Edmonton Frailty Scale - JSON Representation - Smart Bear Implementation Guide v3.4.1

Smart Bear Implementation Guide - Local Development build (v3.4.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: Edmonton Frailty Scale - JSON Representation

Draft as of 2024-09-17
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{
  "resourceType" : "Questionnaire",
  "id" : "EFSQuestionnaire",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire EFSQuestionnaire</b></p><a name=\"EFSQuestionnaire\"> </a><a name=\"hcEFSQuestionnaire\"> </a><a name=\"EFSQuestionnaire-en-US\"> </a><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> EFSQuestionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Edmonton Frailty Scale</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">https://smart-bear.eu/fhir/Questionnaire/EFSQuestionnaire#3.4.1</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 0</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Cognition: Please imagine that this pre-drawn circle is a clock. I would like you to place the numbers in the correct positions then place the hands to indicate a time of ten after eleven</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.0\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">General Health Status : In the past year, how many times have you been admitted to a hospital?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.1\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 2</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">General Health Status : In general, how would you describe your health? </td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.2\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 3</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Functional independence: With how many of the following activities do you require help? (meal preparation,shopping, transportation, telephone,housekeeping, laundry, managing money,taking medications)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.3\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.4\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 4</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Social Support:  When you need help, can you count on someone who is willing and able to meet your needs?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.4\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 5</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Medication use: Do you use five or more different prescription medications on a regular basis?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.5\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 6</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Medication use: At times, do you forget to take your prescription medications?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.6\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 7</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Nutrition: Have you recently lost weight such that your clothing has become looser?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.7\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 8</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Mood: Do you often feel sad or depressed?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.8\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 9</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Continence: Do you have a problem with losing control of urine when you don’t want to?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.9\">2 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.10\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 10</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Functional Performance: I would like you to sit in this chair with your back and arms resting. Then, when I say ‘GO’, please stand up and walk at a safe and comfortable pace to the mark on the floor (approximately 3 m away), return to the chair and sit down</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.10\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.11\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> 11</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">null</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.score\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> score</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">null</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name=\"opt-item.0\"> </a><p><b>Answer options for 0 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSCognition#0 (&quot;No errors&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSCognition#1 (&quot;Minor spacing errors&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSCognition#2 (&quot;Other errors&quot;)</li></ul><a name=\"opt-item.1\"> </a><p><b>Answer options for 1 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthStatus#0 (&quot;0&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthStatus#1 (&quot;1-2&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthStatus#2 (&quot;&gt;=2&quot;)</li></ul><a name=\"opt-item.2\"> </a><p><b>Answer options for 2 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthHospital#0 (&quot;Excellent, very good, or good&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthHospital#1 (&quot;Fair&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthHospital#2 (&quot;Very poor&quot;)</li></ul><a name=\"opt-item.3\"> </a><p><b>Answer options for 3 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalIndipendence#0 (&quot;0-1&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalIndipendence#1 (&quot;2-4&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalIndipendence#2 (&quot;5-8&quot;)</li></ul><a name=\"opt-item.4\"> </a><p><b>Answer options for 4 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSSocialSupport#0 (&quot;Always&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSSocialSupport#1 (&quot;Sometimes&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSSocialSupport#2 (&quot;Never&quot;)</li></ul><a name=\"opt-item.5\"> </a><p><b>Answer options for 5 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#0 (&quot;No&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#1 (&quot;Yes&quot;)</li></ul><a name=\"opt-item.6\"> </a><p><b>Answer options for 6 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#0 (&quot;No&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#1 (&quot;Yes&quot;)</li></ul><a name=\"opt-item.7\"> </a><p><b>Answer options for 7 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#0 (&quot;No&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#1 (&quot;Yes&quot;)</li></ul><a name=\"opt-item.8\"> </a><p><b>Answer options for 8 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#0 (&quot;No&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#1 (&quot;Yes&quot;)</li></ul><a name=\"opt-item.9\"> </a><p><b>Answer options for 9 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#0 (&quot;No&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo#1 (&quot;Yes&quot;)</li></ul><a name=\"opt-item.10\"> </a><p><b>Answer options for 10 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalPerformance#0 (&quot;0-10 s&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalPerformance#1 (&quot;11-20 s&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalPerformance#2 (&quot;One of: &gt;20s or patient unwilling, or requires assistance&quot;)</li></ul></div>"
  },
  "url" : "https://smart-bear.eu/fhir/Questionnaire/EFSQuestionnaire",
  "version" : "3.4.1",
  "name" : "EFSQuestionnaire",
  "title" : "Edmonton Frailty Scale",
  "status" : "draft",
  "date" : "2024-09-17T08:57:54+02:00",
  "description" : "Edmonton Frailty Scale",
  "item" : [
    {
      "linkId" : "0",
      "text" : "Cognition: Please imagine that this pre-drawn circle is a clock. I would like you to place the numbers in the correct positions then place the hands to indicate a time of ten after eleven",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSCognition",
            "code" : "0",
            "display" : "No errors"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSCognition",
            "code" : "1",
            "display" : "Minor spacing errors"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSCognition",
            "code" : "2",
            "display" : "Other errors"
          }
        }
      ]
    },
    {
      "linkId" : "1",
      "text" : "General Health Status : In the past year, how many times have you been admitted to a hospital?",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthStatus",
            "code" : "0",
            "display" : "0"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthStatus",
            "code" : "1",
            "display" : "1-2"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthStatus",
            "code" : "2",
            "display" : ">=2"
          }
        }
      ]
    },
    {
      "linkId" : "2",
      "text" : "General Health Status : In general, how would you describe your health? ",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthHospital",
            "code" : "0",
            "display" : "Excellent, very good, or good"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthHospital",
            "code" : "1",
            "display" : "Fair"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSGeneralHealthHospital",
            "code" : "2",
            "display" : "Very poor"
          }
        }
      ]
    },
    {
      "linkId" : "3",
      "text" : "Functional independence: With how many of the following activities do you require help? (meal preparation,shopping, transportation, telephone,housekeeping, laundry, managing money,taking medications)",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalIndipendence",
            "code" : "0",
            "display" : "0-1"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalIndipendence",
            "code" : "1",
            "display" : "2-4"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalIndipendence",
            "code" : "2",
            "display" : "5-8"
          }
        }
      ]
    },
    {
      "linkId" : "4",
      "text" : "Social Support:  When you need help, can you count on someone who is willing and able to meet your needs?",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSSocialSupport",
            "code" : "0",
            "display" : "Always"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSSocialSupport",
            "code" : "1",
            "display" : "Sometimes"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSSocialSupport",
            "code" : "2",
            "display" : "Never"
          }
        }
      ]
    },
    {
      "linkId" : "5",
      "text" : "Medication use: Do you use five or more different prescription medications on a regular basis?",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "0",
            "display" : "No"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "1",
            "display" : "Yes"
          }
        }
      ]
    },
    {
      "linkId" : "6",
      "text" : "Medication use: At times, do you forget to take your prescription medications?",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "0",
            "display" : "No"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "1",
            "display" : "Yes"
          }
        }
      ]
    },
    {
      "linkId" : "7",
      "text" : "Nutrition: Have you recently lost weight such that your clothing has become looser?",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "0",
            "display" : "No"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "1",
            "display" : "Yes"
          }
        }
      ]
    },
    {
      "linkId" : "8",
      "text" : "Mood: Do you often feel sad or depressed?",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "0",
            "display" : "No"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "1",
            "display" : "Yes"
          }
        }
      ]
    },
    {
      "linkId" : "9",
      "text" : "Continence: Do you have a problem with losing control of urine when you don’t want to?",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "0",
            "display" : "No"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSYesOrNo",
            "code" : "1",
            "display" : "Yes"
          }
        }
      ]
    },
    {
      "linkId" : "10",
      "text" : "Functional Performance: I would like you to sit in this chair with your back and arms resting. Then, when I say ‘GO’, please stand up and walk at a safe and comfortable pace to the mark on the floor (approximately 3 m away), return to the chair and sit down",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalPerformance",
            "code" : "0",
            "display" : "0-10 s"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalPerformance",
            "code" : "1",
            "display" : "11-20 s"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/EFSFunctionalPerformance",
            "code" : "2",
            "display" : "One of: >20s or patient unwilling, or requires assistance"
          }
        }
      ]
    },
    {
      "linkId" : "11",
      "type" : "integer",
      "required" : false
    },
    {
      "linkId" : "score",
      "type" : "integer",
      "required" : true
    }
  ]
}