{ "resourceType": "Questionnaire", "id": "mpc-prostate-cancer", "meta": { "versionId": "0.1.0", "profile": [ "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire|2.7", "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-shareablequestionnaire" ] }, "text": { "status": "generated", "div": "
Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIdTextCardinalityTypeDescription & Constraints\"doco\"
\".\"\".\" Questionnaire
\".\"\".\"\".\" learn-more-introLearn More. What Tests Are Used to Screen for Prostate Cancer?<br/><br/>Screening for prostate cancer is a blood test called the prostate-specific antigen or PSA test. A high PSA level can be a sign of prostate cancer. However, other things like an enlarged prostate or swelling of the prostate also cause a high PSA level. A biopsy of the prostate is necessary to make the diagnosis of cancer.0..1display
\".\"\".\"\".\" learn-more-videoLearn More. Watch a 3-minute video about the PSA testing. We’d like to suggest you watch the video to help you prepare for your upcoming visit. This video can help you prepare to ask questions that are important to you when you visit with your provider. <br/> <br/> <a id="youtube" value="YqticruOZ7U"></a>0..1display
\".\"\".\"\".\" learn-more-uspstfLearn More. See a picture of what happens to 1,000 men who chose to get a PSA test. It shows you how many men benefit from screening – don’t die from prostate cancer. And it shows you how many men are harmed – false positives and complications from treatment.<br/> <br/> <img width="100%" src="https://www.cdc.gov/cancer/prostate/images/prostate-decision-guide-300.jpg"/> <a id="website" value="https://www.uspreventiveservicestaskforce.org/Home/GetFileByID/3795"></a> 0..1display
\".\"\".\"\".\" 1Next Steps. What do you want to do next?1..1choiceOptions: 3 options
\".\"\".\"\".\" 2Next Steps. How do you feel about your decision?0..1group
\".\"\".\"\".\"\".\" 2.1I know the benefits of getting a PSA test.0..1choiceOptions: 5 options
\".\"\".\"\".\"\".\" 2.2I know the risks of getting a PSA test.0..1choiceOptions: 5 options
\".\"\".\"\".\"\".\" 2.3I am clear about which benefits and risks matter most to me.0..1choiceOptions: 5 options
\".\"\".\"\".\"\".\" 2.4I have enough support and advice to make a decision about getting a PSA test.0..1choiceOptions: 5 options
\".\"\".\"\".\"\".\" 2.5I feel sure about the best choice for me.0..1choiceOptions: 5 options
\".\"\".\"\".\" 3Next Steps. Would you like to discuss prostate cancer screening at your next appointment? MyPreventiveCare can let your provider know what you want.1..1boolean
\".\"\".\"\".\" 15Feedback. Please indicate your level of agreement with the following statement:0..1group
\".\"\".\"\".\"\".\" 15.1Using the MyPreventiveCare tool has helped me begin preparing for a conversation with my provider about making health decisions.0..1choiceOptions: 5 options
\".\"\".\"\".\" 16Feedback. Do you have any other feedback or thoughts to share on your use of MyPreventiveCare?0..1text

\"doco\" Documentation for this format

Option Sets

Answer options for 1

Answer options for 2.1

Answer options for 2.2

Answer options for 2.3

Answer options for 2.4

Answer options for 2.5

Answer options for 15.1

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Screening for prostate cancer is a blood test called the prostate-specific antigen or PSA test. A high PSA level can be a sign of prostate cancer. However, other things like an enlarged prostate or swelling of the prostate also cause a high PSA level. A biopsy of the prostate is necessary to make the diagnosis of cancer.", "type": "display" }, { "linkId": "learn-more-video", "prefix": "Learn More", "text": "Watch a 3-minute video about the PSA testing. We’d like to suggest you watch the video to help you prepare for your upcoming visit. This video can help you prepare to ask questions that are important to you when you visit with your provider.

", "type": "display" }, { "linkId": "learn-more-uspstf", "prefix": "Learn More", "text": "See a picture of what happens to 1,000 men who chose to get a PSA test. It shows you how many men benefit from screening – don’t die from prostate cancer. And it shows you how many men are harmed – false positives and complications from treatment.

", "type": "display" }, { "extension": [ { "url": "http://hl7.org/fhir/uv/StructureDefinition/cpg-answerValueSetSource", "valueCanonical": "http://fhir.org/guides/preventive-care/ValueSet/next-step-types" } ], "linkId": "1", "code": [ { "system": "http://fhir.org/guides/preventive-care/CodeSystem/mpc-questionnaire-codes", "code": "mpc-do-next", "display": "What do you want to do next?" } ], "prefix": "Next Steps", "text": "What do you want to do next?", "type": "choice", "required": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.org/guides/preventive-care/CodeSystem/mpc-questionnaire-codes", "code": "more-thought", "display": "I want to give it more thought" } }, { "valueCoding": { "system": "http://fhir.org/guides/preventive-care/CodeSystem/mpc-questionnaire-codes", "code": "get-test", "display": "I want to get a PSA test" } }, { "valueCoding": { "system": "http://fhir.org/guides/preventive-care/CodeSystem/mpc-questionnaire-codes", "code": "do-not-want-test", 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"system": "http://loinc.org", "code": "x", "display": "Strongly disagree" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Disagree" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Neutral" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Agree" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Strongly agree" } } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "drop-down", "display": "Drop down" } ], "text": "Drop down" } }, { "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource", "valueCanonical": "http://loinc.org/vs/LL2949-7" } ], "linkId": "2.2", "code": [ { "system": "mpc codesystem", "code": "x", "display": "Know risks" } ], "text": "I know the risks of getting a PSA test.", 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"display": "Clear on what matters to me" } ], "text": "I am clear about which benefits and risks matter most to me.", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Strongly disagree" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Disagree" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Neutral" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Agree" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Strongly agree" } } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "drop-down", "display": "Drop down" } ], "text": "Drop down" } }, { "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource", "valueCanonical": "http://loinc.org/vs/LL2949-7" } ], "linkId": "2.4", "code": [ { "system": "mpc codesystem", "code": "x", "display": "Have support" } ], "text": "I have enough support and advice to make a decision about getting a PSA test.", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Strongly disagree" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Disagree" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Neutral" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Agree" } }, { "valueCoding": { "system": "http://loinc.org", "code": "x", "display": "Strongly agree" } } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "drop-down", "display": "Drop down" } 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MyPreventiveCare can let your provider know what you want.", "type": "boolean", "required": true }, { "linkId": "15", "code": [ { "system": "http://fhir.org/guides/preventive-care/CodeSystem/mpc-questionnaire-codes", "code": "mpc-feedback", "display": "Feedback about your use of MyPreventiveCare" } ], "prefix": "Feedback", "text": "Please indicate your level of agreement with the following statement:", "type": "group", "required": false, "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "drop-down", "display": "Drop down" } ], "text": "Drop down" } }, { "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-answerValueSetSource", "valueCanonical": "http://loinc.org/vs/LL1606-4" } ], "linkId": "15.1", "code": [ { "system": "http://fhir.org/guides/preventive-care/CodeSystem/mpc-questionnaire-codes", "code": "mpq-1063", "display": "Please indicate your level of agreement with the following statement: Using the MyPreventiveCare tool has helped me begin preparing for a conversation with my provider about making health decisions." } ], "text": "Using the MyPreventiveCare tool has helped me begin preparing for a conversation with my provider about making health decisions.", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "https://loinc.org/LL1606-4/", "code": "LA15238-1", "display": "Disagree a lot" } }, { "valueCoding": { "system": "https://loinc.org/LL1606-4/", "code": "LA15239-9", "display": "Disagree a little" } }, { "valueCoding": { "system": "https://loinc.org/LL1606-4/", "code": "LA15240-7", "display": "Neither agree nor disagree" } }, { "valueCoding": { "system": "https://loinc.org/LL1606-4/", "code": "LA15241-5", "display": "Agree a little" } }, { "valueCoding": { "system": "https://loinc.org/LL1606-4/", "code": "LA15242-3", "display": "Agree a lot" } } ] } ] }, { "linkId": "16", "code": [ { "system": "http://fhir.org/guides/preventive-care/CodeSystem/mpc-questionnaire-codes", "code": "mpq-1064", "display": "Do you have any other feedback or thoughts to share on your use of MyPreventiveCare?" }, { "system": "http://fhir.org/guides/preventive-care/CodeSystem/mpc-questionnaire-codes", "code": "mpc-feedback", "display": "Feedback on your use of MyPreventiveCare" } ], "prefix": "Feedback", "text": "Do you have any other feedback or thoughts to share on your use of MyPreventiveCare?", "type": "text", "required": false } ] }