Generated Narrative: Questionnaire 54127-6 Profile: http://hl7.org/fhir/us/sdc/StructureDefinition/sdc-questionnaire LinkID Text Cardinality Type Flags Description & Constraints This represents an implementation of the "US Surgeon General family health portrait" form found at https://lforms-demo.nlm.nih.gov Questionnaire http://hl7.org/fhir/us/sdc/Questionnaire/54127-6 0 null 0..1 group 0.1 Date Done 0..1 date 0.2 Time Done 0..1 time 0.3 Where Done 0..1 string 0.4 Comment 0..1 string 1 Your health information 1..1 group Definition: http://loinc.org/rdf#54126-8 1.1 null 0..1 group 1.1.1 Name 0..1 string Max Length: 200 Definition: http://loinc.org/rdf#54125-0 1.1.2 Gender 1..1 coding Definition: http://loinc.org/rdf#54131-8 Value Set: LOINC Answer Codes for LL1-9 1.1.2.1.1 Please specify 1..1 string 1.1.3 Date of Birth 0..1 date Definition: http://loinc.org/rdf#21112-8 1.1.4 Were you born a twin? 0..1 coding Definition: http://loinc.org/rdf#54132-6 Value Set: LOINC Answer Codes for LL623-0 Initial Value: Coding = LOINC#LA32-8 "No" 1.1.5 Were you adopted? 0..1 coding Definition: http://loinc.org/rdf#54128-4 Value Set: LOINC Answer Codes for LL361-7 1.1.6 Are your parents related to each other in any way other than marriage? 0..1 coding Definition: http://loinc.org/rdf#54135-9 Value Set: LOINC Answer Codes for LL361-7 1.1.7 Height 1..1 decimal Definition: http://loinc.org/rdf#8302-2 1.1.7.1.1 Units 0..1 coding Value Set: ValueSet Length Units 1.1.8 Weight 0..1 decimal Definition: http://loinc.org/rdf#29463-7 1.1.8.1.1 Units 0..1 coding Value Set: ValueSet Weight Units 1.1.9 Body mass index (BMI) [Ratio] 0..1 decimal Definition: http://loinc.org/rdf#39156-5 1.1.10 Race 1..1 coding Definition: http://loinc.org/rdf#54134-2 Value Set: LOINC Answer Codes for LL629-7 1.1.11 Ethnicity 0..* coding Definition: http://loinc.org/rdf#54133-4 Value Set: LOINC Answer Codes for LL628-9 1.2 Your diseases history 0..* group Definition: http://loinc.org/rdf#54137-5 1.2.1 Disease or Condition 0..1 coding Definition: http://loinc.org/rdf#54140-9 Value Set: LOINC Answer Codes for LL626-3 1.2.2 Age at Diagnosis 0..1 coding Definition: http://loinc.org/rdf#54130-0 Value Set: LOINC Answer Codes for LL619-8 2 Family member health information 0..1 group Definition: http://loinc.org/rdf#54114-4 2.1 null 0..* group 2.1.1.0 Family Member identity 0..1 reference 2.1.1.1 Relationship to you 0..1 coding Definition: http://loinc.org/rdf#54136-7 Value Set: LOINC Answer Codes for LL621-4 2.1.1.2 Name 0..1 string Definition: http://loinc.org/rdf#54138-3 2.1.1.3 Gender 0..1 coding Definition: http://loinc.org/rdf#54123-5 Value Set: LOINC Answer Codes for LL1-9 2.1.1.3.1.1 Please specify 1..1 string 2.1.1.4 Living? 0..1 coding Definition: http://loinc.org/rdf#54139-1 Value Set: LOINC Answer Codes for LL361-7 2.1.1.4.1 null 0..1 group 2.1.1.4.1.1 Cause of Death 0..1 coding Definition: http://loinc.org/rdf#54112-8 Value Set: LOINC Answer Codes for LL627-1 2.1.1.4.1.1.1 Please specify 0..1 string 2.1.1.4.1.2 Age at Death 0..1 coding Definition: http://loinc.org/rdf#54113-6 Value Set: LOINC Answer Codes for LL619-8 2.1.1.4.2 null 0..1 group 2.1.1.4.2.1 Date of Birth 0..1 date Definition: http://loinc.org/rdf#54124-3 2.1.1.4.2.2 Age 0..1 decimal Definition: http://loinc.org/rdf#54141-7 2.1.1.5 Was this person born a twin? 0..1 coding Definition: http://loinc.org/rdf#54121-9 Value Set: LOINC Answer Codes for LL623-0 2.1.1.6 Was this person adopted? 0..1 coding Definition: http://loinc.org/rdf#54122-7 Value Set: LOINC Answer Codes for LL623-0 2.1.1.7 Race 0..* coding Definition: http://loinc.org/rdf#54119-3 Value Set: LOINC Answer Codes for LL629-7 2.1.1.8 Ethnicity 0..* coding Definition: http://loinc.org/rdf#54120-1 Value Set: LOINC Answer Codes for LL628-9 2.1.2 This family member's history of disease 0..* group Definition: http://loinc.org/rdf#54117-7 2.1.2.1 Disease or Condition 1..1 coding Definition: http://loinc.org/rdf#54116-9 Value Set: LOINC Answer Codes for LL626-3 2.1.2.2 Age at Diagnosis 0..1 coding Definition: http://loinc.org/rdf#54115-1 Value Set: LOINC Answer Codes for LL619-8 2.1.2.3 Mock-up item: Height 0..1 decimal 2.1.2.4 Mock-up item: Weight 0..1 decimal 2.1.2.5 Mock-up item: BMI 0..1 decimal Documentation for this format Contained Resources ValueSet #length Profile: http://hl7.org/fhir/us/sdc/StructureDefinition/sdc-valueset name: Length Units status: Active description: Length units immutable: true compose include system: http://unitsofmeasure.org concept code: [in_i] display: inches concept code: cm display: centimeters ValueSet #weight Profile: http://hl7.org/fhir/us/sdc/StructureDefinition/sdc-valueset name: Weight Units status: Active description: Weight units immutable: true compose include system: http://unitsofmeasure.org concept code: [lb_av] display: pounds concept code: km display: kilograms
US Surgeon General - Family Health Portrait
This represents an implementation of the "US Surgeon General family health portrait" form found at https://lforms-demo.nlm.nih.gov
Captures basic family history information
US Surgeon General family health portrait [USSG-FHT]
Are your parents related to each other in any way other than marriage?