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FHIR IG analytics

Packagelt.hl7.fhir.cervical
Resource TypeQuestionnaire
IdQuestionnaire-questionnaire-cervical-cytology-hpv-espbi.json
FHIR VersionR5
Sourcehttps://build.fhir.org/ig/HL7LT/ig-lt-cervical/Questionnaire-questionnaire-cervical-cytology-hpv-espbi.html
URLhttps://hl7.lt/fhir/cervical/Questionnaire/questionnaire-cervical-cytology-hpv-espbi
Version0.0.1
Statusactive
Date2026-03-31T08:00:43+00:00
NameCervicalCytologyHpvESPBI
TitleCervical Cytology and HPV ESPBI Form
DescriptionESPBI form for cervical cancer screening: HPV testing and cytological examination. Based on ADP Table 7.1 (cervical cancer prevention program cytology and HPV kit).

Resources that use this resource

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Resources that this resource uses

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Narrative

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


English


Generated Narrative: Questionnaire questionnaire-cervical-cytology-hpv-espbi

Language: en

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. CervicalCytologyHpvESPBIESPBI form for cervical cancer screening: HPV testing and cytological examination. Based on ADP Table 7.1 (cervical cancer prevention program cytology and HPV kit).Questionnairehttps://hl7.lt/fhir/cervical/Questionnaire/questionnaire-cervical-cytology-hpv-espbi#0.0.1
... facilityHealthcare institution0..1group
.... facility.nameInstitution name0..1string
.... facility.codeInstitution code0..1string
.... facility.divisionDivision / department0..1string
... patientPatient identification0..1group
.... patient.personalCodePersonal code1..1string
.... patient.nameName1..1string
.... patient.surnameSurname1..1string
.... patient.addressAddress0..1string
... referringDoctorReferring physician0..1group
.... referringDoctor.nameDoctor name1..1string
.... referringDoctor.phonePhone number0..1string
.... referringDoctor.emailEmail0..1string
... orderedTestCommissioned test0..1group
.... orderedTest.testTypeTest type0..1codingOptions: 4 options
... sampleCollectionSample collection0..1group
.... sampleCollection.collectionDateCollection date and time1..1dateTime
.... sampleCollection.sampleCodeSample code0..1string
.... sampleCollection.collectorNameCollector name1..1string
.... sampleCollection.collectorSurnameCollector surname1..1string
.... sampleCollection.professionalQualificationProfessional qualification0..1string
... clinicalHistoryOther clinical information0..1group
.... clinicalHistory.cycleDayDay of menstrual cycle0..1integer
.... clinicalHistory.menopauseAgeAge at menopause (years)0..1integer
.... clinicalHistory.hormoneTherapyHormone therapy0..1codingOptions: 2 options
.... clinicalHistory.pregnancyPregnancy0..1codingOptions: 2 options
.... clinicalHistory.lactationLactation0..1codingOptions: 2 options
.... clinicalHistory.radiotherapyRadiotherapy0..1group
..... clinicalHistory.radiotherapy.statusRadiotherapy received0..1codingOptions: 2 options
..... clinicalHistory.radiotherapy.yearsAgoYears ago0..1integer
.... clinicalHistory.chemotherapyChemotherapy0..1group
..... clinicalHistory.chemotherapy.statusChemotherapy received0..1codingOptions: 2 options
..... clinicalHistory.chemotherapy.yearsAgoYears ago0..1integer
.... clinicalHistory.iudIntrauterine device (IUD)0..1codingOptions: 2 options
.... clinicalHistory.conizationConization0..1group
..... clinicalHistory.conization.statusConization performed0..1codingOptions: 3 options
..... clinicalHistory.conization.dateDate of conization0..1date
... sampleSiteSample collection site0..1group
.... sampleSite.siteAnatomical site0..*codingOptions: 4 options
... hpvVaccinationHPV vaccination status0..1group
.... hpvVaccination.statusVaccination status0..1codingOptions: 3 options
... hpvResultsHPV test results0..1group
.... hpvResults.overallResultOverall HPV result0..1codingOptions: 3 options
.... hpvResults.genotypeDetected HPV genotypes0..1group
..... hpvResults.genotype.hpv16HPV 160..1boolean
..... hpvResults.genotype.hpv18HPV 180..1boolean
..... hpvResults.genotype.hpv31HPV 310..1boolean
..... hpvResults.genotype.hpv33HPV 330..1boolean
..... hpvResults.genotype.hpv35HPV 350..1boolean
..... hpvResults.genotype.hpv39HPV 390..1boolean
..... hpvResults.genotype.hpv45HPV 450..1boolean
..... hpvResults.genotype.hpv51HPV 510..1boolean
..... hpvResults.genotype.hpv52HPV 520..1boolean
..... hpvResults.genotype.hpv56HPV 560..1boolean
..... hpvResults.genotype.hpv58HPV 580..1boolean
..... hpvResults.genotype.hpv59HPV 590..1boolean
..... hpvResults.genotype.hpv66HPV 660..1boolean
..... hpvResults.genotype.hpv68HPV 680..1boolean
.... hpvResults.riskGroupHPV risk group0..1codingOptions: 4 options
... cytologyResultsCytology examination results0..1group
.... cytologyResults.institutionExamining institution1..1string
.... cytologyResults.specimenTypeSpecimen type0..1codingOptions: 2 options
.... cytologyResults.suitabilitySpecimen suitability0..1codingOptions: 5 options
.... cytologyResults.pathogensPathogen findings0..1group
..... cytologyResults.pathogens.candidaCandida0..1boolean
..... cytologyResults.pathogens.trichomonasTrichomonas0..1boolean
..... cytologyResults.pathogens.actinomycesActinomyces0..1boolean
..... cytologyResults.pathogens.herpesHerpes simplex0..1boolean
.... cytologyResults.bethesdaDiagnosisBethesda diagnosis0..1codingOptions: 9 options
... immunocytochemistryImmunocytochemistry (p16/Ki-67)0..1group
.... immunocytochemistry.p16Ki67Resultp16/Ki-67 dual staining result0..1codingOptions: 2 options
... conductedByTest conducted by0..1group
.... conductedBy.nameName1..1string
.... conductedBy.surnameSurname1..1string
.... conductedBy.pressNumberPress number (stamp)1..1string
.... conductedBy.responseDateResponse date1..1dateTime
... confirmedByTest confirmed by0..1group
.... confirmedBy.nameName1..1string
.... confirmedBy.surnameSurname1..1string
.... confirmedBy.pressNumberPress number (stamp)1..1string
.... confirmedBy.confirmationDateConfirmation date1..1dateTime

doco Documentation for this format

Options Sets

Answer options for orderedTest.testType

  • http://snomed.info/sct#416107004 ("Cervical cytology test (procedure)")
  • http://snomed.info/sct#609040007 ("Microscopic cytologic examination of smear of specimen from female genital tract prepared using Papanicolaou technique (procedure)")
  • http://snomed.info/sct#35904009 ("Human papillomavirus deoxyribonucleic acid detection (procedure)")
  • http://snomed.info/sct#395126005 ("Immunocytochemistry test (procedure)")

Answer options for clinicalHistory.hormoneTherapy

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.pregnancy

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.lactation

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.radiotherapy.status

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.chemotherapy.status

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.iud

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.conization.status

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")
  • http://snomed.info/sct#261665006 ("Unknown (qualifier value)")

Answer options for sampleSite.site

  • http://snomed.info/sct#36973007 ("Endocervical structure (body structure)")
  • http://snomed.info/sct#28349006 ("Exocervical structure (body structure)")
  • http://snomed.info/sct#76784001 ("Vaginal structure (body structure)")
  • http://snomed.info/sct#45292006 ("Vulval structure (body structure)")

Answer options for hpvVaccination.status

  • http://snomed.info/sct#171258008 ("Up-to-date with immunizations (finding)")
  • http://snomed.info/sct#171259000 ("Not up to date with immunizations (finding)")
  • http://snomed.info/sct#171278000 ("Immunization status unknown (finding)")

Answer options for hpvResults.overallResult

  • http://snomed.info/sct#77851000146104 ("High risk human papillomavirus deoxyribonucleic acid not detected (finding)")
  • http://snomed.info/sct#125154007 ("Specimen unsatisfactory for evaluation (finding)")
  • http://snomed.info/sct#720005005 ("Human papillomavirus deoxyribonucleic acid detected, high risk on cervical specimen (finding)")

Answer options for hpvResults.riskGroup

  • https://tx.hl7.lt/fhir/CodeSystem/hpv-risk-group#highest ("Highest risk genotype group (16, 18)")
  • https://tx.hl7.lt/fhir/CodeSystem/hpv-risk-group#medium ("Medium-risk genotype group (31, 33, 35, 45, 52, 58)")
  • https://tx.hl7.lt/fhir/CodeSystem/hpv-risk-group#lower ("Lower risk genotype group (39, 51, 56, 59, 68)")
  • https://tx.hl7.lt/fhir/CodeSystem/hpv-risk-group#low ("Low-risk HPV genotype group (53, 66, others)")

Answer options for cytologyResults.specimenType

  • http://snomed.info/sct#1179252003 ("Slide submitted as specimen (specimen)")
  • http://snomed.info/sct#430346005 ("Liquid based cytologic material (specimen)")

Answer options for cytologyResults.suitability

  • http://snomed.info/sct#125152006 ("Specimen satisfactory for evaluation (finding)")
  • http://snomed.info/sct#373880007 ("Specimen rejected / not processed (finding)")
  • http://snomed.info/sct#125160007 ("Unsatisfactory for evaluation due to broken slide (finding)")
  • http://snomed.info/sct#125159002 ("Sample unlabeled (finding)")
  • http://snomed.info/sct#281268007 ("Insufficient sample (finding)")

Answer options for cytologyResults.bethesdaDiagnosis

  • http://snomed.info/sct#373887005 ("Negative for intraepithelial lesion or malignancy (finding)")
  • http://snomed.info/sct#441087007 ("Atypical squamous cells of undetermined significance on cervical Papanicolaou smear (finding)")
  • http://snomed.info/sct#62051000119105 ("Low-grade squamous intraepithelial lesion on cervical Papanicolaou smear (finding)")
  • http://snomed.info/sct#441088002 ("Atypical squamous cells on cervical Papanicolaou smear cannot exclude high-grade squamous intraepithelial lesion (finding)")
  • http://snomed.info/sct#62061000119107 ("High-grade squamous intraepithelial lesion on cervical Papanicolaou smear (finding)")
  • http://snomed.info/sct#1162767002 ("Squamous cell carcinoma (morphologic abnormality)")
  • http://snomed.info/sct#373883009 ("Atypical glandular cells, favor neoplastic (morphologic abnormality)")
  • http://snomed.info/sct#51642000 ("Adenocarcinoma in situ (morphologic abnormality)")
  • http://snomed.info/sct#373885002 ("Endometrial cells in a woman forty years of age or older, negative for squamous intraepithelial lesion (finding)")

Answer options for immunocytochemistry.p16Ki67Result

  • http://snomed.info/sct#10828004 ("Positive (qualifier value)")
  • http://snomed.info/sct#260385009 ("Negative (qualifier value)")

Lithuanian


Generated Narrative: Questionnaire questionnaire-cervical-cytology-hpv-espbi

Language: en

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. CervicalCytologyHpvESPBIESPBI form for cervical cancer screening: HPV testing and cytological examination. Based on ADP Table 7.1 (cervical cancer prevention program cytology and HPV kit).Questionnairehttps://hl7.lt/fhir/cervical/Questionnaire/questionnaire-cervical-cytology-hpv-espbi#0.0.1
... facilityHealthcare institution0..1group
.... facility.nameInstitution name0..1string
.... facility.codeInstitution code0..1string
.... facility.divisionDivision / department0..1string
... patientPatient identification0..1group
.... patient.personalCodePersonal code1..1string
.... patient.nameName1..1string
.... patient.surnameSurname1..1string
.... patient.addressAddress0..1string
... referringDoctorReferring physician0..1group
.... referringDoctor.nameDoctor name1..1string
.... referringDoctor.phonePhone number0..1string
.... referringDoctor.emailEmail0..1string
... orderedTestCommissioned test0..1group
.... orderedTest.testTypeTest type0..1codingOptions: 4 options
... sampleCollectionSample collection0..1group
.... sampleCollection.collectionDateCollection date and time1..1dateTime
.... sampleCollection.sampleCodeSample code0..1string
.... sampleCollection.collectorNameCollector name1..1string
.... sampleCollection.collectorSurnameCollector surname1..1string
.... sampleCollection.professionalQualificationProfessional qualification0..1string
... clinicalHistoryOther clinical information0..1group
.... clinicalHistory.cycleDayDay of menstrual cycle0..1integer
.... clinicalHistory.menopauseAgeAge at menopause (years)0..1integer
.... clinicalHistory.hormoneTherapyHormone therapy0..1codingOptions: 2 options
.... clinicalHistory.pregnancyPregnancy0..1codingOptions: 2 options
.... clinicalHistory.lactationLactation0..1codingOptions: 2 options
.... clinicalHistory.radiotherapyRadiotherapy0..1group
..... clinicalHistory.radiotherapy.statusRadiotherapy received0..1codingOptions: 2 options
..... clinicalHistory.radiotherapy.yearsAgoYears ago0..1integer
.... clinicalHistory.chemotherapyChemotherapy0..1group
..... clinicalHistory.chemotherapy.statusChemotherapy received0..1codingOptions: 2 options
..... clinicalHistory.chemotherapy.yearsAgoYears ago0..1integer
.... clinicalHistory.iudIntrauterine device (IUD)0..1codingOptions: 2 options
.... clinicalHistory.conizationConization0..1group
..... clinicalHistory.conization.statusConization performed0..1codingOptions: 3 options
..... clinicalHistory.conization.dateDate of conization0..1date
... sampleSiteSample collection site0..1group
.... sampleSite.siteAnatomical site0..*codingOptions: 4 options
... hpvVaccinationHPV vaccination status0..1group
.... hpvVaccination.statusVaccination status0..1codingOptions: 3 options
... hpvResultsHPV test results0..1group
.... hpvResults.overallResultOverall HPV result0..1codingOptions: 3 options
.... hpvResults.genotypeDetected HPV genotypes0..1group
..... hpvResults.genotype.hpv16HPV 160..1boolean
..... hpvResults.genotype.hpv18HPV 180..1boolean
..... hpvResults.genotype.hpv31HPV 310..1boolean
..... hpvResults.genotype.hpv33HPV 330..1boolean
..... hpvResults.genotype.hpv35HPV 350..1boolean
..... hpvResults.genotype.hpv39HPV 390..1boolean
..... hpvResults.genotype.hpv45HPV 450..1boolean
..... hpvResults.genotype.hpv51HPV 510..1boolean
..... hpvResults.genotype.hpv52HPV 520..1boolean
..... hpvResults.genotype.hpv56HPV 560..1boolean
..... hpvResults.genotype.hpv58HPV 580..1boolean
..... hpvResults.genotype.hpv59HPV 590..1boolean
..... hpvResults.genotype.hpv66HPV 660..1boolean
..... hpvResults.genotype.hpv68HPV 680..1boolean
.... hpvResults.riskGroupHPV risk group0..1codingOptions: 4 options
... cytologyResultsCytology examination results0..1group
.... cytologyResults.institutionExamining institution1..1string
.... cytologyResults.specimenTypeSpecimen type0..1codingOptions: 2 options
.... cytologyResults.suitabilitySpecimen suitability0..1codingOptions: 5 options
.... cytologyResults.pathogensPathogen findings0..1group
..... cytologyResults.pathogens.candidaCandida0..1boolean
..... cytologyResults.pathogens.trichomonasTrichomonas0..1boolean
..... cytologyResults.pathogens.actinomycesActinomyces0..1boolean
..... cytologyResults.pathogens.herpesHerpes simplex0..1boolean
.... cytologyResults.bethesdaDiagnosisBethesda diagnosis0..1codingOptions: 9 options
... immunocytochemistryImmunocytochemistry (p16/Ki-67)0..1group
.... immunocytochemistry.p16Ki67Resultp16/Ki-67 dual staining result0..1codingOptions: 2 options
... conductedByTest conducted by0..1group
.... conductedBy.nameName1..1string
.... conductedBy.surnameSurname1..1string
.... conductedBy.pressNumberPress number (stamp)1..1string
.... conductedBy.responseDateResponse date1..1dateTime
... confirmedByTest confirmed by0..1group
.... confirmedBy.nameName1..1string
.... confirmedBy.surnameSurname1..1string
.... confirmedBy.pressNumberPress number (stamp)1..1string
.... confirmedBy.confirmationDateConfirmation date1..1dateTime

doco Documentation for this format

Options Sets

Answer options for orderedTest.testType

  • http://snomed.info/sct#416107004 ("Cervical cytology test (procedure)")
  • http://snomed.info/sct#609040007 ("Microscopic cytologic examination of smear of specimen from female genital tract prepared using Papanicolaou technique (procedure)")
  • http://snomed.info/sct#35904009 ("Human papillomavirus deoxyribonucleic acid detection (procedure)")
  • http://snomed.info/sct#395126005 ("Immunocytochemistry test (procedure)")

Answer options for clinicalHistory.hormoneTherapy

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.pregnancy

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.lactation

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.radiotherapy.status

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.chemotherapy.status

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.iud

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")

Answer options for clinicalHistory.conization.status

  • http://snomed.info/sct#373066001 ("Yes (qualifier value)")
  • http://snomed.info/sct#373067005 ("No (qualifier value)")
  • http://snomed.info/sct#261665006 ("Unknown (qualifier value)")

Answer options for sampleSite.site

  • http://snomed.info/sct#36973007 ("Endocervical structure (body structure)")
  • http://snomed.info/sct#28349006 ("Exocervical structure (body structure)")
  • http://snomed.info/sct#76784001 ("Vaginal structure (body structure)")
  • http://snomed.info/sct#45292006 ("Vulval structure (body structure)")

Answer options for hpvVaccination.status

  • http://snomed.info/sct#171258008 ("Up-to-date with immunizations (finding)")
  • http://snomed.info/sct#171259000 ("Not up to date with immunizations (finding)")
  • http://snomed.info/sct#171278000 ("Immunization status unknown (finding)")

Answer options for hpvResults.overallResult

  • http://snomed.info/sct#77851000146104 ("High risk human papillomavirus deoxyribonucleic acid not detected (finding)")
  • http://snomed.info/sct#125154007 ("Specimen unsatisfactory for evaluation (finding)")
  • http://snomed.info/sct#720005005 ("Human papillomavirus deoxyribonucleic acid detected, high risk on cervical specimen (finding)")

Answer options for hpvResults.riskGroup

  • https://tx.hl7.lt/fhir/CodeSystem/hpv-risk-group#highest ("Highest risk genotype group (16, 18)")
  • https://tx.hl7.lt/fhir/CodeSystem/hpv-risk-group#medium ("Medium-risk genotype group (31, 33, 35, 45, 52, 58)")
  • https://tx.hl7.lt/fhir/CodeSystem/hpv-risk-group#lower ("Lower risk genotype group (39, 51, 56, 59, 68)")
  • https://tx.hl7.lt/fhir/CodeSystem/hpv-risk-group#low ("Low-risk HPV genotype group (53, 66, others)")

Answer options for cytologyResults.specimenType

  • http://snomed.info/sct#1179252003 ("Slide submitted as specimen (specimen)")
  • http://snomed.info/sct#430346005 ("Liquid based cytologic material (specimen)")

Answer options for cytologyResults.suitability

  • http://snomed.info/sct#125152006 ("Specimen satisfactory for evaluation (finding)")
  • http://snomed.info/sct#373880007 ("Specimen rejected / not processed (finding)")
  • http://snomed.info/sct#125160007 ("Unsatisfactory for evaluation due to broken slide (finding)")
  • http://snomed.info/sct#125159002 ("Sample unlabeled (finding)")
  • http://snomed.info/sct#281268007 ("Insufficient sample (finding)")

Answer options for cytologyResults.bethesdaDiagnosis

  • http://snomed.info/sct#373887005 ("Negative for intraepithelial lesion or malignancy (finding)")
  • http://snomed.info/sct#441087007 ("Atypical squamous cells of undetermined significance on cervical Papanicolaou smear (finding)")
  • http://snomed.info/sct#62051000119105 ("Low-grade squamous intraepithelial lesion on cervical Papanicolaou smear (finding)")
  • http://snomed.info/sct#441088002 ("Atypical squamous cells on cervical Papanicolaou smear cannot exclude high-grade squamous intraepithelial lesion (finding)")
  • http://snomed.info/sct#62061000119107 ("High-grade squamous intraepithelial lesion on cervical Papanicolaou smear (finding)")
  • http://snomed.info/sct#1162767002 ("Squamous cell carcinoma (morphologic abnormality)")
  • http://snomed.info/sct#373883009 ("Atypical glandular cells, favor neoplastic (morphologic abnormality)")
  • http://snomed.info/sct#51642000 ("Adenocarcinoma in situ (morphologic abnormality)")
  • http://snomed.info/sct#373885002 ("Endometrial cells in a woman forty years of age or older, negative for squamous intraepithelial lesion (finding)")

Answer options for immunocytochemistry.p16Ki67Result

  • http://snomed.info/sct#10828004 ("Positive (qualifier value)")
  • http://snomed.info/sct#260385009 ("Negative (qualifier value)")

Source1

{
  "resourceType": "Questionnaire",
  "id": "questionnaire-cervical-cytology-hpv-espbi",
  "language": "en",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "url": "https://hl7.lt/fhir/cervical/Questionnaire/questionnaire-cervical-cytology-hpv-espbi",
  "version": "0.0.1",
  "name": "CervicalCytologyHpvESPBI",
  "title": "Cervical Cytology and HPV ESPBI Form",
  "status": "active",
  "date": "2026-03-31T08:00:43+00:00",
  "publisher": "Lithuanian Medical Library",
  "contact": [
    {
      "name": "Lithuanian Medical Library",
      "telecom": [
        {
          "system": "url",
          "value": "https://medicinosnk.lt"
        },
        {
          "system": "email",
          "value": "info@medicinosnk.lt"
        }
      ]
    }
  ],
  "description": "ESPBI form for cervical cancer screening: HPV testing and cytological examination. Based on ADP Table 7.1 (cervical cancer prevention program cytology and HPV kit).",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "LT"
        }
      ]
    }
  ],
  "item": [
    {
      "linkId": "facility",
      "text": "Healthcare institution",
      "type": "group",
      "item": [
        {
          "linkId": "facility.name",
          "text": "Institution name",
          "type": "string"
        },
        {
          "linkId": "facility.code",
          "text": "Institution code",
          "type": "string"
        },
        {
          "linkId": "facility.division",
          "text": "Division / department",
          "type": "string"
        }
      ]
    },
    {
      "linkId": "patient",
      "text": "Patient identification",
      "type": "group",
      "item": [
        {
          "linkId": "patient.personalCode",
          "text": "Personal code",
          "type": "string",
          "required": true
        },
        {
          "linkId": "patient.name",
          "text": "Name",
          "type": "string",
          "required": true
        },
        {
          "linkId": "patient.surname",
          "text": "Surname",
          "type": "string",
          "required": true
        },
        {
          "linkId": "patient.address",
          "text": "Address",
          "type": "string"
        }
      ]
    },
    {
      "linkId": "referringDoctor",
      "text": "Referring physician",
      "type": "group",
      "item": [
        {
          "linkId": "referringDoctor.name",
          "text": "Doctor name",
          "type": "string",
          "required": true
        },
        {
          "linkId": "referringDoctor.phone",
          "text": "Phone number",
          "type": "string"
        },
        {
          "linkId": "referringDoctor.email",
          "text": "Email",
          "type": "string"
        }
      ]
    },
    {
      "linkId": "orderedTest",
      "text": "Commissioned test",
      "type": "group",
      "item": [
        {
          "linkId": "orderedTest.testType",
          "text": "Test type",
          "type": "coding",
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "416107004",
                "display": "Cervical cytology test (procedure)"
              }
            },
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "609040007",
                "display": "Microscopic cytologic examination of smear of specimen from female genital tract prepared using Papanicolaou technique (procedure)"
              }
            },
            {
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    {
      "linkId": "confirmedBy",
      "text": "Test confirmed by",
      "type": "group",
      "item": [
        {
          "linkId": "confirmedBy.name",
          "text": "Name",
          "type": "string",
          "required": true
        },
        {
          "linkId": "confirmedBy.surname",
          "text": "Surname",
          "type": "string",
          "required": true
        },
        {
          "linkId": "confirmedBy.pressNumber",
          "text": "Press number (stamp)",
          "type": "string",
          "required": true
        },
        {
          "linkId": "confirmedBy.confirmationDate",
          "text": "Confirmation date",
          "type": "dateTime",
          "required": true
        }
      ]
    }
  ]
}