{
  "resourceType": "Questionnaire",
  "id": "qrns-questionnaire-shunt",
  "identifier": [
    {
      "value": "sivz-qrns-questionnaire-shunt"
    }
  ],
  "version": "1",
  "status": "draft",
  "date": "2018-03-21",
  "publisher": "SIVZ",
  "subjectType": [
    "Patient"
  ],
  "item": [
    {
      "linkId": "1",
      "type": "choice",
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_diagnose"
      }
    },
    {
      "linkId": "2",
      "text": "Behandeldatum",
      "type": "date"
    },
    {
      "linkId": "4726",
      "text": "Zwangerschapsleeftijd",
      "type": "choice",
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_shom_zwleeft"
      }
    },
    {
      "linkId": "4731",
      "text": "Geboortegewicht",
      "type": "integer"
    },
    {
      "linkId": "4732",
      "text": "Schedelomtrek bij geboorte",
      "type": "integer"
    },
    {
      "linkId": "4734",
      "text": "Diagnose hydrocephalus",
      "type": "choice",
      "required": true,
      "repeats": true,
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_shom_diag"
      }
    },
    {
      "linkId": "4742",
      "text": "Indien anders, toelichting:",
      "type": "text",
      "enableWhen": [
        {
          "question": "4734",
          "answerCoding": {
            "code": "6"
          }
        }
      ]
    },
    {
      "linkId": "4744",
      "text": "Nevendiagnosen?",
      "type": "choice",
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_shom_nevendiag"
      }
    },
    {
      "linkId": "4750",
      "text": "Indien anders, toelichting:",
      "type": "text",
      "enableWhen": [
        {
          "question": "4744",
          "answerCoding": {
            "code": "6"
          }
        }
      ]
    },
    {
      "linkId": "4752",
      "text": "Heeft patiënt een EVD of Ommaya gehad?",
      "type": "choice",
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_shom_evd"
      }
    },
    {
      "linkId": "4758",
      "text": "Heeft patiënt eerder een derde ventriculostomie gehad?",
      "type": "choice",
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_basis_jnonb"
      }
    },
    {
      "linkId": "4761",
      "text": "Schedelomtrek bij operatie",
      "type": "integer"
    },
    {
      "linkId": "4762",
      "text": "Datum operatie",
      "type": "date",
      "required": true
    },
    {
      "linkId": "4764",
      "text": "Ziekenhuis waar de operatie heeft plaatsgevonden",
      "type": "choice",
      "required": true,
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_ziekenhuis"
      }
    },
    {
      "linkId": "4783",
      "text": "Wat voor shunt werd er geplaatst?",
      "type": "choice",
      "required": true,
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_shunt_4783"
      }
    },
    {
      "linkId": "4786",
      "text": "Indien anders, toelichting:",
      "type": "text",
      "enableWhen": [
        {
          "question": "4783",
          "answerCoding": {
            "code": "6"
          }
        }
      ]
    },
    {
      "linkId": "4788",
      "text": "Shuntmateriaal antibiotica geïmpregneerd?",
      "type": "choice",
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_basis_jnonb"
      }
    },
    {
      "linkId": "4792",
      "text": "Type klep",
      "type": "choice",
      "required": true,
      "options": {
        "reference": "http://hl7.org/fhir/ValueSet/qrns_shunt_4792"
      }
    },
    {
      "linkId": "4797",
      "text": "Indien overig, toelichting:",
      "type": "text",
      "enableWhen": [
        {
          "question": "4792",
          "answerCoding": {
            "code": "5"
          }
        }
      ]
    },
    {
      "linkId": "3",
      "text": "Follow-up",
      "type": "group",
      "item": [
        {
          "linkId": "4",
          "text": "Follow-up datum",
          "type": "date"
        },
        {
          "linkId": "4799",
          "text": "Is de patient overleden?",
          "type": "choice",
          "required": true,
          "options": {
            "reference": "http://hl7.org/fhir/ValueSet/qrns_basis_jnonb"
          }
        },
        {
          "linkId": "4802",
          "text": "Datum overlijden",
          "type": "date",
          "enableWhen": [
            {
              "question": "4799",
              "answerCoding": {
                "code": "1"
              }
            }
          ],
          "required": true
        },
        {
          "linkId": "7249",
          "text": "Is patient overleden aan een hydrocephalus gerelateerd probleem?",
          "type": "choice",
          "enableWhen": [
            {
              "question": "4799",
              "answerCoding": {
                "code": "1"
              }
            }
          ],
          "options": {
            "reference": "http://hl7.org/fhir/ValueSet/qrns_basis_jn"
          }
        },
        {
          "linkId": "2228",
          "text": "Hoeveel revisies hebben er plaatsgevonden tussen plaatsing eerste shunt en overlijden?",
          "type": "integer",
          "enableWhen": [
            {
              "question": "4799",
              "answerCoding": {
                "code": "1"
              }
            }
          ],
          "required": true
        },
        {
          "linkId": "4816",
          "text": "Wordt de patiënt nog gevolgd?",
          "type": "choice",
          "enableWhen": [
            {
              "question": "4799",
              "answerCoding": {
                "code": "0"
              }
            },
            {
              "question": "4799",
              "answerCoding": {
                "code": "8"
              }
            }
          ],
          "required": true,
          "options": {
            "reference": "http://hl7.org/fhir/ValueSet/qrns_basis_jn"
          }
        },
        {
          "linkId": "4818",
          "text": "Datum laatste Follow Up",
          "type": "date",
          "enableWhen": [
            {
              "question": "4799",
              "answerCoding": {
                "code": "0"
              }
            },
            {
              "question": "4799",
              "answerCoding": {
                "code": "8"
              }
            }
          ],
          "required": true
        },
        {
          "linkId": "4820",
          "text": "Is er nog een werkende shunt in situ?",
          "type": "choice",
          "enableWhen": [
            {
              "question": "4799",
              "answerCoding": {
                "code": "0"
              }
            },
            {
              "question": "4799",
              "answerCoding": {
                "code": "8"
              }
            }
          ],
          "required": true,
          "options": {
            "reference": "http://hl7.org/fhir/ValueSet/qrns_basis_jn"
          }
        },
        {
          "linkId": "4822",
          "text": "Einddatum shunt",
          "type": "date",
          "enableWhen": [
            {
              "question": "4820",
              "answerCoding": {
                "code": "0"
              }
            }
          ]
        },
        {
          "linkId": "4803",
          "text": "Hoeveel revisies hebben er plaats gevonden sinds de plaatsing van de eerste ventriculaire shunt?",
          "type": "integer",
          "enableWhen": [
            {
              "question": "4799",
              "answerCoding": {
                "code": "0"
              }
            },
            {
              "question": "4799",
              "answerCoding": {
                "code": "8"
              }
            }
          ],
          "required": true
        },
        {
          "linkId": "4804",
          "text": "Datum revisie 1",
          "type": "date",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            }
          ]
        },
        {
          "linkId": "4806",
          "text": "Reden voor revisie 1",
          "type": "choice",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            }
          ],
          "options": {
            "reference": "http://hl7.org/fhir/ValueSet/qrns_shunt_revreden"
          }
        },
        {
          "linkId": "7238",
          "text": "Datum revisie 2",
          "type": "date",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "2"
              }
            }
          ]
        },
        {
          "linkId": "7239",
          "text": "Reden voor revisie 2",
          "type": "choice",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "2"
              }
            }
          ],
          "options": {
            "reference": "http://hl7.org/fhir/ValueSet/qrns_shunt_revreden"
          }
        },
        {
          "linkId": "7240",
          "text": "Datum revisie 3",
          "type": "date",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "3"
              }
            }
          ]
        },
        {
          "linkId": "7241",
          "text": "Reden voor revisie 3",
          "type": "choice",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "3"
              }
            }
          ],
          "options": {
            "reference": "http://hl7.org/fhir/ValueSet/qrns_shunt_revreden"
          }
        },
        {
          "linkId": "7242",
          "text": "Datum revisie 4",
          "type": "date",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "4"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "4"
              }
            }
          ]
        },
        {
          "linkId": "7243",
          "text": "Reden voor revisie 4",
          "type": "choice",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "4"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "4"
              }
            }
          ],
          "options": {
            "reference": "http://hl7.org/fhir/ValueSet/qrns_shunt_revreden"
          }
        },
        {
          "linkId": "7244",
          "text": "Datum laatste revisie",
          "type": "date",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "4"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "5"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "4"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "5"
              }
            }
          ]
        },
        {
          "linkId": "7245",
          "text": "Reden voor laatste revisie",
          "type": "choice",
          "enableWhen": [
            {
              "question": "2228",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "4"
              }
            },
            {
              "question": "2228",
              "answerCoding": {
                "code": "5"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "1"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "2"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "3"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "4"
              }
            },
            {
              "question": "4803",
              "answerCoding": {
                "code": "5"
              }
            }
          ],
          "options": {
            "reference": "http://hl7.org/fhir/ValueSet/qrns_shunt_revreden"
          }
        }
      ]
    }
  ]
}