{
    "section": "subjective",
    "templateSet": "GERD",
    "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 GERD symptoms",
                    "template": "initial evaluation of GERD symptoms"
                },
                {
                    "text": "follow-up GERD evaluation",
                    "template": "follow-up GERD evaluation"
                },
                {
                    "text": "ongoing GERD management",
                    "template": "ongoing GERD management"
                },
                {
                    "text": "Visit reason (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Frequency\/Duration",
            "template": "Symptoms {children}.",
            "children": [
                {
                    "text": "Temporal pattern",
                    "template": "occur {children}",
                    "children": [
                        {
                            "text": "after meals",
                            "template": "after meals"
                        },
                        {
                            "text": "during meals",
                            "template": "during meals"
                        },
                        {
                            "text": "before meals",
                            "template": "before meals"
                        },
                        {
                            "text": "at night",
                            "template": "at night"
                        },
                        {
                            "text": "in the evening",
                            "template": "in the evening"
                        },
                        {
                            "text": "in the afternoon",
                            "template": "in the afternoon"
                        },
                        {
                            "text": "in the morning",
                            "template": "in the morning"
                        },
                        {
                            "text": "during sleep",
                            "template": "during sleep"
                        },
                        {
                            "text": "during exertion",
                            "template": "during exertion"
                        }
                    ]
                },
                {
                    "text": "Frequency (times\/day)",
                    "template": "typically occur {text} x\/day",
                    "type": "number"
                },
                {
                    "text": "Frequency (times\/week)",
                    "template": "typically occur {text} x\/wk",
                    "type": "number"
                },
                {
                    "text": "Frequency (times\/month)",
                    "template": "typically occur {text} x\/mo",
                    "type": "number"
                },
                {
                    "text": "Other symptom frequency",
                    "template": "typically occur",
                    "type": "alpha"
                },
                {
                    "text": "Duration of episode (seconds)",
                    "template": "typically last {text} sec",
                    "type": "number"
                },
                {
                    "text": "Duration of episode (minutes)",
                    "template": "typically last {text} min",
                    "type": "number"
                },
                {
                    "text": "Duration of episode (hours)",
                    "template": "typically last {text} hr",
                    "type": "number"
                },
                {
                    "text": "Other episode duration",
                    "template": "typically last",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Onset\/Progression",
            "template": "Patient reports {children}.",
            "children": [
                {
                    "text": "Symptom onset (describe)",
                    "template": "symptoms began",
                    "type": "alpha"
                },
                {
                    "text": "gradual onset",
                    "template": "symptoms developed gradually"
                },
                {
                    "text": "sudden onset",
                    "template": "symptoms developed suddenly"
                },
                {
                    "text": "insidious onset",
                    "template": "symptoms developed insidiously"
                },
                {
                    "text": "progressive disease course",
                    "template": "progressive disease course"
                },
                {
                    "text": "stable disease course",
                    "template": "stable disease course"
                },
                {
                    "text": "improving disease course",
                    "template": "improving disease course"
                },
                {
                    "text": "relapsing\/remitting disease course",
                    "template": "relapsing\/remitting disease course"
                },
                {
                    "text": "Improved since (describe)",
                    "template": "improvement over past",
                    "type": "alpha"
                },
                {
                    "text": "No change since (describe)",
                    "template": "no change over past",
                    "type": "alpha"
                },
                {
                    "text": "Worse since (describe)",
                    "template": "worsening over past",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Symptoms",
            "template": "Patient complains of {children}.",
            "children": [
                {
                    "text": "heartburn",
                    "template": "heartburn",
                    "type": "plus-minus"
                },
                {
                    "text": "retrosternal burning",
                    "template": "retrosternal burning",
                    "type": "plus-minus"
                },
                {
                    "text": "retrosternal pain",
                    "template": "retrosternal pain",
                    "type": "plus-minus"
                },
                {
                    "text": "acid regurgitation",
                    "template": "acid regurgitation",
                    "type": "plus-minus"
                },
                {
                    "text": "sour taste in mouth",
                    "template": "sour taste in mouth",
                    "type": "plus-minus"
                },
                {
                    "text": "nausea",
                    "template": "nausea",
                    "type": "plus-minus"
                },
                {
                    "text": "belching",
                    "template": "belching",
                    "type": "plus-minus"
                },
                {
                    "text": "epigastric pain",
                    "template": "epigastric pain",
                    "type": "plus-minus"
                },
                {
                    "text": "globus sensation",
                    "template": "globus sensation",
                    "type": "plus-minus"
                },
                {
                    "text": "dysphagia",
                    "template": "dysphagia",
                    "type": "plus-minus"
                },
                {
                    "text": "odynophagia",
                    "template": "odynophagia",
                    "type": "plus-minus"
                },
                {
                    "text": "cough",
                    "template": "cough",
                    "type": "plus-minus"
                },
                {
                    "text": "other symptoms (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Severity",
            "template": "Symptoms are described as {children}.",
            "children": [
                {
                    "text": "mild",
                    "template": "mild in severity"
                },
                {
                    "text": "moderate",
                    "template": "moderate in severity"
                },
                {
                    "text": "severe",
                    "template": "severe"
                },
                {
                    "text": "Severity scale (0-10)",
                    "template": "{children} out of 10 on pain scale",
                    "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": "symptoms disturb sleep",
                    "template": "disturbing sleep"
                },
                {
                    "text": "symptom severity (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Triggers",
            "template": "Symptoms triggered by {children}.",
            "children": [
                {
                    "text": "acidic foods",
                    "template": "acidic foods"
                },
                {
                    "text": "spicy foods",
                    "template": "spicy foods"
                },
                {
                    "text": "fatty foods",
                    "template": "fatty foods"
                },
                {
                    "text": "late-night meals",
                    "template": "late-night meals"
                },
                {
                    "text": "coffee",
                    "template": "coffee"
                },
                {
                    "text": "carbonated beverages",
                    "template": "carbonated beverages"
                },
                {
                    "text": "chocolate",
                    "template": "chocolate"
                },
                {
                    "text": "physical activity",
                    "template": "physical activity"
                },
                {
                    "text": "other triggers (specify)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Complications",
            "template": "Complicated by {children}.",
            "children": [
                {
                    "text": "Barrett's esophagus",
                    "template": "Barrett's esophagus"
                },
                {
                    "text": "esophageal ulcer",
                    "template": "esophageal ulcer"
                },
                {
                    "text": "esophageal stricture",
                    "template": "esophageal stricture"
                },
                {
                    "text": "esophageal cancer",
                    "template": "esophageal cancer"
                },
                {
                    "text": "GI bleed",
                    "template": "GI bleed"
                },
                {
                    "text": "Other complications (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": "malaise",
                    "template": "malaise",
                    "type": "plus-minus"
                },
                {
                    "text": "vomiting",
                    "template": "vomiting",
                    "type": "plus-minus"
                },
                {
                    "text": "diarrhea",
                    "template": "diarrhea",
                    "type": "plus-minus"
                },
                {
                    "text": "hematemesis",
                    "template": "hematemesis",
                    "type": "plus-minus"
                },
                {
                    "text": "melena",
                    "template": "melena",
                    "type": "plus-minus"
                },
                {
                    "text": "anorexia",
                    "template": "anorexia",
                    "type": "plus-minus"
                },
                {
                    "text": "weight loss",
                    "template": "weight loss",
                    "type": "plus-minus"
                },
                {
                    "text": "other pertinent sx (describe)",
                    "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": "headache",
                            "template": "headache",
                            "type": "plus-minus"
                        },
                        {
                            "text": "diarrhea",
                            "template": "diarrhea",
                            "type": "plus-minus"
                        },
                        {
                            "text": "abdominal pain",
                            "template": "abdominal pain",
                            "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": "flatulence",
                            "template": "flatulence",
                            "type": "plus-minus"
                        },
                        {
                            "text": "dizziness",
                            "template": "dizziness",
                            "type": "plus-minus"
                        },
                        {
                            "text": "taste changes",
                            "template": "taste changes",
                            "type": "plus-minus"
                        },
                        {
                            "text": "arthralgias",
                            "template": "arthralgias",
                            "type": "plus-minus"
                        },
                        {
                            "text": "muscle aches",
                            "template": "muscle aches",
                            "type": "plus-minus"
                        },
                        {
                            "text": "dry mouth",
                            "template": "dry mouth",
                            "type": "plus-minus"
                        },
                        {
                            "text": "dry skin",
                            "template": "dry skin",
                            "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": "hiatal hernia",
                    "template": "hiatal hernia",
                    "type": "plus-minus"
                },
                {
                    "text": "known Hx of GERD",
                    "template": "known Hx of GERD",
                    "type": "plus-minus"
                },
                {
                    "text": "family Hx of GERD",
                    "template": "family Hx of GERD",
                    "type": "plus-minus"
                },
                {
                    "text": "alcohol use",
                    "template": "alcohol use",
                    "type": "plus-minus"
                },
                {
                    "text": "calcium channel blocker use",
                    "template": "calcium channel blocker use",
                    "type": "plus-minus"
                },
                {
                    "text": "beta-agonist use",
                    "template": "beta-agonist use",
                    "type": "plus-minus"
                },
                {
                    "text": "nitrate use",
                    "template": "nitrate use",
                    "type": "plus-minus"
                },
                {
                    "text": "anticholinergic use",
                    "template": "anticholinergic use",
                    "type": "plus-minus"
                },
                {
                    "text": "benzodiazepine use",
                    "template": "benzodiazepine use",
                    "type": "plus-minus"
                },
                {
                    "text": "theophylline use",
                    "template": "theophylline use",
                    "type": "plus-minus"
                },
                {
                    "text": "overweight\/obesity",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "overweight",
                            "template": "overweight",
                            "type": "plus-minus"
                        },
                        {
                            "text": "obese",
                            "template": "obese",
                            "type": "plus-minus"
                        },
                        {
                            "text": "morbid obesity",
                            "template": "morbid obesity",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "obesity contributing factors (describe)",
                    "template": "obesity contributing factors {text}",
                    "type": "alpha"
                },
                {
                    "text": "other medical Hx (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Previous treatments",
            "template": "Previous treatments include {children}.",
            "children": [
                {
                    "text": "Antacids",
                    "template": "antacids",
                    "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": "H2 blockers",
                    "template": "H2 blockers",
                    "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": "PPIs",
                    "template": "PPIs",
                    "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": "Elevating head of bed",
                    "template": "elevating head of bed",
                    "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": "Avoiding food triggers",
                    "template": "avoiding food triggers",
                    "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": "Avoiding food before sleep",
                    "template": "avoiding food before sleep",
                    "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": "Weight loss",
                    "template": "weight loss",
                    "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": "Lifestyle\/Environment factors",
            "template": "Lifestyle\/Environment factors include {children}",
            "children": [
                {
                    "text": "alcohol",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "alcohol use",
                            "template": "alcohol use",
                            "type": "plus-minus"
                        },
                        {
                            "text": "alcohol abuse",
                            "template": "alcohol abuse",
                            "type": "plus-minus"
                        },
                        {
                            "text": "alcohol dependence",
                            "template": "alcohol dependence",
                            "type": "plus-minus"
                        }
                    ]
                },
                {
                    "text": "illicit drug",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "illicit drug use",
                            "template": "illicit drug use",
                            "type": "plus-minus"
                        },
                        {
                            "text": "illicit drug abuse",
                            "template": "illicit drug abuse",
                            "type": "plus-minus"
                        },
                        {
                            "text": "illicit drug dependence",
                            "template": "illicit drug dependence",
                            "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"
                }
            ]
        }
    ]
}
