FHIR IG analytics| Package | lt.hl7.fhir.lung |
| Resource Type | Questionnaire |
| Id | Questionnaire-questionnaire-pre-ldct-lt-lung.json |
| FHIR Version | R5 |
| Source | https://build.fhir.org/ig/HL7LT/ig-lt-lung/Questionnaire-questionnaire-pre-ldct-lt-lung.html |
| URL | https://hl7.lt/fhir/lung/Questionnaire/questionnaire-pre-ldct-lt-lung |
| Version | 0.0.1 |
| Status | active |
| Date | 2026-03-27T05:54:34+00:00 |
| Name | PreLdctQuestionnaireLtLung |
| Title | Questionnaire: Pre-LDCT Questionnaire (LT Lung) |
| Description | Structured data-capture form for the pre-examination questionnaire before LDCT screening, based on ADP Table 7.2. Captures functional status, prior examinations, anthropometrics, smoking history, and current diagnoses. |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
English
Generated Narrative: Questionnaire questionnaire-pre-ldct-lt-lung
Language: en
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  PreLdctQuestionnaireLtLung | Structured data-capture form for the pre-examination questionnaire before LDCT screening, based on ADP Table 7.2. Captures functional status, prior examinations, anthropometrics, smoking history, and current diagnoses. | Questionnaire | https://hl7.lt/fhir/lung/Questionnaire/questionnaire-pre-ldct-lt-lung#0.0.1 | |
  grp-registration | Registration | 0..1 | group | |
   registration-date | CT study registration date | 0..1 | dateTime | |
| grp-functional-status | Functional status | 0..1 | group | |
 self-care | Do you serve yourself? | 1..1 | coding | Options: 2 options |
| bedridden | Bedridden/chairbound | 1..1 | coding | Options: 2 options |
| grp-prior-exams | Prior examinations | 0..1 | group | |
| prior-chest-ct | Previous chest (lung) CT in the last 3 years | 1..1 | coding | Options: 2 options |
| recent-respiratory-infection | Acute respiratory infection within 3 months prior to the invitation | 1..1 | coding | Options: 2 options |
| grp-anthropometrics | Anthropometrics | 0..1 | group | |
 height | Height (cm) | 1..1 | quantity | |
| weight | Body mass weight (kg) | 1..1 | quantity | |
| grp-current-smoking | Current smoking status | 0..1 | group | |
| smokes | Currently smokes | 1..1 | coding | Options: 2 options |
| cigarettes | Cigarettes | 0..1 | coding | Options: 2 options |
 cigarettes-per-day | Number of cigarettes per day | 0..1 | integer | |
| pack-years | Number of pack-years | 0..1 | integer | |
| e-cigarettes | Electronic cigarettes | 0..1 | coding | Options: 2 options |
| heated-tobacco | Heated tobacco | 0..1 | coding | Options: 2 options |
| tobacco | Tobacco (smokeless) | 0..1 | coding | Options: 2 options |
| pipe | Pipe | 0..1 | coding | Options: 2 options |
| grp-smoking-history | Smoking history | 0..1 | group | |
| smoked-before | Smoked before | 1..1 | coding | Options: 2 options |
| years-smoked | How many years did he/she smoke? | 0..1 | integer | |
| years-quit | How many years have not smoked | 0..1 | integer | |
| grp-diagnoses | Diagnoses before examination | 0..1 | group | |
  diagnoses | Diagnoses before examination (ICD codes) | 0..1 | text | |
| Documentation for this format | ||||
Options Sets
Answer options for self-care
Answer options for bedridden
Answer options for prior-chest-ct
Answer options for recent-respiratory-infection
Answer options for smokes
Answer options for cigarettes
Answer options for e-cigarettes
Answer options for heated-tobacco
Answer options for tobacco
Answer options for pipe
Answer options for smoked-before
Lithuanian
Generated Narrative: Questionnaire questionnaire-pre-ldct-lt-lung
Language: en
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
| PreLdctQuestionnaireLtLung | Structured data-capture form for the pre-examination questionnaire before LDCT screening, based on ADP Table 7.2. Captures functional status, prior examinations, anthropometrics, smoking history, and current diagnoses. | Questionnaire | https://hl7.lt/fhir/lung/Questionnaire/questionnaire-pre-ldct-lt-lung#0.0.1 | |
| grp-registration | Registration | 0..1 | group | |
| registration-date | CT study registration date | 0..1 | dateTime | |
| grp-functional-status | Functional status | 0..1 | group | |
| self-care | Do you serve yourself? | 1..1 | coding | Options: 2 options |
| bedridden | Bedridden/chairbound | 1..1 | coding | Options: 2 options |
| grp-prior-exams | Prior examinations | 0..1 | group | |
| prior-chest-ct | Previous chest (lung) CT in the last 3 years | 1..1 | coding | Options: 2 options |
| recent-respiratory-infection | Acute respiratory infection within 3 months prior to the invitation | 1..1 | coding | Options: 2 options |
| grp-anthropometrics | Anthropometrics | 0..1 | group | |
| height | Height (cm) | 1..1 | quantity | |
| weight | Body mass weight (kg) | 1..1 | quantity | |
| grp-current-smoking | Current smoking status | 0..1 | group | |
| smokes | Currently smokes | 1..1 | coding | Options: 2 options |
| cigarettes | Cigarettes | 0..1 | coding | Options: 2 options |
| cigarettes-per-day | Number of cigarettes per day | 0..1 | integer | |
| pack-years | Number of pack-years | 0..1 | integer | |
| e-cigarettes | Electronic cigarettes | 0..1 | coding | Options: 2 options |
| heated-tobacco | Heated tobacco | 0..1 | coding | Options: 2 options |
| tobacco | Tobacco (smokeless) | 0..1 | coding | Options: 2 options |
| pipe | Pipe | 0..1 | coding | Options: 2 options |
| grp-smoking-history | Smoking history | 0..1 | group | |
| smoked-before | Smoked before | 1..1 | coding | Options: 2 options |
| years-smoked | How many years did he/she smoke? | 0..1 | integer | |
| years-quit | How many years have not smoked | 0..1 | integer | |
| grp-diagnoses | Diagnoses before examination | 0..1 | group | |
| diagnoses | Diagnoses before examination (ICD codes) | 0..1 | text | |
| Documentation for this format | ||||
Options Sets
Answer options for self-care
Answer options for bedridden
Answer options for prior-chest-ct
Answer options for recent-respiratory-infection
Answer options for smokes
Answer options for cigarettes
Answer options for e-cigarettes
Answer options for heated-tobacco
Answer options for tobacco
Answer options for pipe
Answer options for smoked-before
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "questionnaire-pre-ldct-lt-lung",
"language": "en",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"url": "https://hl7.lt/fhir/lung/Questionnaire/questionnaire-pre-ldct-lt-lung",
"version": "0.0.1",
"name": "PreLdctQuestionnaireLtLung",
"title": "Questionnaire: Pre-LDCT Questionnaire (LT Lung)",
"status": "active",
"date": "2026-03-27T05:54:34+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": "Structured data-capture form for the pre-examination questionnaire before LDCT screening, based on ADP Table 7.2. Captures functional status, prior examinations, anthropometrics, smoking history, and current diagnoses.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "LT"
}
]
}
],
"item": [
{
"linkId": "grp-registration",
"text": "Registration",
"type": "group",
"item": [
{
"linkId": "registration-date",
"text": "CT study registration date",
"type": "dateTime"
}
]
},
{
"linkId": "grp-functional-status",
"text": "Functional status",
"type": "group",
"item": [
{
"linkId": "self-care",
"text": "Do you serve yourself?",
"type": "coding",
"required": true,
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "bedridden",
"text": "Bedridden/chairbound",
"type": "coding",
"required": true,
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
}
]
},
{
"linkId": "grp-prior-exams",
"text": "Prior examinations",
"type": "group",
"item": [
{
"linkId": "prior-chest-ct",
"text": "Previous chest (lung) CT in the last 3 years",
"type": "coding",
"required": true,
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "recent-respiratory-infection",
"text": "Acute respiratory infection within 3 months prior to the invitation",
"type": "coding",
"required": true,
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
}
]
},
{
"linkId": "grp-anthropometrics",
"text": "Anthropometrics",
"type": "group",
"item": [
{
"linkId": "height",
"text": "Height (cm)",
"type": "quantity",
"required": true
},
{
"linkId": "weight",
"text": "Body mass weight (kg)",
"type": "quantity",
"required": true
}
]
},
{
"linkId": "grp-current-smoking",
"text": "Current smoking status",
"type": "group",
"item": [
{
"linkId": "smokes",
"text": "Currently smokes",
"type": "coding",
"required": true,
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "cigarettes",
"text": "Cigarettes",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
],
"item": [
{
"linkId": "cigarettes-per-day",
"text": "Number of cigarettes per day",
"type": "integer"
},
{
"linkId": "pack-years",
"text": "Number of pack-years",
"type": "integer"
}
]
},
{
"linkId": "e-cigarettes",
"text": "Electronic cigarettes",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "heated-tobacco",
"text": "Heated tobacco",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "tobacco",
"text": "Tobacco (smokeless)",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "pipe",
"text": "Pipe",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
}
]
},
{
"linkId": "grp-smoking-history",
"text": "Smoking history",
"type": "group",
"item": [
{
"linkId": "smoked-before",
"text": "Smoked before",
"type": "coding",
"required": true,
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/lung-questionnaire-options",
"code": "no",
"display": "No"
}
}
]
},
{
"linkId": "years-smoked",
"text": "How many years did he/she smoke?",
"type": "integer"
},
{
"linkId": "years-quit",
"text": "How many years have not smoked",
"type": "integer"
}
]
},
{
"linkId": "grp-diagnoses",
"text": "Diagnoses before examination",
"type": "group",
"item": [
{
"linkId": "diagnoses",
"text": "Diagnoses before examination (ICD codes)",
"type": "text",
"required": false
}
]
}
]
}