ClinicalResponseBaseline
type: Questionnaire
node role: treeRoot
id:
  v: ClinicalResponseBaseline
text:
  status:
    v: generated
  div: LinkId Text Cardinality Type Flags Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> ClinicalResponseBaseline Clinical response questionnaire at baseline (first doctors' visit) Questionnaire http://hl7.org/fhir/uv/ichom-breast-cancer/Questionnaire/ClinicalResponseBaseline#1.0.0 General-Information-Clinical General information 1..1 group NA-Clinical What is the patient's medical record number? 1..1 string Expressions: Initial Value: %patient.id LastName-Clinical What is the patient's last name? 1..1 string Expressions: Initial Value: %patient.name.first().family.first() Demographics Demographic factors 1..1 group Sex Indicate the sex of the patient at birth: 1..1 choice Value Set: AdministrativeGender Expressions: Initial Value: %expandedGender.expansion.contains.where(code=%patient.gender) YearOfBirth In what year was the patient born? 1..1 integer Max Length: 4 Expressions: Initial Value: %patient.birthDate.substring(0,4) Clinical-Factors Clinical factors 1..1 group Height Indicate the patient's body height 1..1 quantity Weight Indicate the patient's weight. 1..1 quantity LATERAL Indicate the laterality of breast cancer 1..1 choice Value Set: Laterality of breast cancer ValueSet FIRSTBC Indicate if this is the first breast cancer 1..1 choice Value Set: Yes, No and Unknown Valueset NewBC Indicate if this is a new cancer on contralateral or ipsilateral breast 1..1 choice Enable When: FIRSTBC = No (expandedYes-NoIndicator#N) Value Set: Laterality of new cancer ValueSet Tumor-Factors Tumor factors 1..1 group HistologicalDateKnown Is the date of histological diagnosis known? 1..1 boolean HistologicalDiagnosisDate Indicate the initial date of histological diagnosis: 1..1 date Enable When: HistologicalDateKnown = true HISTOTYPE Indicate the histologic type of the tumor (select all that apply) 1..* choice Value Set: Histological type of the tumor ValueSet MUTBC Indicate if the patient carries a germline mutation predisposing breast…
extension:
  extension:
    url:
      v: name
    value: Coding
      system:
        v: http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext
      code:
        v: patient
      display:
        v: Patient
  extension:
    url:
      v: type
    value:
      v: Patient
  extension:
    url:
      v: description
    value:
      v: Patient information to pre-populate the form with
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
  value:
    v: informative
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
      value:
        v: http://hl7.org/fhir/uv/ichom-breast-cancer/ImplementationGuide/hl7.fhir.uv.ichom-breast-cancer
        link: http://hl7.org/fhir/uv/ichom-breast-cancer/ImplementationGuide/hl7.fhir.uv.ichom-breast-cancer
url:
  v: http://hl7.org/fhir/uv/ichom-breast-cancer/Questionnaire/ClinicalResponseBaseline
version:
  v: 1.0.0
name:
  v: ClinicalResponseBaseline
title:
  v: Clinical response questionnaire at baseline
status:
  v: draft
experimental:
  v: true
date:
  v: 2023-08-21T16:37:24+00:00
publisher:
  v: HL7 International - Clinical Interoperability Council Group
contact:
  name:
    v: HL7 International - Clinical Interoperability Council Group
  telecom:
    system:
      v: url
    value:
      v: http://www.hl7.org/Special/committees/cic
description:
  v: Clinical response questionnaire at baseline (first doctors' visit)
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
    code:
      v: 001
    display:
      v: World
item:
  link id:
    v: General-Information-Clinical
  text:
    v: General information
  type:
    v: group
  required:
    v: true
  item:
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression
      value: Expression
    link id:
      v: NA-Clinical
    text:
      v: What is the patient's medical record number?
    type:
      v: string
    required:
      v: true
  item:
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression
      value: Expression
    link id:
      v: LastName-Clinical
    text:
      v: What is the patient's last name?
    type:
      v: string
    required:
      v: true
item:
  link id:
    v: Demographics
  text:
    v: Demographic factors
  type:
    v: group
  required:
    v: true
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/variable
      value: Expression
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression
      value: Expression
    link id:
      v: Sex
    text:
      v: Indicate the sex of the patient at birth:
    type:
      v: choice
    required:
      v: true
    answer value set:
      v: http://hl7.org/fhir/ValueSet/administrative-gender
      link: http://hl7.org/fhir/ValueSet/administrative-gender
  item:
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression
      value: Expression
    link id:
      v: YearOfBirth
    text:
      v: In what year was the patient born?
    type:
      v: integer
    required:
      v: true
    max length:
      v: 4
item:
  link id:
    v: Clinical-Factors
  text:
    v: Clinical factors
  type:
    v: group
  required:
    v: true
  item:
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod
      value: Duration
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationExtract
      value:
        v: true
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption
      value: Coding
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-minQuantity
      value: Quantity
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-maxQuantity
      value: Quantity
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption
      value: Coding
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-minQuantity
      value: Quantity
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-maxQuantity
      value: Quantity
    link id:
      v: Height
    code: https://loinc.org/rdf/8302-2
      system:
        v: http://loinc.org

v: text/fhirpath

v: %patient.id

v: text/fhirpath

v: %patient.name.first().family.first()

v: expandedGender

v: application/x-fhir-query

v: ValueSet/$expand?url=http://hl7.org/fhir/ValueSet/administrative-gender

v: text/fhirpath

v: %expandedGender.expansion.contains.where(code=%patient.gender)

v: text/fhirpath

v: %patient.birthDate.substring(0,4)

v: 300

v: a

v: cm

v: cm

v: 10

v: cm

v: 320

v: cm

v: [in_i]

v: [in_i]

v: 3.94

v: [in_i]

v: 126

v: [in_i]

v: 8302-2

v: Body height

v: Indicate the patient's body height

v: quantity

v: true

extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod
  value: Duration
    value:
      v: 300
    system:
      v: http://unitsofmeasure.org
    code:
      v: a
extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationExtract
  value:
    v: true
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption
  value: Coding
    system:
      v: http://unitsofmeasure.org
    code:
      v: kg
    display:
      v: kg
extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-minQuantity
  value: Quantity
    value:
      v: 0.1
    system:
      v: http://unitsofmeasure.org
    code:
      v: kg
extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-maxQuantity
  value: Quantity
    value:
      v: 750
    system:
      v: http://unitsofmeasure.org
    code:
      v: kg
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption
  value: Coding
    system:
      v: http://unitsofmeasure.org
    code:
      v: [lb_av]
    display:
      v: [lb_av]
extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-minQuantity
  value: Quantity
    value:
      v: 0.22
    system:
      v: http://unitsofmeasure.org
    code:
      v: [lb_av]
extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-maxQuantity
  value: Quantity
    value:
      v: 1653.47
    system:
      v: http://unitsofmeasure.org
    code:
      v: [lb_av]
link id:
  v: Weight
code: https://loinc.org/rdf/29463-7
  system:
    v: http://loinc.org
  code:
    v: 29463-7
  display:
    v: Body weight
code: https://loinc.org/rdf/3141-9
  system:
    v: http://loinc.org
  code:
    v: 3141-9
  display:
    v: Body weight Measured
code: http://snomed.info/id/27113001
  system:
    v: http://snomed.info/sct
  code:
    v: 27113001
  display:
    v: Body weight
text:
  v: Indicate the patient's weight.
type:
  v: quantity
required:
  v: true

link id:
  v: LATERAL
text:
  v: Indicate the laterality of breast cancer
type:
  v: choice
required:
  v: true
answer value set:
  v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/LateralityVS
  link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/LateralityVS

link id:
  v: FIRSTBC
text:
  v: Indicate if this is the first breast cancer
type:
  v: choice
required:
  v: true
answer value set:
  v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/NoYesUnknownVS
  link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/NoYesUnknownVS

link id:
  v: NewBC
text:
  v: Indicate if this is a new cancer on contralateral or ipsilateral breast
type:
  v: choice
enable when:
  question:
    v: FIRSTBC
  operator:
    v: =
  answer: Coding
    system:
      v: http://terminology.hl7.org/CodeSystem/v2-0532
    code:
      v: N
required:
  v: true
answer value set:
  v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/LateralityNewCancerVS
  link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/LateralityNewCancerVS

link id:
  v: Tumor-Factors
text:
  v: Tumor factors
type:
  v: group
required:
  v: true
item:
  link id:
    v: HistologicalDateKnown
  text:
    v: Is the date of histological diagnosis known?
  type:
    v: boolean
  required:
    v: true
item:
  link id:
    v: HistologicalDiagnosisDate
  text:
    v: Indicate the initial date of histological diagnosis:
  type:
    v: date
  enable when:
    question:
      v: HistologicalDateKnown
    operator:
      v: =
    answer:
      v: true
  required:
    v: true
item:
  link id:
    v: HISTOTYPE
  text:
    v: Indicate the histologic type of the tumor (select all that apply)
  type:
    v: choice
  required:
    v: true
  repeats:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/HistologicalTypeVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/HistologicalTypeVS
item:
  link id:
    v: MUTBC
  text:
    v: Indicate if the patient carries a germline mutation predisposing breast cancer
  type:
    v: choice
  required:
    v: true
  repeats:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/GermlineMutationVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/GermlineMutationVS
item:
  link id:
    v: GRADEINV
  text:
    v: Indicate the grade of the invasive component of tumor
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/GradingVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/GradingVS
item:
  link id:
    v: GRADEDCIS
  text:
    v: Indicate the tumor grade of DCIS component of tumor
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/GradingVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/GradingVS
item:
  link id:
    v: TNMCT_BREAST
  text:
    v: Indicate the clinical tumor stage (per AJCC 8th Ed.):
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/TNMPrimaryTumorVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/TNMPrimaryTumorVS
item:
  link id:
    v: TNMCN_BREAST
  text:
    v: Indicate the clinical nodal stage (per AJCC 8th Ed.):
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/TNMRegionalNodesVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/TNMRegionalNodesVS
item:
  link id:
    v: TNMCM_BREAST
  text:
    v: Indicate the clinical distant metastasis (per AJCC 8th Ed.):
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/TNMDistantMetastasesVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/TNMDistantMetastasesVS
item:
  link id:
    v: ERSTATUS
  text:
    v: Indicate if the estrogen receptor status is positive:
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/EstrogenStatusVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/EstrogenStatusVS
item:
  link id:
    v: PRSTATUS
  text:
    v: Indicate if the progesterone receptor status is positive:
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/ProgesteroneStatusVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/ProgesteroneStatusVS
item:
  link id:
    v: HER2STATUS
  text:
    v: Indicate if the HER2 receptor status is positive:
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/HER2ReceptorStatusVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/HER2ReceptorStatusVS
item:
  link id:
    v: MolecularProfiling
  text:
    v: Indicate if a molecular profiling tool was used. If so, which one?
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/MolecularProfilingStatusVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/MolecularProfilingStatusVS
item:
  link id:
    v: Mammaprint
  text:
    v: Indicate the mammaprint score on a scale of 0.000 to 1.000
  type:
    v: decimal
  enable when:
    question:
      v: MolecularProfiling
    operator:
      v: =
    answer: Coding
      system:
        v: http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/MolecularProfilingCodeSystem
      code:
        v: mammaprint
  required:
    v: true
item:
  link id:
    v: Oncotype
  text:
    v: Indicate the oncotype score on a scale of 0 to 100
  type:
    v: decimal
  enable when:
    question:
      v: MolecularProfiling
    operator:
      v: =
    answer: Coding
      system:
        v: http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/MolecularProfilingCodeSystem

v: oncotype

v: true

link id:
  v: Endopredict
text:
  v: Indicate the endopredict score on a scale of 1.1 to 6.2
type:
  v: decimal
enable when:
  question:
    v: MolecularProfiling
  operator:
    v: =
  answer: Coding
    system:
      v: http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/MolecularProfilingCodeSystem
    code:
      v: endopredict
required:
  v: true

link id:
  v: Treatment-Variables
text:
  v: Treatment variables
type:
  v: group
required:
  v: true
item:
  link id:
    v: MultMeet
  text:
    v: Indicate if a multidisciplinary meeting was conducted
  type:
    v: choice
  required:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/NoYesUnknownVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/NoYesUnknownVS
item:
  link id:
    v: MultRecTreatments
  text:
    v: Which treatments did the multidisciplinary team recommend (select all that apply)?
  type:
    v: choice
  enable when:
    question:
      v: MultMeet
    operator:
      v: =
    answer: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0532
      code:
        v: Y
  required:
    v: true
  repeats:
    v: true
  answer value set:
    v: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/RecommendedTreatmentTypeVS
    link: http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/RecommendedTreatmentTypeVS