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Packagehl7.fhir.us.cql
Resource TypeQuestionnaire
IdQuestionnaire-GMTPQuestionnaire.json
FHIR VersionR4
Sourcehttps://build.fhir.org/ig/HL7/us-cql-ig/Questionnaire-GMTPQuestionnaire.html
URLhttp://hl7.org/fhir/us/cql/Questionnaire/GMTPQuestionnaire
Version1.0.0
Statusactive
Date2023-10-12T00:00:00+00:00
NameGMTPQuestionnaire
TitleExample Genetic/Molecular Testing Preauthorization Questionnaire
Realmus
Authorityhl7
DescriptionThis is an example of a prior authorization questionnaire developed based on an existing industry prior-authorization form.
CopyrightThis content is informed by the following source, used with permission: https://docushare-web.apps.external.pioneer.humana.com/Marketing/docushare-app?file=1986712

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: Questionnaire GMTPQuestionnaire

LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. GMTPQuestionnaireThis is an example of a prior authorization questionnaire developed based on an existing industry prior-authorization form.Questionnairehttp://hl7.org/fhir/us/cql/Questionnaire/GMTPQuestionnaire#1.0.0
... billing-provider-questionIs the billing provider/referring lab different from servicing provider?0..1boolean
.... billing-provider-infoBilling provider/referring lab information0..1groupEnable When: billing-provider-question =
..... billing-provider-info|nameRequesting provider name0..1string
..... billing-provider-info|phone-numberPhone0..1string
..... billing-provider-info|addressOrdering provider address0..1string
..... billing-provider-info|npiOrdering provider Tax ID/NPI #0..1string
..... billing-provider-info|faxFax0..1string
... test-requestedTest requested0..1group
.... test-requested|service-dateDate of service0..1date
.... test-requested|test-idTest ID0..1string
.... test-requested|test-nameTest name0..1string
.... test-requested|diagnosis-descriptionDiagnosis description0..1string
.... test-requested|diagnosis-icd-codeICD-10 code(s)0..*open-choiceValue Set: ICD-10 Codes
.... test-requested|diagnosis-cpt-codeCPT code(s)0..*open-choiceValue Set: AMA CPT All Codes
... clinical-trialClinical Trial Information0..1group
.... clinical-trial-questionIs the requested test part of a clinical trial?0..1boolean
..... clinical-trial|yes-clinial-trialIf Yes, provide the registration or ID number for the specific trial in which this test is being studied.0..1stringEnable When: clinical-trial-question =
... historyPatient history and related findings0..1group
.... history|patient-historyPatient history including age at diagnosis0..1group
..... history|patient-history|diagnosisDiagnosis0..1string
..... history|patient-history|age-at-onsetAge at onset0..1string
..... history|patient-history|abatementAbatement0..1string
.... history|family-historyFamily history, including age at diagnosis, availability for testing e.g., family member deceased, refused testing or patient not in contact with affected family member and any genetic testing performed on family member - attach pedigree, if available0..1string
.... history|other-findingsOther findings/testing completed - previous genetic testing for condition0..1string
.... history|treatment-relationHow will testing be used in relation to treatment or management of the patient?0..1string
... person-filling-out-formPerson filling out form0..1group
.... person-filling-out-form|nameName0..1string
.... person-filling-out-form|phone-numberPhone number0..1string
.... person-filling-out-form|facilityPhone number0..1string

doco Documentation for this format

Contained Resources


Metadata
Type module-definition from http://terminology.hl7.org/CodeSystem/library-type
Dependency Description: USCore model information
Resource: US Core Model Informationversion: null7.0.0)
Canonical URL: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|7.0.0
Dependency Description: FHIR model information
Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1
Dependency Description: Library UCE
Resource: US Core Elements
Canonical URL: http://hl7.org/fhir/us/cql/Library/USCoreElements
Dependency Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Dependency Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Data Requirement Type: Organization
Profile(s): US Core Organization Profile
Must Support Elements: id
Data Requirement Type: Coverage
Profile(s): Coverage
Must Support Elements: id
Data Requirement Type: Practitioner
Profile(s): US Core Practitioner Profile
Must Support Elements: id
Data Requirement Type: ServiceRequest
Profile(s): ServiceRequest
Must Support Elements: id
Parameters
Name Use Card. Type Documentation
Coverage In 0..1 Coverage
ServiceRequest In 0..1 ServiceRequest
Billing Provider different from Servicing Provider Out 0..1 string
Generated using version 0.5.3-cibuild of the sample-content-ig Liquid templates

Source1

{
  "resourceType": "Questionnaire",
  "id": "GMTPQuestionnaire",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements",
      "extension": [
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "GMTPInitialExpressions"
            },
            {
              "url": "name",
              "valueString": "Retrieve Member Coverage test parameter"
            },
            {
              "url": "statement",
              "valueString": "define \"Retrieve Member Coverage test parameter\":\n  // When executing CQL with the VSCode extension retrieve the resource specific for the test case\n  //   the list of resource ids match the resources from the test case folders\n  singleton from ([FHIR.Coverage] CV where CV.id in {\n    'Coverage-example-GMTP', // testcase: GMTP-example-patient-2\n    'coverage-GMTP-1'        // testcase: USCorePatient-GMTP-1\n  })"
            },
            {
              "url": "displaySequence",
              "valueInteger": 0
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "GMTPInitialExpressions"
            },
            {
              "url": "name",
              "valueString": "Member Coverage"
            },
            {
              "url": "statement",
              "valueString": "define \"Member Coverage\":\n  Coalesce(\n    Coverage,\n    \"Retrieve Member Coverage test parameter\"\n  )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 1
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "GMTPInitialExpressions"
            },
            {
              "url": "name",
              "valueString": "Billing Provider"
            },
            {
              "url": "statement",
              "valueString": "define \"Billing Provider\":\n  UCE.BillingProvider(\"Member Coverage\")"
            },
            {
              "url": "displaySequence",
              "valueInteger": 2
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "GMTPInitialExpressions"
            },
            {
              "url": "name",
              "valueString": "Retrieve Service Request test parameter"
            },
            {
              "url": "statement",
              "valueString": "define \"Retrieve Service Request test parameter\":\n  // When executing CQL with the VSCode extension retrieve the resource specific for the test case\n  //   the list of resource ids match the resources from the test case folders\n  singleton from ([FHIR.ServiceRequest] SR where SR.id in {\n    'ServiceRequest-example-1-GMTP',       // testcase: GMTP-example-patient-2\n    'service-request-USCorePatient-GMTP-1' // testcase: USCorePatient-GMTP-1\n  })"
            },
            {
              "url": "displaySequence",
              "valueInteger": 3
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "GMTPInitialExpressions"
            },
            {
              "url": "name",
              "valueString": "Most Recent ServiceRequest"
            },
            {
              "url": "statement",
              "valueString": "define \"Most Recent ServiceRequest\":\n  Coalesce(\n    ServiceRequest,\n    \"Retrieve Service Request test parameter\"\n  )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 4
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "GMTPInitialExpressions"
            },
            {
              "url": "name",
              "valueString": "Billing Provider different from Servicing Provider"
            },
            {
              "url": "statement",
              "valueString": "define \"Billing Provider different from Servicing Provider\":\n  if \"Billing Provider\".id != First(UCE.ServicingProvider(\"Most Recent ServiceRequest\").id) then\n  'Yes'\n  else \n  'No'"
            },
            {
              "url": "displaySequence",
              "valueInteger": 5
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "USCoreElements"
            },
            {
              "url": "name",
              "valueString": "BillingProvider"
            },
            {
              "url": "statement",
              "valueString": "define function BillingProvider(coverage FHIR.Coverage):\n  singleton from([OrganizationProfile] O\n    where EndsWith(First(coverage.payor.reference.value), O.id))"
            },
            {
              "url": "displaySequence",
              "valueInteger": 6
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value string): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 7
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "USCoreElements"
            },
            {
              "url": "name",
              "valueString": "ServicingProvider"
            },
            {
              "url": "statement",
              "valueString": "define function ServicingProvider(serviceRequest FHIR.ServiceRequest):\n  [PractitionerProfile] P\n    where EndsWith(First(serviceRequest.performer.reference.value), P.id)"
            },
            {
              "url": "displaySequence",
              "valueInteger": 8
            }
          ],
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        }
      ],
      "name": "EffectiveDataRequirements",
      "status": "active",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/library-type",
            "code": "module-definition"
          }
        ]
      },
      "relatedArtifact": [
        {
          "type": "depends-on",
          "display": "USCore model information",
          "resource": "http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|7.0.0"
        },
        {
          "type": "depends-on",
          "display": "FHIR model information",
          "resource": "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"
        },
        {
          "type": "depends-on",
          "display": "Library UCE",
          "resource": "http://hl7.org/fhir/us/cql/Library/USCoreElements"
        },
        {
          "type": "depends-on",
          "display": "Library FHIRHelpers",
          "resource": "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
        },
        {
          "type": "depends-on",
          "display": "Library FHIRHelpers",
          "resource": "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
        }
      ],
      "parameter": [
        {
          "name": "Coverage",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Coverage"
        },
        {
          "name": "ServiceRequest",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "ServiceRequest"
        },
        {
          "name": "Billing Provider different from Servicing Provider",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "string"
        }
      ],
      "dataRequirement": [
        {
          "type": "Organization",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
          ],
          "mustSupport": [
            "id"
          ]
        },
        {
          "type": "Coverage",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Coverage"
          ],
          "mustSupport": [
            "id"
          ]
        },
        {
          "type": "Practitioner",
          "profile": [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
          ],
          "mustSupport": [
            "id"
          ]
        },
        {
          "type": "ServiceRequest",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
          ],
          "mustSupport": [
            "id"
          ]
        },
        {
          "type": "ServiceRequest",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
          ],
          "mustSupport": [
            "id"
          ]
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-library",
      "valueCanonical": "http://hl7.org/fhir/us/cql/Library/GMTPInitialExpressions"
    },
    {
      "extension": [
        {
          "url": "name",
          "valueCoding": {
            "system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
            "code": "patient",
            "display": "Patient"
          }
        },
        {
          "url": "type",
          "valueCode": "Patient"
        },
        {
          "url": "description",
          "valueString": "The patient that is to be used to pre-populate the form"
        }
      ],
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
    },
    {
      "extension": [
        {
          "url": "name",
          "valueCoding": {
            "system": "http://example.org/fhir/CodeSystem/additionalLaunchContext",
            "code": "Coverage",
            "display": "Coverage"
          }
        },
        {
          "url": "type",
          "valueCode": "Coverage"
        },
        {
          "url": "description",
          "valueString": "The Coverage that is to be used to pre-populate the form"
        }
      ],
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
    },
    {
      "extension": [
        {
          "url": "name",
          "valueCoding": {
            "system": "http://example.org/fhir/CodeSystem/additionalLaunchContext",
            "code": "ServiceRequest",
            "display": "ServiceRequest"
          }
        },
        {
          "url": "type",
          "valueCode": "ServiceRequest"
        },
        {
          "url": "description",
          "valueString": "The ServiceRequest that is to be used to pre-populate the form"
        }
      ],
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "cds"
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
      "valueCanonical": "#effective-data-requirements"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "informative",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/us/cql/ImplementationGuide/hl7.fhir.us.cql"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/us/cql/Questionnaire/GMTPQuestionnaire",
  "version": "1.0.0",
  "name": "GMTPQuestionnaire",
  "title": "Example Genetic/Molecular Testing Preauthorization Questionnaire",
  "status": "active",
  "experimental": true,
  "date": "2023-10-12T00:00:00+00:00",
  "publisher": "HL7 International / Clinical Decision Support",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/dss"
        }
      ]
    }
  ],
  "description": "This is an example of a prior authorization questionnaire developed based on an existing industry prior-authorization form.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US",
          "display": "United States of America"
        }
      ]
    }
  ],
  "copyright": "This content is informed by the following source, used with permission: https://docushare-web.apps.external.pioneer.humana.com/Marketing/docushare-app?file=1986712",
  "item": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
          "valueExpression": {
            "language": "text/cql-identifier",
            "expression": "Billing Provider different from Servicing Provider"
          }
        }
      ],
      "linkId": "billing-provider-question",
      "text": "Is the billing provider/referring lab different from servicing provider?",
      "type": "boolean",
      "item": [
        {
          "linkId": "billing-provider-info",
          "text": "Billing provider/referring lab information",
          "type": "group",
          "enableWhen": [
            {
              "question": "billing-provider-question",
              "operator": "=",
              "answerBoolean": true
            }
          ],
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/cql-identifier",
                    "expression": "Billing Provider Name"
                  }
                }
              ],
              "linkId": "billing-provider-info|name",
              "text": "Requesting provider name",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/cql-identifier",
                    "expression": "Billing Provider Phone"
                  }
                }
              ],
              "linkId": "billing-provider-info|phone-number",
              "text": "Phone",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/cql-identifier",
                    "expression": "Billing Provider Address"
                  }
                }
              ],
              "linkId": "billing-provider-info|address",
              "text": "Ordering provider address",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/cql-identifier",
                    "expression": "Billing Provider NPI"
                  }
                }
              ],
              "linkId": "billing-provider-info|npi",
              "text": "Ordering provider Tax ID/NPI #",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/cql-identifier",
                    "expression": "Billing Provider Fax"
                  }
                }
              ],
              "linkId": "billing-provider-info|fax",
              "text": "Fax",
              "type": "string"
            }
          ]
        }
      ]
    },
    {
      "linkId": "test-requested",
      "text": "Test requested",
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/cql-identifier",
                "expression": "Date of Service"
              }
            }
          ],
          "linkId": "test-requested|service-date",
          "text": "Date of service",
          "type": "date"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/cql-identifier",
                "expression": "Test ID"
              }
            }
          ],
          "linkId": "test-requested|test-id",
          "text": "Test ID",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/cql-identifier",
                "expression": "Test name"
              }
            }
          ],
          "linkId": "test-requested|test-name",
          "text": "Test name",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/cql-identifier",
                "expression": "Diagnosis Descriptions"
              }
            }
          ],
          "linkId": "test-requested|diagnosis-description",
          "text": "Diagnosis description",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/cql-identifier",
                "expression": "Test ICD Codes"
              }
            }
          ],
          "linkId": "test-requested|diagnosis-icd-code",
          "text": "ICD-10 code(s)",
          "type": "open-choice",
          "repeats": true,
          "answerValueSet": "http://hl7.org/fhir/ValueSet/icd-10"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/cql-identifier",
                "expression": "Test CPT Codes"
              }
            }
          ],
          "linkId": "test-requested|diagnosis-cpt-code",
          "text": "CPT code(s)",
          "type": "open-choice",
          "repeats": true,
          "answerValueSet": "http://terminology.hl7.org/ValueSet/cpt-all"
        }
      ]
    },
    {
      "linkId": "clinical-trial",
      "text": "Clinical Trial Information",
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/cql-identifier",
                "expression": "Part of clinical trial"
              }
            }
          ],
          "linkId": "clinical-trial-question",
          "text": "Is the requested test part of a clinical trial?",
          "type": "boolean",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/cql-identifier",
                    "expression": "Clinical Trial ID"
                  }
                }
              ],
              "linkId": "clinical-trial|yes-clinial-trial",
              "text": "If Yes, provide the registration or ID number for the specific trial in which this test is being studied.",
              "type": "string",
              "enableWhen": [
                {
                  "question": "clinical-trial-question",
                  "operator": "=",
                  "answerBoolean": true
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId": "history",
      "text": "Patient history and related findings",
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemPopulationContext",
              "valueExpression": {
                "name": "PatientHistory",
                "language": "text/cql-identifier",
                "expression": "Patient history"
              }
            }
          ],
          "linkId": "history|patient-history",
          "text": "Patient history including age at diagnosis",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/cql-expression",
                    "expression": "%PatientHistory.diagnosis"
                  }
                }
              ],
              "linkId": "history|patient-history|diagnosis",
              "text": "Diagnosis",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/cql-expression",
                    "expression": "%PatientHistory.ageAtOnset"
                  }
                }
              ],
              "linkId": "history|patient-history|age-at-onset",
              "text": "Age at onset",
              "type": "string"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
                  "valueExpression": {
                    "language": "text/cql-expression",
                    "expression": "%PatientHistory.abatement"
                  }
                }
              ],
              "linkId": "history|patient-history|abatement",
              "text": "Abatement",
              "type": "string"
            }
          ]
        },
        {
          "linkId": "history|family-history",
          "text": "Family history, including age at diagnosis, availability for testing e.g., family member deceased, refused testing or patient not in contact with affected family member and any genetic testing performed on family member - attach pedigree, if available",
          "type": "string"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
              "valueExpression": {
                "language": "text/cql-identifier",
                "expression": "Previous genetic testing for condition"
              }
            }
          ],
          "linkId": "history|other-findings",
          "text": "Other findings/testing completed - previous genetic testing for condition",
          "type": "string"
        },
        {
          "linkId": "history|treatment-relation",
          "text": "How will testing be used in relation to treatment or management of the patient?",
          "type": "string"
        }
      ]
    },
    {
      "linkId": "person-filling-out-form",
      "text": "Person filling out form",
      "type": "group",
      "item": [
        {
          "linkId": "person-filling-out-form|name",
          "text": "Name",
          "type": "string"
        },
        {
          "linkId": "person-filling-out-form|phone-number",
          "text": "Phone number",
          "type": "string"
        },
        {
          "linkId": "person-filling-out-form|facility",
          "text": "Phone number",
          "type": "string"
        }
      ]
    }
  ]
}