{ "resourceType" : "Questionnaire", "id" : "MEDB21RoutineLabPanelQuestionnaire", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire MEDB21RoutineLabPanelQuestionnaire

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\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\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\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\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeFlagsDescription & Constraints\"doco\"
\".\"\".\" MEDB21RoutineLabPanelNASA Medical Requirements Integration Document for routine laboratory panel. Captures comprehensive blood chemistry, hematology, and urinalysis data for spaceflight crew members.Questionnairehttps://mitre.org/fhir/space-health/Questionnaire/medb-2-1-routine-lab-panel#0.5.12
\".\"\".\"\".\" overviewMedical Requirements Overview0..1group
\".\"\".\"\".\"\".\" overview.mrid-numberMRID Number and Title0..1displayInitial Value: string = MEDB 2.1 Routine Laboratory Panel
\".\"\".\"\".\"\".\" overview.sponsorSponsor1..1choice\"icon\"/\"icon\"/Options: 1 option
Initial Value: Coding = NASA MRID Sponsor Organizations#medical-operations "Medical Operations"
\".\"\".\"\".\"\".\" overview.disciplineDiscipline1..1choice\"icon\"/\"icon\"/Options: 1 option
Initial Value: Coding = NASA MRID Medical Disciplines#laboratory "Laboratory"
\".\"\".\"\".\"\".\" overview.purposePurpose/Objectives1..1textInitial Value: string = To obtain comprehensive clinical laboratory data for health assessment, establish baselines, and monitor for spaceflight-related physiological changes.
\".\"\".\"\".\"\".\" overview.measurement-parametersMeasurement Parameters1..1stringInitial Value: string = Complete blood count, comprehensive metabolic panel, lipid panel, urinalysis
\".\"\".\"\".\"\".\" overview.flight-durationFlight Duration1..1stringInitial Value: string = All flights >= 30 days
\".\"\".\"\".\" preflight-trainingPreflight Training0..1group
\".\"\".\"\".\"\".\" preflight-training.naNo Preflight Training Required0..1display
\".\"\".\"\".\" preflight-activitiesPreflight Activities0..1group
\".\"\".\"\".\"\".\" preflight-activities.descriptionActivity Description0..1textInitial Value: string = Fasting blood draw and urine collection for comprehensive laboratory analysis.
\".\"\".\"\".\"\".\" preflight-activities.durationDuration (minutes)1..1integerInitial Value: integer = 30
\".\"\".\"\".\"\".\" preflight-activities.scheduleSchedule1..1stringInitial Value: string = AME L-9/6 m, L-60 to L-10 days
\".\"\".\"\".\"\".\" preflight-activities.fasting-requiredFasting Required (8-12 hours)1..1booleanInitial Value: boolean = true
\".\"\".\"\".\"\".\" preflight-activities.locationTest Location1..1choiceOptions: 1 option
Initial Value: Coding = NASA Medical Facility Locations#jsc "Johnson Space Center"
\".\"\".\"\".\"\".\" preflight-activities.collection-dateSample Collection Date0..1date
\".\"\".\"\".\"\".\" preflight-activities.collection-completedSample Collection Completed1..1boolean
\".\"\".\"\".\" preflight-cbcPreflight Complete Blood Count0..1group
\".\"\".\"\".\"\".\" preflight-cbc.wbcWBC (10^3/uL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cbc.rbcRBC (10^6/uL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cbc.hemoglobinHemoglobin (g/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cbc.hematocritHematocrit (%)0..1decimal
\".\"\".\"\".\"\".\" preflight-cbc.mcvMCV (fL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cbc.mchMCH (pg)0..1decimal
\".\"\".\"\".\"\".\" preflight-cbc.mchcMCHC (g/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cbc.plateletsPlatelets (10^3/uL)0..1decimal
\".\"\".\"\".\" preflight-cmpPreflight Comprehensive Metabolic Panel0..1group
\".\"\".\"\".\"\".\" preflight-cmp.glucoseGlucose (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.bunBUN (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.creatinineCreatinine (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.sodiumSodium (mEq/L)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.potassiumPotassium (mEq/L)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.chlorideChloride (mEq/L)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.co2CO2 (mEq/L)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.calciumCalcium (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.total-proteinTotal Protein (g/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.albuminAlbumin (g/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.bilirubinTotal Bilirubin (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.alpAlkaline Phosphatase (U/L)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.astAST (U/L)0..1decimal
\".\"\".\"\".\"\".\" preflight-cmp.altALT (U/L)0..1decimal
\".\"\".\"\".\" preflight-lipidPreflight Lipid Panel0..1group
\".\"\".\"\".\"\".\" preflight-lipid.total-cholesterolTotal Cholesterol (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-lipid.hdlHDL Cholesterol (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-lipid.ldlLDL Cholesterol (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" preflight-lipid.triglyceridesTriglycerides (mg/dL)0..1decimal
\".\"\".\"\".\" inflight-activitiesIn-Flight Activities0..1group
\".\"\".\"\".\"\".\" inflight-activities.naNo routine in-flight laboratory collection for this MRID0..1display
\".\"\".\"\".\" postflight-activitiesPostflight Activities0..1group
\".\"\".\"\".\"\".\" postflight-activities.scheduleSchedule0..1stringInitial Value: string = R+0 to R+3 days
\".\"\".\"\".\"\".\" postflight-activities.collection-dateSample Collection Date0..1date
\".\"\".\"\".\"\".\" postflight-activities.collection-completedSample Collection Completed1..1boolean
\".\"\".\"\".\" postflight-cbcPostflight Complete Blood Count0..1group
\".\"\".\"\".\"\".\" postflight-cbc.wbcWBC (10^3/uL)0..1decimal
\".\"\".\"\".\"\".\" postflight-cbc.rbcRBC (10^6/uL)0..1decimal
\".\"\".\"\".\"\".\" postflight-cbc.hemoglobinHemoglobin (g/dL)0..1decimal
\".\"\".\"\".\"\".\" postflight-cbc.hematocritHematocrit (%)0..1decimal
\".\"\".\"\".\"\".\" postflight-cbc.plateletsPlatelets (10^3/uL)0..1decimal
\".\"\".\"\".\" postflight-cmpPostflight Key Metabolic Values0..1group
\".\"\".\"\".\"\".\" postflight-cmp.glucoseGlucose (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" postflight-cmp.creatinineCreatinine (mg/dL)0..1decimal
\".\"\".\"\".\"\".\" postflight-cmp.sodiumSodium (mEq/L)0..1decimal
\".\"\".\"\".\"\".\" postflight-cmp.potassiumPotassium (mEq/L)0..1decimal
\".\"\".\"\".\" data-deliveryData Delivery0..1group
\".\"\".\"\".\"\".\" data-delivery.archiveData Archive System0..1choiceOptions: 1 option
Initial Value: Coding = NASA Medical Data Archive Systems#mmis "Medical Mission Information System"
\".\"\".\"\".\" postflight-debriefPostflight Debrief0..1group
\".\"\".\"\".\"\".\" postflight-debrief.naN/A - Included as part of Medical Operations overall debrief0..1display

\"doco\" Documentation for this format

Options Sets

Answer options for overview.sponsor

Answer options for overview.discipline

Answer options for preflight-activities.location

Answer options for data-delivery.archive

" }, "extension" : [{ "extension" : [{ "url" : "name", "valueCoding" : { "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext", "code" : "patient" } }, { "url" : "type", "valueCode" : "Patient" }, { "url" : "description", "valueString" : "The astronaut/crewmember subject of this medical requirement" }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext" }], "url" : "https://mitre.org/fhir/space-health/Questionnaire/medb-2-1-routine-lab-panel", "version" : "0.5.12", "name" : "MEDB21RoutineLabPanel", "title" : "MEDB 2.1 Routine Laboratory Panel", "status" : "active", "date" : "2017-06-05", "publisher" : "MITRE", "contact" : [{ "name" : "MITRE", "telecom" : [{ "system" : "url", "value" : "https://www.mitre.org/" }] }], "description" : "NASA Medical Requirements Integration Document for routine laboratory panel. Captures comprehensive blood chemistry, hematology, and urinalysis data for spaceflight crew members.", "purpose" : "To assess pre- and postflight clinical laboratory values for comprehensive health assessment of spaceflight crew members", "copyright" : "NASA Johnson Space Center - Medical Requirements Integration Documents (MRIDs) JSC28913", "item" : [{ "linkId" : "overview", "text" : "Medical Requirements Overview", "type" : "group", "item" : [{ "linkId" : "overview.mrid-number", "text" : "MRID Number and Title", "type" : "display", "initial" : [{ "valueString" : "MEDB 2.1 Routine Laboratory Panel" }] }, { "linkId" : "overview.sponsor", "text" : "Sponsor", "type" : "choice", "required" : true, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-sponsor-cs", "code" : "medical-operations", "display" : "Medical Operations" } }], "initial" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-sponsor-cs", "code" : "medical-operations", "display" : "Medical Operations" } }] }, { "linkId" : "overview.discipline", "text" : "Discipline", "type" : "choice", "required" : true, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-discipline-cs", "code" : "laboratory", "display" : "Laboratory" } }], "initial" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-discipline-cs", "code" : "laboratory", "display" : "Laboratory" } }] }, { "linkId" : "overview.purpose", "text" : "Purpose/Objectives", "type" : "text", "required" : true, "initial" : [{ "valueString" : "To obtain comprehensive clinical laboratory data for health assessment, establish baselines, and monitor for spaceflight-related physiological changes." }] }, { "linkId" : "overview.measurement-parameters", "text" : "Measurement Parameters", "type" : "string", "required" : true, "initial" : [{ "valueString" : "Complete blood count, comprehensive metabolic panel, lipid panel, urinalysis" }] }, { "linkId" : "overview.flight-duration", "text" : "Flight Duration", "type" : "string", "required" : true, "initial" : [{ "valueString" : "All flights >= 30 days" }] }] }, { "linkId" : "preflight-training", "text" : "Preflight Training", "type" : "group", "item" : [{ "linkId" : "preflight-training.na", "text" : "No Preflight Training Required", "type" : "display" }] }, { "linkId" : "preflight-activities", "text" : "Preflight Activities", "type" : "group", "item" : [{ "linkId" : "preflight-activities.description", "text" : "Activity Description", "type" : "text", "initial" : [{ "valueString" : "Fasting blood draw and urine collection for comprehensive laboratory analysis." }] }, { "linkId" : "preflight-activities.duration", "text" : "Duration (minutes)", "type" : "integer", "required" : true, "initial" : [{ "valueInteger" : 30 }] }, { "linkId" : "preflight-activities.schedule", "text" : "Schedule", "type" : "string", "required" : true, "initial" : [{ "valueString" : "AME L-9/6 m, L-60 to L-10 days" }] }, { "linkId" : "preflight-activities.fasting-required", "text" : "Fasting Required (8-12 hours)", "type" : "boolean", "required" : true, "initial" : [{ "valueBoolean" : true }] }, { "linkId" : "preflight-activities.location", "text" : "Test Location", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-facility-cs", "code" : "jsc", "display" : "Johnson Space Center" } }], "initial" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-facility-cs", "code" : "jsc", "display" : "Johnson Space Center" } }] }, { "linkId" : "preflight-activities.collection-date", "text" : "Sample Collection Date", "type" : "date" }, { "linkId" : "preflight-activities.collection-completed", "text" : "Sample Collection Completed", "type" : "boolean", "required" : true }] }, { "linkId" : "preflight-cbc", "text" : "Preflight Complete Blood Count", "type" : "group", "item" : [{ "linkId" : "preflight-cbc.wbc", "code" : [{ "system" : "http://loinc.org", "code" : "6690-2", "display" : "Leukocytes [#/volume] in Blood by Automated count" }], "text" : "WBC (10^3/uL)", "type" : "decimal" }, { "linkId" : "preflight-cbc.rbc", "code" : [{ "system" : "http://loinc.org", "code" : "789-8", "display" : "Erythrocytes [#/volume] in Blood by Automated count" }], "text" : "RBC (10^6/uL)", "type" : "decimal" }, { "linkId" : "preflight-cbc.hemoglobin", "code" : [{ "system" : "http://loinc.org", "code" : "718-7", "display" : "Hemoglobin [Mass/volume] in Blood" }], "text" : "Hemoglobin (g/dL)", "type" : "decimal" }, { "linkId" : "preflight-cbc.hematocrit", "code" : [{ "system" : "http://loinc.org", "code" : "4544-3", "display" : "Hematocrit [Volume Fraction] of Blood by Automated count" }], "text" : "Hematocrit (%)", "type" : "decimal" }, { "linkId" : "preflight-cbc.mcv", "code" : [{ "system" : "http://loinc.org", "code" : "787-2", "display" : "MCV [Entitic volume] by Automated count" }], "text" : "MCV (fL)", "type" : "decimal" }, { "linkId" : "preflight-cbc.mch", "code" : [{ "system" : "http://loinc.org", "code" : "785-6", "display" : "MCH [Entitic mass] by Automated count" }], "text" : "MCH (pg)", "type" : "decimal" }, { "linkId" : "preflight-cbc.mchc", "code" : [{ "system" : "http://loinc.org", "code" : "786-4", "display" : "MCHC [Mass/volume] by Automated count" }], "text" : "MCHC (g/dL)", "type" : "decimal" }, { "linkId" : "preflight-cbc.platelets", "code" : [{ "system" : "http://loinc.org", "code" : "777-3", "display" : "Platelets [#/volume] in Blood by Automated count" }], "text" : "Platelets (10^3/uL)", "type" : "decimal" }] }, { "linkId" : "preflight-cmp", "text" : "Preflight Comprehensive Metabolic Panel", "type" : "group", "item" : [{ "linkId" : "preflight-cmp.glucose", "code" : [{ "system" : "http://loinc.org", "code" : "2345-7", "display" : "Glucose [Mass/volume] in Serum or Plasma" }], "text" : "Glucose (mg/dL)", "type" : "decimal" }, { "linkId" : "preflight-cmp.bun", "code" : [{ "system" : "http://loinc.org", "code" : "3094-0", "display" : "Urea nitrogen [Mass/volume] in Serum or Plasma" }], "text" : "BUN (mg/dL)", "type" : "decimal" }, { "linkId" : "preflight-cmp.creatinine", "code" : [{ "system" : "http://loinc.org", "code" : "2160-0", "display" : "Creatinine [Mass/volume] in Serum or Plasma" }], "text" : "Creatinine (mg/dL)", "type" : "decimal" }, { "linkId" : "preflight-cmp.sodium", "code" : [{ "system" : "http://loinc.org", "code" : "2951-2", "display" : "Sodium [Moles/volume] in Serum or Plasma" }], "text" : "Sodium (mEq/L)", "type" : "decimal" }, { "linkId" : "preflight-cmp.potassium", "code" : [{ "system" : "http://loinc.org", "code" : "2823-3", "display" : "Potassium [Moles/volume] in Serum or Plasma" }], "text" : "Potassium (mEq/L)", "type" : "decimal" }, { "linkId" : "preflight-cmp.chloride", "code" : [{ "system" : "http://loinc.org", "code" : "2075-0", "display" : "Chloride [Moles/volume] in Serum or Plasma" }], "text" : "Chloride (mEq/L)", "type" : "decimal" }, { "linkId" : "preflight-cmp.co2", "code" : [{ "system" : "http://loinc.org", "code" : "2028-9", "display" : "Carbon dioxide, total [Moles/volume] in Serum or Plasma" }], "text" : "CO2 (mEq/L)", "type" : "decimal" }, { "linkId" : "preflight-cmp.calcium", "code" : [{ "system" : "http://loinc.org", "code" : "17861-6", "display" : "Calcium [Mass/volume] in Serum or Plasma" }], "text" : "Calcium (mg/dL)", "type" : "decimal" }, { "linkId" : "preflight-cmp.total-protein", "code" : [{ "system" : "http://loinc.org", "code" : "2885-2", "display" : "Protein [Mass/volume] in Serum or Plasma" }], "text" : "Total Protein (g/dL)", "type" : "decimal" }, { "linkId" : "preflight-cmp.albumin", "code" : [{ "system" : "http://loinc.org", "code" : "1751-7", "display" : "Albumin [Mass/volume] in Serum or Plasma" }], "text" : "Albumin (g/dL)", "type" : "decimal" }, { "linkId" : "preflight-cmp.bilirubin", "code" : [{ "system" : "http://loinc.org", "code" : "1975-2", "display" : "Bilirubin.total [Mass/volume] in Serum or Plasma" }], "text" : "Total Bilirubin (mg/dL)", "type" : "decimal" }, { "linkId" : "preflight-cmp.alp", "code" : [{ "system" : "http://loinc.org", "code" : "6768-6", "display" : "Alkaline phosphatase [Enzymatic activity/volume] in Serum or Plasma" }], "text" : "Alkaline Phosphatase (U/L)", "type" : "decimal" }, { "linkId" : "preflight-cmp.ast", "code" : [{ "system" : "http://loinc.org", "code" : "1920-8", "display" : "Aspartate aminotransferase [Enzymatic activity/volume] in Serum or Plasma" }], "text" : "AST (U/L)", "type" : "decimal" }, { "linkId" : "preflight-cmp.alt", "code" : [{ "system" : "http://loinc.org", "code" : "1742-6", "display" : "Alanine aminotransferase [Enzymatic activity/volume] in Serum or Plasma" }], "text" : "ALT (U/L)", "type" : "decimal" }] }, { "linkId" : "preflight-lipid", "text" : "Preflight Lipid Panel", "type" : "group", "item" : [{ "linkId" : "preflight-lipid.total-cholesterol", "code" : [{ "system" : "http://loinc.org", "code" : "2093-3", "display" : "Cholesterol [Mass/volume] in Serum or Plasma" }], "text" : "Total Cholesterol (mg/dL)", "type" : "decimal" }, { "linkId" : "preflight-lipid.hdl", "code" : [{ "system" : "http://loinc.org", "code" : "2085-9", "display" : "Cholesterol in HDL [Mass/volume] in Serum or Plasma" }], "text" : "HDL Cholesterol (mg/dL)", "type" : "decimal" }, { "linkId" : "preflight-lipid.ldl", "code" : [{ "system" : "http://loinc.org", "code" : "2089-1", "display" : "Cholesterol in LDL [Mass/volume] in Serum or Plasma" }], "text" : "LDL Cholesterol (mg/dL)", "type" : "decimal" }, { "linkId" : "preflight-lipid.triglycerides", "code" : [{ "system" : "http://loinc.org", "code" : "2571-8", "display" : "Triglyceride [Mass/volume] in Serum or Plasma" }], "text" : "Triglycerides (mg/dL)", "type" : "decimal" }] }, { "linkId" : "inflight-activities", "text" : "In-Flight Activities", "type" : "group", "item" : [{ "linkId" : "inflight-activities.na", "text" : "No routine in-flight laboratory collection for this MRID", "type" : "display" }] }, { "linkId" : "postflight-activities", "text" : "Postflight Activities", "type" : "group", "item" : [{ "linkId" : "postflight-activities.schedule", "text" : "Schedule", "type" : "string", "initial" : [{ "valueString" : "R+0 to R+3 days" }] }, { "linkId" : "postflight-activities.collection-date", "text" : "Sample Collection Date", "type" : "date" }, { "linkId" : "postflight-activities.collection-completed", "text" : "Sample Collection Completed", "type" : "boolean", "required" : true }] }, { "linkId" : "postflight-cbc", "text" : "Postflight Complete Blood Count", "type" : "group", "item" : [{ "linkId" : "postflight-cbc.wbc", "text" : "WBC (10^3/uL)", "type" : "decimal" }, { "linkId" : "postflight-cbc.rbc", "text" : "RBC (10^6/uL)", "type" : "decimal" }, { "linkId" : "postflight-cbc.hemoglobin", "text" : "Hemoglobin (g/dL)", "type" : "decimal" }, { "linkId" : "postflight-cbc.hematocrit", "text" : "Hematocrit (%)", "type" : "decimal" }, { "linkId" : "postflight-cbc.platelets", "text" : "Platelets (10^3/uL)", "type" : "decimal" }] }, { "linkId" : "postflight-cmp", "text" : "Postflight Key Metabolic Values", "type" : "group", "item" : [{ "linkId" : "postflight-cmp.glucose", "text" : "Glucose (mg/dL)", "type" : "decimal" }, { "linkId" : "postflight-cmp.creatinine", "text" : "Creatinine (mg/dL)", "type" : "decimal" }, { "linkId" : "postflight-cmp.sodium", "text" : "Sodium (mEq/L)", "type" : "decimal" }, { "linkId" : "postflight-cmp.potassium", "text" : "Potassium (mEq/L)", "type" : "decimal" }] }, { "linkId" : "data-delivery", "text" : "Data Delivery", "type" : "group", "item" : [{ "linkId" : "data-delivery.archive", "text" : "Data Archive System", "type" : "choice", "answerOption" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-data-archive-cs", "code" : "mmis", "display" : "Medical Mission Information System" } }], "initial" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-data-archive-cs", "code" : "mmis", "display" : "Medical Mission Information System" } }] }] }, { "linkId" : "postflight-debrief", "text" : "Postflight Debrief", "type" : "group", "item" : [{ "linkId" : "postflight-debrief.na", "text" : "N/A - Included as part of Medical Operations overall debrief", "type" : "display" }] }] }