FHIR IG analytics| Package | lt.hl7.fhir.prostate |
| Resource Type | Questionnaire |
| Id | Questionnaire-questionnaire-prostate-radiologist-referral.json |
| FHIR Version | R5 |
| Source | https://build.fhir.org/ig/HL7LT/ig-lt-prostate/Questionnaire-questionnaire-prostate-radiologist-referral.html |
| URL | https://hl7.lt/fhir/prostate/Questionnaire/prostate-radiologist-referral |
| Version | 0.1.0 |
| Status | draft |
| Date | 2025-06-01 |
| Name | ProstateRadiologistReferral |
| Title | Referral to a radiologist (E027) |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
English
Generated Narrative: Questionnaire questionnaire-prostate-radiologist-referral
Language: en
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  ProstateRadiologistReferral | Questionnaire | https://hl7.lt/fhir/prostate/Questionnaire/prostate-radiologist-referral#0.1.0 | |||
  grp-referral-context | Referral context | 0..1 | group | ||
  diagnosis | Diagnosis (ICD-10) | 1..1 | coding | Options: 2 options | |
| diagnosis-grade-group | Grade group (if C61) | 0..1 | coding | Options: 5 options | |
 specialist-qualification | Specialist qualification | 1..1 | string |  | Initial Value: string = Radiologist |
| institution | Referring institution | 1..1 | string | ||
 screening-programme | Screening programme participant | 1..1 | coding | Options: 2 options | |
| grp-clinical | Clinical information | 0..1 | group | ||
 complaints-anamnesis | Complaints / anamnesis | 0..1 | text | ||
| condition-assessment-info | Condition assessment information | 1..1 | text | ||
| grp-family-history | Family oncological history (first-degree) | 0..1 | group | ||
| family-hx-prostate | Prostate cancer | 0..1 | coding | Options: 3 options | |
| family-hx-breast | Breast cancer | 0..1 | coding | Options: 3 options | |
| family-hx-ovarian | Ovarian cancer | 0..1 | coding | Options: 3 options | |
| family-hx-colon | Colorectal cancer | 0..1 | coding | Options: 3 options | |
| grp-dre | Digital rectal examination | 0..1 | group | ||
| dre-findings | DRE findings (select all that apply) | 0..* | coding | Options: 6 options | |
| grp-vitals | Anthropometrics | 0..1 | group | ||
 height-cm | Height (cm) | 1..1 | quantity | ||
| weight-kg | Weight (kg) | 1..1 | quantity | ||
| bmi-kg-m2 | BMI (kg/m2) | 0..1 | quantity | | |
| grp-psa | PSA | 0..1 | group | ||
| first-psa-ngml | First PSA (ng/ml) | 1..1 | quantity | ||
 first-psa-date | First PSA date | 1..1 | date | ||
| grp-prior-imaging | Prior prostate mpMRI | 0..1 | group | ||
 prior-mpmri | Prior mpMRI documented | 0..1 | boolean | ||
| prior-mpmri-date | Prior mpMRI date | 0..1 | date | ||
| prior-mpmri-pirads | Prior mpMRI PI-RADS category | 0..1 | coding | Options: 4 options | |
| grp-prior-therapy | Prior prostate-directed therapy | 0..1 | group | ||
| prior-prostatectomy | Prior prostate surgery | 0..1 | boolean | ||
| prior-prostatectomy-date | Prostate surgery date | 0..1 | date | ||
| prior-prostate-radiation | Prior prostate radiotherapy | 0..1 | boolean | ||
| prior-prostate-radiation-date | Prostate radiotherapy date | 0..1 | date | ||
| grp-related | Related information | 0..1 | group | ||
| anticoagulant-use | Anticoagulant use | 0..1 | boolean | ||
| grp-additional | Additional information | 0..1 | group | ||
 specialist-additional-info | Additional description for specialist | 0..1 | text | ||
| Documentation for this format | |||||
Options Sets
Answer options for diagnosis
Answer options for diagnosis-grade-group
Answer options for screening-programme
Answer options for family-hx-prostate
Answer options for family-hx-breast
Answer options for family-hx-ovarian
Answer options for family-hx-colon
Answer options for dre-findings
Answer options for prior-mpmri-pirads
Lithuanian
Generated Narrative: Questionnaire questionnaire-prostate-radiologist-referral
Language: en
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
| ProstateRadiologistReferral | Questionnaire | https://hl7.lt/fhir/prostate/Questionnaire/prostate-radiologist-referral#0.1.0 | |||
| grp-referral-context | Referral context | 0..1 | group | ||
| diagnosis | Diagnosis (ICD-10) | 1..1 | coding | Options: 2 options | |
| diagnosis-grade-group | Grade group (if C61) | 0..1 | coding | Options: 5 options | |
| specialist-qualification | Specialist qualification | 1..1 | string | | Initial Value: string = Radiologist |
| institution | Referring institution | 1..1 | string | ||
| screening-programme | Screening programme participant | 1..1 | coding | Options: 2 options | |
| grp-clinical | Clinical information | 0..1 | group | ||
| complaints-anamnesis | Complaints / anamnesis | 0..1 | text | ||
| condition-assessment-info | Condition assessment information | 1..1 | text | ||
| grp-family-history | Family oncological history (first-degree) | 0..1 | group | ||
| family-hx-prostate | Prostate cancer | 0..1 | coding | Options: 3 options | |
| family-hx-breast | Breast cancer | 0..1 | coding | Options: 3 options | |
| family-hx-ovarian | Ovarian cancer | 0..1 | coding | Options: 3 options | |
| family-hx-colon | Colorectal cancer | 0..1 | coding | Options: 3 options | |
| grp-dre | Digital rectal examination | 0..1 | group | ||
| dre-findings | DRE findings (select all that apply) | 0..* | coding | Options: 6 options | |
| grp-vitals | Anthropometrics | 0..1 | group | ||
| height-cm | Height (cm) | 1..1 | quantity | ||
| weight-kg | Weight (kg) | 1..1 | quantity | ||
| bmi-kg-m2 | BMI (kg/m2) | 0..1 | quantity | | |
| grp-psa | PSA | 0..1 | group | ||
| first-psa-ngml | First PSA (ng/ml) | 1..1 | quantity | ||
| first-psa-date | First PSA date | 1..1 | date | ||
| grp-prior-imaging | Prior prostate mpMRI | 0..1 | group | ||
| prior-mpmri | Prior mpMRI documented | 0..1 | boolean | ||
| prior-mpmri-date | Prior mpMRI date | 0..1 | date | ||
| prior-mpmri-pirads | Prior mpMRI PI-RADS category | 0..1 | coding | Options: 4 options | |
| grp-prior-therapy | Prior prostate-directed therapy | 0..1 | group | ||
| prior-prostatectomy | Prior prostate surgery | 0..1 | boolean | ||
| prior-prostatectomy-date | Prostate surgery date | 0..1 | date | ||
| prior-prostate-radiation | Prior prostate radiotherapy | 0..1 | boolean | ||
| prior-prostate-radiation-date | Prostate radiotherapy date | 0..1 | date | ||
| grp-related | Related information | 0..1 | group | ||
| anticoagulant-use | Anticoagulant use | 0..1 | boolean | ||
| grp-additional | Additional information | 0..1 | group | ||
| specialist-additional-info | Additional description for specialist | 0..1 | text | ||
| Documentation for this format | |||||
Options Sets
Answer options for diagnosis
Answer options for diagnosis-grade-group
Answer options for screening-programme
Answer options for family-hx-prostate
Answer options for family-hx-breast
Answer options for family-hx-ovarian
Answer options for family-hx-colon
Answer options for dre-findings
Answer options for prior-mpmri-pirads
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "questionnaire-prostate-radiologist-referral",
"language": "en",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"url": "https://hl7.lt/fhir/prostate/Questionnaire/prostate-radiologist-referral",
"version": "0.1.0",
"name": "ProstateRadiologistReferral",
"title": "Referral to a radiologist (E027)",
"status": "draft",
"subjectType": [
"Patient"
],
"date": "2025-06-01",
"publisher": "Lithuanian Medical Library",
"contact": [
{
"name": "Lithuanian Medical Library",
"telecom": [
{
"system": "url",
"value": "https://medicinosnk.lt"
},
{
"system": "email",
"value": "info@medicinosnk.lt"
}
]
}
],
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "LT"
}
]
}
],
"item": [
{
"linkId": "grp-referral-context",
"text": "Referral context",
"type": "group",
"item": [
{
"linkId": "diagnosis",
"text": "Diagnosis (ICD-10)",
"type": "coding",
"required": true,
"answerOption": [
{
"valueCoding": {
"system": "http://hl7.org/fhir/sid/icd-10",
"code": "N40",
"display": "Enlargement of prostate"
}
},
{
"valueCoding": {
"system": "http://hl7.org/fhir/sid/icd-10",
"code": "C61",
"display": "Malignant neoplasm of prostate"
}
}
]
},
{
"linkId": "diagnosis-grade-group",
"text": "Grade group (if C61)",
"type": "coding",
"required": false,
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "1279715000",
"display": "ISUP Grade Group 1 (Gleason 3+3)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "1279714001",
"display": "ISUP Grade Group 2 (Gleason 3+4)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "1279716004",
"display": "ISUP Grade Group 3 (Gleason 4+3)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "1279717008",
"display": "ISUP Grade Group 4 (Gleason 8)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "1279720000",
"display": "ISUP Grade Group 5 (Gleason 9-10)"
}
}
]
},
{
"linkId": "specialist-qualification",
"text": "Specialist qualification",
"type": "string",
"required": true,
"readOnly": true,
"initial": [
{
"valueString": "Radiologist"
}
]
},
{
"linkId": "institution",
"text": "Referring institution",
"type": "string",
"required": true
},
{
"linkId": "screening-programme",
"text": "Screening programme participant",
"type": "coding",
"required": true,
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-no",
"display": "No"
}
}
]
}
]
},
{
"linkId": "grp-clinical",
"text": "Clinical information",
"type": "group",
"item": [
{
"linkId": "complaints-anamnesis",
"text": "Complaints / anamnesis",
"type": "text",
"required": false
},
{
"linkId": "condition-assessment-info",
"text": "Condition assessment information",
"type": "text",
"required": true
}
]
},
{
"linkId": "grp-family-history",
"text": "Family oncological history (first-degree)",
"type": "group",
"item": [
{
"linkId": "family-hx-prostate",
"text": "Prostate cancer",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-no",
"display": "No"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-unknown",
"display": "Unknown"
}
}
]
},
{
"linkId": "family-hx-breast",
"text": "Breast cancer",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-no",
"display": "No"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-unknown",
"display": "Unknown"
}
}
]
},
{
"linkId": "family-hx-ovarian",
"text": "Ovarian cancer",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-no",
"display": "No"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-unknown",
"display": "Unknown"
}
}
]
},
{
"linkId": "family-hx-colon",
"text": "Colorectal cancer",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-yes",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-no",
"display": "No"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "ynk-unknown",
"display": "Unknown"
}
}
]
}
]
},
{
"linkId": "grp-dre",
"text": "Digital rectal examination",
"type": "group",
"item": [
{
"linkId": "dre-findings",
"text": "DRE findings (select all that apply)",
"type": "coding",
"required": false,
"repeats": true,
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/snomed-prostate-extension",
"code": "standard-prostate",
"display": "Standard prostate (finding)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "276387009",
"display": "Hard prostate (finding)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "276385001",
"display": "Soft prostate (finding)"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/snomed-prostate-extension",
"code": "flexible-prostate",
"display": "Flexible prostate (finding)"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/snomed-prostate-extension",
"code": "inflexible-prostate",
"display": "Inflexible prostate (finding)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "443607001",
"display": "Palpable mass (finding)"
}
}
]
}
]
},
{
"linkId": "grp-vitals",
"text": "Anthropometrics",
"type": "group",
"item": [
{
"linkId": "height-cm",
"text": "Height (cm)",
"type": "quantity",
"required": true
},
{
"linkId": "weight-kg",
"text": "Weight (kg)",
"type": "quantity",
"required": true
},
{
"linkId": "bmi-kg-m2",
"text": "BMI (kg/m2)",
"type": "quantity",
"readOnly": true
}
]
},
{
"linkId": "grp-psa",
"text": "PSA",
"type": "group",
"item": [
{
"linkId": "first-psa-ngml",
"text": "First PSA (ng/ml)",
"type": "quantity",
"required": true
},
{
"linkId": "first-psa-date",
"text": "First PSA date",
"type": "date",
"required": true
}
]
},
{
"linkId": "grp-prior-imaging",
"text": "Prior prostate mpMRI",
"type": "group",
"item": [
{
"linkId": "prior-mpmri",
"text": "Prior mpMRI documented",
"type": "boolean"
},
{
"linkId": "prior-mpmri-date",
"text": "Prior mpMRI date",
"type": "date"
},
{
"linkId": "prior-mpmri-pirads",
"text": "Prior mpMRI PI-RADS category",
"type": "coding",
"answerOption": [
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "pirads-cat-1-2",
"display": "PI-RADS 1-2"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "pirads-cat-3",
"display": "PI-RADS 3"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "pirads-cat-4",
"display": "PI-RADS 4"
}
},
{
"valueCoding": {
"system": "https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options",
"code": "pirads-cat-5",
"display": "PI-RADS 5"
}
}
]
}
]
},
{
"linkId": "grp-prior-therapy",
"text": "Prior prostate-directed therapy",
"type": "group",
"item": [
{
"linkId": "prior-prostatectomy",
"text": "Prior prostate surgery",
"type": "boolean"
},
{
"linkId": "prior-prostatectomy-date",
"text": "Prostate surgery date",
"type": "date"
},
{
"linkId": "prior-prostate-radiation",
"text": "Prior prostate radiotherapy",
"type": "boolean"
},
{
"linkId": "prior-prostate-radiation-date",
"text": "Prostate radiotherapy date",
"type": "date"
}
]
},
{
"linkId": "grp-related",
"text": "Related information",
"type": "group",
"item": [
{
"linkId": "anticoagulant-use",
"text": "Anticoagulant use",
"type": "boolean"
}
]
},
{
"linkId": "grp-additional",
"text": "Additional information",
"type": "group",
"item": [
{
"linkId": "specialist-additional-info",
"text": "Additional description for specialist",
"type": "text"
}
]
}
]
}