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1370 lines
88 KiB
JSON
1370 lines
88 KiB
JSON
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{
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"resourceType":"Questionnaire",
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"version":"October 2015",
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"status":"draft",
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"date":"2015-10-29",
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"publisher":"Cancer Care Ontario",
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"telecom":[
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{
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"system":"email",
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"value":"jon.zammit@cancercare.on.ca"
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}
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],
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"title":"CT Lung for Cancer Staging Template - DRAFT (Short Version)",
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"item":[
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{
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"text":"Patient with high suspicion of cancer as per the PEBC document (EBS #24-2) or radiological/laboratory tests suggesting cancer. Excluding: patients with synchronous lung primary, previous diagnosis of lung cancer, lung cancer surgery or therapy. New single lung primary only.",
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"type":"display"
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},
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{
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"linkId":"root",
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"type":"group",
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"required":true,
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"item":[
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{
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"linkId":"g1",
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"concept":[
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{
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"system":"http://loinc.org",
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"code":"55752-0",
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"display":"Clinical Information"
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}
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],
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"text":"CLINICAL INFORMATION",
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"type":"group",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"1.1"
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}
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],
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"linkId":"1.1",
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"text":"Patient Clinical Information",
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"type":"text"
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},
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"1.2"
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}
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],
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"linkId":"1.2",
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"text":"Previous Examination (Date and Modality)",
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"type":"text"
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}
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]
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},
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{
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"linkId":"g2",
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"text":"IMAGING PROCEDURE DESCRIPTION",
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"type":"group",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"2.1"
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}
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],
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"linkId":"2.1",
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"text":"Overall Image Quality:",
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"type":"choice",
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"option":[{
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"valueCoding":{
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"code":"2.1a",
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"display":"Adequate"
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}},
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{"valueCoding":{
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"code":"2.1b",
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"display":"Suboptimal"
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}},
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{"valueCoding":{
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"code":"2.1c",
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"display":"Non-diagnostic"
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}}
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]
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},
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"2.2"
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}
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],
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"linkId":"2.2",
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"text":"Intravenous Contrast Used?",
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"type":"boolean"
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},
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"2.3"
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}
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],
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"linkId":"2.3",
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"text":"Additional Comments",
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"type":"text"
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}
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]
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},
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{
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"linkId":"g3",
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"text":"FINDINGS",
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"type":"group",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"3"
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}
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],
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"linkId":"g3.0",
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"text":"T Category",
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"type":"group",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"3.1"
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}
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],
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"linkId":"g3.1",
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"text":"Location of Main Nodule/Mass (Primary tumor, or Reference tumor)",
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"type":"group",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"3.1.1"
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}
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],
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"linkId":"q3.1.1",
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"text":"Location of main nodule/mass:",
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"type":"choice",
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"option":[
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{"valueCoding":{
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"code":"3.1.1a",
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"display":"Peripheral"
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}},
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{"valueCoding":{
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"code":"3.1.1b",
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"display":"Central*"
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}},
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{"valueCoding":{
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"code":"3.1.1c",
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"display":"Both*"
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}}
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],
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
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"extension":[
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{
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"url":"#question",
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"valueString":"q3.1.1"
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},
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{
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"url":"#answer",
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"valueCoding":{
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"code":"3.1.1b"
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}
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}
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]
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},
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
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"extension":[
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{
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"url":"#question",
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"valueString":"q3.1.1"
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},
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{
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"url":"#answer",
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"valueCoding":{
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"code":"3.1.1c"
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}
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}
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]
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}
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],
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"linkId":"g3.1.1i",
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"type":"group",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"i)"
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}
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],
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"linkId":"q3.1.1i",
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"text":"What is the distance of the nodule/mass to the carina?",
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"type":"integer",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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"valueCodeableConcept":{
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"coding":[
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{
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"system":"http://hl7.org/fhir/ValueSet/questionnaire-item-control",
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"code":"unit"
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}
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]
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}
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}
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],
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"text":"mm",
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"type":"display"
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}
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]
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},
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{
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"linkId":"3.1.1i.image",
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"text":"image",
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"type":"string"
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},
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{
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"linkId":"3.1.1i.series",
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"text":"series",
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"type":"string"
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}
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]
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}
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]
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},
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"3.1.2"
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}
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],
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"linkId":"3.1.2",
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"text":"State the lobe(s) and segment(s) where the nodule/mass is located",
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"type":"text"
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}
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]
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},
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"3.2"
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}
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],
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"linkId":"g3.2",
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"text":"Size and characteristics of main nodule/mass",
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"type":"group",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"3.2.1"
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}
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],
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"linkId":"3.2.1",
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"text":"Size of the nodule/mass:",
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"type":"choice",
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"option":[
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{"valueCoding":{
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"code":"3.2.1a",
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"display":"Solid nodule/mass"
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}},
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{"valueCoding":{
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"code":"3.2.1b",
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"display":"Part-solid nodule/mass"
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}},
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{"valueCoding":{
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"code":"3.2.1c",
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"display":"Pure Ground glass"
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}}
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],
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"item":[
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{
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"linkId":"g3.2.1",
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"type":"group",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
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"extension":[
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{
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"url":"#question",
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"valueString":"3.2.1"
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},
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{
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"url":"#answer",
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"valueCoding":{
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"code":"3.2.1a"
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}
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}
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]
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}
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],
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"linkId":"g3.2.1a",
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"type":"group",
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"item":[
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{
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"linkId":"3.2.1a",
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"text":"largest dimension:",
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"type":"integer",
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"item":[
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{
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"extension":[
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{
|
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
|
|
"valueCodeableConcept":{
|
|
"coding":[
|
|
{
|
|
"system":"http://hl7.org/fhir/ValueSet/questionnaire-item-control",
|
|
"code":"unit"
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}
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]
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}
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}
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],
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"text":"mm",
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"type":"display"
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}
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]
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},
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{
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"linkId":"3.2.1a.image",
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"text":"image",
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"type":"string"
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},
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{
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"linkId":"3.2.1a.series",
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"text":"series",
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"type":"string"
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}
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]
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}
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]
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}
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]
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},
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{
|
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"extension":[
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|
{
|
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
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"valueString":"3.2.2"
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}
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],
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"linkId":"3.2.2",
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"text":"Plane in which the mass was measured:",
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"type":"choice",
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"option":[
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{
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"code":"3.2.2a",
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"display":"Axial"
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},
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{
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"code":"3.2.2b",
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"display":"Coronal"
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},
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{
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"code":"3.2.2c",
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"display":"Sagittal"
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}
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]
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},
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{
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|
"extension":[
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{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
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"valueString":"3.2.3"
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}
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],
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"linkId":"3.2.3",
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"text":"Other characteristics of the main nodule/mass:",
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"type":"text"
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}
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]
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},
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{
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"extension":[
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{
|
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
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"valueString":"3.3"
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}
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],
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"linkId":"g3.3",
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"text":"Structures directly involved",
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"type":"group",
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"item":[
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{
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"extension":[
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{
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
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"valueString":"3.3.1"
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}
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],
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"linkId":"3.3.1",
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"text":"State if there is bronchial involvement:",
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"type":"choice",
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"option":[
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{
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"code":"3.3.1a",
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"display":"*Yes"
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},
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{
|
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"code":"3.3.1b",
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"display":"No"
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},
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{
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"code":"3.3.1c",
|
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"display":"Uncertain"
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}
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],
|
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"item":[
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{
|
|
"extension":[
|
|
{
|
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
|
|
"valueCodeableConcept":{
|
|
"coding":[
|
|
{
|
|
"system":"http://hl7.org/fhir/ValueSet/questionnaire-display-category",
|
|
"code":"instructions"
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}
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]
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}
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}
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],
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"text":"*If yes, answer i and ii.",
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"type":"display"
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},
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{
|
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"linkId":"g3.3.1",
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"type":"group",
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"item":[
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{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
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{
|
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"url":"#question",
|
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"valueString":"3.3.1"
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},
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{
|
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"url":"#answer",
|
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"valueCoding":{
|
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"code":"3.3.1a"
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}
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}
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]
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}
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],
|
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"linkId":"g3.3.1.yes",
|
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"type":"group",
|
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"item":[
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{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
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"valueString":"i)"
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}
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],
|
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"linkId":"3.3.1i",
|
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"text":"Type of involvement:",
|
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"type":"text"
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},
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{
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"extension":[
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{
|
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"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
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"valueString":"ii)"
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}
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],
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"linkId":"3.3.1ii",
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"text":"State if there is endobronchial involvement:",
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"type":"choice",
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"option":[
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{
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"code":"3.3.1.iia",
|
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"display":"*Yes"
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},
|
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{
|
|
"code":"3.3.1.iib",
|
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"display":"No"
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|
},
|
|
{
|
|
"code":"3.3.1.iic",
|
|
"display":"Uncertain"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"3.3.1ii"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueCoding":{
|
|
"code":"3.3.1.iia"
|
|
}
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"3.3.1iic",
|
|
"text":"Describe:",
|
|
"type":"text"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"3.3.2"
|
|
}
|
|
],
|
|
"linkId":"3.3.2",
|
|
"text":"Is there direct involvement of any other anatomical structures?",
|
|
"type":"boolean",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
|
|
"valueCodeableConcept":{
|
|
"coding":[
|
|
{
|
|
"system":"http://hl7.org/fhir/ValueSet/questionnaire-display-category",
|
|
"code":"instructions"
|
|
}
|
|
]
|
|
}
|
|
}
|
|
],
|
|
"text":"*If yes, indicate and describe all ipsilateral anatomical structures involved by the mass. If no, go to 3.3.3.",
|
|
"type":"display"
|
|
},
|
|
{
|
|
"linkId":"g3.3.2.yes",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"3.3.2"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueBoolean":true
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"3.3.2.Yes",
|
|
"text":"Indicate and describe all ipsilateral anatomical structures involved by the mass:",
|
|
"type":"choice",
|
|
"repeats":true,
|
|
"option":[
|
|
{
|
|
"code":"3.3.2.Yes.a",
|
|
"display":"Pleura"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.b",
|
|
"display":"Brachial Plexus"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.c",
|
|
"display":"Diaphragm"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.d",
|
|
"display":"Mediastinal fat"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.e",
|
|
"display":"Aorta"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.f",
|
|
"display":"Pulmonary Vessel"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.g",
|
|
"display":"Pericardium or Heart"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.h",
|
|
"display":"Mediastinal Vessels (including SVC)"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.i",
|
|
"display":"Trachea/carina"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.j",
|
|
"display":"Esophagus"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.k",
|
|
"display":"Trachea esophageal groove"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.l",
|
|
"display":"Vertebral Body"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.m",
|
|
"display":"Chest wall and Ribs"
|
|
},
|
|
{
|
|
"code":"3.3.2.Yes.n",
|
|
"display":"Other structures"
|
|
}
|
|
],
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"3.3.2.Yes"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueCoding":{
|
|
"code":"3.3.2.Yes.a"
|
|
}
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"3.3.2.Yes.a.text",
|
|
"text":"Pleura, description:",
|
|
"type":"string"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"3.3.3"
|
|
}
|
|
],
|
|
"linkId":"3.3.3",
|
|
"text":"Are there additional suspicious pulmonary nodules?",
|
|
"type":"boolean",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
|
|
"valueCodeableConcept":{
|
|
"coding":[
|
|
{
|
|
"system":"http://hl7.org/fhir/ValueSet/questionnaire-display-category",
|
|
"code":"instructions"
|
|
}
|
|
]
|
|
}
|
|
}
|
|
],
|
|
"text":"*If yes, indicate and describe pulmonary nodules which apply. If no, go to 3.3.4.",
|
|
"type":"display"
|
|
},
|
|
{
|
|
"linkId":"g3.3.3.yes",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"3.3.3"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueBoolean":true
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"3.3.3.Yes",
|
|
"text":"Indicate and describe pulmonary nodules which apply:",
|
|
"type":"choice",
|
|
"option":[
|
|
{
|
|
"code":"3.3.3.Yes.a",
|
|
"display":"In the same lobe"
|
|
},
|
|
{
|
|
"code":"3.3.3.Yes.b",
|
|
"display":"In a different lobe, same lung"
|
|
},
|
|
{
|
|
"code":"3.3.3.Yes.c",
|
|
"display":"In the opposite lung (M1a)"
|
|
}
|
|
],
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"3.3.3.Yes"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueCoding":{
|
|
"code":"3.3.3.Yes.a"
|
|
}
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"3.3.3.Yes.a.text",
|
|
"text":"In the same lobe, description:",
|
|
"type":"string"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"3.3.4"
|
|
}
|
|
],
|
|
"linkId":"3.3.4",
|
|
"text":"Other notable intrathoracic findings (eg lymphangitis carcinomatosis):",
|
|
"type":"text"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"4"
|
|
}
|
|
],
|
|
"linkId":"4.0",
|
|
"text":"N Category",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"4.1"
|
|
}
|
|
],
|
|
"linkId":"4.1",
|
|
"text":"Are there enlarged lymph nodes?",
|
|
"type":"boolean",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
|
|
"valueCodeableConcept":{
|
|
"coding":[
|
|
{
|
|
"system":"http://hl7.org/fhir/ValueSet/questionnaire-display-category",
|
|
"code":"instructions"
|
|
}
|
|
]
|
|
}
|
|
}
|
|
],
|
|
"text":"*If yes, indicate and describe the nodes which apply. If no, go to 4.2.",
|
|
"type":"display"
|
|
},
|
|
{
|
|
"linkId":"g4.1.yes",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"4.1"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueBoolean":true
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"4.1.yes",
|
|
"text":"Nodes and Descriptions:",
|
|
"type":"choice",
|
|
"repeats":true,
|
|
"option":[
|
|
{
|
|
"code":"4.1.yes.a",
|
|
"display":"1 Low Cervical, supraclavicular, and sternal notch nodes"
|
|
},
|
|
{
|
|
"code":"4.1.yes.b",
|
|
"display":"2R Upper Paratracheal (right)"
|
|
},
|
|
{
|
|
"code":"4.1.yes.c",
|
|
"display":"2L Upper paratracheal (left)"
|
|
},
|
|
{
|
|
"code":"4.1.yes.d",
|
|
"display":"3a Pre-vascular"
|
|
},
|
|
{
|
|
"code":"4.1.yes.e",
|
|
"display":"3p Retrotracheal"
|
|
},
|
|
{
|
|
"code":"4.1.yes.f",
|
|
"display":"4R Lower paratracheal (right)"
|
|
},
|
|
{
|
|
"code":"4.1.yes.g",
|
|
"display":"4L Upper paratracheal (left)"
|
|
},
|
|
{
|
|
"code":"4.1.yes.h",
|
|
"display":"5 Subaortic"
|
|
},
|
|
{
|
|
"code":"4.1.yes.i",
|
|
"display":"6 Para-aortic (ascending aorta or phrenic)"
|
|
},
|
|
{
|
|
"code":"4.1.yes.j",
|
|
"display":"7 Subcarinal"
|
|
},
|
|
{
|
|
"code":"4.1.yes.k",
|
|
"display":"8 Paraesophageal (below carina)"
|
|
},
|
|
{
|
|
"code":"4.1.yes.l",
|
|
"display":"9 Pulmonary ligament"
|
|
},
|
|
{
|
|
"code":"4.1.yes.m",
|
|
"display":"10 Hilar"
|
|
},
|
|
{
|
|
"code":"4.1.yes.n",
|
|
"display":"11 Interlobar"
|
|
},
|
|
{
|
|
"code":"4.1.yes.o",
|
|
"display":"12 Lobar"
|
|
},
|
|
{
|
|
"code":"4.1.yes.p",
|
|
"display":"13 Segmental"
|
|
},
|
|
{
|
|
"code":"4.1.yes.q",
|
|
"display":"14 Subsegmental"
|
|
},
|
|
{
|
|
"code":"4.1.yes.r",
|
|
"display":"Other Nodes (axilla, sub-diaphragmatic)"
|
|
}
|
|
],
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"4.1.yes"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueCoding":{
|
|
"code":"4.1.yes.a"
|
|
}
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"4.1.yes.description",
|
|
"text":"Description of node:",
|
|
"type":"string"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"4.2"
|
|
}
|
|
],
|
|
"linkId":"4.2",
|
|
"text":"Other notable findings:",
|
|
"type":"text"
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"5"
|
|
}
|
|
],
|
|
"linkId":"5.0",
|
|
"text":"M Category (Suspicious Extrathoracic Findings (M1b))",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"5.1"
|
|
}
|
|
],
|
|
"linkId":"5.1",
|
|
"text":"Are there suspicious extrathoracic findings?",
|
|
"type":"boolean",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
|
|
"valueCodeableConcept":{
|
|
"coding":[
|
|
{
|
|
"system":"http://hl7.org/fhir/ValueSet/questionnaire-display-category",
|
|
"code":"instructions"
|
|
}
|
|
]
|
|
}
|
|
}
|
|
],
|
|
"text":"*If yes, indicate and describe the structures below which apply. If no, go to 6.",
|
|
"type":"display"
|
|
},
|
|
{
|
|
"linkId":"g5.1.yes",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"5.1"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueBoolean":true
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"5.1.yes",
|
|
"text":"Applicable Structures and Descriptions:",
|
|
"type":"choice",
|
|
"repeats":true,
|
|
"option":[
|
|
{
|
|
"code":"5.1.yes.a",
|
|
"display":"Adrenals"
|
|
},
|
|
{
|
|
"code":"5.1.yes.b",
|
|
"display":"Liver"
|
|
},
|
|
{
|
|
"code":"5.1.yes.c",
|
|
"display":"Bone"
|
|
},
|
|
{
|
|
"code":"5.1.yes.d",
|
|
"display":"Other"
|
|
}
|
|
],
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"5.1.yes"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueCoding":{
|
|
"code":"5.1.yes.d"
|
|
}
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"5.1.yes.d.description",
|
|
"text":"Description of structures:",
|
|
"type":"string"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"6"
|
|
}
|
|
],
|
|
"linkId":"6.0",
|
|
"text":"Additional Findings",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"6.1"
|
|
}
|
|
],
|
|
"linkId":"6.1",
|
|
"text":"Are there additional findings?",
|
|
"type":"boolean",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
|
|
"valueCodeableConcept":{
|
|
"coding":[
|
|
{
|
|
"system":"http://hl7.org/fhir/ValueSet/questionnaire-display-category",
|
|
"code":"instructions"
|
|
}
|
|
]
|
|
}
|
|
}
|
|
],
|
|
"text":"*If yes, indicate and describe the findings below which apply. If no, go to Impressions.",
|
|
"type":"display"
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"6.2"
|
|
},
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"6.1"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueBoolean":true
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"6.2",
|
|
"text":"Findings and Descriptions:",
|
|
"type":"open-choice",
|
|
"repeats":true,
|
|
"option":[
|
|
{
|
|
"code":"6.2a",
|
|
"display":"Emphysema"
|
|
},
|
|
{
|
|
"code":"6.2b",
|
|
"display":"Fibrosis"
|
|
},
|
|
{
|
|
"code":"6.2c",
|
|
"display":"Coronary artery classification"
|
|
},
|
|
{
|
|
"code":"6.2d",
|
|
"display":"Asbestos related pleural disease"
|
|
},
|
|
{
|
|
"code":"6.2e",
|
|
"display":"Interstitial lung disease"
|
|
},
|
|
{
|
|
"code":"6.2f",
|
|
"display":"Atherosclerosis"
|
|
},
|
|
{
|
|
"code":"6.2g",
|
|
"display":"Pulmonary Embolism"
|
|
}
|
|
],
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-enableWhen",
|
|
"extension":[
|
|
{
|
|
"url":"#question",
|
|
"valueString":"6.2"
|
|
},
|
|
{
|
|
"url":"#answer",
|
|
"valueCoding":{
|
|
"code":"6.2a"
|
|
}
|
|
}
|
|
]
|
|
}
|
|
],
|
|
"linkId":"6.2a",
|
|
"text":"Pulmonary, description:",
|
|
"type":"string"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"linkId":"g7",
|
|
"text":"IMPRESSIONS",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"linkId":"g7.1",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"7.1"
|
|
}
|
|
],
|
|
"linkId":"7.1",
|
|
"text":"Impression/Summary:",
|
|
"type":"text"
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"7.2"
|
|
}
|
|
],
|
|
"linkId":"g7.2",
|
|
"text":"Radiologic Staging (TNM Version â 7th edition)",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"linkId":"g7.20",
|
|
"text":"If this is a biopsy proven carcinoma, the preliminary radiologic stage is:",
|
|
"type":"group",
|
|
"item":[
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"i)"
|
|
},
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-questionControl",
|
|
"valueCodeableConcept":{
|
|
"coding":[
|
|
{
|
|
"code":"radio-button",
|
|
"display":"Radio Button"
|
|
}
|
|
]
|
|
}
|
|
},
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
|
|
"valueCode":"horizontal"
|
|
}
|
|
],
|
|
"linkId":"7.2i",
|
|
"text":"Primary Tumour (T):",
|
|
"type":"choice",
|
|
"option":[
|
|
{
|
|
"code":"T1a",
|
|
"display":"T1a"
|
|
},
|
|
{
|
|
"code":"T1b",
|
|
"display":"T1b"
|
|
},
|
|
{
|
|
"code":"T2",
|
|
"display":"T2"
|
|
},
|
|
{
|
|
"code":"T2a",
|
|
"display":"T2a"
|
|
},
|
|
{
|
|
"code":"T2b",
|
|
"display":"T2b"
|
|
},
|
|
{
|
|
"code":"T3",
|
|
"display":"T3"
|
|
},
|
|
{
|
|
"code":"T4",
|
|
"display":"T4"
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"ii)"
|
|
}
|
|
],
|
|
"linkId":"7.2ii",
|
|
"text":"Regional Lymph Nodes (N):",
|
|
"type":"choice",
|
|
"option":[
|
|
{
|
|
"code":"NX",
|
|
"display":"NX"
|
|
},
|
|
{
|
|
"code":"N0",
|
|
"display":"N0"
|
|
},
|
|
{
|
|
"code":"N1",
|
|
"display":"N1"
|
|
},
|
|
{
|
|
"code":"N2",
|
|
"display":"N2"
|
|
},
|
|
{
|
|
"code":"N3",
|
|
"display":"N3"
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"extension":[
|
|
{
|
|
"url":"http://hl7.org/fhir/StructureDefinition/questionnaire-label",
|
|
"valueString":"iii)"
|
|
}
|
|
],
|
|
"linkId":"7.2iii",
|
|
"text":"Distant Metastasis (M):",
|
|
"type":"choice",
|
|
"option":[
|
|
{
|
|
"code":"M0",
|
|
"display":"M0"
|
|
},
|
|
{
|
|
"code":"M1",
|
|
"display":"M1"
|
|
},
|
|
{
|
|
"code":"M1a",
|
|
"display":"M1a"
|
|
},
|
|
{
|
|
"code":"M1b",
|
|
"display":"M1b"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|
|
]
|
|
}
|