{
  "description": "Questionnaire for capturing attention-worthy conditions relevant to diagnostic imaging requests (implants, pregnancy, diabetes, allergies, etc.)",
  "_filename": "Questionnaire-be-questionnaire-imaging-attention-conditions.json",
  "package_name": "hl7.fhir.be.referral",
  "date": "2026-08-25T14:26:35+02:00",
  "publisher": "eHealth Platform",
  "jurisdiction": [ {
    "coding": [ {
      "code": "BE",
      "system": "urn:iso:std:iso:3166",
      "display": "Belgium"
    } ]
  } ],
  "name": "BeQuestionnaireImagingAttentionConditions",
  "item": [ {
    "item": [ {
      "text": "Other implant type",
      "type": "text",
      "_text": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "fr-BE"
          }, {
            "url": "content",
            "valueString": "Autre type d'implant"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "nl-BE"
          }, {
            "url": "content",
            "valueString": "Ander type implantaat"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de"
          }, {
            "url": "content",
            "valueString": "Sonstiger Implantattyp"
          } ]
        } ]
      },
      "linkId": "implants-other",
      "repeats": true,
      "required": true,
      "enableWhen": [ {
        "operator": "=",
        "question": "implants",
        "answerCoding": {
          "code": "40388003",
          "system": "http://snomed.info/sct"
        }
      } ]
    } ],
    "text": "Implants",
    "type": "choice",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Implants"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "nl-BE"
        }, {
          "url": "content",
          "valueString": "Implantaten"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "de"
        }, {
          "url": "content",
          "valueString": "Implantate"
        } ]
      } ]
    },
    "linkId": "implants",
    "repeats": true,
    "required": false,
    "answerValueSet": "https://www.ehealth.fgov.be/standards/fhir/referral/ValueSet/be-vs-implant-type"
  }, {
    "text": "Pregnancy",
    "type": "boolean",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Grossesse"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "nl-BE"
        }, {
          "url": "content",
          "valueString": "Zwangerschap"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "de"
        }, {
          "url": "content",
          "valueString": "Schwangerschaft"
        } ]
      } ]
    },
    "linkId": "pregnancy",
    "required": false
  }, {
    "text": "Diabetes",
    "type": "boolean",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Diabète"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "nl-BE"
        }, {
          "url": "content",
          "valueString": "Diabetes"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "de"
        }, {
          "url": "content",
          "valueString": "Diabetes"
        } ]
      } ]
    },
    "linkId": "diabetes",
    "required": true
  }, {
    "text": "Allergy to contrast agent",
    "type": "boolean",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Allergie à l'agent de contraste"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "nl-BE"
        }, {
          "url": "content",
          "valueString": "Allergie voor contrastmiddel"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "de"
        }, {
          "url": "content",
          "valueString": "Allergie gegen Kontrastmittel"
        } ]
      } ]
    },
    "linkId": "allergy-contrast-agent",
    "required": true
  }, {
    "text": "Metallic debris",
    "type": "boolean",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Débris métalliques"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "nl-BE"
        }, {
          "url": "content",
          "valueString": "Metaalfragment"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "de"
        }, {
          "url": "content",
          "valueString": "Metallischer Fremdkörper"
        } ]
      } ]
    },
    "linkId": "metallic-debris",
    "required": true
  }, {
    "text": "Renal dysfunction",
    "type": "boolean",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Insuffisance rénale"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "nl-BE"
        }, {
          "url": "content",
          "valueString": "Nierinsufficiëntie"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "de"
        }, {
          "url": "content",
          "valueString": "Niereninsuffizienz"
        } ]
      } ]
    },
    "linkId": "renal-dysfunction",
    "required": true
  }, {
    "text": "Other",
    "type": "text",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Autre"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "nl-BE"
        }, {
          "url": "content",
          "valueString": "Andere"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "de"
        }, {
          "url": "content",
          "valueString": "Sonstiges"
        } ]
      } ]
    },
    "linkId": "other",
    "required": false
  }, {
    "text": "None",
    "type": "boolean",
    "_text": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "fr-BE"
        }, {
          "url": "content",
          "valueString": "Aucun"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "nl-BE"
        }, {
          "url": "content",
          "valueString": "Geen"
        } ]
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/translation",
        "extension": [ {
          "url": "lang",
          "valueCode": "de"
        }, {
          "url": "content",
          "valueString": "Kein"
        } ]
      } ]
    },
    "linkId": "none",
    "required": true
  } ],
  "type": null,
  "experimental": null,
  "resourceType": "Questionnaire",
  "title": "Imaging Attention Conditions Questionnaire",
  "package_version": "1.0.0",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-constraint",
    "extension": [ {
      "url": "key",
      "valueId": "attn-1"
    }, {
      "url": "severity",
      "valueCode": "error"
    }, {
      "url": "human",
      "valueString": "At least one attention condition must be answered"
    }, {
      "url": "expression",
      "valueString": "item.where(answer.exists()).exists()"
    } ]
  } ],
  "status": "active",
  "id": "12850b5e-edca-45f2-a05d-9cb6cdf3670e",
  "kind": null,
  "url": "https://www.ehealth.fgov.be/standards/fhir/referral/Questionnaire/be-questionnaire-imaging-attention-conditions",
  "version": "1.0.0",
  "contact": [ {
    "name": "eHealth Platform",
    "telecom": [ {
      "value": "https://www.ehealth.fgov.be/standards/fhir",
      "system": "url"
    }, {
      "value": "support@be-ehealth-standards.atlassian.net",
      "system": "email"
    } ]
  }, {
    "name": "Message Structure eHealth",
    "telecom": [ {
      "use": "work",
      "value": "support@be-ehealth-standards.atlassian.net",
      "system": "email"
    } ]
  } ]
}