SMART DAK Cervical Cancer Screening
0.0.1 - ci-build
SMART DAK Cervical Cancer Screening, published by Dan Heslinga (independent contributor). This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/dhes/smart-dak-cxca/ and changes regularly. See the Directory of published versions
| Draft as of 2026-05-14 |
JSON representation of the CXCAD1 logical model.
{
"resourceType" : "StructureDefinition",
"id" : "CXCAD1",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: StructureDefinition CXCAD1</b></p><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Minimum and Maximum # of times the element can appear in the instance\">Card.</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Additional information about the element\">Description & Constraints</a><span style=\"float: right\"><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1\" title=\"Logical model for the first-encounter intake / anamnesis used at the start of a cervical cancer screening encounter. Mirrors A/641 (2020) Op.Inst. 5.1 (p. 105). Paired with QCXCAD1 Questionnaire for data capture; the eventual SDC StructureMap will extract a filled-in QuestionnaireResponse into FHIR resources conforming to vendored smart-core profiles.\">CXCAD1</a><a name=\"CXCAD1\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;\" href=\"http://hl7.org/fhir/R4/conformance-rules.html#constraints\" title=\"This element has or is affected by constraints ( cxca-d1-pregnant-needs-gestational-age, cxca-d1-hiv-positive-needs-art-status, cxca-d1-hysterectomy-needs-indication, cxca-d1-screening-date-not-future )\">C</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://build.fhir.org/types.html#Base\">Base</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">CXCA.D1 — Cervical Cancer Screening Anamnesis<br class=\"constraint\"/><span title=\"null\" class=\"constraint\">Constraints: </span><span style=\"font-weight:bold\" title=\"If currentlyPregnant = true, gestationalAgeWeeks must be provided\" class=\"constraint\">cxca-d1-pregnant-needs-gestational-age</span><span title=\"null\" class=\"constraint\">, </span><span style=\"font-weight:bold\" title=\"If hivStatus indicates HIV-positive (CXCA.D#DE17), currentlyOnART must be provided\" class=\"constraint\">cxca-d1-hiv-positive-needs-art-status</span><span title=\"null\" class=\"constraint\">, </span><span style=\"font-weight:bold\" title=\"If hadHysterectomy = true, hysterectomyForCervicalCancer must be provided\" class=\"constraint\">cxca-d1-hysterectomy-needs-indication</span><span title=\"null\" class=\"constraint\">, </span><span style=\"font-weight:bold\" title=\"Last screening date cannot be in the future\" class=\"constraint\">cxca-d1-screening-date-not-future</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.clientAge\" title=\"Client's age in years on the encounter date\">clientAge</a><a name=\"CXCAD1.clientAge\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Client's age in years on the encounter date</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.clientEducation\" title=\"Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)\">clientEducation</a><a name=\"CXCAD1.clientEducation\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.numberOfPregnancies\" title=\"Number of pregnancies (gravidity), regardless of outcome\">numberOfPregnancies</a><a name=\"CXCAD1.numberOfPregnancies\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Number of pregnancies (gravidity), regardless of outcome</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.numberOfBirths\" title=\"Number of live births (parity)\">numberOfBirths</a><a name=\"CXCAD1.numberOfBirths\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Number of live births (parity)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.lastMenstrualPeriod\" title=\"First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.\">lastMenstrualPeriod</a><a name=\"CXCAD1.lastMenstrualPeriod\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.currentlyPregnant\" title=\"Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.\">currentlyPregnant</a><a name=\"CXCAD1.currentlyPregnant\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.gestationalAgeWeeks\" title=\"If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.\">gestationalAgeWeeks</a><a name=\"CXCAD1.gestationalAgeWeeks\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.currentContraception\" title=\"Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)\">currentContraception</a><a name=\"CXCAD1.currentContraception\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.pastContraception\" title=\"Description of past contraception methods used (free text)\">pastContraception</a><a name=\"CXCAD1.pastContraception\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Description of past contraception methods used (free text)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.ageAtFirstSexualContact\" title=\"Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.\">ageAtFirstSexualContact</a><a name=\"CXCAD1.ageAtFirstSexualContact\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.ageAtFirstDelivery\" title=\"Client's age in years at first delivery (if any). Risk factor.\">ageAtFirstDelivery</a><a name=\"CXCAD1.ageAtFirstDelivery\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Client's age in years at first delivery (if any). Risk factor.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.numberOfSexualPartners\" title=\"Lifetime number of sexual partners. Risk factor.\">numberOfSexualPartners</a><a name=\"CXCAD1.numberOfSexualPartners\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Lifetime number of sexual partners. Risk factor.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.hasHadSTI\" title=\"Whether the client has had any sexually transmitted infection. Risk factor.\">hasHadSTI</a><a name=\"CXCAD1.hasHadSTI\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Whether the client has had any sexually transmitted infection. Risk factor.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.hivStatus\" title=\"Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.\">hivStatus</a><a name=\"CXCAD1.hivStatus\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.currentlyOnART\" title=\"If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.\">currentlyOnART</a><a name=\"CXCAD1.currentlyOnART\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.lastScreeningDate\" title=\"Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.\">lastScreeningDate</a><a name=\"CXCAD1.lastScreeningDate\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.lastScreeningType\" title=\"Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).\">lastScreeningType</a><a name=\"CXCAD1.lastScreeningType\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.lastScreeningResult\" title=\"Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).\">lastScreeningResult</a><a name=\"CXCAD1.lastScreeningResult\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.hadHysterectomy\" title=\"Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.\">hadHysterectomy</a><a name=\"CXCAD1.hadHysterectomy\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.hysterectomyForCervicalCancer\" title=\"If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.\">hysterectomyForCervicalCancer</a><a name=\"CXCAD1.hysterectomyForCervicalCancer\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.smokingStatus\" title=\"Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).\">smokingStatus</a><a name=\"CXCAD1.smokingStatus\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.alcoholUse\" title=\"Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.\">alcoholUse</a><a name=\"CXCAD1.alcoholUse\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.hasPostcoitalBleeding\" title=\"Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.\">hasPostcoitalBleeding</a><a name=\"CXCAD1.hasPostcoitalBleeding\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.hasIntermenstrualBleeding\" title=\"Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.\">hasIntermenstrualBleeding</a><a name=\"CXCAD1.hasIntermenstrualBleeding\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-CXCAD1-definitions.html#CXCAD1.hasUnusualDischarge\" title=\"Whether the client reports unusual vaginal discharge.\">hasUnusualDischarge</a><a name=\"CXCAD1.hasUnusualDischarge\"> </a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Whether the client reports unusual vaginal discharge.</td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
},
"url" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1",
"version" : "0.0.1",
"name" : "CXCAD1",
"title" : "CXCA.D1 — Cervical Cancer Screening Anamnesis",
"status" : "draft",
"experimental" : false,
"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" : "Logical model for the first-encounter intake / anamnesis used at the start of a cervical cancer screening encounter. Mirrors A/641 (2020) Op.Inst. 5.1 (p. 105). Paired with QCXCAD1 Questionnaire for data capture; the eventual SDC StructureMap will extract a filled-in QuestionnaireResponse into FHIR resources conforming to vendored smart-core profiles.",
"fhirVersion" : "4.0.1",
"kind" : "logical",
"abstract" : false,
"type" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1",
"baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Base",
"derivation" : "specialization",
"snapshot" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString" : "4.0.1"
}
],
"element" : [
{
"id" : "CXCAD1",
"path" : "CXCAD1",
"short" : "CXCA.D1 — Cervical Cancer Screening Anamnesis",
"definition" : "Logical model for the first-encounter intake / anamnesis used at the start of a cervical cancer screening encounter. Mirrors A/641 (2020) Op.Inst. 5.1 (p. 105). Paired with QCXCAD1 Questionnaire for data capture; the eventual SDC StructureMap will extract a filled-in QuestionnaireResponse into FHIR resources conforming to vendored smart-core profiles.",
"min" : 0,
"max" : "*",
"base" : {
"path" : "Base",
"min" : 0,
"max" : "*"
},
"constraint" : [
{
"key" : "cxca-d1-pregnant-needs-gestational-age",
"severity" : "error",
"human" : "If currentlyPregnant = true, gestationalAgeWeeks must be provided",
"expression" : "currentlyPregnant.empty() or currentlyPregnant = false or gestationalAgeWeeks.exists()",
"source" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1"
},
{
"key" : "cxca-d1-hiv-positive-needs-art-status",
"severity" : "error",
"human" : "If hivStatus indicates HIV-positive (CXCA.D#DE17), currentlyOnART must be provided",
"expression" : "hivStatus.empty() or hivStatus.code != 'DE17' or currentlyOnART.exists()",
"source" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1"
},
{
"key" : "cxca-d1-hysterectomy-needs-indication",
"severity" : "error",
"human" : "If hadHysterectomy = true, hysterectomyForCervicalCancer must be provided",
"expression" : "hadHysterectomy.empty() or hadHysterectomy = false or hysterectomyForCervicalCancer.exists()",
"source" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1"
},
{
"key" : "cxca-d1-screening-date-not-future",
"severity" : "error",
"human" : "Last screening date cannot be in the future",
"expression" : "lastScreeningDate.empty() or lastScreeningDate <= today()",
"source" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1"
}
],
"isModifier" : false
},
{
"id" : "CXCAD1.clientAge",
"path" : "CXCAD1.clientAge",
"short" : "Client's age in years on the encounter date",
"definition" : "Client's age in years on the encounter date",
"min" : 1,
"max" : "1",
"base" : {
"path" : "CXCAD1.clientAge",
"min" : 1,
"max" : "1"
},
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.clientEducation",
"path" : "CXCAD1.clientEducation",
"short" : "Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)",
"definition" : "Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.clientEducation",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
]
},
{
"id" : "CXCAD1.numberOfPregnancies",
"path" : "CXCAD1.numberOfPregnancies",
"short" : "Number of pregnancies (gravidity), regardless of outcome",
"definition" : "Number of pregnancies (gravidity), regardless of outcome",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.numberOfPregnancies",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.numberOfBirths",
"path" : "CXCAD1.numberOfBirths",
"short" : "Number of live births (parity)",
"definition" : "Number of live births (parity)",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.numberOfBirths",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.lastMenstrualPeriod",
"path" : "CXCAD1.lastMenstrualPeriod",
"short" : "First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.",
"definition" : "First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.lastMenstrualPeriod",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "date"
}
]
},
{
"id" : "CXCAD1.currentlyPregnant",
"path" : "CXCAD1.currentlyPregnant",
"short" : "Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.",
"definition" : "Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.currentlyPregnant",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.gestationalAgeWeeks",
"path" : "CXCAD1.gestationalAgeWeeks",
"short" : "If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.",
"definition" : "If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.gestationalAgeWeeks",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.currentContraception",
"path" : "CXCAD1.currentContraception",
"short" : "Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)",
"definition" : "Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.currentContraception",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
]
},
{
"id" : "CXCAD1.pastContraception",
"path" : "CXCAD1.pastContraception",
"short" : "Description of past contraception methods used (free text)",
"definition" : "Description of past contraception methods used (free text)",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.pastContraception",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "string"
}
]
},
{
"id" : "CXCAD1.ageAtFirstSexualContact",
"path" : "CXCAD1.ageAtFirstSexualContact",
"short" : "Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.",
"definition" : "Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.ageAtFirstSexualContact",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.ageAtFirstDelivery",
"path" : "CXCAD1.ageAtFirstDelivery",
"short" : "Client's age in years at first delivery (if any). Risk factor.",
"definition" : "Client's age in years at first delivery (if any). Risk factor.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.ageAtFirstDelivery",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.numberOfSexualPartners",
"path" : "CXCAD1.numberOfSexualPartners",
"short" : "Lifetime number of sexual partners. Risk factor.",
"definition" : "Lifetime number of sexual partners. Risk factor.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.numberOfSexualPartners",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.hasHadSTI",
"path" : "CXCAD1.hasHadSTI",
"short" : "Whether the client has had any sexually transmitted infection. Risk factor.",
"definition" : "Whether the client has had any sexually transmitted infection. Risk factor.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.hasHadSTI",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hivStatus",
"path" : "CXCAD1.hivStatus",
"short" : "Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.",
"definition" : "Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.hivStatus",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Coding"
}
]
},
{
"id" : "CXCAD1.currentlyOnART",
"path" : "CXCAD1.currentlyOnART",
"short" : "If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.",
"definition" : "If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.currentlyOnART",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.lastScreeningDate",
"path" : "CXCAD1.lastScreeningDate",
"short" : "Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.",
"definition" : "Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.lastScreeningDate",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "date"
}
]
},
{
"id" : "CXCAD1.lastScreeningType",
"path" : "CXCAD1.lastScreeningType",
"short" : "Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).",
"definition" : "Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.lastScreeningType",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Coding"
}
]
},
{
"id" : "CXCAD1.lastScreeningResult",
"path" : "CXCAD1.lastScreeningResult",
"short" : "Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).",
"definition" : "Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.lastScreeningResult",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Coding"
}
]
},
{
"id" : "CXCAD1.hadHysterectomy",
"path" : "CXCAD1.hadHysterectomy",
"short" : "Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.",
"definition" : "Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.hadHysterectomy",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hysterectomyForCervicalCancer",
"path" : "CXCAD1.hysterectomyForCervicalCancer",
"short" : "If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.",
"definition" : "If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.hysterectomyForCervicalCancer",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.smokingStatus",
"path" : "CXCAD1.smokingStatus",
"short" : "Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).",
"definition" : "Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.smokingStatus",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "Coding"
}
]
},
{
"id" : "CXCAD1.alcoholUse",
"path" : "CXCAD1.alcoholUse",
"short" : "Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.",
"definition" : "Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.alcoholUse",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hasPostcoitalBleeding",
"path" : "CXCAD1.hasPostcoitalBleeding",
"short" : "Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.",
"definition" : "Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.hasPostcoitalBleeding",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hasIntermenstrualBleeding",
"path" : "CXCAD1.hasIntermenstrualBleeding",
"short" : "Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.",
"definition" : "Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.hasIntermenstrualBleeding",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hasUnusualDischarge",
"path" : "CXCAD1.hasUnusualDischarge",
"short" : "Whether the client reports unusual vaginal discharge.",
"definition" : "Whether the client reports unusual vaginal discharge.",
"min" : 0,
"max" : "1",
"base" : {
"path" : "CXCAD1.hasUnusualDischarge",
"min" : 0,
"max" : "1"
},
"type" : [
{
"code" : "boolean"
}
]
}
]
},
"differential" : {
"element" : [
{
"id" : "CXCAD1",
"path" : "CXCAD1",
"short" : "CXCA.D1 — Cervical Cancer Screening Anamnesis",
"definition" : "Logical model for the first-encounter intake / anamnesis used at the start of a cervical cancer screening encounter. Mirrors A/641 (2020) Op.Inst. 5.1 (p. 105). Paired with QCXCAD1 Questionnaire for data capture; the eventual SDC StructureMap will extract a filled-in QuestionnaireResponse into FHIR resources conforming to vendored smart-core profiles.",
"constraint" : [
{
"key" : "cxca-d1-pregnant-needs-gestational-age",
"severity" : "error",
"human" : "If currentlyPregnant = true, gestationalAgeWeeks must be provided",
"expression" : "currentlyPregnant.empty() or currentlyPregnant = false or gestationalAgeWeeks.exists()",
"source" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1"
},
{
"key" : "cxca-d1-hiv-positive-needs-art-status",
"severity" : "error",
"human" : "If hivStatus indicates HIV-positive (CXCA.D#DE17), currentlyOnART must be provided",
"expression" : "hivStatus.empty() or hivStatus.code != 'DE17' or currentlyOnART.exists()",
"source" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1"
},
{
"key" : "cxca-d1-hysterectomy-needs-indication",
"severity" : "error",
"human" : "If hadHysterectomy = true, hysterectomyForCervicalCancer must be provided",
"expression" : "hadHysterectomy.empty() or hadHysterectomy = false or hysterectomyForCervicalCancer.exists()",
"source" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1"
},
{
"key" : "cxca-d1-screening-date-not-future",
"severity" : "error",
"human" : "Last screening date cannot be in the future",
"expression" : "lastScreeningDate.empty() or lastScreeningDate <= today()",
"source" : "http://smart.who.int/cxca/StructureDefinition/CXCAD1"
}
]
},
{
"id" : "CXCAD1.clientAge",
"path" : "CXCAD1.clientAge",
"short" : "Client's age in years on the encounter date",
"definition" : "Client's age in years on the encounter date",
"min" : 1,
"max" : "1",
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.clientEducation",
"path" : "CXCAD1.clientEducation",
"short" : "Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)",
"definition" : "Client's highest level of education completed (free text in this iteration; may be coded against an ISCED valueset in a future iteration)",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "string"
}
]
},
{
"id" : "CXCAD1.numberOfPregnancies",
"path" : "CXCAD1.numberOfPregnancies",
"short" : "Number of pregnancies (gravidity), regardless of outcome",
"definition" : "Number of pregnancies (gravidity), regardless of outcome",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.numberOfBirths",
"path" : "CXCAD1.numberOfBirths",
"short" : "Number of live births (parity)",
"definition" : "Number of live births (parity)",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.lastMenstrualPeriod",
"path" : "CXCAD1.lastMenstrualPeriod",
"short" : "First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.",
"definition" : "First day of the client's most recent menstrual period. Drives sample-collection timing — per A/641 Op.Inst. 5.1 section 10, samples should not be collected during heavy menstrual flow.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "date"
}
]
},
{
"id" : "CXCAD1.currentlyPregnant",
"path" : "CXCAD1.currentlyPregnant",
"short" : "Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.",
"definition" : "Whether the client is currently pregnant. Pregnant women in the first 3 months may be opportunistically included in screening per A/641 section 2.2.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.gestationalAgeWeeks",
"path" : "CXCAD1.gestationalAgeWeeks",
"short" : "If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.",
"definition" : "If currently pregnant, gestational age in weeks. Required if currentlyPregnant = true.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.currentContraception",
"path" : "CXCAD1.currentContraception",
"short" : "Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)",
"definition" : "Description of the client's current contraception method (free text; will bind to a contraception-method valueset when smart-core's medicationstatement-current-contraceptive-methods profile is vendored)",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "string"
}
]
},
{
"id" : "CXCAD1.pastContraception",
"path" : "CXCAD1.pastContraception",
"short" : "Description of past contraception methods used (free text)",
"definition" : "Description of past contraception methods used (free text)",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "string"
}
]
},
{
"id" : "CXCAD1.ageAtFirstSexualContact",
"path" : "CXCAD1.ageAtFirstSexualContact",
"short" : "Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.",
"definition" : "Client's age in years at first sexual contact. Risk factor — earlier age is associated with higher cervical cancer risk.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.ageAtFirstDelivery",
"path" : "CXCAD1.ageAtFirstDelivery",
"short" : "Client's age in years at first delivery (if any). Risk factor.",
"definition" : "Client's age in years at first delivery (if any). Risk factor.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.numberOfSexualPartners",
"path" : "CXCAD1.numberOfSexualPartners",
"short" : "Lifetime number of sexual partners. Risk factor.",
"definition" : "Lifetime number of sexual partners. Risk factor.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "integer"
}
]
},
{
"id" : "CXCAD1.hasHadSTI",
"path" : "CXCAD1.hasHadSTI",
"short" : "Whether the client has had any sexually transmitted infection. Risk factor.",
"definition" : "Whether the client has had any sexually transmitted infection. Risk factor.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hivStatus",
"path" : "CXCAD1.hivStatus",
"short" : "Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.",
"definition" : "Client's HIV status. Bound to CXCA.D codes DE17 (HIV-positive), DE18 (HIV-negative), DE19 (HIV status unknown). Per WHO, WLHIV are 6× more likely to develop cervical cancer.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Coding"
}
]
},
{
"id" : "CXCAD1.currentlyOnART",
"path" : "CXCAD1.currentlyOnART",
"short" : "If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.",
"definition" : "If HIV-positive, whether the client is currently on antiretroviral therapy. Required (per FHIRPath invariant) when hivStatus indicates HIV-positive.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.lastScreeningDate",
"path" : "CXCAD1.lastScreeningDate",
"short" : "Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.",
"definition" : "Date of the client's most recent prior cervical cancer screening, if any. Drives the recall-cycle / not-due-in-cycle decision.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "date"
}
]
},
{
"id" : "CXCAD1.lastScreeningType",
"path" : "CXCAD1.lastScreeningType",
"short" : "Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).",
"definition" : "Type of the most recent prior screening. Bound to CXCA.D codes DE23 (HPV), DE24 (cytology), DE25 (VIA).",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Coding"
}
]
},
{
"id" : "CXCAD1.lastScreeningResult",
"path" : "CXCAD1.lastScreeningResult",
"short" : "Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).",
"definition" : "Result category of the most recent prior screening. Bound to CXCA.D codes DE26 (normal), DE27 (abnormal), DE28 (unknown).",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Coding"
}
]
},
{
"id" : "CXCAD1.hadHysterectomy",
"path" : "CXCAD1.hadHysterectomy",
"short" : "Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.",
"definition" : "Whether the client has had a hysterectomy. Drives the eligibility-exclusion check per A/641 section 2.2.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hysterectomyForCervicalCancer",
"path" : "CXCAD1.hysterectomyForCervicalCancer",
"short" : "If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.",
"definition" : "If hadHysterectomy = true, whether the indication was cervical cancer (in which case the screening exclusion does NOT apply per A/641 section 2.2). Required when hadHysterectomy = true.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.smokingStatus",
"path" : "CXCAD1.smokingStatus",
"short" : "Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).",
"definition" : "Client's smoking status. Bound to CXCA.D codes DE20 (current), DE21 (former), DE22 (never).",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "Coding"
}
]
},
{
"id" : "CXCAD1.alcoholUse",
"path" : "CXCAD1.alcoholUse",
"short" : "Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.",
"definition" : "Whether the client consumes alcohol regularly. Documented as a risk factor per A/641 section 1.3.2.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hasPostcoitalBleeding",
"path" : "CXCAD1.hasPostcoitalBleeding",
"short" : "Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.",
"definition" : "Whether the client reports bleeding after intercourse. May indicate cervical pathology — flag for clinician attention.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hasIntermenstrualBleeding",
"path" : "CXCAD1.hasIntermenstrualBleeding",
"short" : "Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.",
"definition" : "Whether the client reports bleeding between menstrual periods. May indicate cervical pathology.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
]
},
{
"id" : "CXCAD1.hasUnusualDischarge",
"path" : "CXCAD1.hasUnusualDischarge",
"short" : "Whether the client reports unusual vaginal discharge.",
"definition" : "Whether the client reports unusual vaginal discharge.",
"min" : 0,
"max" : "1",
"type" : [
{
"code" : "boolean"
}
]
}
]
}
}