{
    "section": "subjective",
    "templateSet": "Otitis Externa",
    "templates": [
        {
            "text": "Reason for visit",
            "template": "Patient presents for {children}.",
            "children": [
                {
                    "text": "new onset ear sx",
                    "template": "new onset ear sx"
                },
                {
                    "text": "initial evaluation of ear sx",
                    "template": "initial evaluation of ear sx"
                },
                {
                    "text": "follow-up of ear sx",
                    "template": "follow-up of ear sx"
                },
                {
                    "text": "ongoing ear sx management",
                    "template": "ongoing ear sx management"
                },
                {
                    "text": "Visit reason (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Location",
            "template": "Symptoms affecting {children}.",
            "children": [
                {
                    "text": "right",
                    "template": "the right ear"
                },
                {
                    "text": "left",
                    "template": "the left ear"
                },
                {
                    "text": "bilateral",
                    "template": "the left and right ear"
                }
            ]
        },
        {
            "text": "Onset\/Time course",
            "template": "Sx onset and time course: Pt reports {children}.",
            "children": [
                {
                    "text": "acute",
                    "template": "acute"
                },
                {
                    "text": "sudden onset",
                    "template": "sudden onset"
                },
                {
                    "text": "gradual onset",
                    "template": "gradual onset"
                },
                {
                    "text": "recurrent",
                    "template": "recurrent condition"
                },
                {
                    "text": "chronic",
                    "template": "chronic condition"
                },
                {
                    "text": "Duration (days)",
                    "template": "{text} days of sx",
                    "type": "number"
                },
                {
                    "text": "Duration (weeks)",
                    "template": "{text} weeks of sx",
                    "type": "number"
                },
                {
                    "text": "Duration (months)",
                    "template": "{text} months of sx",
                    "type": "number"
                },
                {
                    "text": "Duration (years)",
                    "template": "{text} years of sx",
                    "type": "number"
                },
                {
                    "text": "Duration (describe)",
                    "template": "sx have been present for {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Sx severity",
            "template": "Symptom severity is described as {children}.",
            "children": [
                {
                    "text": "mild",
                    "template": "mild"
                },
                {
                    "text": "moderate",
                    "template": "moderate"
                },
                {
                    "text": "severe",
                    "template": "severe"
                },
                {
                    "text": "severity scale (0-10)",
                    "template": "{children} out of 10",
                    "children": [
                        {
                            "text": "0 (no pain)",
                            "template": "0 (no pain)"
                        },
                        {
                            "text": "1",
                            "template": "1"
                        },
                        {
                            "text": "2",
                            "template": "2"
                        },
                        {
                            "text": "3",
                            "template": "3"
                        },
                        {
                            "text": "4",
                            "template": "4"
                        },
                        {
                            "text": "5",
                            "template": "5"
                        },
                        {
                            "text": "6",
                            "template": "6"
                        },
                        {
                            "text": "7",
                            "template": "7"
                        },
                        {
                            "text": "8",
                            "template": "8"
                        },
                        {
                            "text": "9",
                            "template": "9"
                        },
                        {
                            "text": "10 (max pain)",
                            "template": "10 (max pain)"
                        }
                    ]
                },
                {
                    "text": "other pain severity",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Symptoms",
            "template": "Patient reports the presence\/absence of the following symptoms related to the current\n                        visit: {children}.\n                    ",
            "children": [
                {
                    "text": "none",
                    "template": "none"
                },
                {
                    "text": "ear pain",
                    "template": "ear pain",
                    "type": "plus-minus"
                },
                {
                    "text": "ear ache",
                    "template": "ear ache",
                    "type": "plus-minus"
                },
                {
                    "text": "ear itching",
                    "template": "ear itching",
                    "type": "plus-minus"
                },
                {
                    "text": "ear fullness",
                    "template": "ear fullness",
                    "type": "plus-minus"
                },
                {
                    "text": "ear pressure",
                    "template": "ear pressure",
                    "type": "plus-minus"
                },
                {
                    "text": "ear discharge",
                    "template": "{children} ear discharge",
                    "children": [
                        {
                            "text": "none",
                            "template": "no"
                        },
                        {
                            "text": "clear",
                            "template": "clear"
                        },
                        {
                            "text": "purulent",
                            "template": "purulent"
                        },
                        {
                            "text": "bloody",
                            "template": "bloody"
                        }
                    ]
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Pertinent positive\/negative symptoms include: {children}.",
            "children": [
                {
                    "text": "fever",
                    "template": "fever",
                    "type": "plus-minus"
                },
                {
                    "text": "T max (Fahrenheit)",
                    "template": "T max: {text} F.",
                    "type": "number"
                },
                {
                    "text": "chills",
                    "template": "chills",
                    "type": "plus-minus"
                },
                {
                    "text": "tinnitus",
                    "template": "tinnitus",
                    "type": "plus-minus"
                },
                {
                    "text": "jaw pain",
                    "template": "jaw pain",
                    "type": "plus-minus"
                },
                {
                    "text": "no change in hearing",
                    "template": "no change in hearing"
                },
                {
                    "text": "diminished hearing",
                    "template": "diminished hearing"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Exacerbating\/Alleviating factors",
            "template": "Patient reports that {children}.",
            "children": [
                {
                    "text": "Pulling on ear",
                    "template": "pulling on ear {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": "unknown effect on sx",
                            "template": "has an unknown effect on sx"
                        }
                    ]
                },
                {
                    "text": "OTC medications",
                    "template": "OTC 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": "Prescription medications",
                    "template": "prescription 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": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Tx response",
            "template": "Treatment effects: {children}.",
            "children": [
                {
                    "text": "not on tx",
                    "template": "not on tx"
                },
                {
                    "text": "adherent to current tx",
                    "template": "adherent to current tx"
                },
                {
                    "text": "nonadherent to current tx",
                    "template": "nonadherent to current tx"
                },
                {
                    "text": "treatment response",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "resolved with treatment",
                            "template": "resolved with treatment"
                        },
                        {
                            "text": "improving on treatment",
                            "template": "improving on treatment"
                        },
                        {
                            "text": "unchanged on treatment",
                            "template": "unchanged on treatment"
                        },
                        {
                            "text": "exacerbated despite treatment",
                            "template": "exacerbated despite treatment"
                        }
                    ]
                },
                {
                    "text": "treatment response (describe)",
                    "template": "tx response {text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical Hx specific to visit",
            "template": "Medical Hx specific to visit includes: {children}.",
            "children": [
                {
                    "text": "previous ear infections",
                    "template": "previous ear infections",
                    "type": "plus-minus"
                },
                {
                    "text": "previous ear surgery",
                    "template": "previous ear surgery",
                    "type": "plus-minus"
                },
                {
                    "text": "previous tympanostomy tubes",
                    "template": "previous tympanostomy tubes",
                    "type": "plus-minus"
                },
                {
                    "text": "current tympanostomy tubes",
                    "template": "current tympanostomy tubes",
                    "type": "plus-minus"
                },
                {
                    "text": "recent hear instrumentation",
                    "template": "recent hear instrumentation",
                    "type": "plus-minus"
                },
                {
                    "text": "trauma to ear",
                    "template": "trauma to ear",
                    "type": "plus-minus"
                },
                {
                    "text": "hearing aid use",
                    "template": "hearing aid use",
                    "type": "plus-minus"
                },
                {
                    "text": "eczema",
                    "template": "eczema",
                    "type": "plus-minus"
                },
                {
                    "text": "psoriasis",
                    "template": "psoriasis",
                    "type": "plus-minus"
                },
                {
                    "text": "atopic dermatitis",
                    "template": "atopic dermatitis",
                    "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": "HIV\/AIDS",
                    "template": "HIV\/AIDS",
                    "type": "plus-minus"
                },
                {
                    "text": "immunosuppression (describe)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "other medical Hx (specify)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environmental factors: {children}.",
            "children": [
                {
                    "text": "recent swimming",
                    "template": "recent swimming",
                    "type": "plus-minus"
                },
                {
                    "text": "recent foreign body in ear",
                    "template": "recent foreign body in ear",
                    "type": "plus-minus"
                },
                {
                    "text": "aggressive ear cleaning",
                    "template": "aggressive ear cleaning",
                    "type": "plus-minus"
                },
                {
                    "text": "frequent earplug use",
                    "template": "frequent earplug use",
                    "type": "plus-minus"
                },
                {
                    "text": "frequent headphone use",
                    "template": "frequent headphone use",
                    "type": "plus-minus"
                },
                {
                    "text": "new shampoos",
                    "template": "new shampoos",
                    "type": "plus-minus"
                },
                {
                    "text": "new cosmetics",
                    "template": "new cosmetics",
                    "type": "plus-minus"
                },
                {
                    "text": "new earrings",
                    "template": "new earrings",
                    "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"
                }
            ]
        }
    ]
}
