and stay in bed." } }] }, { "linkId" : "odi-3", "text" : "Lifting", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "I can lift heavy weights without additional pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "I can lift heavy weights but it gives additional pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently placed e.g. on a table." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "Pain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positioned." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "I can lift very light weights." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "I cannot lift or carry anything at all." } }] }, { "linkId" : "odi-4", "text" : "Walking", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "Pain does not prevent me walking any distance." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "Pain prevents me from walking more than one mile." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "Pain prevents me from walking more than a quarter of a mile." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "Pain prevents me from walking more than 100 yards." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "I can only walk using a stick or crutches." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "I am in bed most of the time and have to crawl to the toilet." } }] }, { "linkId" : "odi-5", "text" : "Sitting", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "I can sit in any chair as long as I like." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "I can only sit in my favorite chair as long as I like." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "Pain prevents me from sitting for more than one hour." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "Pain prevents me from sitting for more than half an hour." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "Pain prevents me from sitting for more than 10 minutes." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "Pain prevents me from sitting at all." } }] }, { "linkId" : "odi-6", "text" : "Standing", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "I can stand as long as I want without additional pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "I can stand as long as I want but it gives me additional pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "Pain prevents me from standing for more than 1 hour." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "Pain prevents me from standing for more than half an hour." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "Pain prevents me from standing for more than 10 minutes." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "Pain prevents me from standing at all." } }] }, { "linkId" : "odi-7", "text" : "Sleeping", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "My sleep is never interrupted by pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "My sleep is occasionally interrupted by pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "Because of pain I have less than 6 hours sleep." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "Because of pain I have less than 4 hours sleep." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "Because of pain I have less than 2 hours sleep." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "Pain prevents me from sleeping at all." } }] }, { "linkId" : "odi-8", "text" : "Sex life (if applicable)", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "My sex life is normal and causes no additional pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "My sex life is normal but causes some additional pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "My sex life is nearly normal but is very painful." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "My sex life is severely restricted by pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "My sex life is non existent because of pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "Pain prevents me from having any sex life at all." } }] }, { "linkId" : "odi-9", "text" : "Social life", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "My social life is normal and causes me no additional pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "My social life is normal but increases the degree of pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "Pain has no significant effect on social life apart from limiting my more energetic interests e.g. sports, etc." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "Pain has restricted my social life and I do not go out as often." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "Pain has restricted social life to my home." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "I have no social life because of pain." } }] }, { "linkId" : "odi-10", "text" : "Traveling", "type" : "choice", "answerOption" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 0 }], "valueCoding" : { "display" : "I can travel anywhere without pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 1 }], "valueCoding" : { "display" : "I can travel anywhere but it gives me additional pain." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 2 }], "valueCoding" : { "display" : "Pain is bad but I am able to manage trips over two hours." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 3 }], "valueCoding" : { "display" : "Pain restricts me to trips of less than one hour." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 4 }], "valueCoding" : { "display" : "Pain restricts trips to short necessary journeys under 30 minutes." } }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue", "valueDecimal" : 5 }], "valueCoding" : { "display" : "Pain prevents traveling except to receive treatment." } }] }, { "linkId" : "score", "code" : [{ "system" : "http://loinc.org", "code" : "97909-6", "display" : "Oswestry disability index score ODI" }], "text" : "Oswestry disability index score ODI", "type" : "decimal" }] }