FHIR IG analytics| Package | hl7.fhir.uv.sdc |
| Resource Type | QuestionnaireResponse |
| Id | QuestionnaireResponse-questionnaireresponse-sdc-example-ussg-fht-answers.json |
| FHIR Version | R4 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: QuestionnaireResponse questionnaireresponse-sdc-example-ussg-fht-answers
Language: en
Profile: SDC Standard Questionnaire Response
| LinkID | Text | Definition | Answer |
|---|---|---|---|
![]() | Questionnaire:US Surgeon General - Family Health Portrait | ||
![]() ![]() | |||
![]() ![]() ![]() | Date Done | 2008-01-17 | |
![]() ![]() | Your health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Name | Annie Proband | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Date of Birth | 1966-04-04 | |
![]() ![]() ![]() ![]() | Were you born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Were you adopted? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Are your parents related to each other in any way other than marriage? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Height | 63 | |
![]() ![]() ![]() ![]() ![]() | Units | UCUM: [in_i] ([in_i]) | |
![]() ![]() ![]() ![]() | Weight | 127 | |
![]() ![]() ![]() ![]() ![]() | Units | UCUM: [lb_av] ([lb_av]) | |
![]() ![]() ![]() ![]() | Body mass index (BMI) [Ratio] | 22.5 | |
![]() ![]() ![]() ![]() | Race | LOINC: LA4457-3 (White) | |
![]() ![]() ![]() ![]() | Ethnicity | ||
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10405-1 (Daughter) | |
![]() ![]() ![]() ![]() | Name | Susan | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 17 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10415-0 (Brother) | |
![]() ![]() ![]() ![]() | Name | Brian | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA2-8 (Male) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 32 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() | This family member's history of disease | ||
![]() ![]() ![]() ![]() | Disease or Condition | LOINC: LA14284-6 (Other Cancer) | |
![]() ![]() ![]() ![]() | Age at Diagnosis | LOINC: LA10397-0 (30-39) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10418-4 (Sister) | |
![]() ![]() ![]() ![]() | Name | Janet | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 36 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() | This family member's history of disease | ||
![]() ![]() ![]() ![]() | Disease or Condition | LOINC: LA14283-8 (Breast Cancer) | |
![]() ![]() ![]() ![]() | Age at Diagnosis | LOINC: LA10397-0 (30-39) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10419-2 (Nephew) | |
![]() ![]() ![]() ![]() | Name | Ian | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA2-8 (Male) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 16 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10420-0 (Niece) | |
![]() ![]() ![]() ![]() | Name | Helen | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 15 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10416-8 (Father) | |
![]() ![]() ![]() ![]() | Name | Donald | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA2-8 (Male) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 52 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10425-9 (Paternal Uncle) | |
![]() ![]() ![]() ![]() | Name | Eric | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA2-8 (Male) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 56 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10421-8 (Paternal Aunt) | |
![]() ![]() ![]() ![]() | Name | Fiona | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 57 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() | This family member's history of disease | ||
![]() ![]() ![]() ![]() | Disease or Condition | LOINC: LA10543-9 (Skin Cancer) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10423-4 (Paternal Grandfather) | |
![]() ![]() ![]() ![]() | Name | Bob | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA2-8 (Male) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Cause of Death | LOINC: LA10537-1 (Colon Cancer) | |
![]() ![]() ![]() ![]() ![]() ![]() | Age at Death | LOINC: LA10400-2 (OVER 60) | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() | This family member's history of disease | ||
![]() ![]() ![]() ![]() | Disease or Condition | LOINC: LA10537-1 (Colon Cancer) | |
![]() ![]() ![]() ![]() | Age at Diagnosis | LOINC: LA10400-2 (OVER 60) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10424-2 (Paternal Grandmother) | |
![]() ![]() ![]() ![]() | Name | Claire | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Cause of Death | LOINC: LA10589-2 (Other/Unexpected) | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Please specify | Lou Gehrigs | |
![]() ![]() ![]() ![]() ![]() ![]() | Age at Death | LOINC: LA10400-2 (OVER 60) | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10417-6 (Mother) | |
![]() ![]() ![]() ![]() | Name | Harriet | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Cause of Death | LOINC: LA15682-0 (Ovarian Cancer) | |
![]() ![]() ![]() ![]() ![]() ![]() | Age at Death | LOINC: LA10399-6 (50-59) | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() | This family member's history of disease | ||
![]() ![]() ![]() ![]() | Disease or Condition | LOINC: LA15682-0 (Ovarian Cancer) | |
![]() ![]() ![]() ![]() | Age at Diagnosis | LOINC: LA10398-8 (40-49) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10414-3 (Maternal Uncle) | |
![]() ![]() ![]() ![]() | Name | Rudy | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA2-8 (Male) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 60 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10410-1 (Maternal Aunt) | |
![]() ![]() ![]() ![]() | Name | Julie | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 57 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10412-7 (Maternal Grandfather) | |
![]() ![]() ![]() ![]() | Name | Ian | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA2-8 (Male) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Cause of Death | LOINC: LA16286-9 (Heart attack) | |
![]() ![]() ![]() ![]() ![]() ![]() | Age at Death | LOINC: LA10400-2 (OVER 60) | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10413-5 (Maternal Grandmother) | |
![]() ![]() ![]() ![]() | Name | Gladys | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Cause of Death | LOINC: LA10589-2 (Other/Unexpected) | |
![]() ![]() ![]() ![]() ![]() ![]() | Age at Death | LOINC: LA10400-2 (OVER 60) | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() | This family member's history of disease | ||
![]() ![]() ![]() ![]() | Disease or Condition | LOINC: LA14283-8 (Breast Cancer) | |
![]() ![]() ![]() ![]() | Age at Diagnosis | LOINC: LA10399-6 (50-59) | |
![]() ![]() ![]() | This family member's history of disease | ||
![]() ![]() ![]() ![]() | Disease or Condition | LOINC: LA16982-3 (Asthma) | |
![]() ![]() ![]() ![]() | Age at Diagnosis | LOINC: LA10395-4 (Childhood) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10411-9 (Maternal Cousin) | |
![]() ![]() ![]() ![]() | Name | Karren | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 30 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() | This family member's history of disease | ||
![]() ![]() ![]() ![]() | Disease or Condition | LOINC: LA14283-8 (Breast Cancer) | |
![]() ![]() ![]() ![]() | Age at Diagnosis | LOINC: LA10397-0 (30-39) | |
![]() ![]() | Family member health information | ||
![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() | Relationship to you | LOINC: LA10411-9 (Maternal Cousin) | |
![]() ![]() ![]() ![]() | Name | Mary | |
![]() ![]() ![]() ![]() | Gender | LOINC: LA3-6 (Female) | |
![]() ![]() ![]() ![]() | Living? | LOINC: LA33-6 (Yes) | |
![]() ![]() ![]() ![]() ![]() | |||
![]() ![]() ![]() ![]() ![]() ![]() | Age | 31 | |
![]() ![]() ![]() ![]() | Was this person born a twin? | LOINC: LA32-8 (No) | |
![]() ![]() ![]() ![]() | Was this person adopted? | LOINC: LA32-8 (No) | |
{
"resourceType": "QuestionnaireResponse",
"id": "questionnaireresponse-sdc-example-ussg-fht-answers",
"meta": {
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse"
]
},
"language": "en",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"questionnaire": "http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-ussg-fht|4.0.0-ballot",
"status": "in-progress",
"subject": {
"reference": "http://example.org/fhir/Patient/proband"
},
"authored": "2008-01-17",
"item": [
{
"linkId": "0",
"item": [
{
"linkId": "0.1",
"text": "Date Done",
"answer": [
{
"valueDate": "2008-01-17"
}
]
}
]
},
{
"linkId": "1",
"text": "Your health information",
"item": [
{
"linkId": "1.1",
"item": [
{
"linkId": "1.1.1",
"text": "Name",
"answer": [
{
"valueString": "Annie Proband"
}
]
},
{
"linkId": "1.1.2",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "1.1.3",
"text": "Date of Birth",
"answer": [
{
"valueDate": "1966-04-04"
}
]
},
{
"linkId": "1.1.4",
"text": "Were you born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "1.1.5",
"text": "Were you adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "1.1.6",
"text": "Are your parents related to each other in any way other than marriage?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "1.1.7",
"text": "Height",
"answer": [
{
"valueDecimal": 63,
"item": [
{
"linkId": "1.1.7.1.1",
"text": "Units",
"answer": [
{
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "[in_i]",
"display": "[in_i]"
}
}
]
}
]
}
]
},
{
"linkId": "1.1.8",
"text": "Weight",
"answer": [
{
"valueDecimal": 127,
"item": [
{
"linkId": "1.1.8.1.1",
"text": "Units",
"answer": [
{
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "[lb_av]",
"display": "[lb_av]"
}
}
]
}
]
}
]
},
{
"linkId": "1.1.9",
"text": "Body mass index (BMI) [Ratio]",
"answer": [
{
"valueDecimal": 22.5
}
]
},
{
"linkId": "1.1.10",
"text": "Race",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA4457-3",
"display": "White"
}
}
]
},
{
"linkId": "1.1.11",
"text": "Ethnicity",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA4611-5",
"display": "Mexican"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10606-4",
"display": "South American"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10405-1",
"display": "Daughter"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Susan"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 17
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10415-0",
"display": "Brother"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Brian"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 32
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA14284-6",
"display": "Other Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10397-0",
"display": "30-39"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10418-4",
"display": "Sister"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Janet"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 36
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA14283-8",
"display": "Breast Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10397-0",
"display": "30-39"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10419-2",
"display": "Nephew"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Ian"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 16
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10420-0",
"display": "Niece"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Helen"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 15
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10416-8",
"display": "Father"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Donald"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 52
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10425-9",
"display": "Paternal Uncle"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Eric"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 56
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10421-8",
"display": "Paternal Aunt"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Fiona"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 57
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10543-9",
"display": "Skin Cancer"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10423-4",
"display": "Paternal Grandfather"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Bob"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10537-1",
"display": "Colon Cancer"
}
}
]
},
{
"linkId": "2.1.1.4.1.2",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10537-1",
"display": "Colon Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10424-2",
"display": "Paternal Grandmother"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Claire"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10589-2",
"display": "Other/Unexpected"
},
"item": [
{
"linkId": "2.1.1.4.1.1.1",
"text": "Please specify",
"answer": [
{
"valueString": "Lou Gehrigs"
}
]
}
]
}
]
},
{
"linkId": "2.1.1.4.1.2",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10417-6",
"display": "Mother"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Harriet"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA15682-0",
"display": "Ovarian Cancer"
}
}
]
},
{
"linkId": "2.1.1.4.1.2",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10399-6",
"display": "50-59"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA15682-0",
"display": "Ovarian Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10398-8",
"display": "40-49"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10414-3",
"display": "Maternal Uncle"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Rudy"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 60
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10410-1",
"display": "Maternal Aunt"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Julie"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 57
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10412-7",
"display": "Maternal Grandfather"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Ian"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA2-8",
"display": "Male"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA16286-9",
"display": "Heart attack"
}
}
]
},
{
"linkId": "2.1.1.4.1.2",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10413-5",
"display": "Maternal Grandmother"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Gladys"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
},
"item": [
{
"linkId": "2.1.1.4.1",
"item": [
{
"linkId": "2.1.1.4.1.1",
"text": "Cause of Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10589-2",
"display": "Other/Unexpected"
}
}
]
},
{
"linkId": "2.1.1.4.1.2",
"text": "Age at Death",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10400-2",
"display": "OVER 60"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA14283-8",
"display": "Breast Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10399-6",
"display": "50-59"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA16982-3",
"display": "Asthma"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10395-4",
"display": "Childhood"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10411-9",
"display": "Maternal Cousin"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Karren"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 30
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
},
{
"linkId": "2.1.2",
"text": "This family member's history of disease",
"item": [
{
"linkId": "2.1.2.1",
"text": "Disease or Condition",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA14283-8",
"display": "Breast Cancer"
}
}
]
},
{
"linkId": "2.1.2.2",
"text": "Age at Diagnosis",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10397-0",
"display": "30-39"
}
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Family member health information",
"item": [
{
"linkId": "2.1.1",
"item": [
{
"linkId": "2.1.1.1",
"text": "Relationship to you",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA10411-9",
"display": "Maternal Cousin"
}
}
]
},
{
"linkId": "2.1.1.2",
"text": "Name",
"answer": [
{
"valueString": "Mary"
}
]
},
{
"linkId": "2.1.1.3",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA3-6",
"display": "Female"
}
}
]
},
{
"linkId": "2.1.1.4",
"text": "Living?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA33-6",
"display": "Yes"
},
"item": [
{
"linkId": "2.1.1.4.2",
"item": [
{
"linkId": "2.1.1.4.2.2",
"text": "Age",
"answer": [
{
"valueDecimal": 31
}
]
}
]
}
]
}
]
},
{
"linkId": "2.1.1.5",
"text": "Was this person born a twin?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
},
{
"linkId": "2.1.1.6",
"text": "Was this person adopted?",
"answer": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "LA32-8",
"display": "No"
}
}
]
}
]
}
]
}
]
}