{
    "section": "subjective",
    "templateSet": "Fibromyalgia",
    "templates": [
        {
            "text": "Reason for visit",
            "template": "Patient presents for {children}.",
            "children": [
                {
                    "text": "new onset symptom evaluation",
                    "template": "evaluation of new onset symptoms"
                },
                {
                    "text": "initial evaluation of fibromyalgia symptoms",
                    "template": "initial evaluation of fibromyalgia symptoms"
                },
                {
                    "text": "follow-up evaluation of fibromyalgia",
                    "template": "follow-up evaluation of fibromyalgia"
                },
                {
                    "text": "ongoing management of fibromyalgia",
                    "template": "ongoing management of fibromyalgia"
                },
                {
                    "text": "Visit reason (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Onset\/Time course",
            "template": "Condition {children}.",
            "children": [
                {
                    "text": "acute onset (new condition)",
                    "template": "is reported to have developed acutely"
                },
                {
                    "text": "chronic and ongoing condition",
                    "template": "is chronic and ongoing"
                },
                {
                    "text": "acutely worse (chronic condition)",
                    "template": "is chronic in nature, but has worsened acutely"
                },
                {
                    "text": "progressively worsened",
                    "template": "has worsened progressively over time"
                },
                {
                    "text": "intermittent presence of symptoms",
                    "template": "symptoms are described as intermittently present"
                },
                {
                    "text": "Duration (months)",
                    "template": "is reported as having been present for {text} months",
                    "type": "number"
                },
                {
                    "text": "Duration (years)",
                    "template": "is reported as having been present for {text} years",
                    "type": "number"
                },
                {
                    "text": "Duration (describe)",
                    "template": "is reported as having been present for {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Symptoms\/Functional impact",
            "template": "Patient reports the presence\/absence of the following Hx\/sx related to the current\n                        visit: {children}.\n                    ",
            "children": [
                {
                    "text": "no complaints",
                    "template": "has no complaints"
                },
                {
                    "text": "tender points",
                    "template": "tender points",
                    "type": "plus-minus"
                },
                {
                    "text": "muscle aches",
                    "template": "muscle aches",
                    "type": "plus-minus"
                },
                {
                    "text": "fatigue",
                    "template": "fatigue",
                    "type": "plus-minus"
                },
                {
                    "text": "insomnia",
                    "template": "insomnia",
                    "type": "plus-minus"
                },
                {
                    "text": "Functional impact",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "no limitation of physical activity",
                            "template": "no limitation of physical activity"
                        },
                        {
                            "text": "slight limitation of physical activity",
                            "template": "slight limitation of physical activity"
                        },
                        {
                            "text": "marked limitation of physical activity",
                            "template": "marked limitation of physical activity"
                        },
                        {
                            "text": "unable to carry out any activity",
                            "template": "unable to carry out any activity without discomfort"
                        },
                        {
                            "text": "able to work",
                            "template": "able to work"
                        },
                        {
                            "text": "unable to work",
                            "template": "unable to work"
                        },
                        {
                            "text": "able to carry out usual activities",
                            "template": "able to carry out usual activities"
                        },
                        {
                            "text": "unable to carry out usual activities",
                            "template": "unable to carry out usual activities"
                        }
                    ]
                },
                {
                    "text": "Functional impact",
                    "template": "impaired functional status, described as {text}",
                    "type": "alpha"
                },
                {
                    "text": "other sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Pain detail",
            "template": "Pain is described as {children}.",
            "children": [
                {
                    "text": "Localization",
                    "template": "affecting the {children}",
                    "children": [
                        {
                            "text": "R occiput",
                            "template": "R occiput"
                        },
                        {
                            "text": "L occiput",
                            "template": "L occiput"
                        },
                        {
                            "text": "R trapezius",
                            "template": "R trapezius"
                        },
                        {
                            "text": "L trapezius",
                            "template": "L trapezius"
                        },
                        {
                            "text": "R supraspinatus",
                            "template": "R supraspinatus"
                        },
                        {
                            "text": "L supraspinatus",
                            "template": "L supraspinatus"
                        },
                        {
                            "text": "R gluteus",
                            "template": "R gluteus"
                        },
                        {
                            "text": "L gluteus",
                            "template": "L gluteus"
                        },
                        {
                            "text": "R greater trochanter",
                            "template": "R greater trochanter"
                        },
                        {
                            "text": "L greater trochanter",
                            "template": "L greater trochanter"
                        },
                        {
                            "text": "R lower cervical spine",
                            "template": "R lower cervical spine"
                        },
                        {
                            "text": "L lower cervical spine",
                            "template": "L lower cervical spine"
                        },
                        {
                            "text": "R second rib",
                            "template": "R second rib"
                        },
                        {
                            "text": "L second rib",
                            "template": "L second rib"
                        },
                        {
                            "text": "R lateral epicondyle",
                            "template": "R lateral epicondyle"
                        },
                        {
                            "text": "L lateral epicondyle",
                            "template": "L lateral epicondyle"
                        },
                        {
                            "text": "R knee",
                            "template": "R knee"
                        },
                        {
                            "text": "L knee",
                            "template": "L knee"
                        }
                    ]
                },
                {
                    "text": "Quality",
                    "template": "having {children} quality",
                    "children": [
                        {
                            "text": "pressure",
                            "template": "a pressure-like"
                        },
                        {
                            "text": "sharp",
                            "template": "a sharp"
                        },
                        {
                            "text": "dull",
                            "template": "a dull"
                        },
                        {
                            "text": "aching",
                            "template": "an aching"
                        },
                        {
                            "text": "cramping",
                            "template": "a cramping"
                        },
                        {
                            "text": "spasm",
                            "template": "a spasm-like"
                        },
                        {
                            "text": "electric",
                            "template": "an electric"
                        }
                    ]
                },
                {
                    "text": "Radiation",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "nonradiating",
                            "template": "nonradiating"
                        },
                        {
                            "text": "radiating",
                            "template": "radiating"
                        }
                    ]
                },
                {
                    "text": "Severity (0-10, 10=worst)",
                    "template": "having a severity is rated as {children}",
                    "children": [
                        {
                            "text": "mild",
                            "template": "mild"
                        },
                        {
                            "text": "moderate",
                            "template": "moderate"
                        },
                        {
                            "text": "severe",
                            "template": "severe"
                        },
                        {
                            "text": "0\/10 (no pain)",
                            "template": "0\/10 (no pain)"
                        },
                        {
                            "text": "+1\/10",
                            "template": "+1\/10 (10=worst)"
                        },
                        {
                            "text": "+2\/10",
                            "template": "+2\/10 (10=worst)"
                        },
                        {
                            "text": "+3\/10",
                            "template": "+3\/10 (10=worst)"
                        },
                        {
                            "text": "+4\/10",
                            "template": "+4\/10 (10=worst)"
                        },
                        {
                            "text": "+5\/10",
                            "template": "+5\/10 (10=worst)"
                        },
                        {
                            "text": "+6\/10",
                            "template": "+6\/10 (10=worst)"
                        },
                        {
                            "text": "+7\/10",
                            "template": "+7\/10 (10=worst)"
                        },
                        {
                            "text": "+8\/10",
                            "template": "+8\/10 (10=worst)"
                        },
                        {
                            "text": "+9\/10",
                            "template": "+9\/10 (10=worst)"
                        },
                        {
                            "text": "+10\/10",
                            "template": "+10\/10 (10=worst)"
                        }
                    ]
                },
                {
                    "text": "Timing: constant, intermittent",
                    "template": "Timing: constant, intermittent",
                    "children": [
                        {
                            "text": "constantly present",
                            "template": "constantly present"
                        },
                        {
                            "text": "intermittently present",
                            "template": "intermittently present"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Pertinent positive\/negative symptoms include: {children}.",
            "children": [
                {
                    "text": "cold intolerance",
                    "template": "cold intolerance",
                    "type": "plus-minus"
                },
                {
                    "text": "weakness",
                    "template": "weakness",
                    "type": "plus-minus"
                },
                {
                    "text": "decreased exercise tolerance",
                    "template": "decreased exercise tolerance",
                    "type": "plus-minus"
                },
                {
                    "text": "nausea",
                    "template": "nausea",
                    "type": "plus-minus"
                },
                {
                    "text": "abdominal pain",
                    "template": "abdominal pain",
                    "type": "plus-minus"
                },
                {
                    "text": "constipation",
                    "template": "constipation",
                    "type": "plus-minus"
                },
                {
                    "text": "diarrhea",
                    "template": "diarrhea",
                    "type": "plus-minus"
                },
                {
                    "text": "dysuria",
                    "template": "dysuria",
                    "type": "plus-minus"
                },
                {
                    "text": "urinary frequency",
                    "template": "urinary frequency",
                    "type": "plus-minus"
                },
                {
                    "text": "pelvic pain",
                    "template": "pelvic pain",
                    "type": "plus-minus"
                },
                {
                    "text": "pain during sexual intercourse",
                    "template": "pain during sexual intercourse",
                    "type": "plus-minus"
                },
                {
                    "text": "dry skin",
                    "template": "dry skin",
                    "type": "plus-minus"
                },
                {
                    "text": "dry hair",
                    "template": "dry hair",
                    "type": "plus-minus"
                },
                {
                    "text": "lower extremity swelling",
                    "template": "lower extremity swelling",
                    "type": "plus-minus"
                },
                {
                    "text": "paresthesias",
                    "template": "paresthesias",
                    "type": "plus-minus"
                },
                {
                    "text": "difficulty concentrating",
                    "template": "difficulty concentrating",
                    "type": "plus-minus"
                },
                {
                    "text": "depression",
                    "template": "depression",
                    "type": "plus-minus"
                },
                {
                    "text": "anxiety",
                    "template": "anxiety",
                    "type": "plus-minus"
                },
                {
                    "text": "other pertinent sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Exacerbating\/Alleviating factors",
            "template": "Patient reports that {children}.",
            "children": [
                {
                    "text": "Stress",
                    "template": "stress {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "Exercise",
                    "template": "exercise {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "Massage",
                    "template": "massage {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "Statins",
                    "template": "statins {children}",
                    "children": [
                        {
                            "text": "improve sx",
                            "template": "improve sx"
                        },
                        {
                            "text": "worsen sx",
                            "template": "worsen sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "have no effect on sx"
                        },
                        {
                            "text": "have not been tried",
                            "template": "have not been tried"
                        }
                    ]
                },
                {
                    "text": "NSAIDs",
                    "template": "NSAIDs {children}",
                    "children": [
                        {
                            "text": "improve sx",
                            "template": "improve sx"
                        },
                        {
                            "text": "worsen sx",
                            "template": "worsen sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "have no effect on sx"
                        },
                        {
                            "text": "have not been tried",
                            "template": "have not been tried"
                        }
                    ]
                },
                {
                    "text": "Sleep",
                    "template": "sleep {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "improves sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "worsens sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been observed",
                            "template": "has not been observed"
                        }
                    ]
                },
                {
                    "text": "Opioids",
                    "template": "opioids {children}",
                    "children": [
                        {
                            "text": "improve sx",
                            "template": "improve sx"
                        },
                        {
                            "text": "worsen sx",
                            "template": "worsen sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "have no effect on sx"
                        },
                        {
                            "text": "have not been tried",
                            "template": "have not been tried"
                        }
                    ]
                },
                {
                    "text": "Other contributing factors (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Tx response\/Side effects",
            "template": "Treatment effects: {children}.",
            "children": [
                {
                    "text": "adherent to current tx",
                    "template": "adherent to current tx"
                },
                {
                    "text": "nonadherent to current tx",
                    "template": "nonadherent to current tx"
                },
                {
                    "text": "Reasons for nonadherence",
                    "template": "reasons for nonadherence include {children}",
                    "children": [
                        {
                            "text": "side effects",
                            "template": "side effects"
                        },
                        {
                            "text": "nausea",
                            "template": "nausea"
                        },
                        {
                            "text": "stomach upset",
                            "template": "stomach upset"
                        },
                        {
                            "text": "diarrhea",
                            "template": "diarrhea"
                        },
                        {
                            "text": "swallowing difficulty",
                            "template": "difficulty swallowing"
                        },
                        {
                            "text": "cost",
                            "template": "cost"
                        },
                        {
                            "text": "difficulty scheduling",
                            "template": "difficulty scheduling"
                        },
                        {
                            "text": "forgetfulness",
                            "template": "forgetfulness"
                        },
                        {
                            "text": "no perceived need for tx",
                            "template": "no perceived need for treatment"
                        }
                    ]
                },
                {
                    "text": "Nonadherence (describe)",
                    "template": "nonadherent to tx ({text})",
                    "type": "alpha"
                },
                {
                    "text": "Treatment response",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "resolved with treatment",
                            "template": "resolved with treatment"
                        },
                        {
                            "text": "well-controlled on treatment",
                            "template": "well-controlled on treatment"
                        },
                        {
                            "text": "improving on treatment",
                            "template": "improving on treatment"
                        },
                        {
                            "text": "stable on treatment",
                            "template": "stable on treatment"
                        },
                        {
                            "text": "unchanged on treatment",
                            "template": "unchanged on treatment"
                        },
                        {
                            "text": "variable response to treatment",
                            "template": "variable response to treatment"
                        },
                        {
                            "text": "suboptimally-controlled on treatment",
                            "template": "suboptimally-controlled on treatment"
                        },
                        {
                            "text": "poorly-controlled on treatment",
                            "template": "poorly-controlled on treatment"
                        },
                        {
                            "text": "worsening on treatment",
                            "template": "worsening on treatment"
                        },
                        {
                            "text": "exacerbated despite treatment",
                            "template": "exacerbated despite treatment"
                        }
                    ]
                },
                {
                    "text": "Treatment response (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "Common side effects",
                    "template": "side effects include {children}",
                    "children": [
                        {
                            "text": "dry mouth",
                            "template": "dry mouth",
                            "type": "plus-minus"
                        },
                        {
                            "text": "constipation",
                            "template": "constipation",
                            "type": "plus-minus"
                        },
                        {
                            "text": "nausea\/vomiting",
                            "template": "nausea\/vomiting",
                            "type": "plus-minus"
                        },
                        {
                            "text": "headache",
                            "template": "headache",
                            "type": "plus-minus"
                        },
                        {
                            "text": "dizziness",
                            "template": "dizziness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "drowsiness\/somnolence",
                            "template": "drowsiness\/somnolence",
                            "type": "plus-minus"
                        },
                        {
                            "text": "anxiety\/nervousness",
                            "template": "anxiety\/nervousness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "insomnia",
                            "template": "insomnia",
                            "type": "plus-minus"
                        },
                        {
                            "text": "palpitations",
                            "template": "palpitations",
                            "type": "plus-minus"
                        },
                        {
                            "text": "tachycardia",
                            "template": "tachycardia",
                            "type": "plus-minus"
                        },
                        {
                            "text": "blurred vision",
                            "template": "blurred vision",
                            "type": "plus-minus"
                        },
                        {
                            "text": "appetite incr\/decr",
                            "template": "appetite incr\/decr",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "no side effects noted",
                    "template": "no side effects noted"
                },
                {
                    "text": "Side effects (describe)",
                    "template": "side effects: {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical history includes {children}.",
            "children": [
                {
                    "text": "rheumatoid arthritis",
                    "template": "rheumatoid arthritis",
                    "type": "plus-minus"
                },
                {
                    "text": "ankylosing spondylitis",
                    "template": "ankylosing spondylitis",
                    "type": "plus-minus"
                },
                {
                    "text": "SLE",
                    "template": "SLE",
                    "type": "plus-minus"
                },
                {
                    "text": "osteoarthritis",
                    "template": "osteoarthritis",
                    "type": "plus-minus"
                },
                {
                    "text": "chronic fatigue syndrome",
                    "template": "chronic fatigue syndrome",
                    "type": "plus-minus"
                },
                {
                    "text": "gout",
                    "template": "gout",
                    "type": "plus-minus"
                },
                {
                    "text": "depression",
                    "template": "depression",
                    "type": "plus-minus"
                },
                {
                    "text": "anxiety disorder",
                    "template": "anxiety disorder",
                    "type": "plus-minus"
                },
                {
                    "text": "hypothyroidism",
                    "template": "hypothyroidism",
                    "type": "plus-minus"
                },
                {
                    "text": "ulcerative colitis",
                    "template": "ulcerative colitis",
                    "type": "plus-minus"
                },
                {
                    "text": "other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environment factors include {children}.",
            "children": [
                {
                    "text": "unemployed",
                    "template": "unemployed",
                    "type": "plus-minus"
                },
                {
                    "text": "unable to work",
                    "template": "unable to work",
                    "type": "plus-minus"
                },
                {
                    "text": "alcohol use",
                    "template": "alcohol use",
                    "type": "plus-minus"
                },
                {
                    "text": "high fat diet",
                    "template": "high fat diet",
                    "type": "plus-minus"
                },
                {
                    "text": "regular exercise",
                    "template": "regular exercise",
                    "type": "plus-minus"
                },
                {
                    "text": "sexual abuse",
                    "template": "sexual abuse",
                    "type": "plus-minus"
                },
                {
                    "text": "other lifestyle\/exposure (specify)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Smoking status",
            "template": "Smoking status: {children}.",
            "children": [
                {
                    "text": "nonsmoker",
                    "template": "nonsmoker"
                },
                {
                    "text": "tobacco abuse",
                    "template": "tobacco abuse",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco dependence",
                    "template": "tobacco dependence",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco products used",
                    "template": "tobacco products used include {children}",
                    "children": [
                        {
                            "text": "cigarettes",
                            "template": "cigarettes"
                        },
                        {
                            "text": "cigars",
                            "template": "cigars"
                        },
                        {
                            "text": "pipes",
                            "template": "pipes"
                        },
                        {
                            "text": "water pipes",
                            "template": "water pipes"
                        },
                        {
                            "text": "chew",
                            "template": "chew"
                        },
                        {
                            "text": "snuff",
                            "template": "snuff"
                        }
                    ]
                },
                {
                    "text": "packs per day (specify)",
                    "template": "{text} packs per day",
                    "type": "number"
                },
                {
                    "text": "age at smoking onset (specify)",
                    "template": "started smoking at age {text}",
                    "type": "number"
                },
                {
                    "text": "smoking duration (months)",
                    "template": "smoking duration is {text} months",
                    "type": "number"
                },
                {
                    "text": "smoking duration (years)",
                    "template": "smoking duration is {text} years",
                    "type": "number"
                },
                {
                    "text": "tobacco withdrawal",
                    "template": "tobacco withdrawal",
                    "type": "plus-minus"
                },
                {
                    "text": "tobacco remission",
                    "template": "tobacco remission",
                    "type": "plus-minus"
                },
                {
                    "text": "hx of nicotine dependence (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "second hand smoke type\/exposure (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        }
    ]
}