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{ | |
"name": "component_oncology-family-information-v1.0", | |
"uuid": "xxxx", | |
"processor": "EncounterFormProcessor", | |
"pages": [ | |
{ | |
"label": "Family History", | |
"sections": [ | |
{ | |
"label": "Family Members' Cancer History", | |
"isExpanded": "true", | |
"questions": [ | |
{ | |
"label": "Any family member diagnosed with breast cancer?", | |
"id": "anyFamilydiag", | |
"type": "obs", | |
"required": "true", | |
"questionOptions": { | |
"rendering": "select", | |
"concept": "c9e39076-81ab-481b-8f49-4595ffd3e5db", | |
"answers": [ | |
{ | |
"concept": "a899b35c-1350-11df-a1f1-0026b9348838", | |
"label": "Yes" | |
}, | |
{ | |
"concept": "a899b42e-1350-11df-a1f1-0026b9348838", | |
"label": "No" | |
}, | |
{ | |
"concept": "a899b50a-1350-11df-a1f1-0026b9348838", | |
"label": "Unknown" | |
} | |
] | |
}, | |
"validators": [] | |
}, | |
{ | |
"label": "Any of your family members had breast cancer at or before age 50?", | |
"id": "breastCancerAtOrBefore50", | |
"type": "obs", | |
"questionOptions": { | |
"rendering": "multiCheckbox", | |
"concept": "a1bd2f6e-4cae-4555-83aa-d4dc7f3cfdde", | |
"answers": [ | |
{ | |
"concept": "a898c6f4-1350-11df-a1f1-0026b9348838", | |
"label": "Self" | |
}, | |
{ | |
"concept": "a89ebec4-1350-11df-a1f1-0026b9348838", | |
"label": "Parent" | |
}, | |
{ | |
"concept": "a898c262-1350-11df-a1f1-0026b9348838", | |
"label": "Siblings" | |
}, | |
{ | |
"concept": "a89ebdfc-1350-11df-a1f1-0026b9348838", | |
"label": "Children" | |
}, | |
{ | |
"concept": "a89c9f54-1350-11df-a1f1-0026b9348838", | |
"label": "Patenal grandparent" | |
}, | |
{ | |
"concept": "a89c9e3c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal grandparent" | |
}, | |
{ | |
"concept": "a89ca9ea-1350-11df-a1f1-0026b9348838", | |
"label": "Paternal auntie and uncle" | |
}, | |
{ | |
"concept": "a89ca06c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal auntie and uncle" | |
} | |
] | |
}, | |
"validators": [], | |
"hide": { | |
"hideWhenExpression": "isEmpty(anyFamilydiag) || anyFamilydiag !== 'a899b35c-1350-11df-a1f1-0026b9348838'" | |
} | |
}, | |
{ | |
"label": "Any of your family members had breast cancer after age 50?", | |
"id": "breastCancerAfter50", | |
"type": "obs", | |
"questionOptions": { | |
"rendering": "multiCheckbox", | |
"concept": "d3f348d2-455e-43fd-a742-ed35a1294545", | |
"answers": [ | |
{ | |
"concept": "a898c6f4-1350-11df-a1f1-0026b9348838", | |
"label": "Self" | |
}, | |
{ | |
"concept": "a89ebec4-1350-11df-a1f1-0026b9348838", | |
"label": "Parent" | |
}, | |
{ | |
"concept": "a898c262-1350-11df-a1f1-0026b9348838", | |
"label": "Siblings" | |
}, | |
{ | |
"concept": "a89ebdfc-1350-11df-a1f1-0026b9348838", | |
"label": "Children" | |
}, | |
{ | |
"concept": "a89c9f54-1350-11df-a1f1-0026b9348838", | |
"label": "Patenal grandparent" | |
}, | |
{ | |
"concept": "a89c9e3c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal grandparent" | |
}, | |
{ | |
"concept": "a89ca9ea-1350-11df-a1f1-0026b9348838", | |
"label": "Paternal auntie and uncle" | |
}, | |
{ | |
"concept": "a89ca06c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal auntie and uncle" | |
} | |
] | |
}, | |
"validators": [], | |
"hide": { | |
"hideWhenExpression": "isEmpty(anyFamilydiag) || anyFamilydiag !== 'a899b35c-1350-11df-a1f1-0026b9348838'" | |
} | |
}, | |
{ | |
"label": "Any of your male family members had breast cancer?", | |
"id": "breastCancerinMales", | |
"type": "obs", | |
"questionOptions": { | |
"rendering": "multiCheckbox", | |
"concept": "f0f164cf-e625-4f2e-a1fa-0d4fe4ca2e45", | |
"answers": [ | |
{ | |
"concept": "a898c6f4-1350-11df-a1f1-0026b9348838", | |
"label": "Self" | |
}, | |
{ | |
"concept": "a89ebec4-1350-11df-a1f1-0026b9348838", | |
"label": "Parent" | |
}, | |
{ | |
"concept": "a898c262-1350-11df-a1f1-0026b9348838", | |
"label": "Siblings" | |
}, | |
{ | |
"concept": "a89ebdfc-1350-11df-a1f1-0026b9348838", | |
"label": "Children" | |
}, | |
{ | |
"concept": "a89c9f54-1350-11df-a1f1-0026b9348838", | |
"label": "Patenal grandparent" | |
}, | |
{ | |
"concept": "a89c9e3c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal grandparent" | |
}, | |
{ | |
"concept": "a89ca9ea-1350-11df-a1f1-0026b9348838", | |
"label": "Paternal auntie and uncle" | |
}, | |
{ | |
"concept": "a89ca06c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal auntie and uncle" | |
} | |
] | |
}, | |
"validators": [], | |
"hide": { | |
"hideWhenExpression": "isEmpty(anyFamilydiag) || anyFamilydiag !== 'a899b35c-1350-11df-a1f1-0026b9348838'" | |
} | |
}, | |
{ | |
"label": "Any of your family members had ovarian cancer?", | |
"id": "ovarianCancer", | |
"type": "obs", | |
"questionOptions": { | |
"rendering": "multiCheckbox", | |
"concept": "0d1be6b3-5e0d-44df-8371-089790244a27", | |
"answers": [ | |
{ | |
"concept": "a898c6f4-1350-11df-a1f1-0026b9348838", | |
"label": "Self" | |
}, | |
{ | |
"concept": "a89ebec4-1350-11df-a1f1-0026b9348838", | |
"label": "Parent" | |
}, | |
{ | |
"concept": "a898c262-1350-11df-a1f1-0026b9348838", | |
"label": "Siblings" | |
}, | |
{ | |
"concept": "a89ebdfc-1350-11df-a1f1-0026b9348838", | |
"label": "Children" | |
}, | |
{ | |
"concept": "a89c9f54-1350-11df-a1f1-0026b9348838", | |
"label": "Patenal grandparent" | |
}, | |
{ | |
"concept": "a89c9e3c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal grandparent" | |
}, | |
{ | |
"concept": "a89ca9ea-1350-11df-a1f1-0026b9348838", | |
"label": "Paternal auntie and uncle" | |
}, | |
{ | |
"concept": "a89ca06c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal auntie and uncle" | |
} | |
] | |
}, | |
"validators": [], | |
"hide": { | |
"hideWhenExpression": "isEmpty(anyFamilydiag) || anyFamilydiag !== 'a899b35c-1350-11df-a1f1-0026b9348838'" | |
} | |
}, | |
{ | |
"label": "Any of your family member had other related cancers?", | |
"id": "otherFCancers", | |
"type": "obs", | |
"questionOptions": { | |
"rendering": "multiCheckbox", | |
"concept": "c74a2982-c64c-4a4a-8ca5-d4232f8b940e", | |
"answers": [ | |
{ | |
"concept": "a898c6f4-1350-11df-a1f1-0026b9348838", | |
"label": "Self" | |
}, | |
{ | |
"concept": "a89ebec4-1350-11df-a1f1-0026b9348838", | |
"label": "Parent" | |
}, | |
{ | |
"concept": "a898c262-1350-11df-a1f1-0026b9348838", | |
"label": "Siblings" | |
}, | |
{ | |
"concept": "a89ebdfc-1350-11df-a1f1-0026b9348838", | |
"label": "Children" | |
}, | |
{ | |
"concept": "a89c9f54-1350-11df-a1f1-0026b9348838", | |
"label": "Patenal grandparent" | |
}, | |
{ | |
"concept": "a89c9e3c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal grandparent" | |
}, | |
{ | |
"concept": "a89ca9ea-1350-11df-a1f1-0026b9348838", | |
"label": "Paternal auntie and uncle" | |
}, | |
{ | |
"concept": "a89ca06c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal auntie and uncle" | |
}, | |
{ | |
"concept": "a899e0ac-1350-11df-a1f1-0026b9348838", | |
"label": "None" | |
} | |
] | |
}, | |
"validators": [] | |
}, | |
{ | |
"type": "obsGroup", | |
"label": "Family Cancer history detailed", | |
"id": "othercancerDetail", | |
"questionOptions": { | |
"concept": "d6c78f29-a413-41ff-ab4e-a9463066d140", | |
"rendering": "group" | |
}, | |
"questions": [ | |
{ | |
"label": "If having other cancers, list below:", | |
"id": "otherCancers", | |
"type": "obs", | |
"questionOptions": { | |
"rendering": "multiCheckbox", | |
"concept": "5f221707-12d0-4770-9bc4-d4b28d4a1b09", | |
"answers": [ | |
{ | |
"concept": "9346c2e9-1f4b-4970-aa6d-1d7fbf3cafcf", | |
"label": "Thyroid cancer" | |
}, | |
{ | |
"concept": "9454da12-f3a1-496f-bb96-903221188df8", | |
"label": "Endometrical cancer" | |
}, | |
{ | |
"concept": "2b56b63b-a999-4863-810a-4bd6a6040a55", | |
"label": "Bone or soft tissue cancer" | |
}, | |
{ | |
"concept": "84d94638-c681-49de-9e49-97d8a4f2d703", | |
"label": "Sarcoma" | |
}, | |
{ | |
"concept": "f6382813-cd55-4e0f-ade2-3e2f5917feb7", | |
"label": "Adrenoctortical carcinoma" | |
}, | |
{ | |
"concept": "3163f901-b38c-4121-9039-d748495faeb2", | |
"label": "Brain cancer" | |
}, | |
{ | |
"concept": "497a4d9b-c602-4f4e-bed2-b54ee991886f", | |
"label": "Diffuse gastric cancer" | |
}, | |
{ | |
"concept": "5d5ee579-392e-4ceb-9e7d-892cbae77f44", | |
"label": "Acute leukimia" | |
} | |
] | |
}, | |
"validators": [], | |
"hide": { | |
"hideWhenExpression": "isEmpty(otherFCancers)" | |
} | |
}, | |
{ | |
"label": "Specify other related cancers:", | |
"type": "obs", | |
"questionOptions": { | |
"concept": "a8a06fc6-1350-11df-a1f1-0026b9348838", | |
"rendering": "text" | |
}, | |
"validators": [], | |
"hide": { | |
"hideWhenExpression": "isEmpty(otherFCancers)" | |
} | |
} | |
] | |
} | |
] | |
}, | |
{ | |
"label": "Family Cancer History", | |
"isExpanded": "true", | |
"questions": [ | |
{ | |
"type": "obsGroup", | |
"label": "Family Cancer history detailed", | |
"id": "familyOther", | |
"questionOptions": { | |
"concept": "d6c78f29-a413-41ff-ab4e-a9463066d140", | |
"rendering": "group" | |
}, | |
"questions": [ | |
{ | |
"label": "Any of your family members had other related cancers?", | |
"id": "familyOtherCA", | |
"type": "obs", | |
"questionOptions": { | |
"rendering": "multiCheckbox", | |
"concept": "c74a2982-c64c-4a4a-8ca5-d4232f8b940e", | |
"answers": [ | |
{ | |
"concept": "a899e0ac-1350-11df-a1f1-0026b9348838", | |
"label": "None" | |
}, | |
{ | |
"concept": "a89ebdfc-1350-11df-a1f1-0026b9348838", | |
"label": "Children" | |
}, | |
{ | |
"label": "Cousin", | |
"concept": "a89ebf78-1350-11df-a1f1-0026b9348838" | |
}, | |
{ | |
"concept": "a898c6f4-1350-11df-a1f1-0026b9348838", | |
"label": "Self" | |
}, | |
{ | |
"concept": "a89ebec4-1350-11df-a1f1-0026b9348838", | |
"label": "Parent" | |
}, | |
{ | |
"concept": "a898c262-1350-11df-a1f1-0026b9348838", | |
"label": "Siblings" | |
}, | |
{ | |
"concept": "a89c9f54-1350-11df-a1f1-0026b9348838", | |
"label": "Paternal grandparent" | |
}, | |
{ | |
"concept": "a89c9e3c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal grandparent" | |
}, | |
{ | |
"concept": "a89ca9ea-1350-11df-a1f1-0026b9348838", | |
"label": "Paternal auntie and uncle" | |
}, | |
{ | |
"concept": "a89ca06c-1350-11df-a1f1-0026b9348838", | |
"label": "Maternal auntie and uncle" | |
} | |
] | |
}, | |
"validators": [] | |
}, | |
{ | |
"label": "Specify other related cancers:", | |
"type": "obs", | |
"questionOptions": { | |
"concept": "a8a06fc6-1350-11df-a1f1-0026b9348838", | |
"rendering": "text" | |
}, | |
"validators": [], | |
"hide": { | |
"hideWhenExpression": "isEmpty(familyOtherCA) || arrayContains(['a899e0ac-1350-11df-a1f1-0026b9348838'],familyOtherCA)" | |
} | |
} | |
] | |
} | |
] | |
} | |
] | |
} | |
] | |
} |
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