<status value="draft"/> <subjectType value="Patient"/> <date value="2025-06-01"/> <publisher value="Lithuanian Medical Library"/> <contact> <name value="Lithuanian Medical Library"/> <telecom> <system value="url"/> <value value="https://medicinosnk.lt"/> </telecom> <telecom> <system value="email"/> <value value="info@medicinosnk.lt"/> </telecom> </contact> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="LT"/> </coding> </jurisdiction> <item> <linkId value="grp-referral-context"/> <text value="Referral context"/> <type value="group"/> <item> <linkId value="diagnosis"/> <text value="Diagnosis (ICD-10)"/> <type value="coding"/> <required value="true"/> <answerOption> <valueCoding> <system value="http://hl7.org/fhir/sid/icd-10"/> <code value="N40"/> <display value="Enlargement of prostate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://hl7.org/fhir/sid/icd-10"/> <code value="C61"/> <display value="Malignant neoplasm of prostate"/> </valueCoding> </answerOption> </item> <item> <linkId value="diagnosis-grade-group"/> <text value="Grade group (if C61)"/> <type value="coding"/> <required value="false"/> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="1279715000"/> <display value="ISUP Grade Group 1 (Gleason 3+3)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="1279714001"/> <display value="ISUP Grade Group 2 (Gleason 3+4)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="1279716004"/> <display value="ISUP Grade Group 3 (Gleason 4+3)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="1279717008"/> <display value="ISUP Grade Group 4 (Gleason 8)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="1279720000"/> <display value="ISUP Grade Group 5 (Gleason 9-10)"/> </valueCoding> </answerOption> </item> <item> <linkId value="specialist-qualification"/> <text value="Specialist qualification"/> <type value="string"/> <required value="true"/> <readOnly value="true"/> <initial> <valueString value="Radiologist"/> </initial> </item> <item> <linkId value="institution"/> <text value="Referring institution"/> <type value="string"/> <required value="true"/> </item> <item> <linkId value="screening-programme"/> <text value="Screening programme participant"/> <type value="coding"/> <required value="true"/> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-yes"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-no"/> <display value="No"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="grp-clinical"/> <text value="Clinical information"/> <type value="group"/> <item> <linkId value="complaints-anamnesis"/> <text value="Complaints / anamnesis"/> <type value="text"/> <required value="false"/> </item> <item> <linkId value="condition-assessment-info"/> <text value="Condition assessment information"/> <type value="text"/> <required value="true"/> </item> </item> <item> <linkId value="grp-family-history"/> <text value="Family oncological history (first-degree)"/> <type value="group"/> <item> <linkId value="family-hx-prostate"/> <text value="Prostate cancer"/> <type value="coding"/> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-yes"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-no"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-unknown"/> <display value="Unknown"/> </valueCoding> </answerOption> </item> <item> <linkId value="family-hx-breast"/> <text value="Breast cancer"/> <type value="coding"/> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-yes"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-no"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-unknown"/> <display value="Unknown"/> </valueCoding> </answerOption> </item> <item> <linkId value="family-hx-ovarian"/> <text value="Ovarian cancer"/> <type value="coding"/> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-yes"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-no"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-unknown"/> <display value="Unknown"/> </valueCoding> </answerOption> </item> <item> <linkId value="family-hx-colon"/> <text value="Colorectal cancer"/> <type value="coding"/> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-yes"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-no"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="ynk-unknown"/> <display value="Unknown"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="grp-dre"/> <text value="Digital rectal examination"/> <type value="group"/> <item> <linkId value="dre-findings"/> <text value="DRE findings (select all that apply)"/> <type value="coding"/> <required value="false"/> <repeats value="true"/> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/snomed-prostate-extension"/> <code value="standard-prostate"/> <display value="Standard prostate (finding)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="276387009"/> <display value="Hard prostate (finding)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="276385001"/> <display value="Soft prostate (finding)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/snomed-prostate-extension"/> <code value="flexible-prostate"/> <display value="Flexible prostate (finding)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/snomed-prostate-extension"/> <code value="inflexible-prostate"/> <display value="Inflexible prostate (finding)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="443607001"/> <display value="Palpable mass (finding)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="grp-vitals"/> <text value="Anthropometrics"/> <type value="group"/> <item> <linkId value="height-cm"/> <text value="Height (cm)"/> <type value="quantity"/> <required value="true"/> </item> <item> <linkId value="weight-kg"/> <text value="Weight (kg)"/> <type value="quantity"/> <required value="true"/> </item> <item> <linkId value="bmi-kg-m2"/> <text value="BMI (kg/m2)"/> <type value="quantity"/> <readOnly value="true"/> </item> </item> <item> <linkId value="grp-psa"/> <text value="PSA"/> <type value="group"/> <item> <linkId value="first-psa-ngml"/> <text value="First PSA (ng/ml)"/> <type value="quantity"/> <required value="true"/> </item> <item> <linkId value="first-psa-date"/> <text value="First PSA date"/> <type value="date"/> <required value="true"/> </item> </item> <item> <linkId value="grp-prior-imaging"/> <text value="Prior prostate mpMRI"/> <type value="group"/> <item> <linkId value="prior-mpmri"/> <text value="Prior mpMRI documented"/> <type value="boolean"/> </item> <item> <linkId value="prior-mpmri-date"/> <text value="Prior mpMRI date"/> <type value="date"/> </item> <item> <linkId value="prior-mpmri-pirads"/> <text value="Prior mpMRI PI-RADS category"/> <type value="coding"/> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="pirads-cat-1-2"/> <display value="PI-RADS 1-2"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="pirads-cat-3"/> <display value="PI-RADS 3"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="pirads-cat-4"/> <display value="PI-RADS 4"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options"/> <code value="pirads-cat-5"/> <display value="PI-RADS 5"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="grp-prior-therapy"/> <text value="Prior prostate-directed therapy"/> <type value="group"/> <item> <linkId value="prior-prostatectomy"/> <text value="Prior prostate surgery"/> <type value="boolean"/> </item> <item> <linkId value="prior-prostatectomy-date"/> <text value="Prostate surgery date"/> <type value="date"/> </item> <item> <linkId value="prior-prostate-radiation"/> <text value="Prior prostate radiotherapy"/> <type value="boolean"/> </item> <item> <linkId value="prior-prostate-radiation-date"/> <text value="Prostate radiotherapy date"/> <type value="date"/> </item> </item> <item> <linkId value="grp-related"/> <text value="Related information"/> <type value="group"/> <item> <linkId value="anticoagulant-use"/> <text value="Anticoagulant use"/> <type value="boolean"/> </item> </item> <item> <linkId value="grp-additional"/> <text value="Additional information"/> <type value="group"/> <item> <linkId value="specialist-additional-info"/> <text value="Additional description for specialist"/> <type value="text"/> </item> </item> </Questionnaire>

English

Generated Narrative: Questionnaire questionnaire-prostate-radiologist-referral

Language: en

Structure

LinkID	Text	Cardinality	Type	Description & Constraints
ProstateRadiologistReferral			Questionnaire	https://hl7.lt/fhir/prostate/Questionnaire/prostate-radiologist-referral#0.1.0
grp-referral-context	Referral context	0..1	group
diagnosis	Diagnosis (ICD-10)	1..1	coding	Options: 2 options
diagnosis-grade-group	Grade group (if C61)	0..1	coding	Options: 5 options
specialist-qualification	Specialist qualification	1..1	string	Initial Value: string = Radiologist
institution	Referring institution	1..1	string
screening-programme	Screening programme participant	1..1	coding	Options: 2 options
grp-clinical	Clinical information	0..1	group
complaints-anamnesis	Complaints / anamnesis	0..1	text
condition-assessment-info	Condition assessment information	1..1	text
grp-family-history	Family oncological history (first-degree)	0..1	group
family-hx-prostate	Prostate cancer	0..1	coding	Options: 3 options
family-hx-breast	Breast cancer	0..1	coding	Options: 3 options
family-hx-ovarian	Ovarian cancer	0..1	coding	Options: 3 options
family-hx-colon	Colorectal cancer	0..1	coding	Options: 3 options
grp-dre	Digital rectal examination	0..1	group
dre-findings	DRE findings (select all that apply)	0..*	coding	Options: 6 options
grp-vitals	Anthropometrics	0..1	group
height-cm	Height (cm)	1..1	quantity
weight-kg	Weight (kg)	1..1	quantity
bmi-kg-m2	BMI (kg/m2)	0..1	quantity
grp-psa	PSA	0..1	group
first-psa-ngml	First PSA (ng/ml)	1..1	quantity
first-psa-date	First PSA date	1..1	date
grp-prior-imaging	Prior prostate mpMRI	0..1	group
prior-mpmri	Prior mpMRI documented	0..1	boolean
prior-mpmri-date	Prior mpMRI date	0..1	date
prior-mpmri-pirads	Prior mpMRI PI-RADS category	0..1	coding	Options: 4 options
grp-prior-therapy	Prior prostate-directed therapy	0..1	group
prior-prostatectomy	Prior prostate surgery	0..1	boolean
prior-prostatectomy-date	Prostate surgery date	0..1	date
prior-prostate-radiation	Prior prostate radiotherapy	0..1	boolean
prior-prostate-radiation-date	Prostate radiotherapy date	0..1	date
grp-related	Related information	0..1	group
anticoagulant-use	Anticoagulant use	0..1	boolean
grp-additional	Additional information	0..1	group
specialist-additional-info	Additional description for specialist	0..1	text
Documentation for this format

Options Sets

Answer options for diagnosis

http://hl7.org/fhir/sid/icd-10#N40 ("Enlargement of prostate")
http://hl7.org/fhir/sid/icd-10#C61 ("Malignant neoplasm of prostate")

Answer options for diagnosis-grade-group

http://snomed.info/sct#1279715000 ("ISUP Grade Group 1 (Gleason 3+3)")
http://snomed.info/sct#1279714001 ("ISUP Grade Group 2 (Gleason 3+4)")
http://snomed.info/sct#1279716004 ("ISUP Grade Group 3 (Gleason 4+3)")
http://snomed.info/sct#1279717008 ("ISUP Grade Group 4 (Gleason 8)")
http://snomed.info/sct#1279720000 ("ISUP Grade Group 5 (Gleason 9-10)")

Answer options for screening-programme

https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-yes ("Yes")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-no ("No")

Answer options for family-hx-prostate

https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-yes ("Yes")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-no ("No")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-unknown ("Unknown")

Answer options for family-hx-breast

https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-yes ("Yes")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-no ("No")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-unknown ("Unknown")

Answer options for family-hx-ovarian

https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-yes ("Yes")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-no ("No")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-unknown ("Unknown")

Answer options for family-hx-colon

https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-yes ("Yes")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-no ("No")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#ynk-unknown ("Unknown")

Answer options for dre-findings

https://tx.hl7.lt/fhir/CodeSystem/snomed-prostate-extension#standard-prostate ("Standard prostate (finding)")
http://snomed.info/sct#276387009 ("Hard prostate (finding)")
http://snomed.info/sct#276385001 ("Soft prostate (finding)")
https://tx.hl7.lt/fhir/CodeSystem/snomed-prostate-extension#flexible-prostate ("Flexible prostate (finding)")
https://tx.hl7.lt/fhir/CodeSystem/snomed-prostate-extension#inflexible-prostate ("Inflexible prostate (finding)")
http://snomed.info/sct#443607001 ("Palpable mass (finding)")

Answer options for prior-mpmri-pirads

https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#pirads-cat-1-2 ("PI-RADS 1-2")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#pirads-cat-3 ("PI-RADS 3")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#pirads-cat-4 ("PI-RADS 4")
https://tx.hl7.lt/fhir/CodeSystem/prostate-questionnaire-options#pirads-cat-5 ("PI-RADS 5")