| Package | myhie.v4 |
| Resource Type | Questionnaire |
| Id | q-diabetic-registry |
| FHIR Version | R4 |
| Source | https://simplifier.net/resolve?scope=myhie.v4@1.0.0&canonical=http://fhir.hie.moh.gov.my/Questionnaire/q-diabetic-registry |
| URL | http://fhir.hie.moh.gov.my/Questionnaire/q-diabetic-registry |
| Status | active |
| Date | 2024-04-28T23:30:28.824077+00:00 |
| Title | Diabetic Registry |
No resources found
No resources found
No narrative content found in resource
FHIR{
"resourceType": "Questionnaire",
"id": "q-diabetic-registry",
"url": "http://fhir.hie.moh.gov.my/Questionnaire/q-diabetic-registry",
"title": "Diabetic Registry",
"status": "active",
"date": "2024-04-28T23:30:28.824077+00:00",
"item": [
{
"linkId": "dm",
"text": "Diabetes Details",
"type": "group",
"item": [
{
"linkId": "dm-dx-date",
"text": "Diabetes Diagnosis Date",
"type": "dateTime"
},
{
"linkId": "dm-dx-type",
"text": "Estimate/ Presumed",
"type": "boolean"
},
{
"linkId": "dm-type",
"text": "Diabetes Type",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/1651053999",
"code": "5A10",
"display": "Type 1"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/119724091",
"code": "5A11",
"display": "Type 2"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/119724091",
"code": "5A12",
"display": "Malnutrition-related"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/381961554",
"code": "5A13",
"display": "Other specified type"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/1697306310",
"code": "5A14",
"display": "Type unspecified"
}
}
]
},
{
"linkId": "dm-other",
"text": "If other specified type, please specify",
"type": "choice",
"enableWhen": [
{
"question": "dm-type",
"operator": "=",
"answerCoding": {
"system": "http://id.who.int/icd/entity/381961554",
"code": "5A13",
"display": "Other specified type"
}
}
],
"answerOption": [
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/1651053999",
"code": "5A13.0",
"display": "Diabetes mellitus due to genetic defects of beta cell function"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/119724091",
"code": "5A13.1",
"display": "Diabetes mellitus due to genetic defects in insulin action"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/381961554",
"code": "5A13.2",
"display": "Diabetes mellitus due to diseases of the exocrine pancreas"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/1697306310",
"code": "5A13.3",
"display": "Diabetes mellitus due to endocrinopathies"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/1697306310",
"code": "5A13.4",
"display": "Diabetes mellitus due to drug or chemical"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/1697306310",
"code": "5A13.5",
"display": "Diabetes mellitus due to uncommon forms of immune-mediated diabetes"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/1697306310",
"code": "5A13.6",
"display": "Diabetes mellitus due to other genetic syndromes"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/1697306310",
"code": "5A13.7",
"display": "Diabetes mellitus due to clinically defined subtypes or syndromes"
}
},
{
"valueCoding": {
"system": "http://id.who.int/icd/entity/1697306310",
"code": "5A13.Y",
"display": "Diabetes mellitus due to other specified cause"
}
}
]
},
{
"linkId": "dm-age",
"text": "Diabetes Age",
"type": "decimal"
}
]
},
{
"linkId": "complication",
"text": "Complications",
"type": "group",
"item": [
{
"linkId": "retinopathy",
"text": "Retinopathy",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Present"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "Absent"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
],
"item": [
{
"linkId": "retinopathy-dx-date",
"text": "If Present, date of diagnosis",
"type": "dateTime"
},
{
"linkId": "retinopathy-dx-type",
"text": "Estimate/ Presumed",
"type": "boolean"
},
{
"linkId": "retinopathy-at-dx",
"text": "Complication at diagnosis",
"type": "boolean"
}
]
},
{
"linkId": "ihd",
"text": "Ischaemic heart disease (IHD)",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Present"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "Absent"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
],
"item": [
{
"linkId": "ihd-dx-date",
"text": "If Present, date of diagnosis",
"type": "dateTime"
},
{
"linkId": "ihd-dx-type",
"text": "Estimate/ Presumed",
"type": "boolean"
}
]
},
{
"linkId": "cevd",
"text": "Cerebrovascular disease (ceVD)",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Present"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "Absent"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
],
"item": [
{
"linkId": "cevd-dx-date",
"text": "If Present, date of diagnosis",
"type": "dateTime"
},
{
"linkId": "cevd-dx-type",
"text": "Estimate/ Presumed",
"type": "boolean"
},
{
"linkId": "cevd-at-dx",
"text": "Complication at diagnosis",
"type": "boolean"
}
]
},
{
"linkId": "nephropathy",
"text": "Nephropathy",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Present"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "Absent"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
],
"item": [
{
"linkId": "nephropathy-dx-date",
"text": "If Present, date of diagnosis",
"type": "dateTime"
},
{
"linkId": "nephropathy-dx-type",
"text": "Estimate/ Presumed",
"type": "boolean"
},
{
"linkId": "nephropathy-at-dx",
"text": "Complication at diagnosis",
"type": "boolean"
}
]
},
{
"linkId": "dfu",
"text": "Diabetic foot ulcer",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Present"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "Absent"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
],
"item": [
{
"linkId": "dfu-dx-date",
"text": "If Present, date of diagnosis",
"type": "dateTime"
},
{
"linkId": "dfu-dx-type",
"text": "Estimate/ Presumed",
"type": "boolean"
},
{
"linkId": "dfu-at-dx",
"text": "Complication at diagnosis",
"type": "boolean"
}
]
},
{
"linkId": "amputation",
"text": "Amputation",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Present"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "Absent"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
],
"item": [
{
"linkId": "amputation-dx-date",
"text": "If Present, date of diagnosis",
"type": "dateTime"
},
{
"linkId": "amputation-dx-type",
"text": "Estimate/ Presumed",
"type": "boolean"
},
{
"linkId": "amputation-at-dx",
"text": "Complication at diagnosis",
"type": "boolean"
}
]
}
]
},
{
"linkId": "comorbid",
"text": "Concomitant Co-morbidity",
"type": "group",
"item": [
{
"linkId": "hpt",
"text": "Hypertension",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "No"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
],
"item": [
{
"linkId": "hpt-dx-date",
"text": "If Yes, date of diagnosis",
"type": "dateTime"
},
{
"linkId": "hpt-dx-type",
"text": "Estimate/ Presumed",
"type": "boolean"
}
]
},
{
"linkId": "lipid",
"text": "Dyslipidaemia",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "No"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
],
"item": [
{
"linkId": "lipid-dx-date",
"text": "If Yes, date of diagnosis",
"type": "dateTime"
},
{
"linkId": "lipid-dx-type",
"text": "Estimate/ Presumed",
"type": "boolean"
}
]
},
{
"linkId": "smoking",
"text": "Smoking Status",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "No"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
]
}
]
},
{
"linkId": "service",
"text": "Services",
"type": "group",
"item": [
{
"linkId": "mnt",
"text": "Medical Nutrition Therapy (MNT)",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "No"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
],
"item": [
{
"linkId": "mnt-date",
"text": "If Yes, date seen by Dietitian",
"type": "dateTime"
}
]
}
]
},
{
"linkId": "monitor",
"text": "Monitoring",
"type": "group",
"item": [
{
"linkId": "smbg",
"text": "Self-Monitoring of Blood Glucose (SMBG)",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "52101004",
"display": "Yes"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "2667000",
"display": "No"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "373068000",
"display": "Not Known"
}
}
]
}
]
},
{
"linkId": "fup",
"text": "Follow-Up Details",
"type": "group",
"item": [
{
"linkId": "fup-status",
"text": "Follow-up status",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"code": "1",
"display": "On active follow-up"
}
},
{
"valueCoding": {
"code": "2",
"display": "Loss to follow-up"
}
}
],
"item": [
{
"linkId": "fup-last-date",
"text": "Last visit date",
"type": "dateTime"
},
{
"linkId": "fup-loss-reason",
"text": "Reason loss to follow-up",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"code": "1",
"display": "Transferred care (government)"
}
},
{
"valueCoding": {
"code": "2",
"display": "Transferred care (private)"
}
},
{
"valueCoding": {
"code": "3",
"display": "Self-treatment"
}
},
{
"valueCoding": {
"code": "4",
"display": "Others"
}
},
{
"valueCoding": {
"code": "5",
"display": "Reason not known"
}
}
]
}
]
}
]
},
{
"linkId": "death",
"text": "Deceased Status",
"type": "group",
"item": [
{
"linkId": "death-status",
"text": "Deceased status",
"type": "boolean",
"item": [
{
"linkId": "death-date",
"text": "Deceased date",
"type": "dateTime"
},
{
"linkId": "death-reason",
"text": "Cause of death",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"code": "1",
"display": "Related to Diabetes"
}
},
{
"valueCoding": {
"code": "2",
"display": "Not related to Diabetes"
}
},
{
"valueCoding": {
"code": "3",
"display": "Not known"
}
}
]
}
]
}
]
}
]
}