{
  "resourceType" : "Bundle",
  "id" : "mii-exa-pro-promis-29-bundle",
  "language" : "de",
  "type" : "collection",
  "timestamp" : "2025-01-30T14:35:00Z",
  "entry" : [{
    "fullUrl" : "urn:uuid:a1b2c3d4-e5f6-7890-abcd-ef1234567890",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "patient-example-1",
      "meta" : {
        "profile" : ["https://www.medizininformatik-initiative.de/fhir/core/modul-person/StructureDefinition/Patient"]
      },
      "language" : "de",
      "text" : {
        "status" : "generated"
      },
      "identifier" : [{
        "system" : "http://example.org/fhir/sid/patients",
        "value" : "12345"
      }],
      "name" : [{
        "family" : "Mustermann",
        "given" : ["Erika"]
      }],
      "gender" : "female",
      "birthDate" : "1985-03-15"
    }
  },
  {
    "fullUrl" : "urn:uuid:b2c3d4e5-f6a7-8901-bcde-f12345678901",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "promis-29-response-1",
      "meta" : {
        "profile" : ["https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-pr-pro-questionnaire-response|2027.0.0-ballot.1"]
      },
      "language" : "de",
      "text" : {
        "status" : "generated"
      },
      "questionnaire" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-promis-29|2027.0.0-ballot.1",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/patient-example-1"
      },
      "authored" : "2025-01-30T14:30:00Z",
      "item" : [{
        "linkId" : "PROMIS-29.PhysicalFunction",
        "text" : "KÖRPERLICHE FUNKTION",
        "item" : [{
          "linkId" : "PROMIS-29.PhysicalFunction.Description",
          "text" : "Sind Sie zu folgenden Tätigkeiten imstande:"
        },
        {
          "linkId" : "promis-pfa11",
          "text" : "Können Sie Hausarbeiten erledigen, z.B. Staubsaugen oder Gartenarbeit?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13920-6",
              "display" : "Mit einigen Schwierigkeiten"
            }
          }]
        },
        {
          "linkId" : "promis-pfa21",
          "text" : "Können Sie mit normaler Geschwindigkeit Treppen hoch- und runtergehen?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13920-6",
              "display" : "Mit einigen Schwierigkeiten"
            }
          }]
        },
        {
          "linkId" : "promis-pfa23",
          "text" : "Können Sie mindestens 15 Minuten lang spazieren gehen?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13918-0",
              "display" : "Mit geringen Schwierigkeiten"
            }
          }]
        },
        {
          "linkId" : "promis-pfa53",
          "text" : "Können Sie Besorgungen machen und einkaufen gehen?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13920-6",
              "display" : "Mit einigen Schwierigkeiten"
            }
          }]
        }]
      },
      {
        "linkId" : "PROMIS-29.Anxiety",
        "text" : "ANGST",
        "item" : [{
          "linkId" : "PROMIS-29.Anxiety.Description",
          "text" : "In den letzten 7 Tagen:"
        },
        {
          "linkId" : "promis-edanx01",
          "text" : "Ich fürchtete mich.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10066-1",
              "display" : "Selten"
            }
          }]
        },
        {
          "linkId" : "promis-edanx40",
          "text" : "Ich fand es schwer, auf etwas anderes zu achten als auf meine Angst.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10082-8",
              "display" : "Manchmal"
            }
          }]
        },
        {
          "linkId" : "promis-edanx41",
          "text" : "Meine Sorgen haben mich überwältigt.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10066-1",
              "display" : "Selten"
            }
          }]
        },
        {
          "linkId" : "promis-edanx53",
          "text" : "Ich fühlte mich unruhig.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10066-1",
              "display" : "Selten"
            }
          }]
        }]
      },
      {
        "linkId" : "PROMIS-29.Depression",
        "text" : "DEPRESSION",
        "item" : [{
          "linkId" : "PROMIS-29.Depression.Description",
          "text" : "In den letzten 7 Tagen:"
        },
        {
          "linkId" : "promis-eddep04",
          "text" : "Ich fühlte mich wertlos.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10082-8",
              "display" : "Manchmal"
            }
          }]
        },
        {
          "linkId" : "promis-eddep06",
          "text" : "Ich fühlte mich hilflos.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10082-8",
              "display" : "Manchmal"
            }
          }]
        },
        {
          "linkId" : "promis-eddep29",
          "text" : "Ich fühlte mich niedergeschlagen.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10044-8",
              "display" : "Oft"
            }
          }]
        },
        {
          "linkId" : "promis-eddep41",
          "text" : "Ich fühlte mich hoffnungslos.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10082-8",
              "display" : "Manchmal"
            }
          }]
        }]
      },
      {
        "linkId" : "PROMIS-29.Fatigue",
        "text" : "ERSCHÖPFUNG",
        "item" : [{
          "linkId" : "PROMIS-29.Fatigue.Description",
          "text" : "In den letzten 7 Tagen:"
        },
        {
          "linkId" : "promis-hi7",
          "text" : "Ich bin erschöpft.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13902-4",
              "display" : "Ziemlich"
            }
          }]
        },
        {
          "linkId" : "promis-an3",
          "text" : "Es fällt mir schwer, etwas anzufangen, weil ich müde bin.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13902-4",
              "display" : "Ziemlich"
            }
          }]
        },
        {
          "linkId" : "promis-fatexp41",
          "text" : "Wie ausgelaugt fühlten Sie sich im Allgemeinen?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13909-9",
              "display" : "Mäßig"
            }
          }]
        },
        {
          "linkId" : "promis-fatexp40",
          "text" : "Wie erschöpft waren Sie im Allgemeinen?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13902-4",
              "display" : "Ziemlich"
            }
          }]
        }]
      },
      {
        "linkId" : "PROMIS-29.Sleep",
        "text" : "SCHLAFSTÖRUNGEN",
        "item" : [{
          "linkId" : "PROMIS-29.Sleep.Description",
          "text" : "In den letzten 7 Tagen:"
        },
        {
          "linkId" : "promis-sleep109",
          "text" : "Meine Schlafqualität war ...",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA8968-5",
              "display" : "Mäßig"
            }
          }]
        },
        {
          "linkId" : "promis-sleep116",
          "text" : "Mein Schlaf war erfrischend.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13909-9",
              "display" : "Mäßig"
            }
          }]
        },
        {
          "linkId" : "promis-sleep20",
          "text" : "Ich hatte Schlafprobleme.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13909-9",
              "display" : "Mäßig"
            }
          }]
        },
        {
          "linkId" : "promis-sleep44",
          "text" : "Ich hatte Schwierigkeiten einzuschlafen.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13863-8",
              "display" : "Ein wenig"
            }
          }]
        }]
      },
      {
        "linkId" : "PROMIS-29.Social",
        "text" : "SOZIALE TEILHABE",
        "item" : [{
          "linkId" : "PROMIS-29.Social.Description",
          "text" : "In den letzten 7 Tagen:"
        },
        {
          "linkId" : "promis-srpper23-caps",
          "text" : "Es fällt mir schwer, meine gewohnte Arbeit zu erledigen (einschließlich der Arbeit zu Hause).",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10082-8",
              "display" : "Manchmal"
            }
          }]
        },
        {
          "linkId" : "promis-srpper11-caps",
          "text" : "Es fällt mir schwer, allen meinen regelmäßigen Freizeitaktivitäten mit anderen nachzugehen.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10082-8",
              "display" : "Manchmal"
            }
          }]
        },
        {
          "linkId" : "promis-srpper18-caps",
          "text" : "Es fällt mir schwer, allen Aktivitäten nachzugehen, die ich mit meiner Familie machen möchte.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10066-1",
              "display" : "Selten"
            }
          }]
        },
        {
          "linkId" : "promis-srpper46-caps",
          "text" : "Es fällt mir schwer, allen Aktivitäten nachzugehen, die ich mit Freunden machen möchte.",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA10082-8",
              "display" : "Manchmal"
            }
          }]
        }]
      },
      {
        "linkId" : "PROMIS-29.PainInterference",
        "text" : "SCHMERZBEDINGTE BEEINTRÄCHTIGUNG",
        "item" : [{
          "linkId" : "PROMIS-29.PainInterference.Description",
          "text" : "In den letzten 7 Tagen: Inwieweit beeinträchtigten Schmerzen..."
        },
        {
          "linkId" : "promis-painin9",
          "text" : "Wie sehr beeinträchtigten Schmerzen Ihre Alltagsaktivitäten?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13909-9",
              "display" : "Mäßig"
            }
          }]
        },
        {
          "linkId" : "promis-painin22",
          "text" : "Wie sehr beeinträchtigten Schmerzen Ihre häuslichen Tätigkeiten?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13909-9",
              "display" : "Mäßig"
            }
          }]
        },
        {
          "linkId" : "promis-painin31",
          "text" : "Wie sehr beeinträchtigten Schmerzen Ihre Fähigkeit, an sozialen Aktivitäten teilzunehmen?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13863-8",
              "display" : "Ein wenig"
            }
          }]
        },
        {
          "linkId" : "promis-painin34",
          "text" : "Wie sehr beeinträchtigten Schmerzen Sie bei Ihrer Hausarbeit?",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://loinc.org",
              "code" : "LA13909-9",
              "display" : "Mäßig"
            }
          }]
        }]
      },
      {
        "linkId" : "PROMIS-29.PainIntensity",
        "text" : "SCHMERZINTENSITÄT",
        "item" : [{
          "linkId" : "promis-global07",
          "text" : "Wie würden Sie Ihre Schmerzen im Allgemeinen einschätzen?",
          "answer" : [{
            "valueInteger" : 5
          }]
        }]
      },
      {
        "linkId" : "PROMIS-29.Scores",
        "text" : "BEREICHS-BEWERTUNGEN",
        "item" : [{
          "linkId" : "promis-29-physical-function-raw",
          "text" : "PROMIS-29 Körperliche Funktion - Rohwert",
          "answer" : [{
            "valueDecimal" : 13
          }]
        },
        {
          "linkId" : "promis-29-physical-function-tscore",
          "text" : "PROMIS-29 Körperliche Funktion - T-Score",
          "answer" : [{
            "valueDecimal" : 42.6
          }]
        },
        {
          "linkId" : "promis-29-anxiety-raw",
          "text" : "PROMIS-29 Angst - Rohwert",
          "answer" : [{
            "valueDecimal" : 9
          }]
        },
        {
          "linkId" : "promis-29-anxiety-tscore",
          "text" : "PROMIS-29 Angst - T-Score",
          "answer" : [{
            "valueDecimal" : 56.8
          }]
        },
        {
          "linkId" : "promis-29-depression-raw",
          "text" : "PROMIS-29 Depression - Rohwert",
          "answer" : [{
            "valueDecimal" : 13
          }]
        },
        {
          "linkId" : "promis-29-depression-tscore",
          "text" : "PROMIS-29 Depression - T-Score",
          "answer" : [{
            "valueDecimal" : 63.9
          }]
        },
        {
          "linkId" : "promis-29-fatigue-raw",
          "text" : "PROMIS-29 Erschöpfung - Rohwert",
          "answer" : [{
            "valueDecimal" : 15
          }]
        },
        {
          "linkId" : "promis-29-fatigue-tscore",
          "text" : "PROMIS-29 Erschöpfung - T-Score",
          "answer" : [{
            "valueDecimal" : 64.9
          }]
        },
        {
          "linkId" : "promis-29-sleep-raw",
          "text" : "PROMIS-29 Schlafstörungen - Rohwert",
          "answer" : [{
            "valueDecimal" : 11
          }]
        },
        {
          "linkId" : "promis-29-sleep-tscore",
          "text" : "PROMIS-29 Schlafstörungen - T-Score",
          "answer" : [{
            "valueDecimal" : 53.6
          }]
        },
        {
          "linkId" : "promis-29-social-raw",
          "text" : "PROMIS-29 Soziale Teilhabe - Rohwert",
          "answer" : [{
            "valueDecimal" : 11
          }]
        },
        {
          "linkId" : "promis-29-social-tscore",
          "text" : "PROMIS-29 Soziale Teilhabe - T-Score",
          "answer" : [{
            "valueDecimal" : 39.7
          }]
        },
        {
          "linkId" : "promis-29-pain-interference-raw",
          "text" : "PROMIS-29 Schmerzbedingte Beeinträchtigung - Rohwert",
          "answer" : [{
            "valueDecimal" : 11
          }]
        },
        {
          "linkId" : "promis-29-pain-interference-tscore",
          "text" : "PROMIS-29 Schmerzbedingte Beeinträchtigung - T-Score",
          "answer" : [{
            "valueDecimal" : 60.9
          }]
        }]
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:c3d4e5f6-a7b8-9012-cdef-123456789012",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "obs-promis-29-physical-function-tscore",
      "meta" : {
        "profile" : ["https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/StructureDefinition/mii-pr-pro-promis-29-physical-function-tscore|2027.0.0-ballot.1"]
      },
      "language" : "de",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/workflow-instantiatesCanonical",
        "valueCanonical" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ObservationDefinition/mii-obsdef-pro-promis-29-physical-function-tscore"
      }],
      "status" : "final",
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "91721-1",
          "display" : "PROMIS physical function - version 2.0 T-score"
        }]
      },
      "subject" : {
        "reference" : "Patient/patient-example-1"
      },
      "effectiveDateTime" : "2025-01-30T14:30:00Z",
      "valueQuantity" : {
        "value" : 42.6,
        "unit" : "{score}",
        "system" : "http://unitsofmeasure.org",
        "code" : "{score}"
      },
      "method" : {
        "text" : "PROMIS-29 Profile v2.1"
      },
      "derivedFrom" : [{
        "reference" : "QuestionnaireResponse/promis-29-response-1"
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:d4e5f6a7-b8c9-0123-defa-234567890123",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "obs-promis-29-anxiety-tscore",
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      },
      "language" : "de",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
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        "valueCanonical" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ObservationDefinition/mii-obsdef-pro-promis-29-anxiety-tscore"
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      "status" : "final",
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "71967-4",
          "display" : "PROMIS-29 Anxiety score T-score"
        }]
      },
      "subject" : {
        "reference" : "Patient/patient-example-1"
      },
      "effectiveDateTime" : "2025-01-30T14:30:00Z",
      "valueQuantity" : {
        "value" : 56.8,
        "unit" : "{score}",
        "system" : "http://unitsofmeasure.org",
        "code" : "{score}"
      },
      "method" : {
        "text" : "PROMIS-29 Profile v2.1"
      },
      "derivedFrom" : [{
        "reference" : "QuestionnaireResponse/promis-29-response-1"
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:e5f6a7b8-c9d0-1234-efab-345678901234",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "obs-promis-29-depression-tscore",
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      },
      "language" : "de",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/workflow-instantiatesCanonical",
        "valueCanonical" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ObservationDefinition/mii-obsdef-pro-promis-29-depression-tscore"
      }],
      "status" : "final",
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "77861-3",
          "display" : "PROMIS emotional distress - depression - version 1.0 Tscore"
        }]
      },
      "subject" : {
        "reference" : "Patient/patient-example-1"
      },
      "effectiveDateTime" : "2025-01-30T14:30:00Z",
      "valueQuantity" : {
        "value" : 63.9,
        "unit" : "{score}",
        "system" : "http://unitsofmeasure.org",
        "code" : "{score}"
      },
      "method" : {
        "text" : "PROMIS-29 Profile v2.1"
      },
      "derivedFrom" : [{
        "reference" : "QuestionnaireResponse/promis-29-response-1"
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:f6a7b8c9-d0e1-2345-fabc-456789012345",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "obs-promis-29-fatigue-tscore",
      "meta" : {
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      },
      "language" : "de",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/workflow-instantiatesCanonical",
        "valueCanonical" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/ObservationDefinition/mii-obsdef-pro-promis-29-fatigue-tscore"
      }],
      "status" : "final",
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "77864-7",
          "display" : "PROMIS fatigue - version 1.0 Tscore"
        }]
      },
      "subject" : {
        "reference" : "Patient/patient-example-1"
      },
      "effectiveDateTime" : "2025-01-30T14:30:00Z",
      "valueQuantity" : {
        "value" : 64.9,
        "unit" : "{score}",
        "system" : "http://unitsofmeasure.org",
        "code" : "{score}"
      },
      "method" : {
        "text" : "PROMIS-29 Profile v2.1"
      },
      "derivedFrom" : [{
        "reference" : "QuestionnaireResponse/promis-29-response-1"
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:a7b8c9d0-e1f2-3456-abcd-567890123456",
    "resource" : {
      "resourceType" : "Observation",
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