Generated Narrative: Questionnaire VlCaseSixMonthsFollowup

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

Structure
LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. 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..1choiceiconiconOptions: 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

  • null#treatment-out-001 ("Final (definitive)cure")
  • null#treatment-out-002 ("Relapse")
  • null#treatment-out-003 ("Death")
  • null#treatment-out-004 ("Lost to follow up")

Answer options for 207948215604

  • null#death-cause-001 ("Unknown")
  • null#death-cause-002 ("VL")
  • null#death-cause-003 ("HIV")
  • null#death-cause-004 ("Non medical condition")
  • null#death-cause-005 ("SAE")
  • null#death-cause-006 ("Other disease (specify)")

Answer options for 598808996682

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