FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 4.0.1. For a full list of available versions, see the Directory of published versions

Adverseevent-questionnaire.xml

Regulated Clinical Research Information Management Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Patient, Practitioner, RelatedPerson

Raw XML (canonical form)

Generated Questionnaire for AdverseEvent

<?xml version="1.0" encoding="UTF-8"?>

<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="qs1"/>
  <contained>
    <ValueSet>
      <id value="vs2"/>
      <name value="Type options for AdverseEvent.subject"/>
      <status value="active"/>
      <description value="Type options for AdverseEvent.subject"/>
      <expansion>
        <identifier value="urn:uuid:bacc6df1-3bc4-4543-a505-d7815a03723b"/>
        <timestamp value="2019-10-24T11:53:00+11:00"/>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Patient"/>
          <display value="Patient"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="ResearchSubject"/>
          <display value="ResearchSubject"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Medication"/>
          <display value="Medication"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Device"/>
          <display value="Device"/>
        </contains>
      </expansion>
    </ValueSet>
  </contained>
  <contained>
    <ValueSet>
      <id value="vs3"/>
      <name value="Type options for AdverseEvent.recorder"/>
      <status value="active"/>
      <description value="Type options for AdverseEvent.recorder"/>
      <expansion>
        <identifier value="urn:uuid:ea8f236a-5b7e-4d24-b787-295cf0e371d0"/>
        <timestamp value="2019-10-24T11:53:00+11:00"/>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Patient"/>
          <display value="Patient"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Practitioner"/>
          <display value="Practitioner"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="RelatedPerson"/>
          <display value="RelatedPerson"/>
        </contains>
      </expansion>
    </ValueSet>
  </contained>
  <contained>
    <ValueSet>
      <id value="vs4"/>
      <name value="Type options for AdverseEvent.eventParticipant"/>
      <status value="active"/>
      <description value="Type options for AdverseEvent.eventParticipant"/>
      <expansion>
        <identifier value="urn:uuid:8335eae1-6231-4a32-8b1f-08d77cb2d5d7"/>
        <timestamp value="2019-10-24T11:53:00+11:00"/>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Practitioner"/>
          <display value="Practitioner"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Device"/>
          <display value="Device"/>
        </contains>
      </expansion>
    </ValueSet>
  </contained>
  <contained>
    <ValueSet>
      <id value="vs5"/>
      <name value="Type options for AdverseEvent.suspectEntity.instance"/>
      <status value="active"/>
      <description value="Type options for AdverseEvent.suspectEntity.instance"/>
      <expansion>
        <identifier value="urn:uuid:ffd093eb-1834-4da1-a97b-44112fd13e72"/>
        <timestamp value="2019-10-24T11:53:00+11:00"/>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Substance"/>
          <display value="Substance"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Medication"/>
          <display value="Medication"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="MedicationAdministration"/>
          <display value="MedicationAdministration"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="MedicationStatement"/>
          <display value="MedicationStatement"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Device"/>
          <display value="Device"/>
        </contains>
      </expansion>
    </ValueSet>
  </contained>
  <contained>
    <ValueSet>
      <id value="vs6"/>
      <name value="Type options for AdverseEvent.suspectEntity.causalityAuthor"/>
      <status value="active"/>
      <description value="Type options for AdverseEvent.suspectEntity.causalityAuthor"/>
      <expansion>
        <identifier value="urn:uuid:a76b4213-22f5-4210-a7f2-873b8725b7c4"/>
        <timestamp value="2019-10-24T11:53:00+11:00"/>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Practitioner"/>
          <display value="Practitioner"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="PractitionerRole"/>
          <display value="PractitionerRole"/>
        </contains>
      </expansion>
    </ValueSet>
  </contained>
  <contained>
    <ValueSet>
      <id value="vs7"/>
      <name value="Type options for AdverseEvent.subjectMedicalHistory"/>
      <status value="active"/>
      <description value="Type options for AdverseEvent.subjectMedicalHistory"/>
      <expansion>
        <identifier value="urn:uuid:b651d5ef-2f5d-4df5-a454-3b885bb78f2a"/>
        <timestamp value="2019-10-24T11:53:00+11:00"/>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Condition"/>
          <display value="Condition"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Observation"/>
          <display value="Observation"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="AllergyIntolerance"/>
          <display value="AllergyIntolerance"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="FamilyMemberHistory"/>
          <display value="FamilyMemberHistory"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Immunization"/>
          <display value="Immunization"/>
        </contains>
        <contains>
          <system value="http://hl7.org/fhir/resource-types"/>
          <code value="Procedure"/>
          <display value="Procedure"/>
        </contains>
      </expansion>
    </ValueSet>
  </contained>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
  </identifier>
  <status value="draft"/>
  <date value="2019-10-24T11:53:00+11:00"/>
  <publisher value="Health Level Seven International (Regulated Clinical Research Information Management)"/>
  <item>
    <linkId value="AdverseEvent"/>
    <text value="Medical care, research study or other healthcare event causing physical injury"/>
    <type value="group"/>
    <required value="false"/>
    <repeats value="true"/>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="flyover"/>
            <display value="Fly-over"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <text value="Actual or  potential/avoided event causing unintended physical injury resulting from or contributed to by medical care, a research study or other healthcare setting factors that requires additional monitoring, treatment, or hospitalization, or that results in death."/>
      <type value="display"/>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="string"/>
      </extension>
      <linkId value="AdverseEvent.id"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.id.value"/>
        <text value="Logical id of this artifact"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <linkId value="AdverseEvent.meta"/>
      <text value="Metadata about the resource"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
        <type value="display"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="uri"/>
      </extension>
      <linkId value="AdverseEvent.implicitRules"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. &#xA;&#xA;This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.implicitRules.value"/>
        <text value="A set of rules under which this content was created"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="code"/>
      </extension>
      <linkId value="AdverseEvent.language"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.language.value"/>
        <text value="language"/>
        <type value="choice"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <linkId value="AdverseEvent.text"/>
      <text value="Text summary of the resource, for human interpretation"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later."/>
        <type value="display"/>
      </item>
    </item>
    <item>
      <linkId value="AdverseEvent.contained"/>
      <text value="Contained, inline Resources"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/>
        <type value="display"/>
      </item>
    </item>
    <item>
      <linkId value="AdverseEvent.extension"/>
      <text value="Additional Content defined by implementations"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
        <type value="display"/>
      </item>
    </item>
    <item>
      <linkId value="AdverseEvent.modifierExtension"/>
      <text value="Extensions that cannot be ignored"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
        <type value="display"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="Identifier"/>
      </extension>
      <linkId value="AdverseEvent.identifier"/>
      <text value="Business identifier for the event"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="The identifier(s) of this adverse event that are assigned by business processes and/or used to refer to it when a direct URL reference to the resource itsefl is not appropriate."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.identifier.label"/>
        <text value="label:"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
      <item>
        <linkId value="AdverseEvent.identifier.system"/>
        <text value="system:"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
      <item>
        <linkId value="AdverseEvent.identifier.value"/>
        <text value="value:"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="code"/>
      </extension>
      <linkId value="AdverseEvent.category"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="The type of event which is important to characterize what occurred and caused harm to the subject, or had the potential to cause harm to the subject."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.category.value"/>
        <text value="category"/>
        <type value="choice"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="CodeableConcept"/>
      </extension>
      <linkId value="AdverseEvent.type"/>
      <text value="actual | potential"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="This element defines the specific type of event that occurred or that was prevented from occurring."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.type.coding"/>
        <text value="code:"/>
        <type value="open-choice"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
      <item>
        <linkId value="AdverseEvent.type.text"/>
        <text value="text:"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <linkId value="AdverseEvent.subject"/>
      <text value="Subject or group impacted by event"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="This subject or group impacted by the event.  With a prospective adverse event, there will be no subject as the adverse event was prevented."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.subject._type"/>
        <text value="type"/>
        <type value="choice"/>
        <required value="false"/>
        <repeats value="false"/>
        <options>
          <reference value="#vs2"/>
        </options>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subject._Patient"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Patient"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subject._Patient.value"/>
            <text value="Patient"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subject._ResearchSubject"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="ResearchSubject"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subject._ResearchSubject.value"/>
            <text value="ResearchSubject"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subject._Medication"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Medication"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subject._Medication.value"/>
            <text value="Medication"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subject._Device"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Device"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subject._Device.value"/>
            <text value="Device"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="datetime"/>
      </extension>
      <linkId value="AdverseEvent.date"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="The date (and perhaps time) when the adverse event occurred."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.date.value"/>
        <text value="When the event occurred"/>
        <type value="dateTime"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="Reference"/>
      </extension>
      <linkId value="AdverseEvent.reaction"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="Includes information about the reaction that occurred as a result of exposure to a substance (for example, a drug or a chemical)."/>
        <type value="display"/>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
          <valueCode value="Condition"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
          <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
        </extension>
        <linkId value="AdverseEvent.reaction.value"/>
        <text value="Adverse Reaction Events linked to exposure to substance"/>
        <type value="reference"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="Reference"/>
      </extension>
      <linkId value="AdverseEvent.location"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="The information about where the adverse event occurred."/>
        <type value="display"/>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
          <valueCode value="Location"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
          <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
        </extension>
        <linkId value="AdverseEvent.location.value"/>
        <text value="Location where adverse event occurred"/>
        <type value="reference"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="CodeableConcept"/>
      </extension>
      <linkId value="AdverseEvent.seriousness"/>
      <text value="Mild | Moderate | Severe"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="Describes the seriousness or severity of the adverse event."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.seriousness.coding"/>
        <text value="code:"/>
        <type value="open-choice"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
      <item>
        <linkId value="AdverseEvent.seriousness.text"/>
        <text value="text:"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="CodeableConcept"/>
      </extension>
      <linkId value="AdverseEvent.outcome"/>
      <text value="resolved | recovering | ongoing | resolvedWithSequelae | fatal | unknown"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="Describes the type of outcome from the adverse event."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.outcome.coding"/>
        <text value="code:"/>
        <type value="choice"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
      <item>
        <linkId value="AdverseEvent.outcome.text"/>
        <text value="text:"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <linkId value="AdverseEvent.recorder"/>
      <text value="Who recorded the adverse event"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="Information on who recorded the adverse event.  May be the patient or a practitioner."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.recorder._type"/>
        <text value="type"/>
        <type value="choice"/>
        <required value="false"/>
        <repeats value="false"/>
        <options>
          <reference value="#vs3"/>
        </options>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.recorder._Patient"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Patient"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.recorder._Patient.value"/>
            <text value="Patient"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.recorder._Practitioner"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Practitioner"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.recorder._Practitioner.value"/>
            <text value="Practitioner"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.recorder._RelatedPerson"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="RelatedPerson"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.recorder._RelatedPerson.value"/>
            <text value="RelatedPerson"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <linkId value="AdverseEvent.eventParticipant"/>
      <text value="Who  was involved in the adverse event or the potential adverse event"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="Parties that may or should contribute or have contributed information to the Act. Such information includes information leading to the decision to perform the Act and how to perform the Act (e.g. consultant), information that the Act itself seeks to reveal (e.g. informant of clinical history), or information about what Act was performed (e.g. informant witness)."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.eventParticipant._type"/>
        <text value="type"/>
        <type value="choice"/>
        <required value="false"/>
        <repeats value="false"/>
        <options>
          <reference value="#vs4"/>
        </options>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.eventParticipant._Practitioner"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Practitioner"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.eventParticipant._Practitioner.value"/>
            <text value="Practitioner"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.eventParticipant._Device"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Device"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.eventParticipant._Device.value"/>
            <text value="Device"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
        <valueInteger value="1"/>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="string"/>
      </extension>
      <linkId value="AdverseEvent.description"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="Describes the adverse event in text."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.description.value"/>
        <text value="Description of the adverse event"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <linkId value="AdverseEvent.suspectEntity"/>
      <text value="The suspected agent causing the adverse event"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="Describes the entity that is suspected to have caused the adverse event."/>
        <type value="display"/>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
          <valueInteger value="1"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
          <valueString value="string"/>
        </extension>
        <linkId value="AdverseEvent.suspectEntity.id"/>
        <type value="group"/>
        <required value="false"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <type value="display"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.id.value"/>
          <text value="xml:id (or equivalent in JSON)"/>
          <type value="string"/>
          <required value="false"/>
          <repeats value="false"/>
        </item>
      </item>
      <item>
        <linkId value="AdverseEvent.suspectEntity.extension"/>
        <text value="Additional Content defined by implementations"/>
        <type value="group"/>
        <required value="false"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <type value="display"/>
        </item>
      </item>
      <item>
        <linkId value="AdverseEvent.suspectEntity.modifierExtension"/>
        <text value="Extensions that cannot be ignored"/>
        <type value="group"/>
        <required value="false"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <type value="display"/>
        </item>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs">
          <valueInteger value="1"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
          <valueInteger value="1"/>
        </extension>
        <linkId value="AdverseEvent.suspectEntity.instance"/>
        <text value="Refers to the specific entity that caused the adverse event"/>
        <type value="group"/>
        <required value="true"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="Identifies the actual instance of what caused the adverse event.  May be a substance, medication, medication administration, medication statement or a device."/>
          <type value="display"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.instance._type"/>
          <text value="type"/>
          <type value="choice"/>
          <required value="false"/>
          <repeats value="false"/>
          <options>
            <reference value="#vs5"/>
          </options>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
              <valueString value="Reference"/>
            </extension>
            <linkId value="AdverseEvent.suspectEntity.instance._Substance"/>
            <type value="group"/>
            <item>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
                <valueCode value="Substance"/>
              </extension>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
                <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
              </extension>
              <linkId value="AdverseEvent.suspectEntity.instance._Substance.value"/>
              <text value="Substance"/>
              <type value="reference"/>
              <required value="false"/>
              <repeats value="false"/>
            </item>
          </item>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
              <valueString value="Reference"/>
            </extension>
            <linkId value="AdverseEvent.suspectEntity.instance._Medication"/>
            <type value="group"/>
            <item>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
                <valueCode value="Medication"/>
              </extension>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
                <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
              </extension>
              <linkId value="AdverseEvent.suspectEntity.instance._Medication.value"/>
              <text value="Medication"/>
              <type value="reference"/>
              <required value="false"/>
              <repeats value="false"/>
            </item>
          </item>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
              <valueString value="Reference"/>
            </extension>
            <linkId value="AdverseEvent.suspectEntity.instance._MedicationAdministration"/>
            <type value="group"/>
            <item>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
                <valueCode value="MedicationAdministration"/>
              </extension>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
                <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
              </extension>
              <linkId value="AdverseEvent.suspectEntity.instance._MedicationAdministration.value"/>
              <text value="MedicationAdministration"/>
              <type value="reference"/>
              <required value="false"/>
              <repeats value="false"/>
            </item>
          </item>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
              <valueString value="Reference"/>
            </extension>
            <linkId value="AdverseEvent.suspectEntity.instance._MedicationStatement"/>
            <type value="group"/>
            <item>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
                <valueCode value="MedicationStatement"/>
              </extension>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
                <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
              </extension>
              <linkId value="AdverseEvent.suspectEntity.instance._MedicationStatement.value"/>
              <text value="MedicationStatement"/>
              <type value="reference"/>
              <required value="false"/>
              <repeats value="false"/>
            </item>
          </item>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
              <valueString value="Reference"/>
            </extension>
            <linkId value="AdverseEvent.suspectEntity.instance._Device"/>
            <type value="group"/>
            <item>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
                <valueCode value="Device"/>
              </extension>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
                <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
              </extension>
              <linkId value="AdverseEvent.suspectEntity.instance._Device.value"/>
              <text value="Device"/>
              <type value="reference"/>
              <required value="false"/>
              <repeats value="false"/>
            </item>
          </item>
        </item>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
          <valueInteger value="1"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
          <valueString value="code"/>
        </extension>
        <linkId value="AdverseEvent.suspectEntity.causality"/>
        <type value="group"/>
        <required value="false"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="causality1 | causality2."/>
          <type value="display"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.causality.value"/>
          <text value="causality"/>
          <type value="choice"/>
          <required value="false"/>
          <repeats value="false"/>
        </item>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
          <valueInteger value="1"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
          <valueString value="CodeableConcept"/>
        </extension>
        <linkId value="AdverseEvent.suspectEntity.causalityAssessment"/>
        <text value="assess1 | assess2"/>
        <type value="group"/>
        <required value="false"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="assess1 | assess2."/>
          <type value="display"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.causalityAssessment.coding"/>
          <text value="code:"/>
          <type value="open-choice"/>
          <required value="false"/>
          <repeats value="false"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.causalityAssessment.text"/>
          <text value="text:"/>
          <type value="string"/>
          <required value="false"/>
          <repeats value="false"/>
        </item>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
          <valueInteger value="1"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
          <valueString value="string"/>
        </extension>
        <linkId value="AdverseEvent.suspectEntity.causalityProductRelatedness"/>
        <type value="group"/>
        <required value="false"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="AdverseEvent.suspectEntity.causalityProductRelatedness."/>
          <type value="display"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.causalityProductRelatedness.value"/>
          <text value="AdverseEvent.suspectEntity.causalityProductRelatedness"/>
          <type value="string"/>
          <required value="false"/>
          <repeats value="false"/>
        </item>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
          <valueInteger value="1"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
          <valueString value="CodeableConcept"/>
        </extension>
        <linkId value="AdverseEvent.suspectEntity.causalityMethod"/>
        <text value="method1 | method2"/>
        <type value="group"/>
        <required value="false"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="method1 | method2."/>
          <type value="display"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.causalityMethod.coding"/>
          <text value="code:"/>
          <type value="open-choice"/>
          <required value="false"/>
          <repeats value="false"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.causalityMethod.text"/>
          <text value="text:"/>
          <type value="string"/>
          <required value="false"/>
          <repeats value="false"/>
        </item>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
          <valueInteger value="1"/>
        </extension>
        <linkId value="AdverseEvent.suspectEntity.causalityAuthor"/>
        <text value="AdverseEvent.suspectEntity.causalityAuthor"/>
        <type value="group"/>
        <required value="false"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="AdverseEvent.suspectEntity.causalityAuthor."/>
          <type value="display"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.causalityAuthor._type"/>
          <text value="type"/>
          <type value="choice"/>
          <required value="false"/>
          <repeats value="false"/>
          <options>
            <reference value="#vs6"/>
          </options>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
              <valueString value="Reference"/>
            </extension>
            <linkId value="AdverseEvent.suspectEntity.causalityAuthor._Practitioner"/>
            <type value="group"/>
            <item>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
                <valueCode value="Practitioner"/>
              </extension>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
                <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
              </extension>
              <linkId value="AdverseEvent.suspectEntity.causalityAuthor._Practitioner.value"/>
              <text value="Practitioner"/>
              <type value="reference"/>
              <required value="false"/>
              <repeats value="false"/>
            </item>
          </item>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
              <valueString value="Reference"/>
            </extension>
            <linkId value="AdverseEvent.suspectEntity.causalityAuthor._PractitionerRole"/>
            <type value="group"/>
            <item>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
                <valueCode value="PractitionerRole"/>
              </extension>
              <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
                <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
              </extension>
              <linkId value="AdverseEvent.suspectEntity.causalityAuthor._PractitionerRole.value"/>
              <text value="PractitionerRole"/>
              <type value="reference"/>
              <required value="false"/>
              <repeats value="false"/>
            </item>
          </item>
        </item>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
          <valueInteger value="1"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
          <valueString value="CodeableConcept"/>
        </extension>
        <linkId value="AdverseEvent.suspectEntity.causalityResult"/>
        <text value="result1 | result2"/>
        <type value="group"/>
        <required value="false"/>
        <repeats value="true"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="flyover"/>
                <display value="Fly-over"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <text value="result1 | result2."/>
          <type value="display"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.causalityResult.coding"/>
          <text value="code:"/>
          <type value="open-choice"/>
          <required value="false"/>
          <repeats value="false"/>
        </item>
        <item>
          <linkId value="AdverseEvent.suspectEntity.causalityResult.text"/>
          <text value="text:"/>
          <type value="string"/>
          <required value="false"/>
          <repeats value="false"/>
        </item>
      </item>
    </item>
    <item>
      <linkId value="AdverseEvent.subjectMedicalHistory"/>
      <text value="AdverseEvent.subjectMedicalHistory"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="AdverseEvent.subjectMedicalHistory."/>
        <type value="display"/>
      </item>
      <item>
        <linkId value="AdverseEvent.subjectMedicalHistory._type"/>
        <text value="type"/>
        <type value="choice"/>
        <required value="false"/>
        <repeats value="false"/>
        <options>
          <reference value="#vs7"/>
        </options>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subjectMedicalHistory._Condition"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Condition"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subjectMedicalHistory._Condition.value"/>
            <text value="Condition"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subjectMedicalHistory._Observation"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Observation"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subjectMedicalHistory._Observation.value"/>
            <text value="Observation"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subjectMedicalHistory._AllergyIntolerance"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="AllergyIntolerance"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subjectMedicalHistory._AllergyIntolerance.value"/>
            <text value="AllergyIntolerance"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subjectMedicalHistory._FamilyMemberHistory"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="FamilyMemberHistory"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subjectMedicalHistory._FamilyMemberHistory.value"/>
            <text value="FamilyMemberHistory"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subjectMedicalHistory._Immunization"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Immunization"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subjectMedicalHistory._Immunization.value"/>
            <text value="Immunization"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
            <valueString value="Reference"/>
          </extension>
          <linkId value="AdverseEvent.subjectMedicalHistory._Procedure"/>
          <type value="group"/>
          <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
              <valueCode value="Procedure"/>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
              <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
            </extension>
            <linkId value="AdverseEvent.subjectMedicalHistory._Procedure.value"/>
            <text value="Procedure"/>
            <type value="reference"/>
            <required value="false"/>
            <repeats value="false"/>
          </item>
        </item>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="Reference"/>
      </extension>
      <linkId value="AdverseEvent.referenceDocument"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="AdverseEvent.referenceDocument."/>
        <type value="display"/>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
          <valueCode value="DocumentReference"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
          <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
        </extension>
        <linkId value="AdverseEvent.referenceDocument.value"/>
        <text value="AdverseEvent.referenceDocument"/>
        <type value="reference"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
    <item>
      <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType">
        <valueString value="Reference"/>
      </extension>
      <linkId value="AdverseEvent.study"/>
      <type value="group"/>
      <required value="false"/>
      <repeats value="true"/>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
          <valueCodeableConcept>
            <coding>
              <system value="http://hl7.org/fhir/questionnaire-item-control"/>
              <code value="flyover"/>
              <display value="Fly-over"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <text value="AdverseEvent.study."/>
        <type value="display"/>
      </item>
      <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource">
          <valueCode value="ResearchStudy"/>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter">
          <valueString value="subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
        </extension>
        <linkId value="AdverseEvent.study.value"/>
        <text value="AdverseEvent.study"/>
        <type value="reference"/>
        <required value="false"/>
        <repeats value="false"/>
      </item>
    </item>
  </item>
</Questionnaire>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.