Generated Narrative: Questionnaire PrivateColposcopyVisitQuestionnaire Structure LinkID Text Cardinality Type Description & Constraints PrivateColposcopyVisitQuestionnaire Questionnaire https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/PrivateColposcopyVisitQuestionnaire#0.1.1 #xD; p01-ClinicInformation page 01. Clinic Information 0..1 group #xD; p01-q01-ClinicName page 01 question 1. Colposcopy HPI facility ID 0..1 reference #xD; p02-VisitInformation page 02. Colposcopy Visit 0..1 group #xD; p02-q01-VisitDate page 02 question 1. Date of Visit 1..1 date #xD; p02-q02-AdmissionType page 02 question 2. Admission Type 1..1 choice Options: 3 options #xD; p02-q03-ColposcopyPerformed page 02 question 3. Colposcopy Performed 1..1 boolean #xD; p02-q04-ColposcopySite page 02 question 4. Colposcopy Site 1..1 choice Options: 4 options #xD; p02-q05-ColposcopySiteOther page 02 question 5. Please describe the Alternative Site 1..1 text Enable When: p02-q04-ColposcopySite = #xD; p02-q06-ResultsDiscussed page 02 question 6. Review / Results Discussed? 1..1 boolean #xD; p02-q07-ArrangedTreatment page 02 question 7. Arranged Treatment? 1..1 boolean #xD; p03-ColposcopyFindings page 03. Colposcopy Findings 0..1 group #xD; p03-q01-HysterectomyStatus page 03 question 1. Patient has total hysterectomy? 1..1 boolean #xD; p03-q02-SquamocolumnarJunction page 03 question 2. Squamocolumnar junction visible 1..1 choice Enable When: p03-q01-HysterectomyStatus = Options: 3 options #xD; p03-q03-TransformationZone page 03 question 3. Transformation Zone type 1..1 choice Enable When: p03-q01-HysterectomyStatus = Options: 3 options #xD; p03-q04-LesionPresent page 03 question 4. Lesion Present 1..1 choice Options: 3 options #xD; p03-q05-QuandrantsInvolved page 03 question 5. Number of Quadrants Involved 1..1 choice Enable When: p03-q04-LesionPresent = Options: 4 options #xD; p03-q06-ColposcopicAppearance page 03 question 6. Colposcopic appearance 1..1 choice Options: 3 options #xD; p03-q07-LesionVisible page 03 question 7. Limits of Lesion Visible 1..1 boolean Enable When: p03-q04-LesionPresent = #xD; p03-q08-AbnormalityGrade page 03 question 8. Predicted Grade of Abnormality 1..1 choice Enable When: p03-q06-ColposcopicAppearance = Options: 5 options #xD; p04-ActionsTaken page 04. Actions Taken 0..1 group #xD; p04-q01-CervicalSample page 04 question 1. Cervical / vaginal sample 1..1 choice Options: 4 options #xD; p04-q02-PunchBiopsy page 04 question 2. Punch biopsy 1..1 boolean #xD; p04-q03-BiopsySite page 04 question 3. Site of Biopsy(s) 1..1 text Enable When: p04-q02-PunchBiopsy = #xD; p04-q04-BiopsyReason page 04 question 4. Reason for not taking biopsy(s) 1..1 choice Enable When: p04-q02-PunchBiopsy = Options: 4 options #xD; p04-q05-BiopsyReasonOther page 04 question 5. Other Reason for biopsy not taken 1..1 text Enable When: p04-q04-BiopsyReason = #xD; p04-q06-TreatmentTaken page 04 question 6. Treatment this visit 1..1 boolean #xD; p04-q07-TreatmentType page 04 question 7. Type of treatment 1..1 choice Enable When: p04-q06-TreatmentTaken = Options: 8 options #xD; p04-q08-AnaesthesiaUsed page 04 question 8. Local or general anaesthesia used 1..1 choice Options: 3 options #xD; p04-q09-AnaesthesiaReason page 04 question 9. Reason for General Anasthesia 1..1 text Enable When: p04-q08-AnaesthesiaUsed = #xD; p04-q09.1-AnaesthesiaReasonHelpText page 04 question 9.1. This information is required as 80% of anaesthesia should be local 0..1 display #xD; p05-DataRecieved page 05. Data Recieved 0..1 group #xD; p05-q01-HistologyReport page 05 question 1. Date histology specimen report received 0..1 date #xD; p05-q02-DecisionDate page 05 question 2. Decision to treat date 0..1 date #xD; p05-q03-InformParticipantDate page 05 question 3. Date participant informed 0..1 date #xD; p05-q04-FollowupRecommended page 05 question 4. Follow-up management at colposcopy recommended 0..1 boolean #xD; p05-q05-NextVisit page 05 question 5. Next visit recommended in (months 1..1 choice Enable When: p05-q04-FollowupRecommended = Options: 15 options #xD; Documentation for this format Options Sets Answer options for p02-q02-AdmissionType null#O ("Outpatient") null#D ("Day Patient") null#I ("Inpatient") Answer options for p02-q04-ColposcopySite null#R ("Cervical") null#V ("Vaginal") null#B ("Both Cervical and Vaginal") null#null ("Other") Answer options for p03-q02-SquamocolumnarJunction null#COMPL ("Completely") null#PART ("Partially") null#NVIS ("Not Visible") Answer options for p03-q03-TransformationZone null#COMPL ("Completely") null#PART ("Partially") null#NVIS ("Not Visible") Answer options for p03-q04-LesionPresent null#Y ("Yes") null#N ("No") null#null ("Inconclusive") Answer options for p03-q05-QuandrantsInvolved null#null ("1") null#null ("2") null#null ("3") null#null ("4") Answer options for p03-q06-ColposcopicAppearance null#NRML ("Normal") null#ABML ("Abnormal") null#INCON ("Inconclusive") Answer options for p03-q08-AbnormalityGrade null#Low-Grade Squamous ("Low-Grade Squamous") null#ABML ("High-Grade Squamous") null#INCON ("Glandular (AIS)") null#INCON ("Micro-invasive cancer") null#INCON ("Invasive cancer (squamous/glandular)") Answer options for p04-q01-CervicalSample null#RPT ("Cervical / Vaginal Smear") null#HPV ("HPV test") null#null ("Neither") null#null ("Both") Answer options for p04-q04-BiopsyReason null#null ("Declined") null#null ("Pregnant") null#null ("Discarded as inadequate") null#null ("Other") Answer options for p04-q07-TreatmentType null#ELCT ("Wireloop excisional procedure") null#LASA ("Laser ablation") null#null ("Ablation by means other than laser") null#CKNF ("Cold knife cone biopsy cervix") null#DIC ("Diathermy cone") null#LASE ("Laser cone") null#HYST ("Total hysterectomy") null#SUBH ("Sub-total hysterectomy") Answer options for p04-q08-AnaesthesiaUsed null#GEN ("General") null#LOCAL ("Local") null#NA ("N/A") Answer options for p05-q05-NextVisit null#7D ("7 Days") null#2W ("2 Weeks") null#6W ("6 Weeks") null#1M ("1 Month") null#2M ("2 Months") null#3M ("3 Months") null#4M ("4 Months") null#5M ("5 Months") null#6M ("6 Months") null#7M ("7 Months") null#9M ("9 Months") null#12M ("12 Months") null#18M ("18 Months") null#36M ("36 Months") null#60M ("60 Months")
Private Colposcopy Visit Summary Questionnaire
To gather the Visit details of Private Colposcopy procedure.
This information is required as 80% of anaesthesia should be local
Follow-up management at colposcopy recommended