{ "resourceType" : "Questionnaire", "id" : "QCXCAD1", "language" : "en", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire QCXCAD1

Language: en

Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\".\"\".\" Questionnaire that captures the cervical cancer screening anamnesis required by Mongolia MOH Order A/641 (2020) Op.Inst. 5.1. Paired with CXCAD1 LogicalModel; linkId values match LogicalModel element names so a StructureMap-based extraction can be authored mechanically.Questionnairehttp://smart.who.int/cxca/Questionnaire/QCXCAD1#0.0.1
\".\"\".\"\".\" clientAgeClient's age in years on the encounter date1..1integer
\".\"\".\"\".\" clientEducationHighest level of education completed0..1string
\".\"\".\"\".\" numberOfPregnanciesTotal number of pregnancies (any outcome)0..1integer
\".\"\".\"\".\" numberOfBirthsNumber of live births0..1integer
\".\"\".\"\".\" lastMenstrualPeriodFirst day of the client's most recent menstrual period0..1date
\".\"\".\"\".\" currentlyPregnantIs the client currently pregnant?0..1boolean
\".\"\".\"\".\" gestationalAgeWeeksIf currently pregnant, gestational age in weeks0..1integerEnable When: currentlyPregnant = true
\".\"\".\"\".\" currentContraceptionCurrent contraception method0..1string
\".\"\".\"\".\" pastContraceptionPast contraception methods used0..1string
\".\"\".\"\".\" ageAtFirstSexualContactAge at first sexual contact0..1integer
\".\"\".\"\".\" ageAtFirstDeliveryAge at first delivery (if any)0..1integer
\".\"\".\"\".\" numberOfSexualPartnersLifetime number of sexual partners0..1integer
\".\"\".\"\".\" hasHadSTIHas the client ever had a sexually transmitted infection?0..1boolean
\".\"\".\"\".\" hivStatusHIV status0..1choiceOptions: 3 options
\".\"\".\"\".\" currentlyOnARTIf HIV-positive, currently on antiretroviral therapy?0..1booleanEnable When: hivStatus = HIV-positive (CXCA Data Dictionary#DE17)
\".\"\".\"\".\" lastScreeningDateDate of most recent prior cervical cancer screening (leave blank if never)0..1date
\".\"\".\"\".\" lastScreeningTypeType of most recent prior screening0..1choiceOptions: 3 options
\".\"\".\"\".\" lastScreeningResultResult category of most recent prior screening0..1choiceOptions: 3 options
\".\"\".\"\".\" hadHysterectomyHas the client had a hysterectomy?0..1boolean
\".\"\".\"\".\" hysterectomyForCervicalCancerIf yes, was the hysterectomy for cervical cancer?0..1booleanEnable When: hadHysterectomy = true
\".\"\".\"\".\" smokingStatusSmoking status0..1choiceOptions: 3 options
\".\"\".\"\".\" alcoholUseDoes the client consume alcohol regularly?0..1boolean
\".\"\".\"\".\" hasPostcoitalBleedingBleeding after intercourse?0..1boolean
\".\"\".\"\".\" hasIntermenstrualBleedingBleeding between menstrual periods?0..1boolean
\".\"\".\"\".\" hasUnusualDischargeUnusual vaginal discharge?0..1boolean

\"doco\" Documentation for this format

Options Sets

Answer options for hivStatus

Answer options for lastScreeningType

Answer options for lastScreeningResult

Answer options for smokingStatus

" }, "url" : "http://smart.who.int/cxca/Questionnaire/QCXCAD1", "version" : "0.0.1", "title" : "QCXCAD1 — Cervical Cancer Screening Anamnesis", "status" : "draft", "experimental" : false, "subjectType" : ["Patient"], "date" : "2026-05-14T00:50:23+00:00", "publisher" : "Dan Heslinga (independent contributor)", "contact" : [{ "name" : "Dan Heslinga (independent contributor)", "telecom" : [{ "system" : "url", "value" : "https://github.com/dhes" }] }], "description" : "Questionnaire that captures the cervical cancer screening anamnesis required by Mongolia MOH Order A/641 (2020) Op.Inst. 5.1. Paired with CXCAD1 LogicalModel; linkId values match LogicalModel element names so a StructureMap-based extraction can be authored mechanically.", "item" : [{ "linkId" : "clientAge", "text" : "Client's age in years on the encounter date", "type" : "integer", "required" : true }, { "linkId" : "clientEducation", "text" : "Highest level of education completed", "type" : "string", "required" : false }, { "linkId" : "numberOfPregnancies", "text" : "Total number of pregnancies (any outcome)", "type" : "integer", "required" : false }, { "linkId" : "numberOfBirths", "text" : "Number of live births", "type" : "integer", "required" : false }, { "linkId" : "lastMenstrualPeriod", "text" : "First day of the client's most recent menstrual period", "type" : "date", "required" : false }, { "linkId" : "currentlyPregnant", "text" : "Is the client currently pregnant?", "type" : "boolean", "required" : false }, { "linkId" : "gestationalAgeWeeks", "text" : "If currently pregnant, gestational age in weeks", "type" : "integer", "enableWhen" : [{ "question" : "currentlyPregnant", "operator" : "=", "answerBoolean" : true }], "required" : false }, { "linkId" : "currentContraception", "text" : "Current contraception method", "type" : "string", "required" : false }, { "linkId" : "pastContraception", "text" : "Past contraception methods used", "type" : "string", "required" : false }, { "linkId" : "ageAtFirstSexualContact", "text" : "Age at first sexual contact", "type" : "integer", "required" : false }, { "linkId" : "ageAtFirstDelivery", "text" : "Age at first delivery (if any)", "type" : "integer", "required" : false }, { "linkId" : "numberOfSexualPartners", "text" : "Lifetime number of sexual partners", "type" : "integer", "required" : false }, { "linkId" : "hasHadSTI", "text" : "Has the client ever had a sexually transmitted infection?", "type" : "boolean", "required" : false }, { "linkId" : "hivStatus", "text" : "HIV status", "type" : "choice", "required" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE17", "display" : "HIV-positive" } }, { "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE18", "display" : "HIV-negative" } }, { "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE19", "display" : "HIV status unknown" } }] }, { "linkId" : "currentlyOnART", "text" : "If HIV-positive, currently on antiretroviral therapy?", "type" : "boolean", "enableWhen" : [{ "question" : "hivStatus", "operator" : "=", "answerCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE17" } }], "required" : false }, { "linkId" : "lastScreeningDate", "text" : "Date of most recent prior cervical cancer screening (leave blank if never)", "type" : "date", "required" : false }, { "linkId" : "lastScreeningType", "text" : "Type of most recent prior screening", "type" : "choice", "required" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE23", "display" : "Past screening: HPV high-risk DNA test" } }, { "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE24", "display" : "Past screening: cytology only" } }, { "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE25", "display" : "Past screening: VIA (visual inspection with acetic acid)" } }] }, { "linkId" : "lastScreeningResult", "text" : "Result category of most recent prior screening", "type" : "choice", "required" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE26", "display" : "Past screening: normal / negative" } }, { "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE27", "display" : "Past screening: abnormal / positive" } }, { "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE28", "display" : "Past screening: result unknown" } }] }, { "linkId" : "hadHysterectomy", "text" : "Has the client had a hysterectomy?", "type" : "boolean", "required" : false }, { "linkId" : "hysterectomyForCervicalCancer", "text" : "If yes, was the hysterectomy for cervical cancer?", "type" : "boolean", "enableWhen" : [{ "question" : "hadHysterectomy", "operator" : "=", "answerBoolean" : true }], "required" : false }, { "linkId" : "smokingStatus", "text" : "Smoking status", "type" : "choice", "required" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE20", "display" : "Current smoker" } }, { "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE21", "display" : "Former smoker" } }, { "valueCoding" : { "system" : "http://smart.who.int/cxca/CodeSystem/CXCA.D", "code" : "DE22", "display" : "Never smoker" } }] }, { "linkId" : "alcoholUse", "text" : "Does the client consume alcohol regularly?", "type" : "boolean", "required" : false }, { "linkId" : "hasPostcoitalBleeding", "text" : "Bleeding after intercourse?", "type" : "boolean", "required" : false }, { "linkId" : "hasIntermenstrualBleeding", "text" : "Bleeding between menstrual periods?", "type" : "boolean", "required" : false }, { "linkId" : "hasUnusualDischarge", "text" : "Unusual vaginal discharge?", "type" : "boolean", "required" : false }] }