{ "resourceType" : "Questionnaire", "id" : "VlCaseSixMonthsFollowup", "meta" : { "profile" : ["http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire"] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire VlCaseSixMonthsFollowup

Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire

Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeFlagsDescription & Constraints\"doco\"
\".\"\".\" Six months follow-up examination questionnaire for Visceral Leishmaniasis casesQuestionnairehttp://example.org/Questionnaire/VlCaseSixMonthsFollowup#0.1.0
\".\"\".\"\".\" 768949210140Six (6) Months Follow Up Examination0..1group
\".\"\".\"\".\"\".\" 598716788113Date of Follow-up Examination0..1date
\".\"\".\"\".\"\".\" 854349915390Final Treatment Outcome0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\" 207948215604Cause of Death at Follow-up0..1choiceEnable When: 854349915390 = Death (treatment-out-003)
Options: 6 options
\".\"\".\"\".\"\".\" 598808996682Any Signs or Symptoms of PKDL?0..1choice\"icon\"/\"icon\"/Options: 2 options
\".\"\".\"\".\"\".\" 601245092289Remarks/Notes0..1string
\".\"\".\"\".\"\".\" 183599052402Clinician's Name (Follow-up)0..1string
\".\"\".\"\".\"\".\" 864740040168Clinician's Date (Follow-up)0..1date
\".\"\".\"\".\"\".\" 962832844710Clinician's Signature (Follow-up)0..1string

\"doco\" Documentation for this format

Options Sets

Answer options for 854349915390

Answer options for 207948215604

Answer options for 598808996682

" }, "url" : "http://example.org/Questionnaire/VlCaseSixMonthsFollowup", "version" : "0.1.0", "title" : "VL Case Lab Information", "status" : "draft", "date" : "2026-05-04T06:19:40+00:00", "publisher" : "Kenya National Public Health Institute", "contact" : [{ "name" : "Kenya National Public Health Institute", "telecom" : [{ "system" : "url", "value" : "https://www.nphi.go.ke/" }] }, { "name" : "Kenya National Public Health Institute", "telecom" : [{ "system" : "url", "value" : "https://www.nphi.go.ke/", "use" : "work" }] }], "description" : "Six months follow-up examination questionnaire for Visceral Leishmaniasis cases", "jurisdiction" : [{ "coding" : [{ "system" : "urn:iso:std:iso:3166", "code" : "KE", "display" : "Kenya" }] }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "page", "display" : "Page" }] } }], "linkId" : "768949210140", "text" : "Six (6) Months Follow Up Examination", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://ehelse.no/fhir/StructureDefinition/validationtext", "valueString" : "Cannot be a date in the future" }, { "url" : "http://hl7.org/fhir/StructureDefinition/maxValue", "_valueDate" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue", "valueExpression" : { "language" : "text/fhirpath", "expression" : "today()" } }] } }], "linkId" : "598716788113", "text" : "Date of Follow-up Examination", "type" : "date" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down", "display" : "Drop down" }] } }], "linkId" : "854349915390", "text" : "Final Treatment Outcome", "type" : "choice", "answerOption" : [{ "valueCoding" : { "code" : "treatment-out-001", "display" : "Final (definitive)cure" } }, { "valueCoding" : { "code" : "treatment-out-002", "display" : "Relapse" } }, { "valueCoding" : { "code" : "treatment-out-003", "display" : "Death" } }, { "valueCoding" : { "code" : "treatment-out-004", "display" : "Lost to follow up" } }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down", "display" : "Drop down" }] } }], "linkId" : "207948215604", "text" : "Cause of Death at Follow-up", "type" : "choice", "enableWhen" : [{ "question" : "854349915390", "operator" : "=", "answerCoding" : { "code" : "treatment-out-003", "display" : "Death" } }], "answerOption" : [{ "valueCoding" : { "code" : "death-cause-001", "display" : "Unknown" } }, { "valueCoding" : { "code" : "death-cause-002", "display" : "VL" } }, { "valueCoding" : { "code" : "death-cause-003", "display" : "HIV" } }, { "valueCoding" : { "code" : "death-cause-004", "display" : "Non medical condition" } }, { "valueCoding" : { "code" : "death-cause-005", "display" : "SAE" } }, { "valueCoding" : { "code" : "death-cause-006", "display" : "Other disease (specify)" } }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "radio-button", "display" : "Radio Button" }] } }, { "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }], "linkId" : "598808996682", "text" : "Any Signs or Symptoms of PKDL?", "type" : "choice", "answerOption" : [{ "valueCoding" : { "code" : "yes", "display" : "Yes" } }, { "valueCoding" : { "code" : "no", "display" : "No" } }] }, { "linkId" : "601245092289", "text" : "Remarks/Notes", "type" : "string" }, { "linkId" : "183599052402", "text" : "Clinician's Name (Follow-up)", "type" : "string" }, { "extension" : [{ "url" : "http://ehelse.no/fhir/StructureDefinition/validationtext", "valueString" : "Cannot be a date in the future" }, { "url" : "http://hl7.org/fhir/StructureDefinition/maxValue", "_valueDate" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue", "valueExpression" : { "language" : "text/fhirpath", "expression" : "today()" } }] } }], "linkId" : "864740040168", "text" : "Clinician's Date (Follow-up)", "type" : "date" }, { "linkId" : "962832844710", "text" : "Clinician's Signature (Follow-up)", "type" : "string" }] }] }