Implementation Guide for fælles faglige instrumenter (FFInst)
1.0.0 - release Denmark flag

This page is part of the KLFFinst (v1.0.0: Release) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: EQ-5D questionnaire - JSON Representation

Draft as of 2023-08-27

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{
  "resourceType" : "Questionnaire",
  "id" : "KLToolsCareEQ5D",
  "meta" : {
    "profile" : [
      "http://fhir.kl.dk/ffinst/StructureDefinition/KLToolsQuestionnaire"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Placeholder</div>"
  },
  "url" : "http://fhir.kl.dk/ffinst/Questionnaire/KLToolsCareEQ5D",
  "version" : "1.0.0",
  "name" : "KLToolsCareEQ5D",
  "title" : "EQ-5D questionnaire",
  "status" : "draft",
  "date" : "2023-08-27T10:22:55+02:00",
  "publisher" : "Kommunernes landsforening",
  "contact" : [
    {
      "name" : "Kommunernes landsforening",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://kl.dk"
        },
        {
          "system" : "email",
          "value" : "kl@kl.dk"
        }
      ]
    }
  ],
  "description" : "Ikke-sygdomsspecifikt spørgeskema til at vurdere helbredsrelateret livskvalitet. Tidsrammen for borgers vurdering er borgers aktuelle tilstand (i dag).",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "DNK",
          "display" : "Denmark"
        }
      ]
    }
  ],
  "code" : [
    {
      "system" : "http://snomed.info/sct",
      "code" : "1144655003"
    }
  ],
  "item" : [
    {
      "linkId" : "mobility",
      "code" : [
        {
          "system" : "http://snomed.info/sct",
          "code" : "301438001"
        }
      ],
      "text" : "Bevægelighed",
      "type" : "choice",
      "repeats" : false,
      "answerValueSet" : "http://fhir.kl.dk/ffinst/ValueSet/EQ5Dmobility"
    },
    {
      "linkId" : "hygiene",
      "code" : [
        {
          "system" : "http://snomed.info/sct",
          "code" : "284773001"
        }
      ],
      "text" : "Personlig pleje",
      "type" : "choice",
      "repeats" : false,
      "answerValueSet" : "http://fhir.kl.dk/ffinst/ValueSet/EQ5Dhygiene"
    },
    {
      "linkId" : "activity",
      "code" : [
        {
          "system" : "http://snomed.info/sct",
          "code" : "284545001"
        }
      ],
      "text" : "Sædvanlige aktiviteter (fx arbejde, studie, husarbejde, familie- eller fritidsaktiviteter)",
      "type" : "choice",
      "repeats" : false,
      "answerValueSet" : "http://fhir.kl.dk/ffinst/ValueSet/EQ5Dactivity"
    },
    {
      "linkId" : "pain",
      "code" : [
        {
          "system" : "http://snomed.info/sct",
          "code" : "364624006"
        }
      ],
      "text" : "Smerter/ubehag",
      "type" : "choice",
      "repeats" : false,
      "answerValueSet" : "http://fhir.kl.dk/ffinst/ValueSet/EQ5Dpain"
    },
    {
      "linkId" : "anxiety",
      "code" : [
        {
          "system" : "http://snomed.info/sct",
          "code" : "285854004"
        }
      ],
      "text" : "Angst/Depression",
      "type" : "choice",
      "repeats" : false,
      "answerValueSet" : "http://fhir.kl.dk/ffinst/ValueSet/EQ5Danxiety"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/maxValue",
          "valueInteger" : 100
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
          "valueInteger" : 0
        }
      ],
      "linkId" : "vas",
      "code" : [
        {
          "system" : "http://snomed.info/sct",
          "code" : "736535009"
        }
      ],
      "text" : "EQ-VAS-score",
      "type" : "integer",
      "repeats" : false
    },
    {
      "linkId" : "eq5dcomment",
      "text" : "Kommentar til EQ-5D",
      "type" : "text",
      "repeats" : false
    }
  ]
}