{
    "section": "subjective",
    "templateSet": "Atopic Dermatitis",
    "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 dermatitis symptoms",
                    "template": "initial evaluation of dermatitis symptoms"
                },
                {
                    "text": "follow-up dermatitis evaluation",
                    "template": "follow-up dermatitis evaluation"
                },
                {
                    "text": "ongoing dermatitis management",
                    "template": "ongoing management of dermatitis"
                },
                {
                    "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 (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": "Location",
            "template": "Pt notes atopic dermatitis on the {children}.",
            "children": [
                {
                    "text": "Scalp",
                    "template": "scalp",
                    "children": [
                        {
                            "text": "generalized scalp",
                            "template": "scalp"
                        },
                        {
                            "text": "R side of the scalp",
                            "template": "right side of the scalp"
                        },
                        {
                            "text": "L side of the scalp",
                            "template": "left side of the scalp"
                        },
                        {
                            "text": "nape",
                            "template": "nape"
                        }
                    ]
                },
                {
                    "text": "Face",
                    "template": "face",
                    "children": [
                        {
                            "text": "generalized face",
                            "template": "face"
                        },
                        {
                            "text": "forehead",
                            "template": "forehead"
                        },
                        {
                            "text": "eyelids",
                            "template": "eyelids"
                        },
                        {
                            "text": "R eyelid",
                            "template": "right eyelid"
                        },
                        {
                            "text": "L eyelid",
                            "template": "left eyelid"
                        },
                        {
                            "text": "nose",
                            "template": "nose"
                        },
                        {
                            "text": "cheeks",
                            "template": "cheeks"
                        },
                        {
                            "text": "R cheek",
                            "template": "right cheek"
                        },
                        {
                            "text": "L cheek",
                            "template": "left cheek"
                        },
                        {
                            "text": "above the upper lip",
                            "template": "philtrum"
                        },
                        {
                            "text": "chin",
                            "template": "chin"
                        }
                    ]
                },
                {
                    "text": "Neck",
                    "template": "neck",
                    "children": [
                        {
                            "text": "generalized neck",
                            "template": "neck"
                        },
                        {
                            "text": "front",
                            "template": "front of the"
                        },
                        {
                            "text": "bilateral sides",
                            "template": "sides of the"
                        },
                        {
                            "text": "right side",
                            "template": "right side of the"
                        },
                        {
                            "text": "left side",
                            "template": "left side of the"
                        }
                    ]
                },
                {
                    "text": "Chest",
                    "template": "chest",
                    "children": [
                        {
                            "text": "generalized chest",
                            "template": "chest"
                        },
                        {
                            "text": "right",
                            "template": "right"
                        },
                        {
                            "text": "left",
                            "template": "left"
                        },
                        {
                            "text": "upper",
                            "template": "upper"
                        },
                        {
                            "text": "middle",
                            "template": "middle"
                        },
                        {
                            "text": "lower",
                            "template": "lower"
                        }
                    ]
                },
                {
                    "text": "Abdomen",
                    "template": "abdomen",
                    "children": [
                        {
                            "text": "generalized abdomen",
                            "template": "abdomen"
                        },
                        {
                            "text": "right",
                            "template": "right"
                        },
                        {
                            "text": "left",
                            "template": "left"
                        },
                        {
                            "text": "upper",
                            "template": "upper"
                        },
                        {
                            "text": "middle",
                            "template": "middle"
                        },
                        {
                            "text": "lower",
                            "template": "lower"
                        }
                    ]
                },
                {
                    "text": "Back",
                    "template": "back",
                    "children": [
                        {
                            "text": "generalized back",
                            "template": "back"
                        },
                        {
                            "text": "right",
                            "template": "right"
                        },
                        {
                            "text": "left",
                            "template": "left"
                        },
                        {
                            "text": "upper",
                            "template": "upper"
                        },
                        {
                            "text": "middle",
                            "template": "middle"
                        },
                        {
                            "text": "lower",
                            "template": "lower"
                        }
                    ]
                },
                {
                    "text": "Groin",
                    "template": "groin",
                    "children": [
                        {
                            "text": "bilateral",
                            "template": "bilateral"
                        },
                        {
                            "text": "right",
                            "template": "right"
                        },
                        {
                            "text": "left",
                            "template": "left"
                        }
                    ]
                },
                {
                    "text": "Shoulders",
                    "template": "shoulders",
                    "children": [
                        {
                            "text": "bilateral",
                            "template": "both shoulders"
                        },
                        {
                            "text": "right",
                            "template": "right shoulder"
                        },
                        {
                            "text": "left",
                            "template": "left shoulder"
                        }
                    ]
                },
                {
                    "text": "Arms",
                    "template": "arms",
                    "children": [
                        {
                            "text": "bilateral",
                            "template": "both arms"
                        },
                        {
                            "text": "right",
                            "template": "right arm"
                        },
                        {
                            "text": "left",
                            "template": "left arm"
                        }
                    ]
                },
                {
                    "text": "Wrists",
                    "template": "wrists",
                    "children": [
                        {
                            "text": "bilateral",
                            "template": "both wrists"
                        },
                        {
                            "text": "right",
                            "template": "right wrist"
                        },
                        {
                            "text": "left",
                            "template": "left wrist"
                        }
                    ]
                },
                {
                    "text": "Hands",
                    "template": "hands",
                    "children": [
                        {
                            "text": "bilateral hands",
                            "template": "both hands"
                        },
                        {
                            "text": "right hand",
                            "template": "right hand"
                        },
                        {
                            "text": "left hand",
                            "template": "left hand"
                        },
                        {
                            "text": "bilateral palms",
                            "template": "both palms"
                        },
                        {
                            "text": "right palm",
                            "template": "right palm"
                        },
                        {
                            "text": "left palm",
                            "template": "left palm"
                        }
                    ]
                },
                {
                    "text": "Legs",
                    "template": "legs",
                    "children": [
                        {
                            "text": "bilateral legs",
                            "template": "both legs"
                        },
                        {
                            "text": "right leg",
                            "template": "right leg"
                        },
                        {
                            "text": "left leg",
                            "template": "left leg"
                        }
                    ]
                },
                {
                    "text": "Feet",
                    "template": "feet",
                    "children": [
                        {
                            "text": "bilateral",
                            "template": "both feet"
                        },
                        {
                            "text": "right",
                            "template": "right foot"
                        },
                        {
                            "text": "left",
                            "template": "left foot"
                        }
                    ]
                },
                {
                    "text": "Ankles",
                    "template": "ankles",
                    "children": [
                        {
                            "text": "bilateral",
                            "template": "both ankles"
                        },
                        {
                            "text": "right",
                            "template": "right ankle"
                        },
                        {
                            "text": "left",
                            "template": "left ankle"
                        }
                    ]
                },
                {
                    "text": "Buttocks",
                    "template": "buttock",
                    "children": [
                        {
                            "text": "bilateral",
                            "template": "both buttocks"
                        },
                        {
                            "text": "right",
                            "template": "right buttock"
                        },
                        {
                            "text": "left",
                            "template": "left buttock"
                        }
                    ]
                },
                {
                    "text": "Other locations (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Symptoms",
            "template": "Patient reports the presence\/absence of the following Hx\/sx related to the current\n                        visit: {children}.\n                    ",
            "children": [
                {
                    "text": "pruritus",
                    "template": "pruritus",
                    "type": "plus-minus"
                },
                {
                    "text": "dry skin",
                    "template": "dry skin",
                    "type": "plus-minus"
                },
                {
                    "text": "erythema",
                    "template": "erythema",
                    "type": "plus-minus"
                },
                {
                    "text": "edema",
                    "template": "edema",
                    "type": "plus-minus"
                },
                {
                    "text": "scaling",
                    "template": "scaling",
                    "type": "plus-minus"
                },
                {
                    "text": "vesicles",
                    "template": "vesicles on affected areas",
                    "type": "plus-minus"
                },
                {
                    "text": "papules",
                    "template": "papules on affected areas",
                    "type": "plus-minus"
                },
                {
                    "text": "plaques",
                    "template": "plaques on affected areas",
                    "type": "plus-minus"
                },
                {
                    "text": "keratosis pilaris",
                    "template": "keratosis pilaris",
                    "type": "plus-minus"
                },
                {
                    "text": "hypopigmentation",
                    "template": "hypopigmentation",
                    "type": "plus-minus"
                },
                {
                    "text": "hyperpigmentation",
                    "template": "hyperpigmentation",
                    "type": "plus-minus"
                },
                {
                    "text": "other sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Exacerbating factors",
            "template": "Patient reports that symptoms are worsened by {children}.",
            "children": [
                {
                    "text": "perfumes",
                    "template": "perfumes"
                },
                {
                    "text": "detergents",
                    "template": "detergents"
                },
                {
                    "text": "cosmetics",
                    "template": "cosmetics"
                },
                {
                    "text": "diapers",
                    "template": "diapers"
                },
                {
                    "text": "metals",
                    "template": "metals"
                },
                {
                    "text": "adhesives",
                    "template": "adhesives"
                },
                {
                    "text": "stress",
                    "template": "stress"
                },
                {
                    "text": "pollen",
                    "template": "pollen"
                },
                {
                    "text": "plants",
                    "template": "plants"
                },
                {
                    "text": "dust mites",
                    "template": "dust mites"
                },
                {
                    "text": "light",
                    "template": "light"
                },
                {
                    "text": "weather changes",
                    "template": "changes in weather"
                },
                {
                    "text": "radiation",
                    "template": "radiation"
                },
                {
                    "text": "ingestion (list)",
                    "template": "ingestion of {text}",
                    "type": "alpha"
                },
                {
                    "text": "allergy (list)",
                    "template": "an allergy to {text}",
                    "type": "alpha"
                },
                {
                    "text": "drugs (list)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "contact with (list)",
                    "template": "contact with {text}",
                    "type": "alpha"
                },
                {
                    "text": "other exacerbators (specify)",
                    "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": "no side effects noted",
                    "template": "no side effects noted"
                },
                {
                    "text": "Common side effects",
                    "template": "side effects include {children}",
                    "children": [
                        {
                            "text": "burning",
                            "template": "burning",
                            "type": "plus-minus"
                        },
                        {
                            "text": "pruritis",
                            "template": "pruritis",
                            "type": "plus-minus"
                        },
                        {
                            "text": "skin irritation",
                            "template": "skin irritation",
                            "type": "plus-minus"
                        },
                        {
                            "text": "folliculitis",
                            "template": "folliculitis",
                            "type": "plus-minus"
                        },
                        {
                            "text": "erythema",
                            "template": "erythema",
                            "type": "plus-minus"
                        },
                        {
                            "text": "dryness",
                            "template": "dryness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "rash",
                            "template": "rash",
                            "type": "plus-minus"
                        },
                        {
                            "text": "drowsiness",
                            "template": "drowsiness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "dizziness",
                            "template": "dizziness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "headaches",
                            "template": "headaches",
                            "type": "plus-minus"
                        },
                        {
                            "text": "nausea\/vomiting",
                            "template": "nausea\/vomiting",
                            "type": "plus-minus"
                        },
                        {
                            "text": "diarrhea",
                            "template": "diarrhea",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "Side effects (describe)",
                    "template": "side effects: {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical history includes {children}.",
            "children": [
                {
                    "text": "allergic rhinitis",
                    "template": "allergic rhinitis",
                    "type": "plus-minus"
                },
                {
                    "text": "asthma",
                    "template": "asthma",
                    "type": "plus-minus"
                },
                {
                    "text": "other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Previous treatments",
            "template": "Previous treatments include {children}.",
            "children": [
                {
                    "text": "Emollients",
                    "template": "emollients",
                    "children": [
                        {
                            "text": "not tried",
                            "template": "(not tried)"
                        },
                        {
                            "text": "positive response",
                            "template": "(positive response)"
                        },
                        {
                            "text": "partial response",
                            "template": "(partial response)"
                        },
                        {
                            "text": "no effect",
                            "template": "(no effect)"
                        },
                        {
                            "text": "negative response",
                            "template": "(negative response)"
                        },
                        {
                            "text": "discontinued due to side effects",
                            "template": "(discontinued due to side effects)"
                        }
                    ]
                },
                {
                    "text": "Corticosteroids, topical",
                    "template": "topical corticosteroids",
                    "children": [
                        {
                            "text": "not tried",
                            "template": "(not tried)"
                        },
                        {
                            "text": "positive response",
                            "template": "(positive response)"
                        },
                        {
                            "text": "partial response",
                            "template": "(partial response)"
                        },
                        {
                            "text": "no effect",
                            "template": "(no effect)"
                        },
                        {
                            "text": "negative response",
                            "template": "(negative response)"
                        },
                        {
                            "text": "discontinued due to side effects",
                            "template": "(discontinued due to side effects)"
                        }
                    ]
                },
                {
                    "text": "Corticosteroids, oral",
                    "template": "oral corticosteroids",
                    "children": [
                        {
                            "text": "not tried",
                            "template": "(not tried)"
                        },
                        {
                            "text": "positive response",
                            "template": "(positive response)"
                        },
                        {
                            "text": "partial response",
                            "template": "(partial response)"
                        },
                        {
                            "text": "no effect",
                            "template": "(no effect)"
                        },
                        {
                            "text": "negative response",
                            "template": "(negative response)"
                        },
                        {
                            "text": "discontinued due to side effects",
                            "template": "(discontinued due to side effects)"
                        }
                    ]
                },
                {
                    "text": "Calcineurin inhibitor, topical",
                    "template": "topical calcineurin inhibitor",
                    "children": [
                        {
                            "text": "not tried",
                            "template": "(not tried)"
                        },
                        {
                            "text": "positive response",
                            "template": "(positive response)"
                        },
                        {
                            "text": "partial response",
                            "template": "(partial response)"
                        },
                        {
                            "text": "no effect",
                            "template": "(no effect)"
                        },
                        {
                            "text": "negative response",
                            "template": "(negative response)"
                        },
                        {
                            "text": "discontinued due to side effects",
                            "template": "(discontinued due to side effects)"
                        }
                    ]
                },
                {
                    "text": "Azathioprine",
                    "template": "azathioprine",
                    "children": [
                        {
                            "text": "not tried",
                            "template": "(not tried)"
                        },
                        {
                            "text": "positive response",
                            "template": "(positive response)"
                        },
                        {
                            "text": "partial response",
                            "template": "(partial response)"
                        },
                        {
                            "text": "no effect",
                            "template": "(no effect)"
                        },
                        {
                            "text": "negative response",
                            "template": "(negative response)"
                        },
                        {
                            "text": "discontinued due to side effects",
                            "template": "(discontinued due to side effects)"
                        }
                    ]
                },
                {
                    "text": "Cyclosporine",
                    "template": "cyclosporine",
                    "children": [
                        {
                            "text": "not tried",
                            "template": "(not tried)"
                        },
                        {
                            "text": "positive response",
                            "template": "(positive response)"
                        },
                        {
                            "text": "partial response",
                            "template": "(partial response)"
                        },
                        {
                            "text": "no effect",
                            "template": "(no effect)"
                        },
                        {
                            "text": "negative response",
                            "template": "(negative response)"
                        },
                        {
                            "text": "discontinued due to side effects",
                            "template": "(discontinued due to side effects)"
                        }
                    ]
                },
                {
                    "text": "Methotrexate",
                    "template": "methotrexate",
                    "children": [
                        {
                            "text": "not tried",
                            "template": "(not tried)"
                        },
                        {
                            "text": "positive response",
                            "template": "(positive response)"
                        },
                        {
                            "text": "partial response",
                            "template": "(partial response)"
                        },
                        {
                            "text": "no effect",
                            "template": "(no effect)"
                        },
                        {
                            "text": "negative response",
                            "template": "(negative response)"
                        },
                        {
                            "text": "discontinued due to side effects",
                            "template": "(discontinued due to side effects)"
                        }
                    ]
                },
                {
                    "text": "Topical coal tar",
                    "template": "topical coal tar",
                    "children": [
                        {
                            "text": "not tried",
                            "template": "(not tried)"
                        },
                        {
                            "text": "positive response",
                            "template": "(positive response)"
                        },
                        {
                            "text": "partial response",
                            "template": "(partial response)"
                        },
                        {
                            "text": "no effect",
                            "template": "(no effect)"
                        },
                        {
                            "text": "negative response",
                            "template": "(negative response)"
                        },
                        {
                            "text": "discontinued due to side effects",
                            "template": "(discontinued due to side effects)"
                        }
                    ]
                },
                {
                    "text": "UV light",
                    "template": "UV light",
                    "children": [
                        {
                            "text": "not tried",
                            "template": "(not tried)"
                        },
                        {
                            "text": "positive response",
                            "template": "(positive response)"
                        },
                        {
                            "text": "partial response",
                            "template": "(partial response)"
                        },
                        {
                            "text": "no effect",
                            "template": "(no effect)"
                        },
                        {
                            "text": "negative response",
                            "template": "(negative response)"
                        },
                        {
                            "text": "discontinued due to side effects",
                            "template": "(discontinued due to side effects)"
                        }
                    ]
                },
                {
                    "text": "Other previous tx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Family Hx specific to visit",
            "template": "Family history includes {children}.",
            "children": [
                {
                    "text": "atopic dermatitis",
                    "template": "atopic dermatitis",
                    "type": "plus-minus"
                },
                {
                    "text": "other family 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"
                }
            ]
        }
    ]
}