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See Questionnaire for introduction and use of the resources and its elements.

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The description here applies for Questionnaire resources where processing of corresponding QuestionnaireResponse involves extraction of answer(s) to certain questions in the Questionnaire.

In the eHealth Infrastructure, such processing is performed through rules captured in Library resources. In order to make the rules robust and allow for change of question order and additional questions and answer options, the Questionnaire shall utilize defined questions in the form of DefinedQuestion resources. See DefinedQuestion for further details.

When a question in Questionnaire.item is eligible for extraction in a rule, a DefinedQuestion shall be either found or created and subsequently referenced in Questionnaire.item.definition.

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titleQuestionnaire.item.definition Example

A Questionnaire containing a question suitable for calculating a Medical Research Council (MRC) score is to processed by a MRC score rule. Therefore the particular question must be identifiable in order to extract the answer value from a QuestionnaireResponse in a robust way.

In the following it is given that the MRC score question has been defined (see #Managing-DefinedQuestion) as a DefinedQuestion with:

  • url set to http://ehealth.sundhed.dk/DefinedQuestion/d3db2ad6-b45e-4d21-81db-bcd0ce5d15a3

  • version set to, say, 1

Preparing for robust extraction, the Questionnaire is defined with:

  • Questionnaire.item.definition set to http://ehealth.sundhed.dk/DefinedQuestion/d3db2ad6-b45e-4d21-81db-bcd0ce5d15a3|1

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As noted in DefinedQuestion, despite any reference through Questionnaire.item.definition and the values the DefinedQuestion may have, it is the answer list and other values of the Questionnaire.item that take precedence.

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A Questionnaire defined with the eHealth profile ehealth-questionnaire-advanced (see https://docs.ehealth.sundhed.dk/latest-released/igfhir/StructureDefinition-ehealth-questionnaire-advanced.html ) can contain zero, one or more expressions performing a calculation based on answers to questions in the Questionnaire. The expression can make use of zero, one or more variables which identify the particular question/answers more concisely.

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A Questionnaire defined with eHealth profile ehealth-questionnaire (see https://docs.ehealth.sundhed.dk/latest-released/igfhir/StructureDefinition-ehealth-questionnaire.html ) cannot contain expressions nor variables.

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A variable is supported for a question with answer type choice, integer and decimal provided that:

  • the question is not a calculated expression

  • a question of type choice is single-choice only

  • all answer options for question of type choice have an ordinalValue (see ordinalValue)

An example of a variable evaluating to an ordinal value is shown below as an excerpt of a Questionnaire (in profile ehealth-questionnaire-advanced) in JSON:

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The expression itself is defined in the extension sdc-questionnaire-calculatedExpression (see calculatedExpression) which is an Expression FHIR element type containing:

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Managing-DefinedQuestion
Managing-DefinedQuestion

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See DefinedQuestion for introduction and use of the resource and its elements.

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The QFDD must be represented in a DocumentReference and uploaded to the Document-transformation service by the operation $upload-qfdd described in https://docs.ehealth.sundhed.dk/latestfhir/ig/OperationDefinition--s-upload-QFDD.html .

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Please note that the description of the operation is valid as of v3.0.0 of the eHealth Infrastructure Implementation Guide (IG) even though the link is to the IG continuous build. Please refer to the latest released version of the IG for all other purposes.

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See Uploading and Associating a QFDD for how to associate a FHIR Questionnaire with a QFDD in the Clinical Administration Application.

Associating a FHIR Questionnaire with the QFDD

As described in Relationship between FHIR Questionnaire/QuestionnaireResponse and External Representations the FHIR Questionnaire must be or ultimately made to be a near approximation of the QFDD for the association to be correct.

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