FHIR IG analytics| Package | forms.canshare.co.nz |
| Resource Type | Questionnaire |
| Id | Questionnaire-Breastrequestsandreports-BreastRequest.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/davidhay25/canshareFormsIG/Questionnaire-Breastrequestsandreports-BreastRequest.html |
| URL | http://canshare.co.nz/questionnaire/Breastrequestsandreports-BreastRequest |
| Version | 0.1.0 |
| Status | draft |
| Date | 2026-05-02T20:05:21.674Z |
| Name | Breastrequestsandreports-BreastRequest |
| Title | BreastRequest |
| Description | The main request form |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire Breastrequestsandreports-BreastRequest
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  Breastrequestsandreports-BreastRequest | The main request form | Questionnaire | http://canshare.co.nz/questionnaire/Breastrequestsandreports-BreastRequest#0.1.0 | ||
  66aAjg | BreastRequest | 0..1 | group | ||
  tV0v8Q | Patient | 0..1 | group | ||
  qaOktA | NHI | 0..1 | string | Definition: Patient.identifier.value | |
 yCCn1Q | help text for NHI | 0..1 | display | ||
| Ah66bA | Given name | 0..* | string | ||
| HgydRQ | Family name | 0..1 | string | ||
 Eko8vA | Date of Birth | 0..1 | date | Definition: Patient.birthDate | |
 t39aiw | Ethnicity | 0..1 | open-choice | Definition: Patient.extension.value Enable When: sLExmA = Female (AdministrativeGender#female) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/ethnic-group-level-4-code | |
| sLExmA | Gender | 0..1 | choice |  | Definition: Patient.gender Value Set: AdministrativeGender |
| 9gYExQ | Administration | 0..1 | group | ||
 acEEWg | Date | 0..1 | dateTime | ||
| LpmleA | Clinical Information | 0..1 | group | ||
| afqj9Q | Pathway | 0..1 | choice | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-referral-pathway-simple | |
| 1Sb4CQ | The method or programme that led to this service request, e.g. screening, diagnostic. | 0..1 | display | ||
| eOT4Hw | Clinical Impression (Screening) | 0..1 | choice | Enable When: afqj9Q = National screening programme (SNOMED CT#381081000210101) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-tumour-origin | |
| P23GAQ | 1321324 | 0..1 | display | ||
| HZj_FA | Clinical Impression (Diagnostic) | 0..1 | choice | Enable When: afqj9Q = Diagnostic assessment (SNOMED CT#165197003) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-tumour-origin | |
| Y-eZsA | Clinical Presentation | 0..1 | choice | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-clinical-presentation | |
| KQV-sQ | Clinical Behaviour | 0..1 | group | ||
| u-TOCw | Clinical behaviour | 0..1 | choice | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-clinical-impression-behaviour | |
| 2KwHtg | Clinical category | 0..1 | choice | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-clinical-behaviour-category | |
| q9r65Q | Previous Medical condition | 0..* | group | ||
| n6j-yA | Condition | 0..1 | choice | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-previous-condition | |
| sPFwog | Comments | 0..1 | string | ||
| eZ40Tg | Menopausal status | 0..1 | choice | | Definition: Observation.valueCodeableConcept.coding Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-menopause-status |
| WTJCLw | Neoadjuvant summary | 0..* | group | ||
| Ku_rMA | Adjuvant therapy type | 0..1 | choice | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-neoadjuvant-therapy-type | |
| gQ-Y5A | Adjuvant therapy status | 0..1 | choice | | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-neoadjuvant-therapy-status |
| y_T8Hg | Neoadjuvent summary (2) | 0..1 | group | ||
| xkxV6A | Neoadjuvant chemotherapy | 0..1 | choice | | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-neoadjuvant-therapy-status |
| 3yCfIA | Neoadjuvant hormone therapy | 0..1 | choice | | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-neoadjuvant-therapy-status |
| O4rysA | Neoadjuvant radiotherapy | 0..1 | choice | | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-neoadjuvant-therapy-status |
| VI-F4w | Other neoadjuvant therapy | 0..1 | string | ||
| UFsaIA | Radiology | 0..* | group | ||
| lnvhoA | Radiology type | 0..1 | choice | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-radiology-type | |
| 8DOCXg | Radiologic category | 0..1 | choice | Enable When: lnvhoA = Other (SNOMED CT#74964007) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-radiological-behaviour-category | |
| elj6Pg | Radiologic Finding | 0..* | choice | Enable When: lnvhoA = Other (SNOMED CT#74964007) | |
| _TA1qg | Mammogram Category | 0..1 | choice | Enable When: lnvhoA = Mammogram (SNOMED CT#71651007) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-mammogram-behaviour-category | |
| ItIxXA | Mammogram Finding | 0..1 | choice | Enable When: lnvhoA = Mammogram (SNOMED CT#71651007) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-mammogram-finding | |
| px_AOg | Ultrasound Category | 0..1 | choice | Enable When: lnvhoA = Ultrasound (SNOMED CT#16310003) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-ultrasound-behaviour-category | |
| sUvIZw | Ultrasound Finding | 0..1 | choice | Enable When: lnvhoA = Ultrasound (SNOMED CT#16310003) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-ultrasound-finding | |
 GwBa_g | Comments | 0..1 | text | ||
| F4w9Qg | Tumours | 0..1 | group | ||
 UqCacw | Count | 0..1 | integer | ||
| heaiUg | Details | 0..* | group | ||
| 3HHGaQ | Laterality | 0..1 | choice | | Definition: BodyStructure.locationQualifier.coding Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-laterality |
| MbjvjA | Structure | 0..1 | choice | Definition: BodyStructure.location.coding Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-topography | |
| YSLK3g | Clockface | 0..1 | choice | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-clockface-position | |
 qOZSOg | Dispance from nipple (cm) | 0..1 | decimal | ||
| CKHWag | Maximum dimension (cm) | 0..1 | decimal | ||
| x2IbZQ | Length (cm) | 0..1 | decimal | ||
| HFuV8w | Width (cm) | 0..1 | decimal | ||
| CDwftQ | Depth (cm) | 0..1 | decimal | ||
| jAFQFA | Specimens | 0..1 | group | ||
| Bk07Cw | Count | 0..1 | integer | ||
| vWnoqA | Details | 0..* | group | ||
| kDEz3w | Category | 0..1 | choice | | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-specimen-category-biopsy-cytology |
| Pfx26w | Type | 0..1 | choice | Definition: Specimen.type.coding Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-small-diagnostic-specimen-type | |
| RqvyIA | Laterality | 0..1 | choice | | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-laterality |
| JletPA | Structure | 0..1 | choice | Definition: Specimen.collection.bodySite.coding Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-topography | |
| K-znEA | ProcedureType | 0..1 | choice | Definition: Specimen.collection.method.coding Enable When: Pfx26w = Specimen obtained by core needle biopsy (SNOMED CT#427558003) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-specimen-core-biopsy-procedure-type | |
| HxskzQ | ImageGuidance | 0..1 | choice | Definition: Specimen.collection.extension.value Enable When: Pfx26w = Specimen obtained by core needle biopsy (SNOMED CT#427558003) Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-procedure-image-guided-method | |
| GQ2SPA | Lymph nodes | 0..1 | group | ||
| fj5O1Q | Number taken | 0..1 | integer | ||
| wz0ezA | Number abnormal | 0..1 | integer | ||
| x4KYCA | Comments | 0..1 | string | ||
| aAQhMQ | Node Details | 0..* | group | ||
| DWzM_A | Type | 0..1 | choice | | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-lymph-node-specimen-type-biopsy-excision |
| r82SQw | Laterality | 0..1 | choice | | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-laterality |
| ZKlnww | Structure | 0..1 | choice | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-lymphnode-breast | |
| YQV4mw | Procedure | 0..1 | choice | | Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-lymph-node-specimen-procedure-type |
| Documentation for this format | |||||
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "Breastrequestsandreports-BreastRequest",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extractAllocateId",
"valueString": "patientID"
},
{
"extension": [
{
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"valueCoding": {
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{
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{
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"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
},
{
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"valueCoding": {
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}
},
{
"url": "type",
"valueCode": "Practitioner"
},
{
"url": "description",
"valueString": "The practitioner that is to be used to pre-populate the form"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
}
],
"url": "http://canshare.co.nz/questionnaire/Breastrequestsandreports-BreastRequest",
"version": "0.1.0",
"name": "Breastrequestsandreports-BreastRequest",
"title": "BreastRequest",
"status": "draft",
"date": "2026-05-02T20:05:21.674Z",
"publisher": "CanShare",
"contact": [
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"telecom": [
{
"system": "email",
"value": "david.hay25@gmail.com"
}
]
}
],
"description": "The main request form",
"item": [
{
"extension": [
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"valueCodeableConcept": {
"coding": [
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"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "tab-container"
}
]
}
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-preferredTerminologyServer",
"valueUrl": "https://canshare.co.nz/canshare/proxy/"
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extractAllocateId",
"valueString": "srId"
},
{
"extension": [
{
"url": "definition",
"valueCanonical": "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
},
{
"url": "fullUrl",
"valueString": "%srId"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-definitionExtract"
},
{
"extension": [
{
"url": "definition",
"valueUri": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.subject.reference"
},
{
"url": "expression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patientID"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-definitionExtractValue"
}
],
"linkId": "66aAjg",
"text": "BreastRequest",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-preferredTerminologyServer",
"valueUrl": "https://canshare.co.nz/canshare/proxy"
},
{
"extension": [
{
"url": "definition",
"valueCanonical": "http://hl7.org/fhir/StructureDefinition/Patient"
},
{
"url": "fullUrl",
"valueString": "%patientID"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-definitionExtract"
}
],
"linkId": "tV0v8Q",
"text": "Patient",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patient.identifier.value"
}
}
],
"linkId": "qaOktA",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.identifier.value",
"text": "NHI",
"type": "string",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "flyover"
}
]
}
}
],
"linkId": "yCCn1Q",
"text": "help text for NHI",
"type": "display"
}
]
},
{
"linkId": "Ah66bA",
"text": "Given name",
"type": "string",
"repeats": true
},
{
"linkId": "HgydRQ",
"text": "Family name",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patient.birthDate"
}
}
],
"linkId": "Eko8vA",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.birthDate",
"text": "Date of Birth",
"type": "date"
},
{
"extension": [
{
"extension": [
{
"url": "definition",
"valueUri": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.extension.url"
},
{
"url": "fixed-value",
"valueString": "http://hl7.org.nz/fhir/StructureDefinition/nz-ethnicity"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-definitionExtractValue"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
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"code": "autocomplete"
}
]
}
}
],
"linkId": "t39aiw",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.extension.value",
"text": "Ethnicity",
"type": "open-choice",
"enableWhen": [
{
"question": "sLExmA",
"operator": "=",
"answerCoding": {
"system": "http://hl7.org/fhir/administrative-gender",
"code": "female",
"display": "Female"
}
}
],
"enableBehavior": "all",
"answerValueSet": "https://nzhts.digital.health.nz/fhir/ValueSet/ethnic-group-level-4-code"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patient.gender"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
"valueCode": "horizontal"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "radio-button"
}
]
}
}
],
"linkId": "sLExmA",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.gender",
"text": "Gender",
"type": "choice",
"answerValueSet": "http://hl7.org/fhir/ValueSet/administrative-gender"
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-preferredTerminologyServer",
"valueUrl": "https://canshare.co.nz/canshare/proxy/"
}
],
"linkId": "9gYExQ",
"text": "Administration",
"type": "group",
"item": [
{
"linkId": "acEEWg",
"text": "Date",
"type": "dateTime"
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-preferredTerminologyServer",
"valueUrl": "https://canshare.co.nz/canshare/proxy/"
}
],
"linkId": "LpmleA",
"text": "Clinical Information",
"type": "group",
"item": [
{
"linkId": "afqj9Q",
"text": "Pathway",
"type": "choice",
"answerValueSet": "https://nzhts.digital.health.nz/fhir/ValueSet/canshare-referral-pathway-simple",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "flyover"
}
]
}
}
],
"linkId": "1Sb4CQ",
"text": "The method or programme that led to this service request, e.g. screening, diagnostic.",
"type": "display"
}
]
},
{
"linkId": "eOT4Hw",
"text": "Clinical Impression (Screening)",
"type": "choice",
"enableWhen": [
{
"question": "afqj9Q",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "381081000210101",
"display": "National screening programme"
}
}
],
"enableBehavior": "all",
"answerValueSet": "https://nzhts.digital.health.nz/fhir/ValueSet/canshare-tumour-origin",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "flyover"
}
]
}
}
],
"linkId": "P23GAQ",
"text": "1321324",
"type": "display"
}
]
},
{
"linkId": "HZj_FA",
"text": "Clinical Impression (Diagnostic)",
"type": "choice",
"enableWhen": [
{
"question": "afqj9Q",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "165197003",
"display": "Diagnostic assessment"
}
}
],
"enableBehavior": "all",
"answerValueSet": "https://nzhts.digital.health.nz/fhir/ValueSet/canshare-tumour-origin"
},
{
"linkId": "Y-eZsA",
"text": "Clinical Presentation",
"type": "choice",
"answerValueSet": "https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-clinical-presentation"
},
{
"linkId": "KQV-sQ",
"text": "Clinical Behaviour",
"type": "group",
"item": [
{
"linkId": "u-TOCw",
"text": "Clinical behaviour",
"type": "choice",
"answerValueSet": "https://nzhts.digital.health.nz/fhir/ValueSet/canshare-clinical-impression-behaviour"
},
{
"linkId": "2KwHtg",
"text": "Clinical category",
"type": "choice",
"answerValueSet": "https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-clinical-behaviour-category"
}
]
},
{
"linkId": "q9r65Q",
"text": "Previous Medical condition",
"type": "group",
"repeats": true,
"item": [
{
"linkId": "n6j-yA",
"text": "Condition",
"type": "choice",
"answerValueSet": "https://nzhts.digital.health.nz/fhir/ValueSet/canshare-breast-previous-condition"
},
{
"linkId": "sPFwog",
"text": "Comments",
"type": "string"
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extractAllocateId",
"valueString": "obseZ40Tg"
},
{
"extension": [
{
"url": "definition",
"valueCanonical": "http://hl7.org/fhir/StructureDefinition/Observation"
},
{
"url": "fullUrl",
"valueString": "%obseZ40Tg"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-definitionExtract"
},
{
"extension": [
{
"url": "definition",
"valueUri": "http://hl7.org/fhir/StructureDefinition/Observation#Observation.status"
},
{
"url": "fixed-value"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-definitionExtractValue"
},
{
"extension": [
{
"url": "definition",
"valueUri": "http://hl7.org/fhir/StructureDefinition/Observation#Observation.subject.reference"
},
{
"url": "expression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patientID"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-definitionExtractValue"
},
{
"extension": [
{
"url": "definition",
"valueUri": "http://hl7.org/fhir/StructureDefinition/Observation#Observation.code.coding"
},
{
"url": "fixed-value",
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "161712005",
"display": "Menopause"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-definitionExtractValue"
},
{
"extension": [
{
"url": "definition",
"valueUri": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo.reference"
},
{
"url": "expression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%obseZ40Tg"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-definitionExtractValue"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
"valueCode": "horizontal"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "radio-button"
}
]
}
}
],
"linkId": "eZ40Tg",
"definition": "http://hl7.org/fhir/StructureDefinition/Observation#Observation.valueCodeableConcept.coding",
"text": "Menopausal status",
"type": "choice",
"answerValueSet": "https://nzhts.digital.health.nz/fhir/ValueSet/canshare-menopause-status"
},
{
"linkId": "WTJCLw",
"text": "Neoadjuvant summary",
"type": "group",
"repeats": true,
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