SACQComorbidities
type: Questionnaire
node role: treeRoot
resource.id:
  value: SACQComorbidities
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: LinkId Text Cardinality Type Description & Constraints SACQComorbidities Questionnaire https://connect.ichom.org/fhir/Questionnaire/SACQComorbidities#0.0.1 ComorbiditiesSACQ Have you been told by a doctor that you have any of the following? 1..* choice Value Set: SACQ Patient's comorbidity history ComorbiditiesSACQ_HeartDiseaseFU1 Do you receive treatment for heart disease (For example, angina, heart failure, or heart attack)? 0..1 boolean Enable When: ComorbiditiesSACQ = Heart disease (SNOMED CT#56265001) ComorbiditiesSACQ_HeartDiseaseFU2 Does your heart disease limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Heart disease (SNOMED CT#56265001) ComorbiditiesSACQ_HighBloodPressureFU1 Do you receive treatment for high blood pressure? 0..1 boolean Enable When: ComorbiditiesSACQ = High blood pressure (SNOMED CT#38341003) ComorbiditiesSACQ_HighBloodPressureFU2 Does your high blood pressure limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = High blood pressure (SNOMED CT#38341003) ComorbiditiesSACQ_LungDiseaseFU1 Do you receive treatment for lung disease? 0..1 boolean Enable When: ComorbiditiesSACQ = Lung disorder (SNOMED CT#19829001) ComorbiditiesSACQ_LungDiseaseFU2 Does your lung disease limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Lung disorder (SNOMED CT#19829001) ComorbiditiesSACQ_DiabetesFU1 Do you receive treatment for diabetes? 0..1 boolean Enable When: ComorbiditiesSACQ = Diabetes mellitus (SNOMED CT#73211009) ComorbiditiesSACQ_DiabetesFU2 Does your diabetes limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Diabetes mellitus (SNOMED CT#73211009) ComorbiditiesSACQ_StomachDiseaseFU1 Do you receive treatment for an ulcer or stomach disease? 0..1 boolean Enable When: ComorbiditiesSACQ = Ulcer (disorder) (SNOMED CT#429040005) ComorbiditiesSACQ_StomachDiseaseFU2 Does your ulcer or stomach disease limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Ulcer (disorder) (SNOMED…
questionnaire.url:
  value: https://connect.ichom.org/fhir/Questionnaire/SACQComorbidities
questionnaire.version:
  value: 0.0.1
questionnaire.name:
  value: SACQComorbidities
questionnaire.title:
  value: SACQ comorbidities
questionnaire.status:
  value: draft
questionnaire.experimental:
  value: true
questionnaire.date:
  value: 2022-03-28T13:44:43+00:00
questionnaire.publisher:
  value: ICHOM
questionnaire.contact:
  index: 0
  contact detail.name:
    value: ICHOM
  contact detail.telecom:
    index: 0
    contact point.system:
      value: url
    contact point.value:
      value: https://ichom.org
questionnaire.jurisdiction:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://unstats.un.org/unsd/methods/m49/m49.htm
    coding.code:
      value: 001
    coding.display:
      value: World
questionnaire.item:
  index: 0
  questionnaire.item.link id:
    value: ComorbiditiesSACQ
  questionnaire.item.text:
    value: Have you been told by a doctor that you have any of the following?
  questionnaire.item.type:
    value: choice
  questionnaire.item.required:
    value: true
  questionnaire.item.repeats:
    value: true
  questionnaire.item.answer value set:
    value: https://connect.ichom.org/fhir/ValueSet/SACQ-patient-comorbidity-history
    link: https://connect.ichom.org/fhir/ValueSet/SACQ-patient-comorbidity-history
questionnaire.item:
  index: 1
  questionnaire.item.link id:
    value: ComorbiditiesSACQ_HeartDiseaseFU1
  questionnaire.item.text:
    value: Do you receive treatment for heart disease (For example, angina, heart failure, or heart attack)?
  questionnaire.item.type:
    value: boolean
  questionnaire.item.enable when:
    index: 0
    questionnaire.item.enable when.question:
      value: ComorbiditiesSACQ
    questionnaire.item.enable when.operator:
      value: =
    questionnaire.item.enable when.answer coding: http://snomed.info/id/56265001
      coding.system:
        value: http://snomed.info/sct
      coding.code:
        value: 56265001
questionnaire.item:
  index: 2
  questionnaire.item.link id:
    value: ComorbiditiesSACQ_HeartDiseaseFU2
  questionnaire.item.text:
    value: Does your heart disease limit your activities?
  questionnaire.item.type:
    value: boolean
  questionnaire.item.enable when:
    index: 0
    questionnaire.item.enable when.question:
      value: ComorbiditiesSACQ
    questionnaire.item.enable when.operator:
      value: =
    questionnaire.item.enable when.answer coding: http://snomed.info/id/56265001
      coding.system:
        value: http://snomed.info/sct
      coding.code:
        value: 56265001
questionnaire.item:
  index: 3
  questionnaire.item.link id:
    value: ComorbiditiesSACQ_HighBloodPressureFU1
  questionnaire.item.text:
    value: Do you receive treatment for high blood pressure?
  questionnaire.item.type:
    value: boolean
  questionnaire.item.enable when:
    index: 0
    questionnaire.item.enable when.question:
      value: ComorbiditiesSACQ
    questionnaire.item.enable when.operator:
      value: =
    questionnaire.item.enable when.answer coding: http://snomed.info/id/38341003
      coding.system:
        value: http://snomed.info/sct
      coding.code:
        value: 38341003
questionnaire.item:
  index: 4
  questionnaire.item.link id:
    value: ComorbiditiesSACQ_HighBloodPressureFU2
  questionnaire.item.text:
    value: Does your high blood pressure limit your activities?
  questionnaire.item.type:
    value: boolean
  questionnaire.item.enable when:
    index: 0
    questionnaire.item.enable when.question:
      value: ComorbiditiesSACQ
    questionnaire.item.enable when.operator:
      value: =
    questionnaire.item.enable when.answer coding: http://snomed.info/id/38341003
      coding.system:
        value: http://snomed.info/sct
      coding.code:
        value: 38341003
questionnaire.item:
  index: 5
  questionnaire.item.link id:
    value: ComorbiditiesSACQ_LungDiseaseFU1
  questionnaire.item.text:
    value: Do you receive treatment for lung disease?
  questionnaire.item.type:
    value: boolean
  questionnaire.item.enable when:
    index: 0
    questionnaire.item.enable when.question:
      value: ComorbiditiesSACQ
    questionnaire.item.enable when.operator:
      value: =
    questionnaire.item.enable when.answer coding: http://snomed.info/id/19829001
      coding.system:
        value: http://snomed.info/sct
      coding.code:
        value: 19829001
questionnaire.item:
  index: 6
  questionnaire.item.link id:
    value: ComorbiditiesSACQ_LungDiseaseFU2
  questionnaire.item.text:
    value: Does your lung disease limit your activities?
  questionnaire.item.type:
    value: boolean
  questionnaire.item.enable when:
    index: 0
    questionnaire.item.enable when.question:
      value: ComorbiditiesSACQ
    questionnaire.item.enable when.operator:
      value: =
    questionnaire.item.enable when.answer coding: http://snomed.info/id/19829001
      coding.system:
        value: http://snomed.info/sct
      coding.code:
        value: 19829001
questionnaire.item:
  index: 7
  questionnaire.item.link id:
    value: ComorbiditiesSACQ_DiabetesFU1
  questionnaire.item.text:
    value: Do you receive treatment for diabetes?
  questionnaire.item.type:
    value: boolean
  questionnaire.item.enable when:
    index: 0
    questionnaire.item.enable when.question:
      value: ComorbiditiesSACQ
    questionnaire.item.enable when.operator:
      value: =
    questionnaire.item.enable when.answer coding: http://snomed.info/id/73211009
      coding.system:
        value: http://snomed.info/sct
      coding.code:
        value: 73211009
questionnaire.item:
  index: 8
  questionnaire.item.link id:
    value: ComorbiditiesSACQ_DiabetesFU2
  questionnaire.item.text:
    value: Does your diabetes limit your activities?
  questionnaire.item.type:
    value: boolean
  questionnaire.item.enable when:
    index: 0
    questionnaire.item.enable when.answer coding: http://snomed.info/id/73211009

value: ComorbiditiesSACQ

value: =

http://snomed.info/id/73211009
coding.system:
  value: http://snomed.info/sct
coding.code:
  value: 73211009

index: 9
questionnaire.item.link id:
  value: ComorbiditiesSACQ_StomachDiseaseFU1
questionnaire.item.text:
  value: Do you receive treatment for an ulcer or stomach disease?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/429040005
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 429040005

index: 10
questionnaire.item.link id:
  value: ComorbiditiesSACQ_StomachDiseaseFU2
questionnaire.item.text:
  value: Does your ulcer or stomach disease limit your activities?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/429040005
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 429040005

index: 11
questionnaire.item.link id:
  value: ComorbiditiesSACQ_KidneyDiseaseFU1
questionnaire.item.text:
  value: Do you receive treatment for kidney disease?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/90708001
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 90708001

index: 12
questionnaire.item.link id:
  value: ComorbiditiesSACQ_KidneyDiseaseFU2
questionnaire.item.text:
  value: Does your kidney disease limit your activities?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/90708001
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 90708001

index: 13
questionnaire.item.link id:
  value: ComorbiditiesSACQ_LiverDiseaseFU1
questionnaire.item.text:
  value: Do you receive treatment for liver disease?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/235856003
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 235856003

index: 14
questionnaire.item.link id:
  value: ComorbiditiesSACQ_LiverDiseaseFU2
questionnaire.item.text:
  value: Does your liver disease limit your activities?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/235856003
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 235856003

index: 15
questionnaire.item.link id:
  value: ComorbiditiesSACQ_BloodDiseaseFU1
questionnaire.item.text:
  value: Do you receive treatment for anemia or other blood disease?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/271737000
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 271737000

index: 16
questionnaire.item.link id:
  value: ComorbiditiesSACQ_BloodDiseaseFU2
questionnaire.item.text:
  value: Does your anemia or other blood disease limit your activities?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/271737000
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 271737000

index: 17
questionnaire.item.link id:
  value: ComorbiditiesSACQ_CancerFU1
questionnaire.item.text:
  value: Do you receive treatment for cancer/another cancer?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding:
    coding.system:
      value: http://connect.ichom.org/fhir/CodeSystem/sacq-patient-comorbidity-history
    coding.code:
      value: cancer-within-5yrs

index: 18
questionnaire.item.link id:
  value: ComorbiditiesSACQ_CancerFU2
questionnaire.item.text:
  value: Does your cancer/other cancer limit your activities?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding:
    coding.system:
      value: http://connect.ichom.org/fhir/CodeSystem/sacq-patient-comorbidity-history
    coding.code:
      value: cancer-within-5yrs

index: 19
questionnaire.item.link id:
  value: ComorbiditiesSACQ_DepressionFU1
questionnaire.item.text:
  value: Do you receive treatment for depression?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/35489007
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 35489007

index: 20
questionnaire.item.link id:
  value: ComorbiditiesSACQ_DepressionFU2
questionnaire.item.text:
  value: Does your depression limit your activities?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/35489007
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 35489007

index: 21
questionnaire.item.link id:
  value: ComorbiditiesSACQ_OsteoarthritisFU1
questionnaire.item.text:
  value: Do you receive treatment for osteoarthritis/degenerative arthritis?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/396275006
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 396275006

index: 22
questionnaire.item.link id:
  value: ComorbiditiesSACQ_OsteoarthritisFU2
questionnaire.item.text:
  value: Does your osteoarthritis/degenerative arthritis limit your activities?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/396275006
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 396275006

index: 23
questionnaire.item.link id:
  value: ComorbiditiesSACQ_BackPainFU1
questionnaire.item.text:
  value: Do you receive treatment for back pain?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/161891005
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 161891005

index: 24
questionnaire.item.link id:
  value: ComorbiditiesSACQ_BackPainFU2
questionnaire.item.text:
  value: Does your back pain limit your activities?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/161891005
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 161891005

index: 25
questionnaire.item.link id:
  value: ComorbiditiesSACQ_RheumatoidArthritisFU1
questionnaire.item.text:
  value: Do you receive treatment for rheumatoid arthritis?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/69896004
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 69896004

index: 26
questionnaire.item.link id:
  value: ComorbiditiesSACQ_RheumatoidArthritisFU2
questionnaire.item.text:
  value: Does your rheumatoid arthritis limit your activities?
questionnaire.item.type:
  value: boolean
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding: http://snomed.info/id/69896004
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 69896004

index: 27
questionnaire.item.link id:
  value: ComorbiditiesSACQ_Other
questionnaire.item.text:
  value: What other medical problems are you experiencing?
questionnaire.item.type:
  value: text
questionnaire.item.enable when:
  index: 0
  questionnaire.item.enable when.question:
    value: ComorbiditiesSACQ
  questionnaire.item.enable when.operator:
    value: =
  questionnaire.item.enable when.answer coding:
    coding.system:
      value: http://connect.ichom.org/fhir/CodeSystem/sacq-patient-comorbidity-history
    coding.code:
      value: other-medical-problems

index: 28
questionnaire.item.link id:
  value: ComorbiditiesSACQ_Score
questionnaire.item.text:
  value: What is the total summed score of the patient's SACQ responses?
questionnaire.item.type:
  value: integer