{
  "resourceType": "Questionnaire",
  "id": "spark4",
  "meta": {
    "versionId": "spark4",
    "lastUpdated": "2015-10-02T14:04:18.531+00:00"
  },
  "language": "en",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Todo</div>"
  },
  "contained": [
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      "resourceType": "ValueSet",
      "id": "d1e8086-vs",
      "status": "active",
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        "concept": [
          {
            "code": "Primary",
            "display": "Primary Diagnosis",
            "definition": "Occurring first in time or sequence; original; of greatest rank or importance or value.: The investigation, analysis and recognition of the presence and nature of disease, condition, or injury from expressed signs and symptoms; also, the scientific determination of any kind; the concise results of such an investigation."
          },
          {
            "code": "Secondary",
            "display": "Secondary Diagnosis",
            "definition": "Derived as a result of a primary condition; not direct or immediate; of second rank or importance or value.: The investigation, analysis and recognition of the presence and nature of disease, condition, or injury from expressed signs and symptoms; also, the scientific determination of any kind; the concise results of such an investigation."
          },
          {
            "code": "Treatment-related",
            "display": "Treatment related secondary malignancy Diagnosis",
            "definition": "A disorder characterized by development of a malignancy most probably as a result of treatment for a previously existing malignancy.: The investigation, analysis and recognition of the presence and nature of disease, condition, or injury from expressed signs and symptoms; also, the scientific determination of any kind; the concise results of such an investigation."
          },
          {
            "code": "Unknown",
            "display": "Unknown",
            "definition": "Not known, not observed, not recorded, or refused."
          }
        ]
      }
    },
    {
      "resourceType": "ValueSet",
      "id": "d1e8407-vs",
      "status": "active",
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        "caseSensitive": true,
        "concept": [
          {
            "code": "Initial same as Current",
            "display": "Initial diagnosis same as current",
            "definition": "Initial diagnosis same as current"
          },
          {
            "code": "At Progression",
            "display": "Disease Progression",
            "definition": "Cancer that continues to grow or spread."
          },
          {
            "code": "At Restaging",
            "display": "Restaging",
            "definition": "Two or more adjacent copies of an identical pattern.: The extent of a cancer within the body, especially whether the disease has spread from the original site to other parts of the body."
          },
          {
            "code": "Initial Diagnosis",
            "display": "First Diagnosis",
            "definition": "Preceding all others in time or space or degree.: The investigation, analysis and recognition of the presence and nature of disease, condition, or injury from expressed signs and symptoms; also, the scientific determination of any kind; the concise results of such an investigation."
          },
          {
            "code": "Current Diagnosis",
            "display": "Current Diagnosis",
            "definition": "Occurring in or belonging to the present time.: The investigation, analysis and recognition of the presence and nature of disease, condition, or injury from expressed signs and symptoms; also, the scientific determination of any kind; the concise results of such an investigation."
          }
        ]
      }
    },
    {
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      "status": "active",
      "codeSystem": {
        "system": "http://nci.nih.gov/xml/owl/cadsr/form/form_design_identifier/3921052v1.0/question_identifier#3921081v1.0-cs",
        "caseSensitive": true,
        "concept": [
          {
            "code": "Cytologic",
            "display": "Cytological Procedure",
            "definition": "Technique or procedure for manipulation of cells and analysis of cell properties and subcellular features."
          },
          {
            "code": "Histologic",
            "display": "Histological Procedure",
            "definition": "Technique or procedure used for the study of the microanatomy of tissues and their cellular structure; usually involves microscopic examination of tissue slices."
          },
          {
            "code": "Histologic and Cytologic",
            "display": "Histologic and Cytologic Procedures",
            "definition": "Pertaining to the combined microscopic physical features of cells and their surrounding extracellular environment in tissues.: The light microscopic study of normal and abnormal cells in fine needle aspirates (FNAs), body cavity fluids, and smears.: Having been established or verified."
          }
        ]
      }
    },
    {
      "resourceType": "ValueSet",
      "id": "d1e9025-vs",
      "status": "active",
      "codeSystem": {
        "system": "http://nci.nih.gov/xml/owl/cadsr/form/form_design_identifier/3921052v1.0/question_identifier#3921085v1.0-cs",
        "caseSensitive": true,
        "concept": [
          {
            "code": "G1",
            "display": "Well Differentiated",
            "definition": "Describes tumor cells that generally retain the appearance of normal cells and tend to grow and spread at a slower rate than undifferentiated or poorly differentiated tumor cells."
          },
          {
            "code": "G2",
            "display": "Moderately Differentiated",
            "definition": "Definition not available."
          },
          {
            "code": "G3",
            "display": "Poorly Differentiated",
            "definition": "Describes tumor cells that generally have lost most of the appearance of normal cells. They tend to grow and spread."
          },
          {
            "code": "G4",
            "display": "Undifferentiated",
            "definition": "A term used to describe cells or tissues that do not have specialized (\"mature\") structures or functions. Undifferentiated cancer cells often grow and spread quickly."
          },
          {
            "code": "GB",
            "display": "Borderline Histologic Grade",
            "definition": "Straddling the dividing line between two categories.: The degree of abnormality of cancer cells, a measure of differentiation, the extent to which cancer cells are similar in appearance and function to healthy cells of the same tissue type. The degree of differentiation often relates to the clinical behavior of the particular tumor. Based on the microscopic findings, tumor grade is commonly described by one of four degrees of severity. Histopathologic grade of a tumor may be used to plan treatment and estimate the future course, outcome, and overall prognosis of disease. Certain types of cancers, such as soft tissue sarcoma, primary brain tumors, lymphomas, and breast have special grading systems."
          },
          {
            "code": "GX",
            "display": "Grade Cannot be Assessed",
            "definition": "An operation in which a term denies or inverts the meaning of another term or construction.: Having determined the value, significance, or extent of.: The degree of abnormality of cancer cells, a measure of differentiation, the extent to which cancer cells are similar in appearance and function to healthy cells of the same tissue type. The degree of differentiation often relates to the clinical behavior of the particular tumor. Based on the microscopic findings, tumor grade is commonly described by one of four degrees of severity. Histopathologic grade of a tumor may be used to plan treatment and estimate the future course, outcome, and overall prognosis of disease. Certain types of cancers, such as soft tissue sarcoma, primary brain tumors, lymphomas, and breast have special grading systems."
          },
          {
            "code": "High Grade",
            "display": "High Grade",
            "definition": "Used to describe tumor samples that exhibit poorly differentiated or undifferentiated cells. They are generally expected to be fast growing and aggressive."
          },
          {
            "code": "Low Grade",
            "display": "Low Grade",
            "definition": "Used to describe tumor samples that exhibit well to moderately well differentiated cells. They are generally expected to be slow growing and less aggressive."
          }
        ]
      }
    }
  ],
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      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-category",
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        "coding": [
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  "identifier": [
    {
      "system": "http://nci.nih.gov/xml/owl/cadsr/form/form_design_identifier",
      "value": "3921052v1.0/"
    }
  ],
  "status": "draft",
  "date": "2013-10-16",
  "publisher": "National Cancer Institute (NCI)",
  "group": {
    "linkId": "root",
    "title": "Diagnosis NCI Standard Template",
    "required": true,
    "group": [
      {
        "linkId": "3921053v1.0",
        "title": "Mandatory Diagnosis Questions",
        "text": "These items must be included when this data is collected for reporting.",
        "required": true,
        "question": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-deReference",
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            ],
            "linkId": "3921059v1.0",
            "text": "Date of Current Pathologic Diagnosis",
            "type": "string"
          },
          {
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              }
            ],
            "linkId": "3921060v1.0",
            "text": "Diagnosis Type",
            "type": "open-choice",
            "options": {
              "reference": "#d1e8086-vs"
            }
          },
          {
            "extension": [
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              }
            ],
            "linkId": "3921065v1.0",
            "text": "Primary Site",
            "type": "string"
          }
        ]
      },
      {
        "linkId": "3921066v1.0",
        "title": "Conditional Diagnosis Questions",
        "text": "There are business rules to indicate situations under which these elements should be used on a case report form.",
        "question": [
          {
            "extension": [
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            "linkId": "3921071v1.0",
            "text": "Diagnosis Time Point",
            "type": "open-choice",
            "options": {
              "reference": "#d1e8407-vs"
            }
          }
        ]
      },
      {
        "linkId": "3921077v1.0",
        "title": "Optional Diagnosis Questions",
        "text": "There is no requirement for inclusion of these elements on the case report form. If the design and scientific questions posed in the study dictate the need to collect this type of data, these elements should be included.",
        "question": [
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            "linkId": "3921079v1.0",
            "text": "Reviewing Pathologist",
            "type": "string"
          },
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            ],
            "linkId": "3921080v1.0",
            "text": "MedDRA disease code",
            "type": "string"
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            "linkId": "3921081v1.0",
            "text": "Assessment Method",
            "type": "open-choice",
            "options": {
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            "linkId": "3921085v1.0",
            "text": "Tumor grade",
            "type": "open-choice",
            "options": {
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