MEDB18AudiometryQuestionnaire
type: Questionnaire
node role: treeRoot
id:
  v: MEDB18AudiometryQuestionnaire
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: Questionnaire MEDB18AudiometryQuestionnaire Structure LinkID Text Cardinality Type Flags Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> MEDB18Audiometry NASA Medical Requirements Integration Document for audiometric assessment. Captures pre- and postflight hearing threshold data to monitor crew hearing status. Questionnaire https://mitre.org/fhir/space-health/Questionnaire/medb-1-8-audiometry#0.5.12 #xD; overview Medical Requirements Overview 0..1 group #xD; overview.mrid-number MRID Number and Title 0..1 display Initial Value: string = MEDB 1.8 Audiometry #xD; overview.sponsor Sponsor 1..1 choice Options: 1 option Initial Value: Coding = NASA MRID Sponsor Organizations#medical-operations "Medical Operations" #xD; overview.discipline Discipline 1..1 choice Options: 1 option Initial Value: Coding = NASA MRID Medical Disciplines#audiology "Audiology" #xD; overview.purpose Purpose/Objectives 1..1 text Initial Value: string = To assess pre- and postflight hearing thresholds on crew members using pure tone audiometry. To track hearing changes across missions. #xD; overview.measurement-parameters Measurement Parameters 1..1 string Initial Value: string = Pure tone air conduction thresholds at 500, 1000, 2000, 3000, 4000, 6000, 8000 Hz #xD; overview.flight-duration Flight Duration 1..1 string Initial Value: string = >= 30 days #xD; preflight-training Preflight Training 0..1 group #xD; preflight-training.na No Preflight Training Required 0..1 display #xD; preflight-activities Preflight Activities 0..1 group #xD; preflight-activities.description Activity Description 0..1 text Initial Value: string = Pure tone audiometry is performed in a sound-treated booth. Testing includes air conduction thresholds at standard frequencies. #xD; preflight-activities.duration Duration (minutes) 1..1 integer Initial Value: integer = 15 #xD; preflight-activities.schedule Schedule 1..1 string Initial Value: string = Annual medica…
extension:
  extension:
    url:
      v: name
      l: name
    value: Coding
      system:
        v: http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext
        l: launchContext
      code:
        v: patient
  extension:
    url:
      v: type
      l: type
    value: Code
      v: Patient
  extension:
    url:
      v: description
      l: description
    value: String
      v: The astronaut/crewmember subject of this medical requirement
  url:
    v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext
    l: sdc-questionnaire-launchContext
url:
  v: https://mitre.org/fhir/space-health/Questionnaire/medb-1-8-audiometry
  l: medb-1-8-audiometry
version:
  v: 0.5.12
name:
  v: MEDB18Audiometry
title:
  v: MEDB 1.8 Audiometry
status:
  v: active
date:
  v: 2017-06-05
publisher:
  v: MITRE
contact:
  name:
    v: MITRE
  telecom:
    system:
      v: url
    value:
      v: https://www.mitre.org/
description:
  v: NASA Medical Requirements Integration Document for audiometric assessment. Captures pre- and postflight hearing threshold data to monitor crew hearing status.
purpose:
  v: To assess pre- and postflight hearing thresholds on crew members using pure tone audiometry
copyright:
  v: NASA Johnson Space Center - Medical Requirements Integration Documents (MRIDs) JSC28913
item:
  link id:
    v: overview
  text:
    v: Medical Requirements Overview
  type:
    v: group
  item:
    link id:
      v: overview.mrid-number
    text:
      v: MRID Number and Title
    type:
      v: display
    initial:
      value: String
        v: MEDB 1.8 Audiometry
  item:
    link id:
      v: overview.sponsor
    text:
      v: Sponsor
    type:
      v: choice
    required:
      v: true
    read only:
      v: true
    answer option:
      value: Coding
    initial:
      value: Coding
  item:
    link id:
      v: overview.discipline
    text:
      v: Discipline
    type:
      v: choice
    required:
      v: true
    read only:
      v: true
    answer option:
      value: Coding
    initial:
      value: Coding
  item:
    link id:
      v: overview.purpose
    text:
      v: Purpose/Objectives
    type:
      v: text
    required:
      v: true
    initial:
      value: String
        v: To assess pre- and postflight hearing thresholds on crew members using pure tone audiometry. To track hearing changes across missions.
  item:
    link id:
      v: overview.measurement-parameters
    text:
      v: Measurement Parameters
    type:
      v: string
    required:
      v: true
    initial:
      value: String
        v: Pure tone air conduction thresholds at 500, 1000, 2000, 3000, 4000, 6000, 8000 Hz
  item:
    link id:
      v: overview.flight-duration
    text:
      v: Flight Duration
    type:
      v: string
    required:
      v: true
    initial:
      value: String
        v: >= 30 days
item:
  link id:
    v: preflight-training
  text:
    v: Preflight Training
  type:
    v: group
  item:
    link id:
      v: preflight-training.na
    text:
      v: No Preflight Training Required
    type:
      v: display
item:
  link id:
    v: preflight-activities
  text:
    v: Preflight Activities
  type:
    v: group
  item:
    link id:
      v: preflight-activities.description
    text:
      v: Activity Description
    type:
      v: text
    initial:
      value: String
        v: Pure tone audiometry is performed in a sound-treated booth. Testing includes air conduction thresholds at standard frequencies.
  item:
    link id:
      v: preflight-activities.duration
    text:
      v: Duration (minutes)
    type:
      v: integer
    required:
      v: true
    initial:
      value: Integer
        v: 15
  item:
    link id:
      v: preflight-activities.schedule
    text:
      v: Schedule
    type:
      v: string
    required:
      v: true
    initial:
      value: String
        v: Annual medical examination and L-60 to L-10 days

v: medical-operations

v: Medical Operations

v: medical-operations

v: Medical Operations

v: audiology

v: Audiology

v: audiology

v: Audiology

link id:
  v: preflight-activities.hardware
text:
  v: Preflight Hardware
type:
  v: choice
required:
  v: true
answer option:
  value: Coding
    system:
      v: https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-hardware-cs
      l: nasa-medical-hardware-cs
    code:
      v: audiometer
    display:
      v: Audiometer
initial:
  value: Coding
    system:
      v: https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-hardware-cs
      l: nasa-medical-hardware-cs
    code:
      v: audiometer
    display:
      v: Audiometer

link id:
  v: preflight-activities.location
text:
  v: Test Location
type:
  v: choice
required:
  v: true
answer option:
  value: Coding
    system:
      v: https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-facility-cs
      l: nasa-medical-facility-cs
    code:
      v: jsc
    display:
      v: Johnson Space Center
initial:
  value: Coding
    system:
      v: https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-facility-cs
      l: nasa-medical-facility-cs
    code:
      v: jsc
    display:
      v: Johnson Space Center

link id:
  v: preflight-activities.test-date
text:
  v: Preflight Audiometry Date
type:
  v: date
required:
  v: false

link id:
  v: preflight-activities.test-completed
text:
  v: Preflight Audiometry Completed
type:
  v: boolean
required:
  v: true

link id:
  v: preflight-audiometry-results
text:
  v: Preflight Audiometry Results
type:
  v: group
item:
  link id:
    v: preflight-audiometry-results.right-ear
  text:
    v: Right Ear Thresholds
  type:
    v: group
  item:
    link id:
      v: preflight-audiometry-results.right-ear.500hz
    code: https://loinc.org/rdf/89024-4
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89024-4
      display:
        v: Hearing threshold Ear - right --500 Hz
    text:
      v: 500 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.right-ear.1000hz
    code: https://loinc.org/rdf/89023-6
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89023-6
      display:
        v: Hearing threshold Ear - right --1000 Hz
    text:
      v: 1000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.right-ear.2000hz
    code: https://loinc.org/rdf/89022-8
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89022-8
      display:
        v: Hearing threshold Ear - right --2000 Hz
    text:
      v: 2000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.right-ear.3000hz
    code: https://loinc.org/rdf/89021-0
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89021-0
      display:
        v: Hearing threshold Ear - right --3000 Hz
    text:
      v: 3000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.right-ear.4000hz
    code: https://loinc.org/rdf/89020-2
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89020-2
      display:
        v: Hearing threshold Ear - right --4000 Hz
    text:
      v: 4000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.right-ear.6000hz
    code: https://loinc.org/rdf/89019-4
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89019-4
      display:
        v: Hearing threshold Ear - right --6000 Hz
    text:
      v: 6000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.right-ear.8000hz
    code: https://loinc.org/rdf/89018-6
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89018-6
      display:
        v: Hearing threshold Ear - right --8000 Hz
    text:
      v: 8000 Hz Threshold (dB HL)
    type:
      v: integer
item:
  link id:
    v: preflight-audiometry-results.left-ear
  text:
    v: Left Ear Thresholds
  type:
    v: group
  item:
    link id:
      v: preflight-audiometry-results.left-ear.500hz
    code: https://loinc.org/rdf/89017-8
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89017-8
      display:
        v: Hearing threshold Ear - left --500 Hz
    text:
      v: 500 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.left-ear.1000hz
    code: https://loinc.org/rdf/89016-0
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89016-0
      display:
        v: Hearing threshold Ear - left --1000 Hz
    text:
      v: 1000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.left-ear.2000hz
    code: https://loinc.org/rdf/89015-2
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89015-2
      display:
        v: Hearing threshold Ear - left --2000 Hz
    text:
      v: 2000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.left-ear.3000hz
    code: https://loinc.org/rdf/89014-5
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89014-5
      display:
        v: Hearing threshold Ear - left --3000 Hz
    text:
      v: 3000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.left-ear.4000hz
    code: https://loinc.org/rdf/89013-7
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89013-7
      display:
        v: Hearing threshold Ear - left --4000 Hz
    text:
      v: 4000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: preflight-audiometry-results.left-ear.6000hz
    code: https://loinc.org/rdf/89012-9

https://loinc.org/rdf/89012-9
system:
  v: http://loinc.org
  l: loinc.org
code:
  v: 89012-9
display:
  v: Hearing threshold Ear - left --6000 Hz

v: 6000 Hz Threshold (dB HL)

v: integer

link id:
  v: preflight-audiometry-results.left-ear.8000hz
code: https://loinc.org/rdf/89011-1
  system:
    v: http://loinc.org
    l: loinc.org
  code:
    v: 89011-1
  display:
    v: Hearing threshold Ear - left --8000 Hz
text:
  v: 8000 Hz Threshold (dB HL)
type:
  v: integer

link id:
  v: preflight-audiometry-results.interpretation
text:
  v: Audiometric Interpretation
type:
  v: choice
answer option:
  value: Coding
    type: http://snomed.info/id/162339002
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 162339002
    display:
      v: Hearing normal
answer option:
  value: Coding
    type: http://snomed.info/id/15188001
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 15188001
    display:
      v: Hearing loss
answer option:
  value: Coding
    type: http://snomed.info/id/95820000
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 95820000
    display:
      v: Bilateral hearing loss

link id:
  v: preflight-audiometry-results.notes
text:
  v: Audiometric Notes
type:
  v: text

link id:
  v: inflight-activities
text:
  v: In-Flight Activities
type:
  v: group
item:
  link id:
    v: inflight-activities.na
  text:
    v: No In-Flight Activities
  type:
    v: display

link id:
  v: postflight-activities
text:
  v: Postflight Activities
type:
  v: group
item:
  link id:
    v: postflight-activities.schedule
  text:
    v: Schedule
  type:
    v: string
  initial:
    value: String
      v: R+3 to R+7 days
item:
  link id:
    v: postflight-activities.test-date
  text:
    v: Postflight Audiometry Date
  type:
    v: date
item:
  link id:
    v: postflight-activities.test-completed
  text:
    v: Postflight Audiometry Completed
  type:
    v: boolean
  required:
    v: true

link id:
  v: postflight-audiometry-results
text:
  v: Postflight Audiometry Results
type:
  v: group
item:
  link id:
    v: postflight-audiometry-results.right-ear
  text:
    v: Right Ear Thresholds
  type:
    v: group
  item:
    link id:
      v: postflight-audiometry-results.right-ear.500hz
    code: https://loinc.org/rdf/89024-4
      system:
        v: http://loinc.org
        l: loinc.org
      code:
        v: 89024-4
      display:
        v: Hearing threshold Ear - right --500 Hz
    text:
      v: 500 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.right-ear.1000hz
    text:
      v: 1000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.right-ear.2000hz
    text:
      v: 2000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.right-ear.4000hz
    text:
      v: 4000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.right-ear.6000hz
    text:
      v: 6000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.right-ear.8000hz
    text:
      v: 8000 Hz Threshold (dB HL)
    type:
      v: integer
item:
  link id:
    v: postflight-audiometry-results.left-ear
  text:
    v: Left Ear Thresholds
  type:
    v: group
  item:
    link id:
      v: postflight-audiometry-results.left-ear.500hz
    text:
      v: 500 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.left-ear.1000hz
    text:
      v: 1000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.left-ear.2000hz
    text:
      v: 2000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.left-ear.4000hz
    text:
      v: 4000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.left-ear.6000hz
    text:
      v: 6000 Hz Threshold (dB HL)
    type:
      v: integer
  item:
    link id:
      v: postflight-audiometry-results.left-ear.8000hz
    text:
      v: 8000 Hz Threshold (dB HL)
    type:
      v: integer
item:
  link id:
    v: postflight-audiometry-results.interpretation
  text:
    v: Audiometric Interpretation
  type:
    v: choice
  answer option:
    value: Coding
      type: http://snomed.info/id/162339002
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 162339002
      display:
        v: Hearing normal
  answer option:
    value: Coding
      type: http://snomed.info/id/15188001
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 15188001
      display:
        v: Hearing loss
  answer option:
    value: Coding
      type: http://snomed.info/id/95820000
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 95820000
      display:
        v: Bilateral hearing loss
item:
  link id:
    v: postflight-audiometry-results.comparison
  text:
    v: Comparison to Preflight
  type:
    v: choice
  answer option:
    value: String
      v: No significant change
  answer option:
    value: String
      v: Threshold shift detected
  answer option:
    value: String
      v: Unable to compare

link id:
  v: data-delivery
text:
  v: Data Delivery
type:
  v: group
item:
  link id:
    v: data-delivery.archive
  text:
    v: Data Archive System
  type:
    v: choice
  answer option:
    value: Coding
      system:
        v: https://mitre.org/fhir/space-health/CodeSystem/nasa-data-archive-cs
        l: nasa-data-archive-cs
      code:
        v: mmis
      display:
        v: Medical Mission Information System
  initial:
    value: Coding
      system:
        v: https://mitre.org/fhir/space-health/CodeSystem/nasa-data-archive-cs
        l: nasa-data-archive-cs
      code:
        v: mmis
      display:
        v: Medical Mission Information System

link id:
  v: postflight-debrief
text:
  v: Postflight Debrief
type:
  v: group
item:
  link id:
    v: postflight-debrief.na
  text:
    v: N/A - Included as part of Medical Operations overall debrief
  type:
    v: display