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HIV_Discontinuation.json
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HIV_Discontinuation.json
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{
"name": "HIV Discontinuation",
"description": "HIV Discontinuation",
"version": "1",
"published": true,
"uuid": "e3237ede-fa70-451f-9e6c-0908bc39f8b9",
"retired": false,
"encounter": "HIV Discontinuation",
"meta": {
"programs": {
"uuid": "dfdc6d40-2f2f-463d-ba90-cc97350441a8",
"isEnrollment": false,
"discontinuationDateQuestionId": "discontinueDate"
}
},
"pages": [
{
"label": "HIV Discontinuation",
"sections": [
{
"label": "Visit Details",
"isExpanded": "true",
"questions": [
{
"label": "Date:",
"type": "encounterDatetime",
"questionOptions": {
"rendering": "ui-select-extended"
},
"id": "encDate",
"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": "HIV Discontinuation",
"isExpanded": "true",
"questions": [
{
"label": "Effective discontinuation date",
"type": "obs",
"id": "discontinueDate",
"required": "true",
"questionOptions": {
"concept": "164384AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "date"
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
},
{
"type": "js_expression",
"failsWhenExpression": "(new moment(encDate)).isAfter((new moment(myValue)), 'day'))",
"message": "Discontinuation Date should not be greater than the encounter date."
}
]
},
{
"label": "Reason:",
"type": "obs",
"id": "idReason",
"required": "true",
"questionOptions": {
"concept": "161555AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "select",
"answers": [
{
"concept": "5240AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Lost to Follow"
},
{
"concept": "819AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Cannot afford Treatment"
},
{
"concept": "1067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Unknown"
},
{
"concept": "164349AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Stopped Treatment"
},
{
"concept": "159492AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Transferred Out"
},
{
"concept": "160034AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Died"
},
{
"concept": "5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Other"
}
]
}
},
{
"label": "Date of Death, if Known:",
"type": "obs",
"id": "dateOfDeath",
"questionOptions": {
"concept": "1543AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "date"
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
},
{
"type": "js_expression",
"failsWhenExpression": "(new moment(encDate)).isAfter((new moment(myValue)), 'day'))",
"message": "Date client died should not be greater than the encounter date."
}
],
"hide": {
"hideWhenExpression": "isEmpty(idReason) || idReason !== '160034AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
},
{
"label": "Death reason:",
"type": "obs",
"id": "deathReason",
"required": "true",
"questionOptions": {
"concept": "1599AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "select",
"answers": [
{
"concept": "163324AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in TB"
},
{
"concept": "116030AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in cancer"
},
{
"concept": "142917AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Unknown cause"
},
{
"concept": "160159AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other infectious and parasitic diseases"
},
{
"concept": "160158AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Other HIV disease resulting in other diseases or conditions leading to death"
},
{
"concept": "133478AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Other natural causes not directly related to HIV"
},
{
"concept": "123812AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Non-natural causes"
}
]
},
"hide": {
"hideWhenExpression": "isEmpty(idReason) || idReason !== '160034AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
},
{
"label": "Specific cause of death:",
"type": "obs",
"required": "true",
"id": "specificCauseOfDeath",
"questionOptions": {
"concept": "1748AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "select",
"answers": [
{
"concept": "123122AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other viral infections"
},
{
"concept": "5333AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other bacterial infections"
},
{
"concept": "156670AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other specified diseases including encephalopathy or lymphoid interstitial pneumonitis or wasting syndrome and others"
},
{
"concept": "156667AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in Burkitts lymphoma"
},
{
"concept": "115195AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other types of non-Hodgkin lymphoma"
},
{
"concept": "145439AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Non-communicable diseases such as Diabetes and hypertension"
},
{
"concept": "116031AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in unspecified malignant neoplasms"
},
{
"concept": "5350AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other mycoses"
},
{
"concept": "882AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in Pneumocystis jirovecii pneumonia - HIV disease resulting in Pneumocystis carinii pneumonia"
},
{
"concept": "156672AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in multiple malignant neoplasms"
},
{
"concept": "155010AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in Kaposis sarcoma"
},
{
"concept": "160160AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other conditions including acute HIV infection syndrome or persistent generalized lymphadenopathy or hematological and immunological abnormalities and others"
},
{
"concept": "156668AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in candidiasis"
},
{
"concept": "156671AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in multiple infections"
},
{
"concept": "159988AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other malignant neoplasms"
},
{
"concept": "156673AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in mycobacterial infection"
},
{
"concept": "156669AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in cytomegaloviral disease"
},
{
"concept": "171AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in unspecified infectious or parasitic disease - HIV disease resulting in infection NOS"
},
{
"concept": "165609AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "COVID-19 Complications"
},
{
"concept": "161548AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in Unspecified HIV disease"
},
{
"concept": "160159AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other infectious and parasitic diseases"
},
{
"concept": "157593AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "HIV disease resulting in other malignant neoplasms of lymphoid and haematopoietic and related tissue"
}
]
},
"hide": {
"hideWhenExpression": "isEmpty(idReason) || idReason !== '160034AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' || deathReason === '123812AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' || deathReason === '133478AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' || deathReason === '142917AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' "
}
},
{
"label": "Other natural causes:",
"type": "obs",
"id": "otherNaturalCauses",
"questionOptions": {
"concept": "162580AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "text"
},
"hide": {
"hideWhenExpression": "isEmpty(idReason) || idReason !== '160034AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' || deathReason !== '133478AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' "
}
},
{
"label": "Non-natural causes:",
"type": "obs",
"id": "nonNaturalCauses",
"questionOptions": {
"concept": "160218AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "text"
},
"hide": {
"hideWhenExpression": "isEmpty(idReason) || idReason !== '160034AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' || deathReason !== '123812AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' "
}
},
{
"label": "Transfer to Facility:",
"type": "obs",
"id": "transferToFacility",
"questionOptions": {
"concept": "159495AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "encounterLocation"
},
"hide": {
"hideWhenExpression": "isEmpty(idReason) || idReason !== '159492AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
},
{
"label": "Date Transferred Out",
"type": "obs",
"id": "transferOutDate",
"questionOptions": {
"concept": "160649AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "date"
},
"hide": {
"hideWhenExpression": "isEmpty(idReason) || idReason !== '159492AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
},
{
"type": "js_expression",
"failsWhenExpression": "(new moment(encDate)).isAfter((new moment(myValue)), 'day'))",
"message": "Date transferred out should not be greater than the encounter date."
}
]
},
{
"label": "Transfer out verified?",
"type": "obs",
"id": "trVerifiedObs",
"questionOptions": {
"concept": "1285AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "radio",
"answers": [
{
"concept": "1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "No"
},
{
"concept": "1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"label": "Yes"
}
]
},
"hide": {
"hideWhenExpression": "isEmpty(idReason) || idReason !== '159492AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
}
},
{
"label": "Date verified",
"type": "obs",
"id": "trfVerificationDate",
"questionOptions": {
"concept": "164133AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA",
"rendering": "date"
},
"hide": {
"hideWhenExpression": "isEmpty(idReason) || (trVerifiedObs !== '1065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' && trVerifiedObs !== '1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA') || trVerifiedObs === '1066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'"
},
"validators": [
{
"type": "date",
"allowFutureDates": "false"
},
{
"type": "js_expression",
"failsWhenExpression": "(new moment(encDate)).isAfter((new moment(myValue)), 'day'))",
"message": "Date verified should not be greater than the encounter date."
}
]
}
]
}
]
}
],
"processor": "EncounterFormProcessor",
"referencedForms": []
}