{
    "section": "subjective",
    "templateSet": "Cerumen Impaction",
    "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 cerumen impaction",
                    "template": "initial evaluation of cerumen impaction"
                },
                {
                    "text": "follow-up cerumen impaction evaluation",
                    "template": "follow-up cerumen impaction evaluation"
                },
                {
                    "text": "ongoing cerumen impaction management",
                    "template": "ongoing cerumen impaction management"
                },
                {
                    "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": "severity is reported to have acutely worsened"
                },
                {
                    "text": "progressively worsened",
                    "template": "is reported to have progressively worsened"
                },
                {
                    "text": "Duration (days)",
                    "template": "is reported as having been present for {text} days",
                    "type": "number"
                },
                {
                    "text": "Duration (weeks)",
                    "template": "is reported as having been present for {text} weeks",
                    "type": "number"
                },
                {
                    "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": "Affected ear",
            "template": "Patient complains of symptoms involving {children}.",
            "children": [
                {
                    "text": "right",
                    "template": "right ear"
                },
                {
                    "text": "left",
                    "template": "left ear"
                },
                {
                    "text": "both",
                    "template": "both ears"
                }
            ]
        },
        {
            "text": "Symptoms",
            "template": "Patient reports {children}.",
            "children": [
                {
                    "text": "decreased hearing",
                    "template": "decreased hearing",
                    "type": "plus-minus"
                },
                {
                    "text": "ear pain",
                    "template": "ear pain",
                    "type": "plus-minus"
                },
                {
                    "text": "ear wax",
                    "template": "ear wax",
                    "type": "plus-minus"
                },
                {
                    "text": "foreign body sensation",
                    "template": "foreign body sensation",
                    "type": "plus-minus"
                },
                {
                    "text": "tinnitus",
                    "template": "tinnitus",
                    "type": "plus-minus"
                },
                {
                    "text": "ear fullness",
                    "template": "sensation of ear fullness",
                    "type": "plus-minus"
                },
                {
                    "text": "ear drainage",
                    "template": "ear drainage",
                    "type": "plus-minus"
                },
                {
                    "text": "cough",
                    "template": "cough",
                    "type": "plus-minus"
                },
                {
                    "text": "URI symptoms",
                    "template": "URI symptoms",
                    "type": "plus-minus"
                },
                {
                    "text": "vertigo",
                    "template": "vertigo",
                    "type": "plus-minus"
                },
                {
                    "text": "other symptoms (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Contributory factors",
            "template": "Possible contributory factors include {children}.",
            "children": [
                {
                    "text": "cotton tipped applicator use",
                    "template": "use of cotton-tipped applicators"
                },
                {
                    "text": "earplug use",
                    "template": "use of earplugs"
                },
                {
                    "text": "hearing aid use",
                    "template": "use of hearing aid"
                },
                {
                    "text": "Down syndrome",
                    "template": "history of Down syndrome"
                },
                {
                    "text": "nursing home resident",
                    "template": "living in a nursing home"
                },
                {
                    "text": "cognitive impairment",
                    "template": "cognitive impairment"
                },
                {
                    "text": "other contributory factors (specify)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical history includes {children}.",
            "children": [
                {
                    "text": "diabetes type 1",
                    "template": "diabetes type 1",
                    "type": "plus-minus"
                },
                {
                    "text": "diabetes type 2",
                    "template": "diabetes type 2",
                    "type": "plus-minus"
                },
                {
                    "text": "immunosuppression",
                    "template": "immunosuppression",
                    "type": "plus-minus"
                },
                {
                    "text": "previous ear surgery",
                    "template": "previous ear surgery",
                    "type": "plus-minus"
                },
                {
                    "text": "other medical Hx (describe)",
                    "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"
                }
            ]
        }
    ]
}