{ "resourceType" : "Questionnaire", "id" : "MEDB51AerobicFitnessQuestionnaire", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire MEDB51AerobicFitnessQuestionnaire

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
LinkIDTextCardinalityTypeFlagsDescription & Constraints\"doco\"
\".\"\".\" MEDB51AerobicFitnessNASA Medical Requirements Integration Document for aerobic fitness assessment. Captures VO2max and related cardiovascular fitness data for spaceflight crew members.Questionnairehttps://mitre.org/fhir/space-health/Questionnaire/medb-5-1-aerobic-fitness#0.5.12
\".\"\".\"\".\" overviewMedical Requirements Overview0..1group
\".\"\".\"\".\"\".\" overview.mrid-numberMRID Number and Title0..1displayInitial Value: string = MEDB 5.1 Aerobic Fitness Assessment
\".\"\".\"\".\"\".\" overview.sponsorSponsor1..1choice\"icon\"/\"icon\"/Options: 1 option
Initial Value: Coding = NASA MRID Sponsor Organizations#exercise-physiology "Exercise Physiology"
\".\"\".\"\".\"\".\" overview.disciplineDiscipline1..1choice\"icon\"/\"icon\"/Options: 1 option
Initial Value: Coding = NASA MRID Medical Disciplines#bone-muscle-exercise "Bone/Muscle/Exercise"
\".\"\".\"\".\"\".\" overview.purposePurpose/Objectives1..1textInitial Value: string = To assess aerobic capacity (VO2max) using graded exercise testing. Establish baseline fitness and monitor for spaceflight-related cardiovascular deconditioning.
\".\"\".\"\".\"\".\" overview.measurement-parametersMeasurement Parameters1..1stringInitial Value: string = VO2max, heart rate, blood pressure, workload, rating of perceived exertion
\".\"\".\"\".\"\".\" overview.flight-durationFlight Duration1..1stringInitial Value: string = >= 30 days
\".\"\".\"\".\" preflight-trainingPreflight Training0..1group
\".\"\".\"\".\"\".\" preflight-training.descriptionTraining Description0..1textInitial Value: string = Exercise hardware familiarization including T2 treadmill, CEVIS cycle, and ARED resistive exercise device.
\".\"\".\"\".\"\".\" preflight-training.durationDuration (minutes)0..1integerInitial Value: integer = 120
\".\"\".\"\".\"\".\" preflight-training.scheduleSchedule0..1stringInitial Value: string = L-12 months
\".\"\".\"\".\"\".\" preflight-training.completedTraining Completed0..1boolean
\".\"\".\"\".\" preflight-activitiesPreflight Activities0..1group
\".\"\".\"\".\"\".\" preflight-activities.descriptionActivity Description0..1textInitial Value: string = Graded exercise test (GXT) on treadmill or cycle ergometer with metabolic gas analysis. Test continues to volitional exhaustion or physician-determined endpoint.
\".\"\".\"\".\"\".\" preflight-activities.durationDuration (minutes)0..1integerInitial Value: integer = 45
\".\"\".\"\".\"\".\" preflight-activities.scheduleSchedule0..1stringInitial Value: string = L-180 to L-60 days
\".\"\".\"\".\"\".\" preflight-activities.hardwareTest Hardware0..1choiceOptions: 2 options
\".\"\".\"\".\"\".\" preflight-activities.locationTest Location0..1choiceOptions: 1 option
Initial Value: Coding = NASA Medical Facility Locations#jsc "Johnson Space Center"
\".\"\".\"\".\"\".\" preflight-activities.test-dateTest Date0..1date
\".\"\".\"\".\"\".\" preflight-activities.test-completedTest Completed1..1boolean
\".\"\".\"\".\" preflight-fitness-resultsPreflight Fitness Results0..1group
\".\"\".\"\".\"\".\" preflight-fitness-results.vo2max-absoluteVO2max Absolute (L/min)0..1decimal
\".\"\".\"\".\"\".\" preflight-fitness-results.vo2max-relativeVO2max Relative (mL/kg/min)0..1decimal
\".\"\".\"\".\"\".\" preflight-fitness-results.max-heart-rateMaximum Heart Rate (bpm)0..1integer
\".\"\".\"\".\"\".\" preflight-fitness-results.max-workloadMaximum Workload (Watts or Speed/Grade)0..1string
\".\"\".\"\".\"\".\" preflight-fitness-results.resting-hrResting Heart Rate (bpm)0..1integer
\".\"\".\"\".\"\".\" preflight-fitness-results.resting-bp-systolicResting Systolic BP (mmHg)0..1integer
\".\"\".\"\".\"\".\" preflight-fitness-results.resting-bp-diastolicResting Diastolic BP (mmHg)0..1integer
\".\"\".\"\".\"\".\" preflight-fitness-results.respiratory-exchange-ratioPeak RER0..1decimal
\".\"\".\"\".\"\".\" preflight-fitness-results.test-termination-reasonTest Termination Reason0..1choiceOptions: 6 options
\".\"\".\"\".\"\".\" preflight-fitness-results.fitness-categoryFitness Category0..1choiceOptions: 5 options
\".\"\".\"\".\"\".\" preflight-fitness-results.notesTest Notes0..1text
\".\"\".\"\".\" inflight-activitiesIn-Flight Activities0..1group
\".\"\".\"\".\"\".\" inflight-activities.descriptionActivity Description0..1textInitial Value: string = Periodic submaximal exercise tests using CEVIS or T2 to estimate VO2max changes during mission.
\".\"\".\"\".\"\".\" inflight-activities.scheduleSchedule0..1stringInitial Value: string = Flight Day 14, monthly thereafter
\".\"\".\"\".\"\".\" inflight-activities.inflight-vo2-estimateIn-Flight VO2max Estimate (mL/kg/min)0..1decimal
\".\"\".\"\".\" postflight-activitiesPostflight Activities0..1group
\".\"\".\"\".\"\".\" postflight-activities.scheduleSchedule0..1stringInitial Value: string = R+5 to R+7 days, R+30 days
\".\"\".\"\".\"\".\" postflight-activities.test-datePostflight Test Date0..1date
\".\"\".\"\".\"\".\" postflight-activities.test-completedPostflight Test Completed1..1boolean
\".\"\".\"\".\" postflight-fitness-resultsPostflight Fitness Results0..1group
\".\"\".\"\".\"\".\" postflight-fitness-results.vo2max-absoluteVO2max Absolute (L/min)0..1decimal
\".\"\".\"\".\"\".\" postflight-fitness-results.vo2max-relativeVO2max Relative (mL/kg/min)0..1decimal
\".\"\".\"\".\"\".\" postflight-fitness-results.max-heart-rateMaximum Heart Rate (bpm)0..1integer
\".\"\".\"\".\"\".\" postflight-fitness-results.percent-changePercent Change from Preflight (%)0..1decimal
\".\"\".\"\".\"\".\" postflight-fitness-results.deconditioning-assessmentDeconditioning Assessment0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\" postflight-fitness-results.reconditioning-planReconditioning Plan Required0..1boolean
\".\"\".\"\".\" 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.scheduleSchedule0..1stringInitial Value: string = R+30 days
\".\"\".\"\".\"\".\" postflight-debrief.completedDebrief Completed0..1boolean

\"doco\" Documentation for this format

Options Sets

Answer options for overview.sponsor

Answer options for overview.discipline

Answer options for preflight-activities.hardware

Answer options for preflight-activities.location

Answer options for preflight-fitness-results.test-termination-reason

Answer options for preflight-fitness-results.fitness-category

Answer options for postflight-fitness-results.deconditioning-assessment

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-5-1-aerobic-fitness", "version" : "0.5.12", "name" : "MEDB51AerobicFitness", "title" : "MEDB 5.1 Aerobic Fitness Assessment", "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 aerobic fitness assessment. Captures VO2max and related cardiovascular fitness data for spaceflight crew members.", "purpose" : "To assess pre- and postflight aerobic capacity (VO2max) using graded exercise testing to monitor cardiovascular deconditioning.", "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 5.1 Aerobic Fitness Assessment" }] }, { "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" : "exercise-physiology", "display" : "Exercise Physiology" } }], "initial" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-sponsor-cs", "code" : "exercise-physiology", "display" : "Exercise Physiology" } }] }, { "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" : "bone-muscle-exercise", "display" : "Bone/Muscle/Exercise" } }], "initial" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-discipline-cs", "code" : "bone-muscle-exercise", "display" : "Bone/Muscle/Exercise" } }] }, { "linkId" : "overview.purpose", "text" : "Purpose/Objectives", "type" : "text", "required" : true, "initial" : [{ "valueString" : "To assess aerobic capacity (VO2max) using graded exercise testing. Establish baseline fitness and monitor for spaceflight-related cardiovascular deconditioning." }] }, { "linkId" : "overview.measurement-parameters", "text" : "Measurement Parameters", "type" : "string", "required" : true, "initial" : [{ "valueString" : "VO2max, heart rate, blood pressure, workload, rating of perceived exertion" }] }, { "linkId" : "overview.flight-duration", "text" : "Flight Duration", "type" : "string", "required" : true, "initial" : [{ "valueString" : ">= 30 days" }] }] }, { "linkId" : "preflight-training", "text" : "Preflight Training", "type" : "group", "item" : [{ "linkId" : "preflight-training.description", "text" : "Training Description", "type" : "text", "initial" : [{ "valueString" : "Exercise hardware familiarization including T2 treadmill, CEVIS cycle, and ARED resistive exercise device." }] }, { "linkId" : "preflight-training.duration", "text" : "Duration (minutes)", "type" : "integer", "initial" : [{ "valueInteger" : 120 }] }, { "linkId" : "preflight-training.schedule", "text" : "Schedule", "type" : "string", "initial" : [{ "valueString" : "L-12 months" }] }, { "linkId" : "preflight-training.completed", "text" : "Training Completed", "type" : "boolean" }] }, { "linkId" : "preflight-activities", "text" : "Preflight Activities", "type" : "group", "item" : [{ "linkId" : "preflight-activities.description", "text" : "Activity Description", "type" : "text", "initial" : [{ "valueString" : "Graded exercise test (GXT) on treadmill or cycle ergometer with metabolic gas analysis. Test continues to volitional exhaustion or physician-determined endpoint." }] }, { "linkId" : "preflight-activities.duration", "text" : "Duration (minutes)", "type" : "integer", "initial" : [{ "valueInteger" : 45 }] }, { "linkId" : "preflight-activities.schedule", "text" : "Schedule", "type" : "string", "initial" : [{ "valueString" : "L-180 to L-60 days" }] }, { "linkId" : "preflight-activities.hardware", "text" : "Test Hardware", "type" : "choice", "answerOption" : [{ "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-hardware-cs", "code" : "quinton-treadmill", "display" : "Quinton Treadmill" } }, { "valueCoding" : { "system" : "https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-hardware-cs", "code" : "cevis", "display" : "CEVIS Cycle Ergometer" } }] }, { "linkId" : "preflight-activities.location", "text" : "Test Location", "type" : "choice", "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.test-date", "text" : "Test Date", "type" : "date" }, { "linkId" : "preflight-activities.test-completed", "text" : "Test Completed", "type" : "boolean", "required" : true }] }, { "linkId" : "preflight-fitness-results", "text" : "Preflight Fitness Results", "type" : "group", "item" : [{ "linkId" : "preflight-fitness-results.vo2max-absolute", "code" : [{ "system" : "http://loinc.org", "code" : "62872-7", "display" : "Oxygen consumption (VO2) at maximal exercise --peak" }], "text" : "VO2max Absolute (L/min)", "type" : "decimal" }, { "linkId" : "preflight-fitness-results.vo2max-relative", "text" : "VO2max Relative (mL/kg/min)", "type" : "decimal" }, { "linkId" : "preflight-fitness-results.max-heart-rate", "code" : [{ "system" : "http://loinc.org", "code" : "55426-2", "display" : "Heart rate --peak exercise" }], "text" : "Maximum Heart Rate (bpm)", "type" : "integer" }, { "linkId" : "preflight-fitness-results.max-workload", "text" : "Maximum Workload (Watts or Speed/Grade)", "type" : "string" }, { "linkId" : "preflight-fitness-results.resting-hr", "code" : [{ "system" : "http://loinc.org", "code" : "8867-4", "display" : "Heart rate" }], "text" : "Resting Heart Rate (bpm)", "type" : "integer" }, { "linkId" : "preflight-fitness-results.resting-bp-systolic", "code" : [{ "system" : "http://loinc.org", "code" : "8480-6", "display" : "Systolic blood pressure" }], "text" : "Resting Systolic BP (mmHg)", "type" : "integer" }, { "linkId" : "preflight-fitness-results.resting-bp-diastolic", "code" : [{ "system" : "http://loinc.org", "code" : "8462-4", "display" : "Diastolic blood pressure" }], "text" : "Resting Diastolic BP (mmHg)", "type" : "integer" }, { "linkId" : "preflight-fitness-results.respiratory-exchange-ratio", "code" : [{ "system" : "http://loinc.org", "code" : "20564-1", "display" : "Oxygen content/Oxygen consumption ratio" }], "text" : "Peak RER", "type" : "decimal" }, { "linkId" : "preflight-fitness-results.test-termination-reason", "text" : "Test Termination Reason", "type" : "choice", "answerOption" : [{ "valueString" : "Volitional exhaustion" }, { "valueString" : "Target heart rate achieved" }, { "valueString" : "ECG abnormality" }, { "valueString" : "Blood pressure response" }, { "valueString" : "Symptoms" }, { "valueString" : "Equipment failure" }] }, { "linkId" : "preflight-fitness-results.fitness-category", "text" : "Fitness Category", "type" : "choice", "answerOption" : [{ "valueString" : "Superior" }, { "valueString" : "Excellent" }, { "valueString" : "Good" }, { "valueString" : "Fair" }, { "valueString" : "Poor" }] }, { "linkId" : "preflight-fitness-results.notes", "text" : "Test Notes", "type" : "text" }] }, { "linkId" : "inflight-activities", "text" : "In-Flight Activities", "type" : "group", "item" : [{ "linkId" : "inflight-activities.description", "text" : "Activity Description", "type" : "text", "initial" : [{ "valueString" : "Periodic submaximal exercise tests using CEVIS or T2 to estimate VO2max changes during mission." }] }, { "linkId" : "inflight-activities.schedule", "text" : "Schedule", "type" : "string", "initial" : [{ "valueString" : "Flight Day 14, monthly thereafter" }] }, { "linkId" : "inflight-activities.inflight-vo2-estimate", "text" : "In-Flight VO2max Estimate (mL/kg/min)", "type" : "decimal" }] }, { "linkId" : "postflight-activities", "text" : "Postflight Activities", "type" : "group", "item" : [{ "linkId" : "postflight-activities.schedule", "text" : "Schedule", "type" : "string", "initial" : [{ "valueString" : "R+5 to R+7 days, R+30 days" }] }, { "linkId" : "postflight-activities.test-date", "text" : "Postflight Test Date", "type" : "date" }, { "linkId" : "postflight-activities.test-completed", "text" : "Postflight Test Completed", "type" : "boolean", "required" : true }] }, { "linkId" : "postflight-fitness-results", "text" : "Postflight Fitness Results", "type" : "group", "item" : [{ "linkId" : "postflight-fitness-results.vo2max-absolute", "text" : "VO2max Absolute (L/min)", "type" : "decimal" }, { "linkId" : "postflight-fitness-results.vo2max-relative", "text" : "VO2max Relative (mL/kg/min)", "type" : "decimal" }, { "linkId" : "postflight-fitness-results.max-heart-rate", "text" : "Maximum Heart Rate (bpm)", "type" : "integer" }, { "linkId" : "postflight-fitness-results.percent-change", "text" : "Percent Change from Preflight (%)", "type" : "decimal" }, { "linkId" : "postflight-fitness-results.deconditioning-assessment", "text" : "Deconditioning Assessment", "type" : "choice", "answerOption" : [{ "valueString" : "Minimal (<5% decline)" }, { "valueString" : "Mild (5-10% decline)" }, { "valueString" : "Moderate (10-20% decline)" }, { "valueString" : "Significant (>20% decline)" }] }, { "linkId" : "postflight-fitness-results.reconditioning-plan", "text" : "Reconditioning Plan Required", "type" : "boolean" }] }, { "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.schedule", "text" : "Schedule", "type" : "string", "initial" : [{ "valueString" : "R+30 days" }] }, { "linkId" : "postflight-debrief.completed", "text" : "Debrief Completed", "type" : "boolean" }] }] }