diff --git a/configuration/ampathforms/Maxillofacial_Clinical_Form.json b/configuration/ampathforms/Maxillofacial_Clinical_Form.json new file mode 100644 index 00000000..bbb1bfaf --- /dev/null +++ b/configuration/ampathforms/Maxillofacial_Clinical_Form.json @@ -0,0 +1,1833 @@ +{ + "name": "Maxillofacial Clinical Consultation Form", + "description": "Maxillofacial Speciality Clinic Form", + "version": "1", + "published": true, + "uuid": "6966c105-70a7-4b45-af12-de3163058caa", + "retired": false, + "encounter": "Consultation", + "pages": [ + { + "label": "Visit Details", + "sections": [ + { + "label": "Encounter Details", + "isExpanded": "true", + "questions": [ + { + "label": "Visit date:", + "type": "encounterDatetime", + "required": "true", + "id": "encDate", + "questionOptions": { + "rendering": "date" + }, + "validators": [ + { + "type": "date", + "allowFutureDates": "false" + } + ] + }, + { + "label": "Provider:", + "type": "encounterProvider", + "questionOptions": { + "rendering": "ui-select-extended" + }, + "id": "encProvider " + }, + { + "label": "Location:", + "type": "encounterLocation", + "questionOptions": { + "rendering": "ui-select-extended" + }, + "id": "encLocation" + } + ] + } + ] + }, + { + "label": "Patient's History", + "sections": [ + { + "label": "Patient Compalints", + "isExpanded": "true", + "questions": [ + { + "label": "Patient having complaint(s) today?", + "type": "obs", + "id": "complaintsToday", + "required": "true", + "questionOptions": { + "concept": "5219AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "radio", + "answers": [ + { + "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Yes" + }, + { + "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "No" + } + ] + }, + "hide": { + "hideWhenExpression": "visitTo === '167050AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + } + }, + { + "label": "Presenting complaints", + "type": "obsGroup", + "id": "ComplaintLodgeByClient", + "questionOptions": { + "concept": "160531AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "repeating" + }, + "validators": [], + "hide": { + "hideWhenExpression": "complaintsToday !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + "questions": [ + { + "label": "Complaint", + "type": "obs", + "id": "cOmplaIntField", + "questionOptions": { + "concept": "5219AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "select", + "answers": [ + { + "concept": "5954AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Difficulty in swallowing" + }, + { + "concept": "142369AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Difficulty in opening the mouth" + }, + { + "concept": "155940AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Difficulty in chewing" + }, + { + "concept": "127206AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": " Lack of saliva " + }, + { + "concept": "132653AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Numbness" + }, + { + "concept": "114403AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Pain" + }, + { + "concept": "163894AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Swelling" + }, + { + "concept": "124105AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Trismus" + }, + { + "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Other" + } + ] + } + }, + { + "label": "Specify other complaints", + "type": "obs", + "id": "OtherSpecificComplaints", + "questionOptions": { + "concept": "20395601-257c-490c-86c2-acffb627f91f", + "rendering": "textarea" + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(cOmplaIntField) || cOmplaIntField !== '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + } + }, + { + "label": "Site", + "type": "obs", + "id": "complaintSite", + "questionOptions": { + "concept": "161011AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "text" + }, + "validators": [], + "hide": { + "hideWhenExpression": "cOmplaIntField !== '114403AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' || cOmplaIntField !== '163894AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + } + }, + { + "label": "Duration (Days)", + "type": "obs", + "id": "complaint-duration", + "questionOptions": { + "concept": "159368AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "number", + "min": "0" + }, + "validators": [] + }, + { + "label": "Onset Status", + "type": "obs", + "id": "onsetStatus", + "questionOptions": { + "concept": "d7a3441d-6aeb-49be-b7d6-b2a3bb39e78d", + "rendering": "select", + "answers": [ + { + "concept": "1499AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Gradual" + }, + { + "concept": "162707AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Sudden" + } + ] + } + }, + { + "label": "Severity", + "type": "obs", + "id": "seViD", + "questionOptions": { + "concept": "160287AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "number", + "min": "0.0", + "max": "10.0" + }, + "hide": { + "hideWhenExpression": "cOmplaIntField !== '114403AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + } + } + ] + }, + { + "label": "History of presenting illiness notes", + "type": "obs", + "id": "ClinICNotes", + "questionOptions": { + "concept": "1390AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "textarea", + "rows": "10" + }, + "validators": [], + "hide": { + "hideWhenExpression": "visitTo === '167050AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + } + } + ] + }, + { + "label": "Past Medical/Surgical History", + "isExpanded": "true", + "questions": [ + { + "label": "Previous/current illnesses or diseases?", + "type": "obs", + "id": "medHis", + "questionOptions": { + "rendering": "radio", + "concept": "1806AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "answers": [ + { + "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Yes" + }, + { + "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "No" + } + ] + }, + "hide": { + "hideWhenExpression": "visitTo === '167050AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + } + }, + { + "label": "Specify the Illnesses or Diseases:", + "required": "true", + "type": "obs", + "questionOptions": { + "rendering": "checkbox", + "concept": "162737AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "answers": [ + { + "concept": "166778AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Malignancy/Tumour" + }, + { + "concept": "144240AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Congenital anomaly" + }, + { + "concept": "127645AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Total resorption of the jaws" + }, + { + "concept": "163405AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "TMJ Ankylosis" + }, + { + "concept": "147912AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Bell’s Palsy" + }, + { + "concept": "115432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Heart Attack" + }, + { + "concept": "115432AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Myocardial Infarction" + }, + { + "concept": "121610AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Angina Pectoris" + }, + { + "concept": "111103AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Cerebrovascular accident (C.V.A)" + }, + { + "concept": "117399AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Hypertension" + }, + { + "concept": "139069AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Heart Failure" + }, + { + "concept": "159339AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Bleeding Disorders" + }, + { + "concept": "119481AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Diabetes" + }, + { + "concept": "127447AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Rheumatic Fever" + }, + { + "concept": "111479AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Viral Hepatitis" + }, + { + "concept": "1169AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "HIV" + }, + { + "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Other" + } + ] + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(medHis) || medHis !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + "id": "curreNtmeD" + }, + { + "label": "Other (Specify)", + "type": "obs", + "id": "specifyTIllneSS", + "questionOptions": { + "concept": "160632AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "text" + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(curreNtmeD) || !arrayContains(curreNtmeD, '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')" + } + } + ] + }, + { + "label": "History of accident/trauma", + "isExpanded": "true", + "questions": [ + { + "label": "History of accident/trauma?", + "type": "obs", + "id": "TrUmAHis", + "questionOptions": { + "rendering": "radio", + "concept": "159520AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "answers": [ + { + "concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Yes" + }, + { + "concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "No" + } + ] + }, + "hide": { + "hideWhenExpression": "visitTo === '167050AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + } + }, + { + "label": "Explain", + "type": "obs", + "id": "trAumAExp", + "questionOptions": { + "concept": "160632AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "textarea", + "rows": "10" + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(TrUmAHis) || TrUmAHis !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + } + } + ] + }, + { + "label": "Family History", + "isExpanded": "true", + "questions": [ + { + "label": "Family History", + "type": "obs", + "id": "fAmHisT", + "questionOptions": { + "concept": "140228AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "checkbox", + "answers": [ + { + "label": "Congenital Anomalies(lip clefts or palate clefts)", + "concept": "120543AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" + }, + { + "label": "Craniofacial syndrome", + "concept": "131737AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" + }, + { + "label": "Dental anormalies", + "concept": "119559AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" + }, + { + "label": "Mandibular Prognathism", + "concept": "115928AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" + }, + { + "label": "Others", + "concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA" + } + ] + } + }, + { + "label": "Other (Specify)", + "type": "obs", + "id": "specifyTherapy", + "questionOptions": { + "concept": "160632AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "text" + }, + "validators": [], + "hide": { + "hideWhenExpression": "isEmpty(fAmHisT) || !arrayContains(fAmHisT, '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')" + } + } + ] + } + ] + }, + { + "label": "Patient's Examination", + "sections": [ + { + "label": "General Oral Examination", + "isExpanded": "true", + "questions": [ + { + "label": "Oral examination findings:", + "required": "true", + "type": "obs", + "questionOptions": { + "rendering": "checkbox", + "concept": "162737AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "answers": [ + { + "concept": "1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "None" + }, + { + "concept": "140824AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Facial asymmetry", + "disableWhenExpression": "myValue === '1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + { + "concept": "131014AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Reduced and painful eye movements", + "disableWhenExpression": "myValue === '1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + { + "concept": "140919AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Proptosis", + "disableWhenExpression": "myValue === 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"disableWhenExpression": "myValue === '1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + { + "concept": "143438AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Restricted lateral mandibular movement", + "disableWhenExpression": "myValue === '1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + { + "concept": "135645AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Joint locking", + "disableWhenExpression": "myValue === '1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + { + "concept": "145015AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Missing jawbone", + "disableWhenExpression": "myValue === '1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + { + "concept": "5226AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Poorly defined jaw", + "disableWhenExpression": "myValue === '1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + { + "concept": "143820AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Small lower jaw (Micrognathia)", + "disableWhenExpression": "myValue === '1107AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + }, + { + "concept": 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"questionOptions": { + "concept": "faa7fd68-5a34-4ba2-b60f-6ba7ec77b391", + "rendering": "radio", + "answers": [ + { + "concept": "166335AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Mandible" + }, + { + "concept": "166280AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Maxilla" + }, + { + "concept": "d8a9101d-f0db-43e3-a214-b22f1e84ec16", + "label": "Both" + } + ] + }, + "hide": { + "hideWhenExpression": "isEmpty(genExamFindings) || !arrayContains(genExamFindings, '145015AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')" + } + }, + { + "label": "Lymphdenopathy findings", + "type": "obs", + "id": "lYmphfinds", + "questionOptions": { + "concept": "faa7fd68-5a34-4ba2-b60f-6ba7ec77b391", + "rendering": "radio", + "answers": [ + { + "concept": "158971AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Submental" + }, + { + "concept": "504AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Submandibular" + }, + { + "concept": "164487AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Deep Cervical" + }, + { + "concept": 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"concept": "152286AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Everted" + }, + { + "concept": "fbbb5cd7-6d96-4da2-8709-490499fbe703", + "label": "Serous Discharge" + }, + { + "concept": "1076AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Purulent" + } + ] + } + } + ] + }, + { + "label": "Open bite findings", + "type": "obs", + "id": "OBfinds", + "questionOptions": { + "concept": "faa7fd68-5a34-4ba2-b60f-6ba7ec77b391", + "rendering": "radio", + "answers": [ + { + "concept": "121557AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Anterior Open Bite" + }, + { + "concept": "113936AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Posterior Open Bite" + } + ] + }, + "hide": { + "hideWhenExpression": "isEmpty(IntragenExamFindings) || !arrayContains(IntragenExamFindings, '114994AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')" + } + }, + { + "label": "Occlusion findings", + "type": "obs", + "id": "OCCfinds", + "questionOptions": { + "concept": "faa7fd68-5a34-4ba2-b60f-6ba7ec77b391", + "rendering": "radio", + "answers": [ + { + "concept": "139745AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Neutro occlusion" + }, + { + "concept": "141872AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Disto occlusion" + }, + { + "concept": "134291AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Messio occlusion" + } + ] + }, + "hide": { + "hideWhenExpression": "isEmpty(IntragenExamFindings) || !arrayContains(IntragenExamFindings, '139745AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')" + } + }, + { + "label": "Number of loose Central Incisor", + "type": "obs", + "id": "CTfinds", + "questionOptions": { + "concept": "159930AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "number", + "max": "4", + "min": "0" + }, + "hide": { + "hideWhenExpression": "isEmpty(IntragenExamFindings) || !arrayContains(IntragenExamFindings, '5226AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA')" + } + }, + { + "label": "Number of loose Lateral Incisor", + "type": "obs", + "id": "LTfinds", + "questionOptions": { + "concept": "163172AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + 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