PanCareSurPass Project HL7 FHIR Implementation Guide, published by PanCareSurPass Project. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/pcsp/ and changes regularly. See the Directory of published versions
Official URL: http://hl7.eu/fhir/ig/pcsp/Questionnaire/FollowupSurPass | Version: 0.2.0 | |||
Draft as of 2025-09-03 | Computable Name: FollowupSurPass |
Follow up form. The first Followup-Surpass form must be completed at the same time as the SurPass is delivered or in any case at the first visit after the end of the treatment (OT).
LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
---|---|---|---|---|---|
![]() ![]() | Follow up form. The first Followup-Surpass form must be completed at the same time as the SurPass is delivered or in any case at the first visit after the end of the treatment (OT). | Questionnaire | http://hl7.eu/fhir/ig/pcsp/Questionnaire/FollowupSurPass#0.2.0 | ||
![]() ![]() ![]() | First visit? | 1..1 | choice | Value Set: YesNoVS | |
![]() ![]() ![]() | Informed consent to participate in the Followup-SurPass | 1..1 | choice | Enable When: first-visit = Value Set: YesNoVS | |
![]() ![]() ![]() | Consent date | 0..1 | date | ![]() ![]() | Enable When: first-visit = |
![]() ![]() ![]() | Visit date | 1..1 | date | ||
![]() ![]() ![]() | Predisposing genetic syndromes or clinical conditions associated with the tumor diagnosed after the first off-therapy | 0..1 | choice | Enable When: first-visit = Value Set: YesNoVS | |
![]() ![]() ![]() ![]() | If yes, specify | 1..1 | text | Enable When: new-cancer-after-off-therapy = | |
![]() ![]() ![]() | Other clinical pictures, not associated with the tumor at the time of diagnosis | 0..1 | choice | Enable When: first-visit = Value Set: YesNoVS | |
![]() ![]() ![]() ![]() | If yes, specify | 1..1 | text | Enable When: other-clinical = | |
![]() ![]() ![]() | After the first off therapy the patient experienced one or more pathological conditions | 1..1 | choice | Enable When: first-visit = Value Set: YesNoVS | |
![]() ![]() ![]() ![]() | Pathological conditions | 1..* | group | Enable When: new-condition-after-off-therapy = | |
![]() ![]() ![]() ![]() ![]() | Condition | 1..1 | choice | Value Set: Conditions: follow up | |
![]() ![]() ![]() ![]() ![]() | null | 0..1 | text | ![]() ![]() | Initial Value: string = This space will contain guidance for the selected condition. Content is not yet available. |
![]() ![]() ![]() ![]() ![]() | If other, specify | 1..1 | text | Enable When:
| |
![]() ![]() ![]() ![]() ![]() | Onset date | 1..1 | date | ||
![]() ![]() ![]() ![]() ![]() | Grading m-CTCAE at onset/last visit | 1..1 | choice | Value Set: Grade: follow up | |
![]() ![]() ![]() ![]() ![]() | Evolution | 1..1 | choice | Options: 2 options | |
![]() ![]() ![]() ![]() ![]() | If yes, date | 1..1 | date | Enable When: condition-evolution-1 = | |
![]() ![]() ![]() ![]() ![]() | If changed, new grading | 1..1 | choice | Enable When: condition-evolution-1 = Value Set: Grade: follow up | |
![]() ![]() ![]() ![]() ![]() | Details | 0..1 | text | ||
![]() ![]() ![]() ![]() ![]() | Next check-up planned on | 0..1 | text | ||
![]() ![]() ![]() | Have any pathological conditions that were still present (unresolved) at the previous visit resolved or changed in degree? | 1..1 | choice | Enable When: first-visit = Value Set: YesNoNAVS | |
![]() ![]() ![]() ![]() | Pathological conditions | 1..* | group | Enable When: | |
![]() ![]() ![]() ![]() ![]() | Condition | 1..1 | choice | Value Set: Conditions: follow up | |
![]() ![]() ![]() ![]() ![]() | null | 0..1 | text | ![]() ![]() | Initial Value: string = This space will contain guidance for the selected condition. Content is not yet available. |
![]() ![]() ![]() ![]() ![]() | If other, specify | 1..1 | text | Enable When:
| |
![]() ![]() ![]() ![]() ![]() | Onset date | 1..1 | date | ||
![]() ![]() ![]() ![]() ![]() | Grading m-CTCAE at onset/last visit | 1..1 | choice | Value Set: Grade: follow up | |
![]() ![]() ![]() ![]() ![]() | Evolution | 1..1 | choice | Enable When: condition-changed = Options: 3 options | |
![]() ![]() ![]() ![]() ![]() | If yes, date | 1..1 | date | Enable When: condition-evolution-2 = | |
![]() ![]() ![]() ![]() ![]() | If changed, new grading | 1..1 | choice | Enable When: condition-evolution-2 = Value Set: Grade: follow up | |
![]() ![]() ![]() ![]() ![]() | Details | 0..1 | text | ||
![]() ![]() ![]() ![]() ![]() | Next check-up planned on | 0..1 | text | ||
![]() ![]() ![]() | After the first off therapy the patient experienced one or more pathological conditions? | 0..1 | choice | Enable When: first-visit = Value Set: YesNoVS | |
![]() ![]() ![]() ![]() | Pathological conditions | 1..* | group | Enable When: new-cancer-after-last-visit = | |
![]() ![]() ![]() ![]() ![]() | Condition | 1..1 | choice | Value Set: Conditions: follow up | |
![]() ![]() ![]() ![]() ![]() | null | 0..1 | text | ![]() ![]() | Initial Value: string = This space will contain guidance for the selected condition. Content is not yet available. |
![]() ![]() ![]() ![]() ![]() | If other, specify | 1..1 | text | Enable When:
| |
![]() ![]() ![]() ![]() ![]() | Onset date | 1..1 | date | ||
![]() ![]() ![]() ![]() ![]() | Grading m-CTCAE at onset/last visit | 1..1 | choice | Value Set: Grade: follow up | |
![]() ![]() ![]() ![]() ![]() | Evolution | 1..1 | choice | Options: 2 options | |
![]() ![]() ![]() ![]() ![]() | If yes, date | 1..1 | date | Enable When: condition-evolution-3 = | |
![]() ![]() ![]() ![]() ![]() | If changed, new grading | 1..1 | choice | Enable When: condition-evolution-3 = Value Set: Grade: follow up | |
![]() ![]() ![]() ![]() ![]() | Details | 0..1 | text | ||
![]() ![]() ![]() ![]() ![]() | Next check-up planned on | 0..1 | text | ||
![]() ![]() ![]() | Notes | 0..1 | string | ||
![]() ![]() ![]() | Reports relating to significant laboratory instrumental tests | 0..* | attachment | ||
Options Sets
Answer options for condition-evolution-1
Answer options for condition-evolution-2
Answer options for condition-evolution-3
http://loinc.org
Code | Display |
LA32-8 | NO |
LA33-6 | YES |
http://loinc.org
Code | Display |
LA32-8 | NO |
LA33-6 | YES |
LA30226-7 | Not applicable (N/A) |