{
    "section": "subjective",
    "templateSet": "Anemia, Iron Deficiency",
    "templates": [
        {
            "text": "Reason for visit",
            "template": "Patient presents for {children}.",
            "children": [
                {
                    "text": "evaluation of anemia",
                    "template": "evaluation of anemia"
                },
                {
                    "text": "lab report indicating anemia",
                    "template": "lab report indicating anemia"
                },
                {
                    "text": "sx suggestive of anemia",
                    "template": "sx suggestive of anemia"
                },
                {
                    "text": "follow-up anemia visit",
                    "template": "follow-up anemia visit"
                },
                {
                    "text": "Visit reason (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Onset\/Time course",
            "template": "Sx onset and time course: Pt reports {children}.",
            "children": [
                {
                    "text": "acute onset of sx",
                    "template": "acute onset of sx"
                },
                {
                    "text": "gradual onset of sx",
                    "template": "gradual onset of sx"
                },
                {
                    "text": "chronic sx",
                    "template": "chronic sx"
                },
                {
                    "text": "acute worsening of chronic sx",
                    "template": "acute worsening of chronic sx"
                },
                {
                    "text": "progressive worsening of sx",
                    "template": "progressive worsening of sx"
                },
                {
                    "text": "Duration (days)",
                    "template": "{text} days sx",
                    "type": "number"
                },
                {
                    "text": "Duration (weeks)",
                    "template": "{text} weeks sx",
                    "type": "number"
                },
                {
                    "text": "Duration (months)",
                    "template": "{text} months sx",
                    "type": "number"
                },
                {
                    "text": "Duration (years)",
                    "template": "{text} years sx",
                    "type": "number"
                },
                {
                    "text": "Duration (describe)",
                    "template": "{text} sx",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Symptoms",
            "template": "Patient reports the presence\/absence of the following Hx\/sx related to the current visit:\n                        {children}.\n                    ",
            "children": [
                {
                    "text": "no symptoms",
                    "template": "no symptoms"
                },
                {
                    "text": "weakness",
                    "template": "weakness",
                    "type": "plus-minus"
                },
                {
                    "text": "fatigue",
                    "template": "fatigue",
                    "type": "plus-minus"
                },
                {
                    "text": "irritability",
                    "template": "irritability",
                    "type": "plus-minus"
                },
                {
                    "text": "headaches",
                    "template": "headaches",
                    "type": "plus-minus"
                },
                {
                    "text": "exercise intolerance",
                    "template": "exercise intolerance",
                    "type": "plus-minus"
                },
                {
                    "text": "shortness of breath",
                    "template": "shortness of breath",
                    "type": "plus-minus"
                },
                {
                    "text": "other sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Pertinent positive\/negative symptoms include: {children}.",
            "children": [
                {
                    "text": "hematemesis",
                    "template": "hematemesis",
                    "type": "plus-minus"
                },
                {
                    "text": "melena",
                    "template": "melena",
                    "type": "plus-minus"
                },
                {
                    "text": "hematochezia",
                    "template": "hematochezia",
                    "type": "plus-minus"
                },
                {
                    "text": "hematuria",
                    "template": "hematuria",
                    "type": "plus-minus"
                },
                {
                    "text": "dyspnea",
                    "template": "dyspnea",
                    "type": "plus-minus"
                },
                {
                    "text": "dyspnea on exertion",
                    "template": "dyspnea on exertion",
                    "type": "plus-minus"
                },
                {
                    "text": "chest pain",
                    "template": "chest pain",
                    "type": "plus-minus"
                },
                {
                    "text": "palpitations",
                    "template": "palpitations",
                    "type": "plus-minus"
                },
                {
                    "text": "dizziness",
                    "template": "dizziness",
                    "type": "plus-minus"
                },
                {
                    "text": "confusion",
                    "template": "confusion",
                    "type": "plus-minus"
                },
                {
                    "text": "syncope",
                    "template": "syncope",
                    "type": "plus-minus"
                },
                {
                    "text": "pica",
                    "template": "pica",
                    "type": "plus-minus"
                },
                {
                    "text": "weight loss",
                    "template": "weight loss",
                    "type": "plus-minus"
                },
                {
                    "text": "easy bruising",
                    "template": "easy bruising",
                    "type": "plus-minus"
                },
                {
                    "text": "paresthesias",
                    "template": "paresthesias",
                    "type": "plus-minus"
                },
                {
                    "text": "restless legs syndrome",
                    "template": "restless legs syndrome",
                    "type": "plus-minus"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Tx response\/Side effects",
            "template": "Treatment effects: {children}.",
            "children": [
                {
                    "text": "not on treatment",
                    "template": "not on treatment"
                },
                {
                    "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": "constipation",
                            "template": "constipation"
                        },
                        {
                            "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 reason)",
                    "template": "nonadherent to tx due to {text}",
                    "type": "alpha"
                },
                {
                    "text": "Treatment response",
                    "template": "condition {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": "with variable response to tx"
                        },
                        {
                            "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": "pt describes tx response as {text}",
                    "type": "alpha"
                },
                {
                    "text": "no side effects noted",
                    "template": "no side effects noted"
                },
                {
                    "text": "Common side effects",
                    "template": "side effects include {children}",
                    "children": [
                        {
                            "text": "dyspepsia",
                            "template": "dyspepsia",
                            "type": "plus-minus"
                        },
                        {
                            "text": "nausea",
                            "template": "nausea",
                            "type": "plus-minus"
                        },
                        {
                            "text": "vomiting",
                            "template": "vomiting",
                            "type": "plus-minus"
                        },
                        {
                            "text": "constipation",
                            "template": "constipation",
                            "type": "plus-minus"
                        },
                        {
                            "text": "diarrhea",
                            "template": "diarrhea",
                            "type": "plus-minus"
                        },
                        {
                            "text": "dark stools",
                            "template": "dark stools",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "Side effects (describe)",
                    "template": "side effects: {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical Hx specific to visit includes {children}.",
            "children": [
                {
                    "text": "Recent surgery (specify)",
                    "template": "{text} surgery",
                    "type": "alpha"
                },
                {
                    "text": "Recent trauma (specify)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "Recent blood loss (specify)",
                    "template": "recent blood loss related to {text}",
                    "type": "alpha"
                },
                {
                    "text": "H. pylori gastritis",
                    "template": "H. pylori gastritis",
                    "type": "plus-minus"
                },
                {
                    "text": "fibroids",
                    "template": "fibroids",
                    "type": "plus-minus"
                },
                {
                    "text": "Hx of ulcers",
                    "template": "hx of ulcers",
                    "type": "plus-minus"
                },
                {
                    "text": "celiac disease",
                    "template": "celiac disease",
                    "type": "plus-minus"
                },
                {
                    "text": "gastric bypass",
                    "template": "gastric bypass",
                    "type": "plus-minus"
                },
                {
                    "text": "chronic liver disease",
                    "template": "chronic liver disease",
                    "type": "plus-minus"
                },
                {
                    "text": "kidney disease",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CKD stage 1",
                            "template": "CKD stage 1",
                            "type": "plus-minus"
                        },
                        {
                            "text": "CKD stage 2 (mild)",
                            "template": "CKD stage 2 (mild)",
                            "type": "plus-minus"
                        },
                        {
                            "text": "CKD stage 3 (moderate)",
                            "template": "CKD stage 3 (moderate)",
                            "type": "plus-minus"
                        },
                        {
                            "text": "CKD stage 4 (severe)",
                            "template": "CKD stage 4 (severe)",
                            "type": "plus-minus"
                        },
                        {
                            "text": "ESRD",
                            "template": "End Stage Renal Disease",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "diabetes type 1",
                    "template": "diabetes type 1",
                    "type": "plus-minus"
                },
                {
                    "text": "diabetes type 2",
                    "template": "diabetes type 2",
                    "type": "plus-minus"
                },
                {
                    "text": "CHF",
                    "template": "CHF",
                    "type": "plus-minus"
                },
                {
                    "text": "HIV",
                    "template": "HIV",
                    "type": "plus-minus"
                },
                {
                    "text": "sickle cell anemia",
                    "template": "sickle cell anemia",
                    "type": "plus-minus"
                },
                {
                    "text": "hereditary spherocytosis",
                    "template": "hereditary spherocytosis",
                    "type": "plus-minus"
                },
                {
                    "text": "on anticoagulant",
                    "template": "on anticoagulant",
                    "type": "plus-minus"
                },
                {
                    "text": "recent blood donation",
                    "template": "recent blood donation",
                    "type": "plus-minus"
                },
                {
                    "text": "cancer (specify type)",
                    "template": "{text} cancer",
                    "type": "alpha"
                },
                {
                    "text": "other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "OB\/Gyn Hx specific to visit",
            "template": "OB\/Gyn Hx specific to visit includes {children}.",
            "children": [
                {
                    "text": "heavy menses",
                    "template": "heavy menses",
                    "type": "plus-minus"
                },
                {
                    "text": "vaginal bleeding",
                    "template": "vaginal bleeding",
                    "type": "plus-minus"
                },
                {
                    "text": "recent pregnancy",
                    "template": "recent pregnancy",
                    "type": "plus-minus"
                },
                {
                    "text": "current pregnancy",
                    "template": "current pregnancy",
                    "type": "plus-minus"
                },
                {
                    "text": "breastfeeding now",
                    "template": "current breastfeeding",
                    "type": "plus-minus"
                },
                {
                    "text": "other OB\/Gyn Hx (specify)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environment factors include {children}.",
            "children": [
                {
                    "text": "vegetarian diet",
                    "template": "vegetarian diet",
                    "type": "plus-minus"
                },
                {
                    "text": "vegan diet",
                    "template": "vegan diet",
                    "type": "plus-minus"
                },
                {
                    "text": "heavy ETOH use",
                    "template": "heavy ETOH use",
                    "type": "plus-minus"
                },
                {
                    "text": "NSAID use",
                    "template": "NSAID use",
                    "type": "plus-minus"
                },
                {
                    "text": "corticosteroid use",
                    "template": "corticosteroid use",
                    "type": "plus-minus"
                },
                {
                    "text": "ACE\/ARB use",
                    "template": "ACE\/ARB use",
                    "type": "plus-minus"
                },
                {
                    "text": "HIV medications",
                    "template": "HIV medications",
                    "type": "plus-minus"
                },
                {
                    "text": "recent antibiotic use",
                    "template": "recent antibiotic use",
                    "type": "plus-minus"
                },
                {
                    "text": "lead exposure",
                    "template": "lead exposure",
                    "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"
                }
            ]
        },
        {
            "text": "Family Hx specific to visit",
            "template": "Family Hx specific to visit includes {children}.",
            "children": [
                {
                    "text": "sickle cell anemia",
                    "template": "sickle cell anemia",
                    "type": "plus-minus"
                },
                {
                    "text": "thalassemia",
                    "template": "thalassemia",
                    "type": "plus-minus"
                },
                {
                    "text": "G6PD deficiency",
                    "template": "G6PD deficiency",
                    "type": "plus-minus"
                },
                {
                    "text": "bleeding disorders",
                    "template": "bleeding disorders",
                    "type": "plus-minus"
                },
                {
                    "text": "colon cancer",
                    "template": "colon cancer",
                    "type": "plus-minus"
                },
                {
                    "text": "other family Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        }
    ]
}