ICHOM FHIR Implementation Guide: Breast Cancer
1.0.0-ballot - ballot
ICHOM FHIR Implementation Guide: Breast Cancer
1.0.0-ballot - ballot
This page is part of the ICHOM FHIR Implementation Guide: Breast Cancer (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions 
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<ValueSet>
<id value="SACQPatientComorbidityHistory"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ValueSet</b><a name="SACQPatientComorbidityHistory"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource ValueSet "SACQPatientComorbidityHistory" </p></div><p><b>url</b>: <code>http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/SACQPatientComorbidityHistory</code></p><p><b>version</b>: 5.1</p><p><b>name</b>: SACQPatientComorbidityHistory</p><p><b>title</b>: SACQ Patient's comorbidity history ValueSet</p><p><b>status</b>: active</p><p><b>experimental</b>: false</p><p><b>publisher</b>: ICHOM</p><p><b>description</b>: Patient's documented history of comorbidities</p><p><b>copyright</b>: This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement</p><blockquote><p><b>compose</b></p><blockquote><p><b>include</b></p><p><b>system</b>: <a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">SNOMED CT (all versions)</a></p><blockquote><p><b>concept</b></p><p><b>code</b>: 373572006</p><p><b>display</b>: I have no other diseases</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 56265001</p><p><b>display</b>: Heart disease (For example, angina, heart attack, or heart failure)</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 38341003</p><p><b>display</b>: High blood pressure</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 19829001</p><p><b>display</b>: Lung disease (For example, asthma, chronic bronchitis, or emphysema)</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 73211009</p><p><b>display</b>: Diabetes</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 29384001</p><p><b>display</b>: Ulcer or stomach disease</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 90708001</p><p><b>display</b>: Kidney disease</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 235856003</p><p><b>display</b>: Liver disease</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 414022008</p><p><b>display</b>: Anemia or other blood disease</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 363346000</p><p><b>display</b>: Cancer/Other cancer (within the last 5 years)</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 35489007</p><p><b>display</b>: Depression</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 396275006</p><p><b>display</b>: Osteoarthritis, degenerative arthritis</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 161891005</p><p><b>display</b>: Back pain</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: 69896004</p><p><b>display</b>: Rheumatoid arthritis</p></blockquote></blockquote><blockquote><p><b>include</b></p><p><b>system</b>: <a href="http://terminology.hl7.org/5.0.0/CodeSystem-v3-NullFlavor.html">NullFlavor</a></p><h3>Concepts</h3><table class="grid"><tr><td>-</td><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>*</td><td>OTH</td><td>Other medical problems</td></tr></table></blockquote></blockquote></div>
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value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/SACQPatientComorbidityHistory"/>
<version value="5.1"/>
<name value="SACQPatientComorbidityHistory"/>
<title value="SACQ Patient's comorbidity history ValueSet"/>
<status value="active"/>
<experimental value="false"/>
<publisher value="ICHOM"/>
<description value="Patient's documented history of comorbidities"/>
<copyright
value="This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement"/>
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<concept>
<code value="373572006"/>
<display value="I have no other diseases"/>
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<concept>
<code value="56265001"/>
<display
value="Heart disease (For example, angina, heart attack, or heart failure)"/>
</concept>
<concept>
<code value="38341003"/>
<display value="High blood pressure"/>
</concept>
<concept>
<code value="19829001"/>
<display
value="Lung disease (For example, asthma, chronic bronchitis, or emphysema)"/>
</concept>
<concept>
<code value="73211009"/>
<display value="Diabetes"/>
</concept>
<concept>
<code value="29384001"/>
<display value="Ulcer or stomach disease"/>
</concept>
<concept>
<code value="90708001"/>
<display value="Kidney disease"/>
</concept>
<concept>
<code value="235856003"/>
<display value="Liver disease"/>
</concept>
<concept>
<code value="414022008"/>
<display value="Anemia or other blood disease"/>
</concept>
<concept>
<code value="363346000"/>
<display value="Cancer/Other cancer (within the last 5 years)"/>
</concept>
<concept>
<code value="35489007"/>
<display value="Depression"/>
</concept>
<concept>
<code value="396275006"/>
<display value="Osteoarthritis, degenerative arthritis"/>
</concept>
<concept>
<code value="161891005"/>
<display value="Back pain"/>
</concept>
<concept>
<code value="69896004"/>
<display value="Rheumatoid arthritis"/>
</concept>
</include>
<include>
<system
value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
<concept>
<code value="OTH"/>
<display value="Other medical problems"/>
</concept>
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<request>
<method value="PUT"/>
<url value="ValueSet/SACQPatientComorbidityHistory"/>
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<entry>
<resource>
<CodeSystem>
<id value="AgreementResponseCodeSystem"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: CodeSystem</b><a name="AgreementResponseCodeSystem"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource CodeSystem "AgreementResponseCodeSystem" </p></div><p><b>url</b>: <code>http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/AgreementResponseCodeSystem</code></p><p><b>version</b>: 5.1</p><p><b>name</b>: AgreementResponseCodeSystem</p><p><b>title</b>: Agreement response CodeSystem</p><p><b>status</b>: active</p><p><b>experimental</b>: false</p><p><b>publisher</b>: ICHOM</p><p><b>description</b>: Codes used in a Patient Reported Outcomes Instrument to express the degree of agreement</p><p><b>caseSensitive</b>: true</p><p><b>content</b>: complete</p><p><b>count</b>: 4</p><blockquote><p><b>concept</b></p><p><b>code</b>: no</p><p><b>display</b>: Not at all</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: little</p><p><b>display</b>: A little</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: quite</p><p><b>display</b>: Quite a bit</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: very</p><p><b>display</b>: Very much</p></blockquote></div>
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<url
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<version value="5.1"/>
<name value="AgreementResponseCodeSystem"/>
<title value="Agreement response CodeSystem"/>
<status value="active"/>
<experimental value="false"/>
<publisher value="ICHOM"/>
<description
value="Codes used in a Patient Reported Outcomes Instrument to express the degree of agreement"/>
<caseSensitive value="true"/>
<content value="complete"/>
<count value="4"/>
<concept>
<code value="no"/>
<display value="Not at all"/>
</concept>
<concept>
<code value="little"/>
<display value="A little"/>
</concept>
<concept>
<code value="quite"/>
<display value="Quite a bit"/>
</concept>
<concept>
<code value="very"/>
<display value="Very much"/>
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<method value="PUT"/>
<url value="CodeSystem/AgreementResponseCodeSystem"/>
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<entry>
<resource>
<ValueSet>
<id value="AgreementResponseVS"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ValueSet</b><a name="AgreementResponseVS"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource ValueSet "AgreementResponseVS" </p></div><p><b>url</b>: <code>http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS</code></p><p><b>version</b>: 5.1</p><p><b>name</b>: AgreementResponseVS</p><p><b>title</b>: Agreement response ValueSet</p><p><b>status</b>: active</p><p><b>experimental</b>: false</p><p><b>publisher</b>: ICHOM</p><p><b>description</b>: Valueset used in a Patient Reported Outcomes Instrument to express the degree of agreement</p><blockquote><p><b>compose</b></p><blockquote><p><b>include</b></p><p><b>system</b>: <a href="Bundle-DebugBundlePatient-02-Follow-Up.html">Agreement response CodeSystem</a></p><blockquote><p><b>concept</b></p><p><b>code</b>: no</p><p><b>display</b>: Not at all</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: little</p><p><b>display</b>: A little</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: quite</p><p><b>display</b>: Quite a bit</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: very</p><p><b>display</b>: Very much</p></blockquote></blockquote></blockquote></div>
</text>
<url
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
<version value="5.1"/>
<name value="AgreementResponseVS"/>
<title value="Agreement response ValueSet"/>
<status value="active"/>
<experimental value="false"/>
<publisher value="ICHOM"/>
<description
value="Valueset used in a Patient Reported Outcomes Instrument to express the degree of agreement"/>
<compose>
<include>
<system
value="http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/AgreementResponseCodeSystem"/>
<concept>
<code value="no"/>
<display value="Not at all"/>
</concept>
<concept>
<code value="little"/>
<display value="A little"/>
</concept>
<concept>
<code value="quite"/>
<display value="Quite a bit"/>
</concept>
<concept>
<code value="very"/>
<display value="Very much"/>
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<request>
<method value="PUT"/>
<url value="ValueSet/AgreementResponseVS"/>
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<entry>
<resource>
<CodeSystem>
<id value="SatisfactionResponseCodeSystem"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: CodeSystem</b><a name="SatisfactionResponseCodeSystem"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource CodeSystem "SatisfactionResponseCodeSystem" </p></div><p><b>url</b>: <code>http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/SatisfactionResponseCodeSystem</code></p><p><b>version</b>: 5.1</p><p><b>name</b>: SatisfactionResponseCodeSystem</p><p><b>title</b>: Satisfaction response CodeSystem</p><p><b>status</b>: active</p><p><b>experimental</b>: false</p><p><b>publisher</b>: ICHOM</p><p><b>description</b>: Codes used in a Patient Reported Outcomes Instrument to express the statisfation response</p><p><b>caseSensitive</b>: true</p><p><b>content</b>: complete</p><p><b>count</b>: 4</p><blockquote><p><b>concept</b></p><p><b>code</b>: very-dissatisfied</p><p><b>display</b>: Very dissatisfied</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: somewhat-dissatisfied</p><p><b>display</b>: Somewhat dissatisfied</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: somewhat-satisfied</p><p><b>display</b>: Somewhat satisfied</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: very-satisfied</p><p><b>display</b>: Very satisfied</p></blockquote></div>
</text>
<url
value="http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/SatisfactionResponseCodeSystem"/>
<version value="5.1"/>
<name value="SatisfactionResponseCodeSystem"/>
<title value="Satisfaction response CodeSystem"/>
<status value="active"/>
<experimental value="false"/>
<publisher value="ICHOM"/>
<description
value="Codes used in a Patient Reported Outcomes Instrument to express the statisfation response"/>
<caseSensitive value="true"/>
<content value="complete"/>
<count value="4"/>
<concept>
<code value="very-dissatisfied"/>
<display value="Very dissatisfied"/>
</concept>
<concept>
<code value="somewhat-dissatisfied"/>
<display value="Somewhat dissatisfied"/>
</concept>
<concept>
<code value="somewhat-satisfied"/>
<display value="Somewhat satisfied"/>
</concept>
<concept>
<code value="very-satisfied"/>
<display value="Very satisfied"/>
</concept>
</CodeSystem>
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<request>
<method value="PUT"/>
<url value="CodeSystem/SatisfactionResponseCodeSystem"/>
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<entry>
<resource>
<ValueSet>
<id value="SatisfactionResponseVS"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ValueSet</b><a name="SatisfactionResponseVS"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource ValueSet "SatisfactionResponseVS" </p></div><p><b>url</b>: <code>http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/SatisfactionResponseVS</code></p><p><b>version</b>: 5.1</p><p><b>name</b>: SatisfactionResponseVS</p><p><b>title</b>: Satisfaction response ValueSet</p><p><b>status</b>: active</p><p><b>experimental</b>: false</p><p><b>publisher</b>: ICHOM</p><p><b>description</b>: Valueset used in a Patient Reported Outcomes Instrument to express the statisfation response</p><blockquote><p><b>compose</b></p><blockquote><p><b>include</b></p><p><b>system</b>: <a href="Bundle-DebugBundlePatient-02-Follow-Up.html">Satisfaction response CodeSystem</a></p><blockquote><p><b>concept</b></p><p><b>code</b>: very-dissatisfied</p><p><b>display</b>: Very dissatisfied</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: somewhat-dissatisfied</p><p><b>display</b>: Somewhat dissatisfied</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: somewhat-satisfied</p><p><b>display</b>: Somewhat satisfied</p></blockquote><blockquote><p><b>concept</b></p><p><b>code</b>: very-satisfied</p><p><b>display</b>: Very satisfied</p></blockquote></blockquote></blockquote></div>
</text>
<url
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/SatisfactionResponseVS"/>
<version value="5.1"/>
<name value="SatisfactionResponseVS"/>
<title value="Satisfaction response ValueSet"/>
<status value="active"/>
<experimental value="false"/>
<publisher value="ICHOM"/>
<description
value="Valueset used in a Patient Reported Outcomes Instrument to express the statisfation response"/>
<compose>
<include>
<system
value="http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/SatisfactionResponseCodeSystem"/>
<concept>
<code value="very-dissatisfied"/>
<display value="Very dissatisfied"/>
</concept>
<concept>
<code value="somewhat-dissatisfied"/>
<display value="Somewhat dissatisfied"/>
</concept>
<concept>
<code value="somewhat-satisfied"/>
<display value="Somewhat satisfied"/>
</concept>
<concept>
<code value="very-satisfied"/>
<display value="Very satisfied"/>
</concept>
</include>
</compose>
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<request>
<method value="PUT"/>
<url value="ValueSet/SatisfactionResponseVS"/>
</request>
</entry>
<entry>
<resource>
<Questionnaire>
<id value="PatientReportedBaseline"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Questionnaire</b><a name="PatientReportedBaseline"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Questionnaire "PatientReportedBaseline" </p></div><p><b>url</b>: <code>http://hl7.org/fhir/uv/ichom-breast-cancer/Questionnaire/PatientReportedBaseline</code></p><p><b>name</b>: PatientReportedBaseline</p><p><b>title</b>: Patient reported response at baseline</p><p><b>status</b>: draft</p><p><b>experimental</b>: true</p><p><b>publisher</b>: ICHOM</p><blockquote><p><b>item</b></p><p><b>linkId</b>: General-Information-Clinical</p><p><b>text</b>: General information</p><p><b>type</b>: group</p><p><b>required</b>: true</p><h3>Items</h3><table class="grid"><tr><td>-</td><td><b>LinkId</b></td><td><b>Text</b></td><td><b>Type</b></td><td><b>Required</b></td></tr><tr><td>*</td><td>NA-Clinical</td><td>What is your medical record number?</td><td>string</td><td>true</td></tr><tr><td>*</td><td>LastName-Clinical</td><td>What is your last name?</td><td>string</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: Demographics</p><p><b>text</b>: Demographic factors</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p><p><b>linkId</b>: Sex</p><p><b>text</b>: Please indicate your sex at birth</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><p><b>answerValueSet</b>: <a href="http://hl7.org/fhir/R4/valueset-administrative-gender.html">AdministrativeGender</a></p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: COUNTRY</p><p><b>text</b>: What is your country of residence?</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><p><b>answerValueSet</b>: <a href="http://hl7.org/fhir/R4/valueset-iso3166-1-3.html">Iso 3166 Part 1: 3 Letter Codes</a></p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: Ethnicity</p><p><b>text</b>: Please indicate the ethnicity that you identify with</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><p><b>answerValueSet</b>: <a href="http://terminology.hl7.org/5.0.0/ValueSet-v3-Ethnicity.html">Ethnicity</a></p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: Race</p><p><b>text</b>: Please indicate the biological race that you identify with</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><p><b>answerValueSet</b>: <a href="http://terminology.hl7.org/5.0.0/ValueSet-v3-Race.html">Race</a></p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: EducationLevel</p><p><b>text</b>: Please indicate your highest level of schooling</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><p><b>answerValueSet</b>: <a href="ValueSet-EducationLevelVS.html">Education level of patient ValueSet</a></p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: RelationshipStatus</p><p><b>text</b>: Please indicate your current relationship status</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><p><b>answerValueSet</b>: <a href="ValueSet-RelationshipStatusVS.html">Relationship status of patient ValueSet</a></p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: MENOPAUSE</p><p><b>text</b>: Please indicate your current menopausal status</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><p><b>answerValueSet</b>: <a href="ValueSet-MenopausalStatusVS.html">Menopausal status of patient ValueSet</a></p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: Baseline-Clinical-Factors</p><p><b>text</b>: Clinical factors</p><p><b>type</b>: group</p><p><b>required</b>: true</p><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ</p><p><b>text</b>: Have you been told by a doctor that you have any of the following?</p><p><b>type</b>: choice</p><p><b>required</b>: true</p><p><b>repeats</b>: true</p><p><b>answerValueSet</b>: <a href="Bundle-DebugBundlePatient-01-Baseline.html">SACQ Patient's comorbidity history ValueSet</a></p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_HeartDiseaseFU1</p><p><b>text</b>: Do you receive treatment for heart disease (For example, angina, heart failure, or heart attack)?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_HeartDiseaseFU2</p><p><b>text</b>: Does your heart disease limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_HighBloodPressureFU1</p><p><b>text</b>: Do you receive treatment for high blood pressure?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_HighBloodPressureFU2</p><p><b>text</b>: Does your high blood pressure limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_LungDiseaseFU1</p><p><b>text</b>: Do you receive treatment for lung disease?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_LungDiseaseFU2</p><p><b>text</b>: Does your lung disease limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_DiabetesFU1</p><p><b>text</b>: Do you receive treatment for diabetes?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_DiabetesFU2</p><p><b>text</b>: Does your diabetes limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_StomachDiseaseFU1</p><p><b>text</b>: Do you receive treatment for an ulcer or stomach disease?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_StomachDiseaseFU2</p><p><b>text</b>: Does your ulcer or stomach disease limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_KidneyDiseaseFU1</p><p><b>text</b>: Do you receive treatment for kidney disease?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_KidneyDiseaseFU2</p><p><b>text</b>: Does your kidney disease limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_LiverDiseaseFU1</p><p><b>text</b>: Do you receive treatment for liver disease?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_LiverDiseaseFU2</p><p><b>text</b>: Does your liver disease limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_BloodDiseaseFU1</p><p><b>text</b>: Do you receive treatment for anemia or other blood disease?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_BloodDiseaseFU2</p><p><b>text</b>: Does your anemia or other blood disease limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_CancerFU1</p><p><b>text</b>: Do you receive treatment for cancer/another cancer?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_CancerFU2</p><p><b>text</b>: Does your cancer/other cancer limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_DepressionFU1</p><p><b>text</b>: Do you receive treatment for depression?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_DepressionFU2</p><p><b>text</b>: Does your depression limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_OsteoarthritisFU1</p><p><b>text</b>: Do you receive treatment for osteoarthritis/degenerative arthritis?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_OsteoarthritisFU2</p><p><b>text</b>: Does your osteoarthritis/degenerative arthritis limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_BackPainFU1</p><p><b>text</b>: Do you receive treatment for back pain?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_BackPainFU2</p><p><b>text</b>: Does your back pain limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_RheumatoidArthritisFU1</p><p><b>text</b>: Do you receive treatment for rheumatoid arthritis?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_RheumatoidArthritisFU2</p><p><b>text</b>: Does your rheumatoid arthritis limit your activities?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: ComorbiditiesSACQ_Other</p><p><b>text</b>: What other medical problems are you experiencing?</p><p><b>type</b>: text</p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: Treatment-Variables</p><p><b>text</b>: Treatment Variables</p><p><b>type</b>: group</p><p><b>required</b>: true</p><h3>Items</h3><table class="grid"><tr><td>-</td><td><b>LinkId</b></td><td><b>Text</b></td><td><b>Type</b></td><td><b>Required</b></td><td><b>AnswerValueSet</b></td></tr><tr><td>*</td><td>PatientEducation</td><td>Did you feel you received sufficient information about your treatment options?</td><td>choice</td><td>true</td><td><a href="ValueSet-PatientEducationVS.html">Patient Treatment Education ValueSet</a></td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: Degree-of-Health-EORTC-QLQ</p><p><b>text</b>: Degree of Health - EORTC-QLQ</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: EORTCQLQ-Question01-05</p><p><b>text</b>: We are interested in some things about you and your health. Please answer all of the questions yourself by selecting the answer that best applies to you. There are no 'right' or 'wrong' answers. The information that you provide will remain strictly confidential.</p><p><b>type</b>: group</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: EORTCQLQ-Question06-28</p><p><b>text</b>: During the past week:</p><p><b>type</b>: group</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: EORTCQLQ-Question29-30</p><p><b>text</b>: For the following questions please select the number between 1 and 7 that best applies to you, with 1 = Very poor and 7 = Excellent.</p><p><b>type</b>: group</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: EORTCQLQ-Question31-43</p><p><b>text</b>: Patients sometimes report that they have the following symptoms or problems. Please indicate the extent to which you have experienced these symptoms or problems during the past week. Please answer by selecting the answer that best applies to you. During the past week:</p><p><b>type</b>: group</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: EORTCQLQ-Question44-46</p><p><b>text</b>: During the past four weeks:</p><p><b>type</b>: group</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: EORTCQLQ-Question47-69</p><p><b>text</b>: During the past week:</p><p><b>type</b>: group</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: EORTCQLQ-Question70-71</p><p><b>text</b>: During the past four weeks:</p><p><b>type</b>: group</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: EORTCQLQ-Question72-73</p><p><b>text</b>: Please answer the following two questions only if you have been sexually active:</p><p><b>type</b>: group</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: EORTCQLQ-Question74-75</p><p><b>text</b>: During the past week:</p><p><b>type</b>: group</p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: Degree-of-Health-BreastQ</p><p><b>text</b>: Degree of Health - BreastQ:</p><p><b>type</b>: group</p><blockquote><p><b>item</b></p><p><b>linkId</b>: IntroBreastQ</p><p><b>text</b>: With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks,
how satisfied or dissatisfied have you been with:</p><p><b>type</b>: group</p></blockquote></blockquote></div>
</text>
<url
value="http://hl7.org/fhir/uv/ichom-breast-cancer/Questionnaire/PatientReportedBaseline"/>
<name value="PatientReportedBaseline"/>
<title value="Patient reported response at baseline"/>
<status value="draft"/>
<experimental value="true"/>
<publisher value="ICHOM"/>
<item>
<linkId value="General-Information-Clinical"/>
<text value="General information"/>
<type value="group"/>
<required value="true"/>
<item>
<linkId value="NA-Clinical"/>
<text value="What is your medical record number?"/>
<type value="string"/>
<required value="true"/>
</item>
<item>
<linkId value="LastName-Clinical"/>
<text value="What is your last name?"/>
<type value="string"/>
<required value="true"/>
</item>
</item>
<item>
<linkId value="Demographics"/>
<text value="Demographic factors"/>
<type value="group"/>
<required value="true"/>
<item>
<linkId value="Sex"/>
<text value="Please indicate your sex at birth"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/ValueSet/administrative-gender"/>
</item>
<item>
<linkId value="COUNTRY"/>
<text value="What is your country of residence?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet value="http://hl7.org/fhir/ValueSet/iso3166-1-3"/>
</item>
<item>
<linkId value="Ethnicity"/>
<text
value="Please indicate the ethnicity that you identify with"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://terminology.hl7.org/ValueSet/v3-Ethnicity"/>
</item>
<item>
<linkId value="Race"/>
<text
value="Please indicate the biological race that you identify with"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://terminology.hl7.org/ValueSet/v3-Race"/>
</item>
<item>
<linkId value="EducationLevel"/>
<text value="Please indicate your highest level of schooling"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/EducationLevelVS"/>
</item>
<item>
<linkId value="RelationshipStatus"/>
<text value="Please indicate your current relationship status"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/RelationshipStatusVS"/>
</item>
<item>
<linkId value="MENOPAUSE"/>
<text value="Please indicate your current menopausal status"/>
<type value="choice"/>
<enableWhen>
<question value="Sex"/>
<operator value="="/>
<answerCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="female"/>
</answerCoding>
</enableWhen>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/MenopausalStatusVS"/>
</item>
</item>
<item>
<linkId value="Baseline-Clinical-Factors"/>
<text value="Clinical factors"/>
<type value="group"/>
<required value="true"/>
<item>
<linkId value="ComorbiditiesSACQ"/>
<text
value="Have you been told by a doctor that you have any of the following?"/>
<type value="choice"/>
<required value="true"/>
<repeats value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/SACQPatientComorbidityHistory"/>
</item>
<item>
<linkId value="ComorbiditiesSACQ_HeartDiseaseFU1"/>
<text
value="Do you receive treatment for heart disease (For example, angina, heart failure, or heart attack)?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="56265001"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_HeartDiseaseFU2"/>
<text value="Does your heart disease limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="56265001"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_HighBloodPressureFU1"/>
<text value="Do you receive treatment for high blood pressure?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="38341003"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_HighBloodPressureFU2"/>
<text
value="Does your high blood pressure limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="38341003"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_LungDiseaseFU1"/>
<text value="Do you receive treatment for lung disease?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="19829001"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_LungDiseaseFU2"/>
<text value="Does your lung disease limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="19829001"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_DiabetesFU1"/>
<text value="Do you receive treatment for diabetes?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="73211009"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_DiabetesFU2"/>
<text value="Does your diabetes limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="73211009"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_StomachDiseaseFU1"/>
<text
value="Do you receive treatment for an ulcer or stomach disease?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="29384001"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_StomachDiseaseFU2"/>
<text
value="Does your ulcer or stomach disease limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="29384001"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_KidneyDiseaseFU1"/>
<text value="Do you receive treatment for kidney disease?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="90708001"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_KidneyDiseaseFU2"/>
<text value="Does your kidney disease limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="90708001"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_LiverDiseaseFU1"/>
<text value="Do you receive treatment for liver disease?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="235856003"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_LiverDiseaseFU2"/>
<text value="Does your liver disease limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="235856003"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_BloodDiseaseFU1"/>
<text
value="Do you receive treatment for anemia or other blood disease?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="414022008"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_BloodDiseaseFU2"/>
<text
value="Does your anemia or other blood disease limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="414022008"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_CancerFU1"/>
<text
value="Do you receive treatment for cancer/another cancer?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="363346000"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_CancerFU2"/>
<text
value="Does your cancer/other cancer limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="363346000"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_DepressionFU1"/>
<text value="Do you receive treatment for depression?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="35489007"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_DepressionFU2"/>
<text value="Does your depression limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="35489007"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_OsteoarthritisFU1"/>
<text
value="Do you receive treatment for osteoarthritis/degenerative arthritis?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="396275006"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_OsteoarthritisFU2"/>
<text
value="Does your osteoarthritis/degenerative arthritis limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="396275006"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_BackPainFU1"/>
<text value="Do you receive treatment for back pain?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="161891005"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_BackPainFU2"/>
<text value="Does your back pain limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="161891005"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_RheumatoidArthritisFU1"/>
<text value="Do you receive treatment for rheumatoid arthritis?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="69896004"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_RheumatoidArthritisFU2"/>
<text
value="Does your rheumatoid arthritis limit your activities?"/>
<type value="boolean"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system value="http://snomed.info/sct"/>
<code value="69896004"/>
</answerCoding>
</enableWhen>
</item>
<item>
<linkId value="ComorbiditiesSACQ_Other"/>
<text value="What other medical problems are you experiencing?"/>
<type value="text"/>
<enableWhen>
<question value="ComorbiditiesSACQ"/>
<operator value="="/>
<answerCoding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
<code value="OTH"/>
</answerCoding>
</enableWhen>
</item>
</item>
<item>
<linkId value="Treatment-Variables"/>
<text value="Treatment Variables"/>
<type value="group"/>
<required value="true"/>
<item>
<linkId value="PatientEducation"/>
<text
value="Did you feel you received sufficient information about your treatment options?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/PatientEducationVS"/>
</item>
</item>
<item>
<linkId value="Degree-of-Health-EORTC-QLQ"/>
<text value="Degree of Health - EORTC-QLQ"/>
<type value="group"/>
<item>
<linkId value="EORTCQLQ-Question01-05"/>
<text
value="We are interested in some things about you and your health. Please answer all of the questions yourself by selecting the answer that best applies to you. There are no 'right' or 'wrong' answers. The information that you provide will remain strictly confidential."/>
<type value="group"/>
<item>
<linkId value="EORTCQLQC30_Q01"/>
<text
value="Do you have any trouble doing strenuous activities, like carrying a heavy shopping bag or a suitcase?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q02"/>
<text value="Do you have any trouble taking a long walk?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q03"/>
<text
value="Do you have any trouble taking a short walk outside of the house?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q04"/>
<text
value="Do you need to stay in bed or a chair during the day?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q05"/>
<text
value="Do you need help with eating, dressing, washing yourself or using the toilet?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
</item>
<item>
<linkId value="EORTCQLQ-Question06-28"/>
<text value="During the past week:"/>
<type value="group"/>
<item>
<linkId value="EORTCQLQC30_Q06"/>
<text
value="Were you limited in doing either your work or other daily activities?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q07"/>
<text
value="Were you limited in pursuing your hobbies or other leisure time activities?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q08"/>
<text value="Were you short of breath?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q09"/>
<text value="Have you had pain?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q10"/>
<text value="Did you need to rest?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q11"/>
<text value="Have you had trouble sleeping?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q12"/>
<text value="Have you felt weak?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q13"/>
<text value="Have you lacked appetite?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q14"/>
<text value="Have you felt nauseated?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q15"/>
<text value="Have you vomited?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q16"/>
<text value="Have you been constipated?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q17"/>
<text value="Have you had diarrhea?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q18"/>
<text value="Were you tired?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q19"/>
<text value="Did pain interfere with your daily activities?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q20"/>
<text
value="Have you had difficulty in concentrating on things, like reading a newspaper or watching television?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q21"/>
<text value="Did you feel tense?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q22"/>
<text value="Did you worry?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q23"/>
<text value="Did you feel irritable?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q24"/>
<text value="Did you feel depressed?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q25"/>
<text value="Have you had difficulty remembering things?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q26"/>
<text
value="Has your physical condition or medical treatment interfered with your family life?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q27"/>
<text
value="Has your physical condition or medical treatment interfered with your social activities?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQC30_Q28"/>
<text
value="Has your physical condition or medical treatment caused you financial difficulties?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
</item>
<item>
<linkId value="EORTCQLQ-Question29-30"/>
<text
value="For the following questions please select the number between 1 and 7 that best applies to you, with 1 = Very poor and 7 = Excellent."/>
<type value="group"/>
<item>
<linkId value="EORTCQLQC30_Q29"/>
<text
value="How would you rate your overall health during the past week?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<valueInteger value="1"/>
</answerOption>
<answerOption>
<valueInteger value="2"/>
</answerOption>
<answerOption>
<valueInteger value="3"/>
</answerOption>
<answerOption>
<valueInteger value="4"/>
</answerOption>
<answerOption>
<valueInteger value="5"/>
</answerOption>
<answerOption>
<valueInteger value="6"/>
</answerOption>
<answerOption>
<valueInteger value="7"/>
</answerOption>
</item>
<item>
<linkId value="EORTCQLQC30_Q30"/>
<text
value="How would you rate your overall quality of life during the past week?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<valueInteger value="1"/>
</answerOption>
<answerOption>
<valueInteger value="2"/>
</answerOption>
<answerOption>
<valueInteger value="3"/>
</answerOption>
<answerOption>
<valueInteger value="4"/>
</answerOption>
<answerOption>
<valueInteger value="5"/>
</answerOption>
<answerOption>
<valueInteger value="6"/>
</answerOption>
<answerOption>
<valueInteger value="7"/>
</answerOption>
</item>
</item>
<item>
<linkId value="EORTCQLQ-Question31-43"/>
<text
value="Patients sometimes report that they have the following symptoms or problems. Please indicate the extent to which you have experienced these symptoms or problems during the past week. Please answer by selecting the answer that best applies to you. During the past week:"/>
<type value="group"/>
<item>
<linkId value="EORTCQLQBR23_Q31"/>
<text value="Have you had dry mouth?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q32"/>
<text value="Have food and drink tasted different than usual?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q33"/>
<text
value="Have your eyes been painful, irritated or watery?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q34"/>
<text value="Have you lost any hair?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q35"/>
<text value="Have you been upset by the loss of your hair?"/>
<type value="choice"/>
<enableWhen>
<question value="EORTCQLQBR23_Q34"/>
<operator value="!="/>
<answerCoding>
<system
value="http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/AgreementResponseCodeSystem"/>
<code value="no"/>
<display value="Not at all"/>
</answerCoding>
</enableWhen>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q36"/>
<text value="Have you felt ill or unwell?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q37"/>
<text value="Have you had hot flushes?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q38"/>
<text value="Have you had headaches?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q39"/>
<text
value="Have you felt physically less attractive as a result of your disease or treatment?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q40"/>
<text
value="Have you felt less feminine as a result of your disease or treatment?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q41"/>
<text value="Have you had problems looking at yourself naked?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q42"/>
<text value="Have you been dissatisfied with your body?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q43"/>
<text
value="Have you worried about your health in the future?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
</item>
<item>
<linkId value="EORTCQLQ-Question44-46"/>
<text value="During the past four weeks:"/>
<type value="group"/>
<item>
<linkId value="EORTCQLQBR23_Q44"/>
<text
value="Have you been sexually active? (with or without intercourse)"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q45"/>
<text
value="To what extent were you sexually active? (with or without intercourse)"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q46"/>
<text value="Has sex been enjoyable for you?"/>
<type value="choice"/>
<enableWhen>
<question value="EORTCQLQBR23_Q45"/>
<operator value="!="/>
<answerCoding>
<system
value="http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/AgreementResponseCodeSystem"/>
<code value="no"/>
<display value="Not at all"/>
</answerCoding>
</enableWhen>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
</item>
<item>
<linkId value="EORTCQLQ-Question47-69"/>
<text value="During the past week:"/>
<type value="group"/>
<item>
<linkId value="EORTCQLQBR23_Q48"/>
<text value="Have you had a swollen arm or hand?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q49"/>
<text
value="Have you had problems raising your arm or moving it sideways?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q50"/>
<text
value="Have you had any pain in the area of your affected breast?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q51"/>
<text
value="Has the area of your affected breast been swollen?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q52"/>
<text
value="Has the area of your affected breast been oversensitive?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR23_Q53"/>
<text
value="Have you had skin problems on or in the area of your affected breast (e.g., itchy, dry, flaky)?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q54"/>
<text value="Have you sweated excessively?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q55"/>
<text value="Have you had mood swings?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q56"/>
<text value="Have you been dizzy?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q57"/>
<text value="Have you had soreness in your mouth?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q58"/>
<text value="Have you had any reddening in your mouth?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q59"/>
<text value="Have you had pain in your hands or feet?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q60"/>
<text
value="Have you had any redenning on your hands or feet?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q61"/>
<text value="Have you had tingling in your fingers or toes?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q62"/>
<text value="Have you had numbness in your fingers or toes?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q63"/>
<text value="Have you had problems with your joints?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q64"/>
<text value="Have you had stiffness in your joints?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q65"/>
<text value="Have you had pain in your joints?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q66"/>
<text value="Have you had aches or pains in your bones?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q67"/>
<text value="Have you had aches or pains in your muscles?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q68"/>
<text value="Have you gained weight?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q69"/>
<text value="Has weight gain been a problem for you?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
</item>
<item>
<linkId value="EORTCQLQ-Question70-71"/>
<text value="During the past four weeks:"/>
<type value="group"/>
<item>
<linkId value="EORTCQLQBR45_Q70"/>
<text value="Have you had a dry vagina?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q71"/>
<text value="Have you had discomfort in your vagina?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
</item>
<item>
<linkId value="EORTCQLQ-Question72-73"/>
<text
value="Please answer the following two questions only if you have been sexually active:"/>
<type value="group"/>
<item>
<linkId value="EORTCQLQBR45_Q72"/>
<text
value="Have you had pain in your vagina during sexual activity?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q73"/>
<text
value="Have you experienced a dry vagina during sexual activity?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
</item>
<item>
<linkId value="EORTCQLQ-Question74-75"/>
<text value="During the past week:"/>
<type value="group"/>
<item>
<linkId value="EORTCQLQBR45_Q74"/>
<text
value="Have you been satisfied with the cosmetic result of the surgery?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
<item>
<linkId value="EORTCQLQBR45_Q75"/>
<text
value="Have you been satisfied with the appearance of the skin of your affected breast (thoracic area)?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/AgreementResponseVS"/>
</item>
</item>
</item>
<item>
<linkId value="Degree-of-Health-BreastQ"/>
<text value="Degree of Health - BreastQ:"/>
<type value="group"/>
<item>
<linkId value="IntroBreastQ"/>
<text
value="With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks,
how satisfied or dissatisfied have you been with:"/>
<type value="group"/>
<item>
<linkId value="BREASTQMAST_Q01"/>
<text value="How you look in the mirror clothed?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/SatisfactionResponseVS"/>
</item>
<item>
<linkId value="BREASTQMAST_Q02"/>
<text value="How comfortable your bras fit?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/SatisfactionResponseVS"/>
</item>
<item>
<linkId value="BREASTQMAST_Q03"/>
<text value="Being able to wear clothing that is more fitted?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/SatisfactionResponseVS"/>
</item>
<item>
<linkId value="BREASTQMAST_Q04"/>
<text value="How you look in the mirror unclothed?"/>
<type value="choice"/>
<required value="true"/>
<answerValueSet
value="http://hl7.org/fhir/uv/ichom-breast-cancer/ValueSet/SatisfactionResponseVS"/>
</item>
</item>
</item>
</Questionnaire>
</resource>
<request>
<method value="PUT"/>
<url value="Questionnaire/PatientReportedBaseline"/>
</request>
</entry>
</Bundle>
IG © 2021+ HL7 International - Clinical Interoperability Council Group. Package hl7.fhir.uv.ichom-breast-cancer#1.0.0-ballot based on FHIR 4.0.1. Generated 2022-12-07
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