Generated Narrative: Questionnaire VlCaseHospitalization Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire Structure LinkID Text Cardinality Type Flags Description & Constraints Hospitalization and treatment information for Visceral Leishmaniasis cases Questionnaire http://example.org/Questionnaire/VlCaseHospitalization#0.1.0 #xD; 782742635664 Treatment/Hospitilazation 0..1 group #xD; 428237064956 IP No 1..1 string #xD; 272556667885 Hospital Ward 1..1 string #xD; 885705999856 Date of Admission 1..1 date #xD; 150613899880 Date Leishmaniasis Treatment Started 1..1 date #xD; 733604782646 Treatment Regimen 1..1 choice Options: 5 options #xD; 498949031326 Other Treatment Regimen ( Specify) 1..1 string Enable When: 733604782646 = Other (Specify). (reg-005) #xD; regimen-dosage Treatment Regimen Dosage 1..1 decimal #xD; 175945763878 Number of Treatment Days 1..1 choice Options: 4 options #xD; 686824046139 Number of treatment days (Specify) 1..1 integer Enable When: 175945763878 = Other (Specify) (trtemnt-004) #xD; 723427815459 Was Treatment Completed? 0..1 choice Options: 2 options #xD; 342763225855 Reason for Incomplete Treatment 1..1 string Enable When: 723427815459 = No (no) #xD; 708058904265 Initial Treatment Outcome 1..1 choice Options: 5 options #xD; 131738268669 Cause of Death 1..1 choice Enable When: 708058904265 = Death (outcome-005) Options: 6 options #xD; 884379481934 Was there any reported severe adverse event of drug(s) used? 1..1 choice Options: 2 options #xD; 560909523868 Input Name(s) of Drug Causing Adverse Event 1..1 string Enable When: 884379481934 = Yes (yes) #xD; 396444399071 Indicate Description of Severe Adverse Event 1..1 string Enable When: 884379481934 = Yes (yes) #xD; 904748389038 Any other condition(s) treated during Initial VL treatment? 1..1 choice Options: 2 options #xD; 922498480736 Name of Other Condition 1..1 string Enable When: 904748389038 = Yes (yes) #xD; Documentation for this format Options Sets Answer options for 733604782646 null#reg-001 ("Combination (SSG + Paramomycin)(17 days)") null#reg-002 ("Pentostam (SSG) (30 days)") null#reg-003 ("Glucantime") null#reg-004 ("Liposomal Amphotericin B (6-10 days)") null#reg-005 ("Other (Specify).") Answer options for 175945763878 null#trtemnt-001 ("6-10 Days") null#trtemnt-002 ("17 Days") null#trtemnt-003 ("30 Days") null#trtemnt-004 ("Other (Specify)") Answer options for 723427815459 null#yes ("Yes") null#no ("No") Answer options for 708058904265 null#outcome-001 ("Initial cure") null#outcome-002 ("Probable non-response") null#outcome-003 ("Confirmed non-response") null#outcome-004 ("Default") null#outcome-005 ("Death") Answer options for 131738268669 null#death-cause-001 ("Unknown") null#death-cause-002 ("VL") null#death-cause-003 ("HIV") null#death-cause-004 ("Other disease") null#death-cause-005 ("SAE") null#death-cause-006 ("Non-medical condition") Answer options for 884379481934 null#yes ("Yes") null#no ("No") Answer options for 904748389038 null#yes ("Yes") null#no ("No")
Hospitalization and treatment information for Visceral Leishmaniasis cases
Combination (SSG + Paramomycin)(17 days)
Was there any reported severe adverse event of drug(s) used?
Input Name(s) of Drug Causing Adverse Event
Indicate Description of Severe Adverse Event
Any other condition(s) treated during Initial VL treatment?