This page is part of the Structured Data Capture FHIR IG (v1.6: STU 2 Ballot 1) based on FHIR v1.6.0. . For a full list of available versions, see the Directory of published versions
This is a pre-release of a future version of SDC (expected to be STU 2). The current version is STU 2.
For a full list of available versions, see the Directory of published versions .
{ "resourceType" : "QuestionnaireResponse", "id" : "questionnaireresponse-sdc-example-ussg-fht-answers", "text" : { "status" : "generated", "div" : "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: questionnaireresponse-sdc-example-ussg-fht-answers</p><p><b>questionnaire</b>: <a href="Questionnaire/questionnaire-sdc-profile-example-ussg-fht">Questionnaire/questionnaire-sdc-profile-example-ussg-fht</a></p><p><b>status</b>: in-progress</p><p><b>subject</b>: <a href="http://hl7.org/fhir/Patient/proband">http://hl7.org/fhir/Patient/proband</a></p><p><b>authored</b>: 17/01/2008</p><blockquote><p><b>item</b></p><p><b>linkId</b>: 0</p><h3>Items</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 1</p><p><b>text</b>: Your health information</p><h3>Items</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>text</b>: Family member health information</p><h3>Items</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>" }, "questionnaire" : { "reference" : "Questionnaire/questionnaire-sdc-profile-example-ussg-fht" }, "status" : "in-progress", "subject" : { "reference" : "http://hl7.org/fhir/Patient/proband" }, "authored" : "2008-01-17", "item" : [ { "linkId" : "0", "item" : [ { "linkId" : "0.1", "text" : "Date Done", "answer" : [ { "valueDate" : "2008-01-17" } } } } }, { "linkId" : "1", "text" : "Your health information", "item" : [ { "linkId" : "1.1", "item" : [ { "linkId" : "1.1.1", "text" : "Name", "answer" : [ { "valueString" : "Annie Proband" } } }, { "linkId" : "1.1.2", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "1.1.3", "text" : "Date of Birth", "answer" : [ { "valueDate" : "1966-04-04" } } }, { "linkId" : "1.1.4", "text" : "Were you born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "1.1.5", "text" : "Were you adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "1.1.6", "text" : "Are your parents related to each other in any way other than marriage?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "1.1.7", "text" : "Height", "answer" : [ { "valueDecimal" : 63, "item" : [ { "linkId" : "1.1.7.1", "item" : [ { "linkId" : "1.1.7.1.1", "text" : "Units", "answer" : [ { "valueCoding" : { "system" : "http://unitsofmeasure.org", "code" : "[in_i]", "display" : "inches" } } } } } } } } } }, { "linkId" : "1.1.8", "text" : "Weight", "answer" : [ { "valueDecimal" : 127, "item" : [ { "linkId" : "1.1.8.1", "item" : [ { "linkId" : "1.1.8.1.1", "text" : "Units", "answer" : [ { "valueCoding" : { "system" : "http://unitsofmeasure.org", "code" : "lb", "display" : "pounds" } } } } } } } } } }, { "linkId" : "1.1.9", "text" : "Body mass index (BMI) [Ratio]", "answer" : [ { "valueDecimal" : 22.5 } } }, { "linkId" : "1.1.10", "text" : "Race", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA4457-3", "display" : "White" } } } }, { "linkId" : "1.1.11", "text" : "Ethnicity", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10602-3", "display" : "-- Mexican" } }, { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10606-4", "display" : "-- South American" } } } } } } } }, { "linkId" : "2", "text" : "Family member health information", "item" : [ { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10405-1", "display" : "Daughter" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Susan" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 17 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10415-0", "display" : "Brother" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Brian" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA2-8", "display" : "Male" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 32 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } }, { "linkId" : "2.1.2", "text" : "This family member's history of disease", "item" : [ { "linkId" : "2.1.2.1", "text" : "Disease or Condition", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10550-4", "display" : "-- Other Cancer" } } } }, { "linkId" : "2.1.2.2", "text" : "Age at Diagnosis", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10397-0", "display" : "30-39" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10418-4", "display" : "Sister" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Janet" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 36 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } }, { "linkId" : "2.1.2", "text" : "This family member's history of disease", "item" : [ { "linkId" : "2.1.2.1", "text" : "Disease or Condition", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10536-3", "display" : "-- Breast Cancer" } } } }, { "linkId" : "2.1.2.2", "text" : "Age at Diagnosis", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10397-0", "display" : "30-39" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10419-2", "display" : "Nephew" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Ian" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA2-8", "display" : "Male" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 16 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10420-0", "display" : "Niece" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Helen" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 15 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10416-8", "display" : "Father" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Donald" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA2-8", "display" : "Male" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 52 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10425-9", "display" : "Paternal Uncle" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Eric" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA2-8", "display" : "Male" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 56 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10421-8", "display" : "Paternal Aunt" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Fiona" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 57 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } }, { "linkId" : "2.1.2", "text" : "This family member's history of disease", "item" : [ { "linkId" : "2.1.2.1", "text" : "Disease or Condition", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10543-9", "display" : "-- Skin Cancer" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10423-4", "display" : "Paternal Grandfather" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Bob" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA2-8", "display" : "Male" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" }, "item" : [ { "linkId" : "2.1.1.4.1", "item" : [ { "linkId" : "2.1.1.4.1.1", "text" : "Cause of Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10537-1", "display" : "-- Colon Cancer" } } } }, { "linkId" : "2.1.1.4.1.2", "text" : "Age at Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10400-2", "display" : "OVER 60" } } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } }, { "linkId" : "2.1.2", "text" : "This family member's history of disease", "item" : [ { "linkId" : "2.1.2.1", "text" : "Disease or Condition", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10537-1", "display" : "-- Colon Cancer" } } } }, { "linkId" : "2.1.2.2", "text" : "Age at Diagnosis", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10400-2", "display" : "OVER 60" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10424-2", "display" : "Paternal Grandmother" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Claire" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" }, "item" : [ { "linkId" : "2.1.1.4.1", "item" : [ { "linkId" : "2.1.1.4.1.1", "text" : "Cause of Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10589-2", "display" : "-- Other/Unexpected" }, "item" : [ { "linkId" : "2.1.1.4.1.1.1", "item" : [ { "text" : "Please specify", "answer" : [ { "valueString" : "Lou Gehrigs" } } } } } } } } }, { "linkId" : "2.1.1.4.1.2", "text" : "Age at Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10400-2", "display" : "OVER 60" } } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10417-6", "display" : "Mother" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Harriet" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" }, "item" : [ { "linkId" : "2.1.1.4.1", "item" : [ { "linkId" : "2.1.1.4.1.1", "text" : "Cause of Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10539-7", "display" : "-- Ovarian Cancer" } } } }, { "linkId" : "2.1.1.4.1.2", "text" : "Age at Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10399-6", "display" : "50-59" } } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } }, { "linkId" : "2.1.2", "text" : "This family member's history of disease", "item" : [ { "linkId" : "2.1.2.1", "text" : "Disease or Condition", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10539-7", "display" : "-- Ovarian Cancer" } } } }, { "linkId" : "2.1.2.2", "text" : "Age at Diagnosis", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10398-8", "display" : "40-49" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10414-3", "display" : "Maternal Uncle" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Rudy" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA2-8", "display" : "Male" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 60 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10410-1", "display" : "Maternal Aunt" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Julie" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 57 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10412-7", "display" : "Maternal Grandfather" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Ian" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA2-8", "display" : "Male" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" }, "item" : [ { "linkId" : "2.1.1.4.1", "item" : [ { "linkId" : "2.1.1.4.1.1", "text" : "Cause of Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10558-7", "display" : "-- Heart Attack" } } } }, { "linkId" : "2.1.1.4.1.2", "text" : "Age at Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10400-2", "display" : "OVER 60" } } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10413-5", "display" : "Maternal Grandmother" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Gladys" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" }, "item" : [ { "linkId" : "2.1.1.4.1", "item" : [ { "linkId" : "2.1.1.4.1.1", "text" : "Cause of Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10571-0", "display" : "-- Other/Unknown" } } } }, { "linkId" : "2.1.1.4.1.2", "text" : "Age at Death", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10400-2", "display" : "OVER 60" } } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } }, { "linkId" : "2.1.2", "text" : "This family member's history of disease", "item" : [ { "linkId" : "2.1.2.1", "text" : "Disease or Condition", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10536-3", "display" : "-- Breast Cancer" } } } }, { "linkId" : "2.1.2.2", "text" : "Age at Diagnosis", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10399-6", "display" : "50-59" } } } } } }, { "linkId" : "2.1.2", "text" : "This family member's history of disease", "item" : [ { "linkId" : "2.1.2.1", "text" : "Disease or Condition", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10564-5", "display" : "-- Asthma" } } } }, { "linkId" : "2.1.2.2", "text" : "Age at Diagnosis", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10395-4", "display" : "Childhood" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10411-9", "display" : "Maternal Cousin" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Karren" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 30 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } }, { "linkId" : "2.1.2", "text" : "This family member's history of disease", "item" : [ { "linkId" : "2.1.2.1", "text" : "Disease or Condition", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10536-3", "display" : "-- Breast Cancer" } } } }, { "linkId" : "2.1.2.2", "text" : "Age at Diagnosis", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10397-0", "display" : "30-39" } } } } } } } }, { "linkId" : "2.1", "item" : [ { "linkId" : "2.1.1", "item" : [ { "linkId" : "2.1.1.1", "text" : "Relationship to you", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA10411-9", "display" : "Maternal Cousin" } } } }, { "linkId" : "2.1.1.2", "text" : "Name", "answer" : [ { "valueString" : "Mary" } } }, { "linkId" : "2.1.1.3", "text" : "Gender", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA3-6", "display" : "Female" } } } }, { "linkId" : "2.1.1.4", "text" : "Living?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA33-6", "display" : "Yes" }, "item" : [ { "linkId" : "2.1.1.4.2", "item" : [ { "linkId" : "2.1.1.4.2.2", "text" : "Age", "answer" : [ { "valueDecimal" : 31 } } } } } } } } }, { "linkId" : "2.1.1.5", "text" : "Was this person born a twin?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } }, { "linkId" : "2.1.1.6", "text" : "Was this person adopted?", "answer" : [ { "valueCoding" : { "system" : "http://loinc.org", "code" : "LA32-8", "display" : "No" } } } } } } } } } } } }