FHIR IG analytics| Package | tewhatuora.rheumaticfever |
| Resource Type | Questionnaire |
| Id | Questionnaire-DiagnosisRiskFactorsQuestionnaire.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/tewhatuora/fhir-rheumatic-fever/Questionnaire-DiagnosisRiskFactorsQuestionnaire.html |
| URL | https://fhir-ig.digital.health.nz/rheumatic-fever/Questionnaire/DiagnosisRiskFactorsQuestionnaire |
| Version | 1.0.0 |
| Status | draft |
| Date | 2024-01-01 |
| Name | DiagnosisRiskFactorsQuestionnaire |
| Title | Diagnosis Risk Factors Questionnaire |
| Authority | national |
| Description | Gathers risk factor information during rheumatic fever diagnosis assessment |
| Purpose | Gathers risk factor information during rheumatic fever diagnosis assessment |
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FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "DiagnosisRiskFactorsQuestionnaire",
"url": "https://fhir-ig.digital.health.nz/rheumatic-fever/Questionnaire/DiagnosisRiskFactorsQuestionnaire",
"identifier": [
{
"use": "official",
"value": "DiagnosisRiskFactorsQuestionnaire",
"period": {
"start": "2024-01-01"
}
}
],
"version": "1.0.0",
"name": "DiagnosisRiskFactorsQuestionnaire",
"title": "Diagnosis Risk Factors Questionnaire",
"status": "draft",
"experimental": false,
"subjectType": [
"Patient"
],
"date": "2024-01-01",
"publisher": "Te Whatu Ora",
"contact": [
{
"name": "Te Whatu Ora",
"telecom": [
{
"system": "url",
"value": "https://www.tewhatuora.govt.nz/"
},
{
"system": "email",
"value": "integration@tewhatuora.govt.nz"
}
]
},
{
"name": "HNZ Integration Team",
"telecom": [
{
"system": "email",
"value": "integration@tewhatuora.govt.nz",
"use": "work"
}
]
}
],
"description": "Gathers risk factor information during rheumatic fever diagnosis assessment",
"purpose": "Gathers risk factor information during rheumatic fever diagnosis assessment",
"item": [
{
"linkId": "page1",
"prefix": "page1",
"text": "Please complete this questionnaire to assess risk factors for rheumatic fever diagnosis.",
"type": "display"
},
{
"linkId": "SoreThroat4Weeks",
"prefix": "1)",
"text": "Did the patient have a sore throat in the four weeks prior to onset?",
"type": "choice",
"required": true,
"repeats": false,
"answerValueSet": "https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/nz-questionnaireresponse-qualifiedyesno-code"
},
{
"linkId": "AntibioticsSoreThroat",
"prefix": "2)",
"text": "Did the patient receive antibiotics for a sore throat?",
"type": "choice",
"required": true,
"repeats": false,
"answerValueSet": "https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/nz-questionnaireresponse-qualifiedyesno-code"
},
{
"linkId": "AntibioticsDetails",
"prefix": "3)",
"text": "Antibiotics used for sore throat / Strep A treatment",
"type": "text",
"enableWhen": [
{
"question": "AntibioticsSoreThroat",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "373066001",
"display": "Yes (qualifier value)"
}
}
],
"required": true
},
{
"linkId": "SoreThroatTreatedProperly",
"prefix": "4)",
"text": "Was the patient's sore throat appropriately treated?",
"type": "choice",
"required": true,
"repeats": false,
"answerValueSet": "https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/nz-questionnaireresponse-qualifiedyesno-code"
},
{
"linkId": "FamilyHistoryARFRHD",
"prefix": "5)",
"text": "Family History of ARF / RHD?",
"type": "choice",
"required": true,
"repeats": false,
"answerValueSet": "https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/nz-questionnaireresponse-qualifiedyesno-code"
},
{
"linkId": "FamilyHistoryDetails",
"prefix": "5.1)",
"text": "Details of Family History",
"type": "text",
"enableWhen": [
{
"question": "FamilyHistoryARFRHD",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "373066001",
"display": "Yes (qualifier value)"
}
}
],
"required": true
},
{
"linkId": "FamilyHistoryRelationship",
"prefix": "6)",
"text": "Family History Relationship to Patient",
"type": "choice",
"enableWhen": [
{
"question": "FamilyHistoryARFRHD",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "373066001",
"display": "Yes (qualifier value)"
}
}
],
"required": true,
"repeats": true,
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "375005",
"display": "Sibling (person)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "40683002",
"display": "Parent (person)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "38312007",
"display": "Grandparent (person)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "25211005",
"display": "Aunt (person)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "38048003",
"display": "Uncle (person)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "55538000",
"display": "Cousin (person)"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "125677006",
"display": "Other relative (person)"
}
}
]
},
{
"linkId": "PastMedicalHistoryARF",
"prefix": "7)",
"text": "Any past medical history that may have been ARF?",
"type": "choice",
"required": true,
"repeats": false,
"answerValueSet": "https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/nz-questionnaireresponse-qualifiedyesno-code"
},
{
"linkId": "EvidencePreviousRHD",
"prefix": "8)",
"text": "Any evidence of previous RHD?",
"type": "choice",
"required": true,
"repeats": false,
"answerValueSet": "https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/nz-questionnaireresponse-qualifiedyesno-code"
},
{
"linkId": "PMHXDetailsARFRHD",
"prefix": "9)",
"text": "Details of PMHX of possible ARF / RHD",
"type": "text",
"enableWhen": [
{
"question": "PastMedicalHistoryARF",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "373066001",
"display": "Yes (qualifier value)"
}
},
{
"question": "EvidencePreviousRHD",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "373066001",
"display": "Yes (qualifier value)"
}
}
],
"enableBehavior": "any",
"required": true
}
]
}