The change to the questionnaire definition to make the display label for questions "text" property from string to markdown increases the complexity of processing when not required. This is of particular concern when not doing a web based interaction, this is also overhead processing required when usually not necessary.

This signficantly raises the bar on renderers to have a markdown processor as the minimum. The style sensitive extension could indicate if the markdown "must" be shown in order to complete the form.

Also, if we're going to keep that change, will need to be propagated to the QuestionnaireResponse.item.text property too.