EarHealthAndHearing
type: Questionnaire
node role: treeRoot
id:
  v: EarHealthAndHearing
meta:
  profile:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-render
    l: sdc-questionnaire-render
  profile:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-modular
    l: sdc-questionnaire-modular
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: Questionnaire EarHealthAndHearing Profiles: Advanced Rendering Questionnaire, SDC Modular Questionnaire Structure LinkID Text Cardinality Type Flags Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> EarHealthAndHearing Questionnaire http://www.health.gov.au/assessments/mbs/715/EarHealthAndHearing#0.4.0 #xD; de71bbd0-178c-4974-9c75-55d5a48c66f7 Ear health and hearing 0..1 group #xD; CD-in-progress-6 In progress 0..1 display #xD; CD-complete-6 Complete 0..1 display #xD; CD-attention-6 Attention required 0..1 display #xD; f3473e82-4336-4858-96de-3a61eff5abfb Child listening concerns 0..1 group #xD; f982c374-f023-4e68-8968-1f1f5d3969ae Is there anything that you are worried about with your child's listening? 0..1 choice Value Set: Yes/No #xD; 297114f4-8c3f-4916-b840-c38ea14d37b1 Details 0..1 text Enable When: f982c374-f023-4e68-8968-1f1f5d3969ae = #xD; d2a3a346-7b20-4634-beb4-f2bdc7252fe5 Child language concerns 0..1 group #xD; 06c150f8-4d54-4d10-aeff-2ef7567b6812 Is there anything you are worried about with your child's language/talking? 0..1 choice Value Set: Yes/No #xD; 30dc1581-f6b7-49f0-be09-3902178a495f Details 0..1 text Enable When: 06c150f8-4d54-4d10-aeff-2ef7567b6812 = #xD; 6662bc91-fd05-4ea0-a96b-1cc124a9769a Child snoring 0..1 group #xD; b326271b-e9b1-45a0-b899-125364833702 Do you notice snoring/noisy breathing at night/while your child is sleeping? 0..1 choice Value Set: Yes/No #xD; 36a3967c-e79a-49a7-8022-ac9561c4e656 Details 0..1 text Enable When: b326271b-e9b1-45a0-b899-125364833702 = #xD; ec7b6e93-e1f0-41f5-b2c2-43c7ddff8aed Hearing concerns 0..1 group #xD; 3e53edc7-c90e-4681-a006-b7a05b91a02c Is there anything that you are worried about with your hearing? 0..1 choice Value Set: Yes/No #xD; d72dacb8-a9b3-483b-ae24-8b062873b2cb Details 0..1 text Enable When: 3e53edc7-c90e-4681-a006-b7a05b91a02c = #xD; 11aa62ca-5a52-428b-952b-cfbcd2c75824 Last hearing test (audiology) 0..1 date #xD; 31452c47-30…
contained: ValueSet
  id:
    v: YesNo
  url:
    v: https://smartforms.csiro.au/ig/ValueSet/YesNo
    l: YesNo
  name:
    v: YesNo
  title:
    v: Yes/No
  status:
    v: draft
  experimental:
    v: false
  description:
    v: Concepts for Yes and No
  compose:
    include:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0532
        l: v2-0532
      version:
        v: 2.0.0
  expansion:
    timestamp:
      v: 2025-09-18T16:28:54+10:00
    total:
      v: 2
    offset:
      v: 0
    parameter:
      name:
        v: count
      value: Integer
        v: 1000
    parameter:
      name:
        v: offset
      value: Integer
        v: 0
    parameter:
      name:
        v: excludeNested
      value: Boolean
        v: false
    parameter:
      name:
        v: used-codesystem
      value: Uri
        v: http://terminology.hl7.org/CodeSystem/v2-0532|2.0.0
        l: http://terminology.hl7.org/CodeSystem/v2-0532
    contains:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0532
        l: v2-0532
      code:
        v: Y
      display:
        v: Yes
    contains:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0532
        l: v2-0532
      code:
        v: N
      display:
        v: No
extension:
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extension:
  extension:
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    value: Coding
      system:
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      code:
        v: patient
  extension:
    url:
      v: type
      l: type
    value: Code
      v: Patient
  extension:
    url:
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      l: description
    value: String
      v: The patient that is to be used to pre-populate the form
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext
    l: sdc-questionnaire-launchContext
extension:
  extension:
    url:
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  extension:
    url:
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      l: type
    value: Code
      v: Practitioner
  extension:
    url:
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      l: description
    value: String
      v: The practitioner user that is to be used to pre-populate the form
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    l: sdc-questionnaire-launchContext
extension:
  extension:
    url:
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      l: name
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      v: Encounter
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      l: description
    value: String
      v: The encounter that is to be used to pre-populate the form
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    l: sdc-questionnaire-launchContext
extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembleContext
    l: sdc-questionnaire-assembleContext
  value: String
    v: age
extension:
  url:
    v: http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]
    l: extension-Questionnaire.versionAlgorithm[x]
  value: Coding
    system:
      v: http://hl7.org/fhir/version-algorithm
      l: version-algorithm
    code:
      v: semver
url:
  v: http://www.health.gov.au/assessments/mbs/715/EarHealthAndHearing
  l: EarHealthAndHearing
version:
  v: 0.4.0
name:
  v: EarHealthAndHearing
title:
  v: Aboriginal and Torres Strait Islander Health Check - Ear Health And Hearing
status:
  v: draft
experimental:
  v: false
subject type:
  v: Patient
date:
  v: 2025-03-14

v: Y

v: Yes

v: N

v: No

v: AEHRC CSIRO

name:
  v: AEHRC CSIRO
telecom:
  system:
    v: url
  value:
    v: https://confluence.csiro.au/display/PCDQFPhase2/Primary+Care+Data+Quality+Foundations+-+Phase+2

coding:
  system:
    v: urn:iso:std:iso:3166
    l: 3166
  code:
    v: AU
  display:
    v: Australia

v: Copyright © 2022+ Australian Government Department of Health and Aged Care - All rights reserved. This content is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. See https://creativecommons.org/licenses/by-sa/4.0/.

extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
    l: sdc-questionnaire-enableWhenExpression
  value: Expression
    language:
      v: text/fhirpath
    expression:
      v: %age.exists()
text:
  v: Ear health and hearing
type:
  v: group
repeats:
  v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
      l: sdc-questionnaire-enableWhenExpression
    value: Expression
      language:
        v: text/fhirpath
      expression:
        v: %resource.repeat(item).where(linkId='MarkComplete-6').answer.value = 'In progress' or %resource.repeat(item).where(linkId='MarkComplete-6').answer.value.empty()
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      l: questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: CD-in-progress-6
  text:
    v: In progress
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/rendering-xhtml
        l: rendering-xhtml
      value: String
        v: <img width='24' height='24' src='[binary]' style="align-self: center;"/>
  type:
    v: display
item:
  extension:
    url:
      v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
      l: sdc-questionnaire-enableWhenExpression
    value: Expression
      language:
        v: text/fhirpath
      expression:
        v: %resource.repeat(item).where(linkId='MarkComplete-6').answer.value = 'Complete'
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      l: questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: CD-complete-6
  text:
    v: Complete
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/rendering-xhtml
        l: rendering-xhtml
      value: String
        v: <img width='24' height='24' src='[binary]' style="align-self: center;"/>
  type:
    v: display
item:
  extension:
    url:
      v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
      l: sdc-questionnaire-enableWhenExpression
    value: Expression
      language:
        v: text/fhirpath
      expression:
        v: %resource.repeat(item).where(linkId='MarkComplete-6').answer.value = 'Attention required'
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      l: questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: CD-attention-6
  text:
    v: Attention required
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/rendering-xhtml
        l: rendering-xhtml
      value: String
        v: <img width='24' height='24' src='[binary]' style="align-self: center;"/>
  type:
    v: display
item:
  extension:
    url:
      v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
      l: sdc-questionnaire-enableWhenExpression
    value: Expression
      language:
        v: text/fhirpath
      expression:
        v: %age <= 12
  text:
    v: Child listening concerns
  type:
    v: group
  repeats:
    v: false
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
        l: questionnaire-itemControl
      value: CodeableConcept
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation
        l: questionnaire-choiceOrientation
      value: Code
        v: horizontal
    text:
      v: Is there anything that you are worried about with your child's listening?
    type:
      v: choice
    repeats:
      v: false
    answer value set:
      v: #YesNo
      l: YesNo
  item:
    text:
      v: Details
    type:
      v: text
    enable when:
      operator:
        v: =
      answer: Coding
    repeats:
      v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
      l: sdc-questionnaire-enableWhenExpression
    value: Expression
      language:
        v: text/fhirpath
      expression:
        v: %age <= 12
  text:
    v: Child language concerns
  type:
    v: group
  repeats:
    v: false
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
        l: questionnaire-itemControl
      value: CodeableConcept
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation
        l: questionnaire-choiceOrientation
      value: Code
        v: horizontal
    text:
      v: Is there anything you are worried about with your child's language/talking?
    type:
      v: choice
    repeats:
      v: false
    answer value set:
      v: #YesNo
      l: YesNo
  item:
    text:
      v: Details
    type:
      v: text
    enable when:
      operator:
        v: =
      answer: Coding
    repeats:
      v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
      l: sdc-questionnaire-enableWhenExpression
    value: Expression
      language:
        v: text/fhirpath
      expression:
        v: %age <= 12

v: context-display

v: context-display

v: context-display

system:
  v: http://hl7.org/fhir/questionnaire-item-control
  l: questionnaire-item-control
code:
  v: radio-button

v: Y

system:
  v: http://hl7.org/fhir/questionnaire-item-control
  l: questionnaire-item-control
code:
  v: radio-button

v: Y

v: Child snoring

v: group

v: false

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    l: questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
        l: questionnaire-item-control
      code:
        v: radio-button
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation
    l: questionnaire-choiceOrientation
  value: Code
    v: horizontal
text:
  v: Do you notice snoring/noisy breathing at night/while your child is sleeping?
type:
  v: choice
repeats:
  v: false
answer value set:
  v: #YesNo
  l: YesNo

text:
  v: Details
type:
  v: text
enable when:
  operator:
    v: =
  answer: Coding
    system:
      v: http://terminology.hl7.org/CodeSystem/v2-0136
      l: v2-0136
    code:
      v: Y
repeats:
  v: false

extension:
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
    l: sdc-questionnaire-enableWhenExpression
  value: Expression
    language:
      v: text/fhirpath
    expression:
      v: %age > 12
text:
  v: Hearing concerns
type:
  v: group
repeats:
  v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      l: questionnaire-itemControl
    value: CodeableConcept
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation
      l: questionnaire-choiceOrientation
    value: Code
      v: horizontal
  text:
    v: Is there anything that you are worried about with your hearing?
  type:
    v: choice
  repeats:
    v: false
  answer value set:
    v: #YesNo
    l: YesNo
item:
  text:
    v: Details
  type:
    v: text
  enable when:
    operator:
      v: =
    answer: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0136
        l: v2-0136
      code:
        v: Y
  repeats:
    v: false

v: radio-button

text:
  v: Last hearing test (audiology)
type:
  v: date
repeats:
  v: false

text:
  v: Ear examination
type:
  v: group
repeats:
  v: false
item:
  text:
    v: Otoscopy
  type:
    v: group
  repeats:
    v: false
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory
        l: questionnaire-displayCategory
      value: CodeableConcept
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
        l: sdc-questionnaire-enableWhenExpression
      value: Expression
    text:
      v: Video otoscopy procedure recommended where possible as it allows for parental education and for images to be saved for tracking over time.
    type:
      v: display
  item:
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
        l: sdc-questionnaire-enableWhenExpression
      value: Expression
    text:
      v: Otoscopy findings
    type:
      v: group
    repeats:
      v: false
    item:
      extension:
        value: CodeableConcept
      extension:
        value: String
      text:
        v: Left ear
      type:
        v: open-choice
      repeats:
        v: true
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
    item:
      extension:
        value: CodeableConcept
      extension:
        value: String
      text:
        v: Right ear
      type:
        v: open-choice
      repeats:
        v: true
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
  item:
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
        l: sdc-questionnaire-enableWhenExpression
      value: Expression
    text:
      v: Otoscopy findings
    type:
      v: group
    repeats:
      v: false
    item:
      extension:
        value: CodeableConcept
      extension:
        value: String
      text:
        v: Left ear
      type:
        v: open-choice
      repeats:
        v: true
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
    item:
      extension:
        value: CodeableConcept
      extension:
        value: String
      text:
        v: Right ear
      type:
        v: open-choice
      repeats:
        v: true
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
      answer option:
        value: String
item:
  extension:
    url:
      v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression
      l: sdc-questionnaire-enableWhenExpression
    value: Expression
      language:
        v: text/fhirpath
      expression:
        v: (%age > 5) and (%age <= 12)
  text:
    v: Tympanometry
  type:
    v: group
  repeats:
    v: false
  item:
    text:
      v: Left ear
    type:
      v: text
    repeats:
      v: false
  item:
    text:
      v: Right ear
    type:
      v: text
    repeats:
      v: false

system:
  v: http://hl7.org/fhir/questionnaire-display-category
  l: questionnaire-display-category
code:
  v: instructions

v: text/fhirpath

v: %age <= 12

v: text/fhirpath

v: %age <= 12

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
    l: questionnaire-item-control
  code:
    v: check-box

String
v: Other, please specify

String
v: Clear and intact

String
v: Dull and intact

String
v: Discharge

String
v: Retracted

String
v: Unable to view eardrum

String
v: Wax

String
v: Grommet in canal

String
v: Grommet in eardrum

String
v: Perforation

String
v: Red/bulging

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
    l: questionnaire-item-control
  code:
    v: check-box

String
v: Other, please specify

String
v: Clear and intact

String
v: Dull and intact

String
v: Discharge

String
v: Retracted

String
v: Unable to view eardrum

String
v: Wax

String
v: Grommet in canal

String
v: Grommet in eardrum

String
v: Perforation

String
v: Red/bulging

v: text/fhirpath

v: %age > 12

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
    l: questionnaire-item-control
  code:
    v: check-box

String
v: Other, please specify

String
v: Clear and intact

String
v: Dull and intact

String
v: Discharge

String
v: Retracted

String
v: Unable to view eardrum

String
v: Wax

CodeableConcept
coding:
  system:
    v: http://hl7.org/fhir/questionnaire-item-control
    l: questionnaire-item-control
  code:
    v: check-box

String
v: Other, please specify

String
v: Clear and intact

String
v: Dull and intact

String
v: Discharge

String
v: Retracted

String
v: Unable to view eardrum

String
v: Wax

text:
  v: Health priorities, actions and follow-up
type:
  v: text
repeats:
  v: false

link id:
  v: earhealthandhearing-section-end-divider
text:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/rendering-style
      l: rendering-style
    value: String
      v: border-top: 1px solid #ccc;
type:
  v: display

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    l: questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
        l: questionnaire-item-control
      code:
        v: radio-button
link id:
  v: MarkComplete-6
text:
  v: Section completion status
type:
  v: choice
repeats:
  v: false
answer option:
  value: String
    v: Complete
answer option:
  value: String
    v: In progress
answer option:
  value: String
    v: Attention required