{
    "section": "subjective",
    "templateSet": "Weight loss, unintended",
    "templates": [
        {
            "text": "Reason for visit",
            "template": "Patient presents for {children}.",
            "children": [
                {
                    "text": "new onset weight loss",
                    "template": "new onset weight loss"
                },
                {
                    "text": "initial evaluation of weight loss",
                    "template": "initial evaluation of weight loss"
                },
                {
                    "text": "follow-up of weight loss",
                    "template": "follow-up of weight loss"
                },
                {
                    "text": "ongoing weight loss management",
                    "template": "ongoing weight loss management"
                },
                {
                    "text": "Visit reason (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Onset\/Time course",
            "template": "Sx onset and time course: Pt reports {children}.",
            "children": [
                {
                    "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": "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": "weight loss, unknown amount",
                    "template": "weight loss, unknown amount"
                },
                {
                    "text": "weight loss (specify pounds)",
                    "template": "weight loss {text} pounds",
                    "type": "number"
                },
                {
                    "text": "Decrease in clothing size (specify)",
                    "template": "{text} clothing sizes decreased",
                    "type": "number"
                }
            ]
        },
        {
            "text": "Pertinent positives\/negatives",
            "template": "Pertinent positive\/negative symptoms include: {children}.",
            "children": [
                {
                    "text": "loss of appetite",
                    "template": "loss of appetite",
                    "type": "plus-minus"
                },
                {
                    "text": "fever",
                    "template": "fever",
                    "type": "plus-minus"
                },
                {
                    "text": "chills",
                    "template": "chills",
                    "type": "plus-minus"
                },
                {
                    "text": "night sweats",
                    "template": "night sweats",
                    "type": "plus-minus"
                },
                {
                    "text": "polyuria",
                    "template": "polyuria",
                    "type": "plus-minus"
                },
                {
                    "text": "polyphagia",
                    "template": "polyphagia",
                    "type": "plus-minus"
                },
                {
                    "text": "polydipsia",
                    "template": "polydipsia",
                    "type": "plus-minus"
                },
                {
                    "text": "nausea",
                    "template": "nausea",
                    "type": "plus-minus"
                },
                {
                    "text": "vomiting",
                    "template": "vomiting",
                    "type": "plus-minus"
                },
                {
                    "text": "diarrhea",
                    "template": "diarrhea",
                    "type": "plus-minus"
                },
                {
                    "text": "constipation",
                    "template": "constipation",
                    "type": "plus-minus"
                },
                {
                    "text": "change in bowel habits",
                    "template": "change in bowel habits",
                    "type": "plus-minus"
                },
                {
                    "text": "abdominal pain",
                    "template": "abdominal pain",
                    "type": "plus-minus"
                },
                {
                    "text": "dysphagia",
                    "template": "dysphagia",
                    "type": "plus-minus"
                },
                {
                    "text": "change in taste",
                    "template": "change in taste",
                    "type": "plus-minus"
                },
                {
                    "text": "odynophagia",
                    "template": "odynophagia",
                    "type": "plus-minus"
                },
                {
                    "text": "blood in stools",
                    "template": "blood in stools",
                    "type": "plus-minus"
                },
                {
                    "text": "early satiety",
                    "template": "early satiety",
                    "type": "plus-minus"
                },
                {
                    "text": "dehydration",
                    "template": "dehydration",
                    "type": "plus-minus"
                },
                {
                    "text": "cough",
                    "template": "cough",
                    "type": "plus-minus"
                },
                {
                    "text": "shortness of breath",
                    "template": "shortness of breath",
                    "type": "plus-minus"
                },
                {
                    "text": "chest pain",
                    "template": "chest pain",
                    "type": "plus-minus"
                },
                {
                    "text": "weakness",
                    "template": "weakness",
                    "type": "plus-minus"
                },
                {
                    "text": "irritability",
                    "template": "irritability",
                    "type": "plus-minus"
                },
                {
                    "text": "depressed mood",
                    "template": "depressed mood",
                    "type": "plus-minus"
                },
                {
                    "text": "anhedonia",
                    "template": "anhedonia",
                    "type": "plus-minus"
                },
                {
                    "text": "hopelessness",
                    "template": "hopelessness",
                    "type": "plus-minus"
                },
                {
                    "text": "suicidal ideation",
                    "template": "suicidal ideation",
                    "type": "plus-minus"
                },
                {
                    "text": "guilty feelings",
                    "template": "guilty feelings",
                    "type": "plus-minus"
                },
                {
                    "text": "loss of energy",
                    "template": "loss of energy",
                    "type": "plus-minus"
                },
                {
                    "text": "difficulty concentrating",
                    "template": "difficulty concentrating",
                    "type": "plus-minus"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medical hx specific to visit",
            "template": "Medical Hx specific to visit includes: {children}.",
            "children": [
                {
                    "text": "Hx of GI surgery",
                    "template": "Hx of GI surgery",
                    "type": "plus-minus"
                },
                {
                    "text": "Hx of cancer (specify type)",
                    "template": "cancer ({text})",
                    "type": "alpha"
                },
                {
                    "text": "depression",
                    "template": "depression",
                    "type": "plus-minus"
                },
                {
                    "text": "anxiety disorder",
                    "template": "anxiety disorder",
                    "type": "plus-minus"
                },
                {
                    "text": "HIV\/AIDS",
                    "template": "HIV\/AIDS",
                    "type": "plus-minus"
                },
                {
                    "text": "CAD",
                    "template": "CAD",
                    "type": "plus-minus"
                },
                {
                    "text": "CHF",
                    "template": "CHF",
                    "type": "plus-minus"
                },
                {
                    "text": "COPD",
                    "template": "COPD",
                    "type": "plus-minus"
                },
                {
                    "text": "IBD",
                    "template": "inflammatory bowel 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": "celiac disease",
                    "template": "celiac 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": "liver disease",
                    "template": "liver disease",
                    "type": "plus-minus"
                },
                {
                    "text": "TB exposure",
                    "template": "TB exposure",
                    "type": "plus-minus"
                },
                {
                    "text": "hypothyroidism",
                    "template": "hypothyroidism",
                    "type": "plus-minus"
                },
                {
                    "text": "hyperthyroidism",
                    "template": "hyperthyroidism",
                    "type": "plus-minus"
                },
                {
                    "text": "dementia",
                    "template": "dementia",
                    "type": "plus-minus"
                },
                {
                    "text": "Other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Medication exposures",
            "template": "Medication exposures include: {children}.",
            "children": [
                {
                    "text": "none",
                    "template": "none"
                },
                {
                    "text": "NSAIDS",
                    "template": "NSAIDS"
                },
                {
                    "text": "SSRIs",
                    "template": "SSRIs"
                },
                {
                    "text": "metformin",
                    "template": "metformin"
                },
                {
                    "text": "exenatide",
                    "template": "exenatide"
                },
                {
                    "text": "levodopa",
                    "template": "levodopa"
                },
                {
                    "text": "digoxin",
                    "template": "digoxin"
                },
                {
                    "text": "anticonvulsants",
                    "template": "anticonvulsants"
                },
                {
                    "text": "antiretrovirals",
                    "template": "antiretrovirals"
                },
                {
                    "text": "ephedra",
                    "template": "ephedra"
                },
                {
                    "text": "St. John's wort",
                    "template": "St. John's wort"
                },
                {
                    "text": "herbal diuretics",
                    "template": "herbal diuretics"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environmental factors: {children}.",
            "children": [
                {
                    "text": "significant stress",
                    "template": "significant stress",
                    "type": "plus-minus"
                },
                {
                    "text": "change in diet",
                    "template": "change in diet",
                    "type": "plus-minus"
                },
                {
                    "text": "heavy caffeine intake",
                    "template": "heavy caffeine intake",
                    "type": "plus-minus"
                },
                {
                    "text": "heavy alcohol use",
                    "template": "heavy alcohol use",
                    "type": "plus-minus"
                },
                {
                    "text": "drug use",
                    "template": "drug use",
                    "type": "plus-minus"
                },
                {
                    "text": "IVDU",
                    "template": "IVDU",
                    "type": "plus-minus"
                },
                {
                    "text": "wears dentures",
                    "template": "wears dentures",
                    "type": "plus-minus"
                },
                {
                    "text": "recent increased physical activity",
                    "template": "recent increased physical activity",
                    "type": "plus-minus"
                },
                {
                    "text": "nursing home resident",
                    "template": "nursing home resident",
                    "type": "plus-minus"
                },
                {
                    "text": "Occupation (specify)",
                    "template": "occupation is {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"
                }
            ]
        }
    ]
}