{
  "resourceType": "Questionnaire",
  "id": "antenatal-visit-alc-tob-drug-screening-qa-en-s1",
  "meta": {
    "profile": [
      "http://hl7.org.au/fhir/ch/v1/StructureDefinition/ncdhc-questionnaire-base"
    ]
  },
  "language": "en-AU",
  "version": "mhc-v1",
  "title": "My Alcohol, Tobacco and Other Drug screening Questionnaire",
  "experimental": false,
  "status": "active",
  "date": "2020-04-16",
  "publisher": "National Children's Digital Health Collaborative (NCDHC)",
  "description": "Question model to My Alcohol, Tobacco and Other Drug screening section of Antenatal Visit",
  "code": [
    {
      "system": "http://hl7.org.au/fhir/ch/v1/CodeSystem/ncdhc-hi-type-1",
      "code": "ANTVSTCLC",
      "display": "Antenatal Visit"
    }
  ],
  "subjectType": [
    "Encounter",
    "Observation"
  ],
  "item": [
    {
      "linkId": "1",      
      "code": [
        {
          "system": "http://snomed.info/sct",
          "code": "182838006"
        }
      ],
      "text": "Medication Changes",
      "type": "group",
      "item": [
        {
          "linkId": "1.1",
          "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-medication-pres-change-definitions.html#Observation.valueCodeableConcept:valueCodeableConcept",
          "type": "choice",
          "item": [
            {
              "linkId": "1.1.1",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-medication-pres-change-definitions.html#Observation.comment",
              "text": "Comments",
              "type": "string"
            }
          ]
        }
      ]  
    },
    {
      "linkId": "2",
      "code": [
        {
          "system": "http://snomed.info/sct",
          "code": "771155005"
        }
      ],
      "text": "Brief Smoking intervention",
      "type": "group",
      "item": [
        {
          "linkId": "2.1",
          "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-bi-tobacco-usage-definitions.html#Observation.valueCodeableConcept:valueCodeableConcept",
          "type": "choice",
          "item": [
            {
              "linkId": "2.1.1",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-bi-tobacco-usage-definitions.html#Observation.component:CigarettesPerDay.valueQuantity:valueQuantity",
              "text": "Cigarettes per day",
              "type": "string"
            },
            {
              "linkId": "2.1.2",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-bi-tobacco-usage-definitions.html#Observation.component:SmokingQuitDate.valueDateTime:valueDateTime",
              "text": "Smoking - Quit date",
              "type": "dateTime"
            }
          ]
        }
      ]
    },
    {
      "linkId": "3",
      "code": [
        {
          "system": "http://snomed.info/sct",
          "code": "1373571000168106"
        }
      ],
      "text": "Brief Alcohol intervention",
      "type": "group",
      "item": [
        {
          "linkId": "3.1",
          "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-bi-alcohol-intake-definitions.html#Observation.valueCodeableConcept:valueCodeableConcept",
          "type": "choice",
          "item": [
            {
              "linkId": "3.1.1",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-bi-alcohol-intake-definitions.html#Observation.component:AvgStdDringsPerDay.valueQuantity:valueQuantity",
              "text": "Average standard drinks per day",
              "type": "string"
            },
            {
              "linkId": "3.1.2",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-bi-alcohol-intake-definitions.html#Observation.component:AlcoholQuitDate.valueDateTime:valueDateTime",
              "text": "Alcohol - Quit date",
              "type": "dateTime"
            }
          ]
        }
      ]
    },
    {
      "linkId": "4",
      "code": [
        {
          "system": "http://snomed.info/sct",
          "code": "409063005"
        }
      ],
      "text": "Other Brief intervention",
      "type": "group",
      "item": [
        {
          "linkId": "4.1",
          "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-bi-other-definitions.html#Observation.value[x]:valueCodeableConcept",
          "type": "choice",
          "item": [
            {
              "linkId": "4.1.1",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-bi-alcohol-intake-definitions.html##Observation.component.valueString:valueString",
              "text": "Intervention type",
              "type": "string"
            },
            {
              "linkId": "4.1.2",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-bi-other-definitions.html#Observation.comment",
              "text": "Additional comments",
              "type": "string"
            }
          ]
        }
      ]
    },
    {
      "linkId": "5",
      "code": [
        {
          "system": "http://snomed.info/sct",
          "code": "440664005"
        }
      ],
      "text": "Illicit drugs",
      "type": "group",
      "item": [
        {
          "linkId": "5.1",
          "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-illicit-drugs-gestation-definitions.html#Observation.valueCodeableConcept:valueCodeableConcept",
          "type": "choice",
          "item": [
            {
              "linkId": "5.1.1",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-illicit-drugs-gestation-definitions.html#Observation.component:DrugType.valueCodeableConcept:valueCodeableConcept",
              "text": "Drug type",
              "type": "choice"
            },
            {
              "linkId": "5.1.2",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-illicit-drugs-gestation-definitions.html#Observation.component:FetalGestationalAge:valueQuantity",
              "text": "Number of weeks",
              "type": "string"
            },
            {
              "linkId": "5.1.3",
              "definition": "http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-illicit-drugs-gestation-definitions.html#Observation.component:DrugQuitDate.valueDateTime:valueDateTime",
              "text": "Illicit drugs - Quit date",
              "type": "dateTime"
            }
          ]
        }
      ]
    }
  ]
}