{
    "section": "subjective",
    "templateSet": "Prostatitis, Acute",
    "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 prostate symptoms",
                    "template": "initial evaluation of prostate symptoms"
                },
                {
                    "text": "follow-up evaluation of prostatitis",
                    "template": "follow-up evaluation of prostatitis"
                },
                {
                    "text": "ongoing management of prostatitis",
                    "template": "ongoing management of prostatitis"
                },
                {
                    "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": "acutely worse (chronic condition)",
                    "template": "is chronic in nature, but has worsened acutely"
                },
                {
                    "text": "Duration (hours)",
                    "template": "is reported as having been present for {text} hours",
                    "type": "number"
                },
                {
                    "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": "Symptoms",
            "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": "fever",
                    "template": "fever",
                    "type": "plus-minus"
                },
                {
                    "text": "frequent need to urinate",
                    "template": "frequent need to urinate",
                    "type": "plus-minus"
                },
                {
                    "text": "dysuria",
                    "template": "dysuria",
                    "type": "plus-minus"
                },
                {
                    "text": "nocturia",
                    "template": "nocturia",
                    "type": "plus-minus"
                },
                {
                    "text": "foul smelling urine",
                    "template": "foul smelling urine",
                    "type": "plus-minus"
                },
                {
                    "text": "cloudy urine",
                    "template": "cloudy urine",
                    "type": "plus-minus"
                },
                {
                    "text": "hematuria",
                    "template": "hematuria",
                    "type": "plus-minus"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Other pertinent positive\/negative sx include: {children}.",
            "children": [
                {
                    "text": "nausea",
                    "template": "nausea",
                    "type": "plus-minus"
                },
                {
                    "text": "abdominal pain",
                    "template": "abdominal pain",
                    "type": "plus-minus"
                },
                {
                    "text": "suprapubic pain",
                    "template": "suprapubic pain",
                    "type": "plus-minus"
                },
                {
                    "text": "abdominal distension",
                    "template": "abdominal distension",
                    "type": "plus-minus"
                },
                {
                    "text": "back pain",
                    "template": "back pain",
                    "type": "plus-minus"
                },
                {
                    "text": "flank pain",
                    "template": "flank pain",
                    "type": "plus-minus"
                },
                {
                    "text": "incomplete bladder emptying",
                    "template": "incomplete bladder emptying",
                    "type": "plus-minus"
                },
                {
                    "text": "stuttering urine stream",
                    "template": "stuttering urine stream",
                    "type": "plus-minus"
                },
                {
                    "text": "urinary incontinence",
                    "template": "urinary incontinence",
                    "type": "plus-minus"
                },
                {
                    "text": "difficulty postponing urination",
                    "template": "difficulty postponing urination",
                    "type": "plus-minus"
                },
                {
                    "text": "difficulty initiating urine stream",
                    "template": "difficulty initiating urine stream",
                    "type": "plus-minus"
                },
                {
                    "text": "weak urine stream",
                    "template": "weak urine stream",
                    "type": "plus-minus"
                },
                {
                    "text": "other pertinent sx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Exacerbating\/Alleviating factors",
            "template": "Patient reports that {children}.",
            "children": [
                {
                    "text": "Urinary catheterization",
                    "template": "urinary catheterization {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "has improved sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "has worsened sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "Cystoscopy",
                    "template": "cystoscopy {children}",
                    "children": [
                        {
                            "text": "improves sx",
                            "template": "has improved sx"
                        },
                        {
                            "text": "worsens sx",
                            "template": "has worsened sx"
                        },
                        {
                            "text": "no effect on sx",
                            "template": "has no effect on sx"
                        },
                        {
                            "text": "has not been tried",
                            "template": "has not been tried"
                        }
                    ]
                },
                {
                    "text": "TURP",
                    "template": "TURP {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": "BCG",
                    "template": "BCG {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": "Antimicrobial medications",
                    "template": "antimicrobial medications {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": "contributing factors include {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical history includes {children}.",
            "children": [
                {
                    "text": "recurrent UTI",
                    "template": "recurrent UTI",
                    "type": "plus-minus"
                },
                {
                    "text": "pyelonephritis",
                    "template": "pyelonephritis",
                    "type": "plus-minus"
                },
                {
                    "text": "nephrolithiasis",
                    "template": "nephrolithiasis",
                    "type": "plus-minus"
                },
                {
                    "text": "BPH",
                    "template": "BPH",
                    "type": "plus-minus"
                },
                {
                    "text": "detrusor instability",
                    "template": "detrusor instability",
                    "type": "plus-minus"
                },
                {
                    "text": "h\/o prostate surgery",
                    "template": "h\/o prostate surgery",
                    "type": "plus-minus"
                },
                {
                    "text": "indwelling urinary catheter",
                    "template": "indwelling urinary catheter",
                    "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": "immunosuppression",
                    "template": "immunosuppression",
                    "type": "plus-minus"
                },
                {
                    "text": "renal insufficiency",
                    "template": "renal insufficiency",
                    "type": "plus-minus"
                },
                {
                    "text": "Hx STD",
                    "template": "Hx STD",
                    "type": "plus-minus"
                },
                {
                    "text": "other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environment factors {children}.",
            "children": [
                {
                    "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": "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 history includes {children}.",
            "children": [
                {
                    "text": "prostate cancer",
                    "template": "prostate cancer",
                    "type": "plus-minus"
                },
                {
                    "text": "other family Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        }
    ]
}