enrollmentformschema
type: Questionnaire
node role: treeRoot
id:
  v: enrollmentformschema
text:
  status:
    v: generated
  div: Structure LinkID Text Cardinality Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> Questionnaire https://kind-lab.github.io/vbai-fhir/Questionnaire-enrollmentformschema#2.2.0 ef_select_language Select a language: Select a language 0..1 choice Options: 3 options ef_any_vision_related_req Let's customize your experience: This application requires you to read text to answer questions. Do you have any vision-related requirements we can assist with? 0..1 choice Options: 2 options ef_vision_a11y_options Yes, I would like to use some of the accessibility features of the app 0..1 string Enable When: ef_any_vision_related_req = '1' ef_any_hearing_related_req This application may present some sound files for you to listen to. Do you have any hearing-related requirements we can assist with? 0..1 choice Options: 2 options ef_hearing_a11y_options Yes, I would like to use some of the accessibility features of the app 0..1 string Enable When: ef_any_hearing_related_req = '1' ef_any_physical_challenges This application requires you to navigate through the questions using a touch screen. Do you have any physical challenges we can accomodate? 0..1 choice Options: 2 options ef_physical_a11y_options Yes, I would like to use some of the accessibility features of the app 0..1 string Enable When: ef_any_physical_challenges = '1' ef_any_cognitive_challeges This application requires you to read text, answer questions, and follow directions. Do you have any cognitive challenges, including difficulty reading, that we can assist with? 0..1 choice Options: 2 options ef_cognitive_a11y_options Yes, I would like to use some of the accessibility features of the app 0..1 string Enable When: ef_any_cognitive_challeges = '1' ef_completed_by Who is participating in completing this survey?: Check all that apply 0..1 string ef_primary_language Tell us about yourself: What is your primary language? 0..1 choice Options: 4 options ef_primary_language_other If …
url:
  v: https://kind-lab.github.io/vbai-fhir/Questionnaire-enrollmentformschema
version:
  v: 2.2.0
title:
  v: enrollment_form_schema
status:
  v: active
date:
  v: 2024-05-29T18:29:25Z
publisher:
  v: KinD Lab
contact:
  name:
    v: KinD Lab
  telecom:
    system:
      v: url
    value:
      v: http://fhir.kindlab.sickkids.ca
item:
  link id:
    v: ef_select_language
  text:
    v: Select a language: Select a language
  type:
    v: choice
  answer option:
    value:
      v: English
  answer option:
    value:
      v: Español
  answer option:
    value:
      v: Français
item:
  link id:
    v: ef_any_vision_related_req
  text:
    v: Let's customize your experience: This application requires you to read text to answer questions. Do you have any vision-related requirements we can assist with?
  type:
    v: choice
  answer option:
    value:
      v: Yes
  answer option:
    value:
      v: No
item:
  link id:
    v: ef_vision_a11y_options
  text:
    v: Yes, I would like to use some of the accessibility features of the app
  type:
    v: string
  enable when:
    question:
      v: ef_any_vision_related_req
    operator:
      v: =
    answer:
      v: '1'
item:
  link id:
    v: ef_any_hearing_related_req
  text:
    v: This application may present some sound files for you to listen to. Do you have any hearing-related requirements we can assist with?
  type:
    v: choice
  answer option:
    value:
      v: Yes
  answer option:
    value:
      v: No
item:
  link id:
    v: ef_hearing_a11y_options
  text:
    v: Yes, I would like to use some of the accessibility features of the app
  type:
    v: string
  enable when:
    question:
      v: ef_any_hearing_related_req
    operator:
      v: =
    answer:
      v: '1'
item:
  link id:
    v: ef_any_physical_challenges
  text:
    v: This application requires you to navigate through the questions using a touch screen. Do you have any physical challenges we can accomodate?
  type:
    v: choice
  answer option:
    value:
      v: Yes
  answer option:
    value:
      v: No
item:
  link id:
    v: ef_physical_a11y_options
  text:
    v: Yes, I would like to use some of the accessibility features of the app
  type:
    v: string
  enable when:
    question:
      v: ef_any_physical_challenges
    operator:
      v: =
    answer:
      v: '1'
item:
  link id:
    v: ef_any_cognitive_challeges
  text:
    v: This application requires you to read text, answer questions, and follow directions. Do you have any cognitive challenges, including difficulty reading, that we can assist with?
  type:
    v: choice
  answer option:
    value:
      v: Yes
  answer option:
    value:
      v: No
item:
  link id:
    v: ef_cognitive_a11y_options
  text:
    v: Yes, I would like to use some of the accessibility features of the app
  type:
    v: string
  enable when:
    question:
      v: ef_any_cognitive_challeges
    operator:
      v: =
    answer:
      v: '1'
item:
  link id:
    v: ef_completed_by
  text:
    v: Who is participating in completing this survey?: Check all that apply
  type:
    v: string
item:
  link id:
    v: ef_primary_language
  text:
    v: Tell us about yourself: What is your primary language?
  type:
    v: choice
  answer option:
    value:
      v: English
  answer option:
    value:
      v: French
  answer option:
    value:
      v: Spanish
  answer option:
    value:
      v: Other (Please specify below)
item:
  link id:
    v: ef_primary_language_other
  text:
    v: If primary language is "other", please specify:
  type:
    v: string
  enable when:
    question:
      v: ef_primary_language
    operator:
      v: =
    answer:
      v: '4'
item:
  link id:
    v: ef_fluent_languages
  text:
    v: Do you speak any additional language(s) fluently (similar to a native speaker)?
  type:
    v: string
item:
  link id:
    v: ef_fluent_language_other

v: If you speak any other languages fluently, please specify:

v: string

question:
  v: ef_fluent_languages
operator:
  v: =
answer:
  v: 5

link id:
  v: ef_dob
text:
  v: What is your date of birth?
type:
  v: string

link id:
  v: ef_laryng_cancer
text:
  v: Do you have any of these conditions, diagnosed by a clinician? (Check all that apply if you currently have the condition)Voice Disorders: Laryngeal cancer
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_benign_cord_lesion
text:
  v: Lesions of the vocal cord (nodule, polyp, cyst)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_rrp
text:
  v: Recurrent laryngeal papilloma (RRP)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_spas_dys
text:
  v: Spasmodic dysphonia / Laryngeal Tremor
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_voc_fold_paralysis
text:
  v: Vocal fold paralysis
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_alz_dementia_mci
text:
  v: Neurological and Neurodegenerative Disorders: Alzheimer's, dementia, or mild cognitive impairment
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_als
text:
  v: Amyotrophic Lateral Sclerosis (ALS)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_parkinsons
text:
  v: Parkinson's disease
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_alcohol_subst_abuse
text:
  v: Mood and Psychiatric Disorders: Alcohol or Substance Use Disorder
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_gad
text:
  v: Anxiety disorder
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_add_adhd
text:
  v: Attention-Deficit / Hyperactivity Disorder (ADHD)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_asd
text:
  v: Autism Spectrum Disorder (ASD)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_bipolar
text:
  v: Bipolar Disorder
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_bpd
text:
  v: Borderline Personality Disorder (BPD)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_depression
text:
  v: Depression or Major Depressive Disorder
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_ed
text:
  v: Eating Disorder (ED)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_insomnia
text:
  v: Insomnia / sleep disorder
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_ocd
text:
  v: Obsessive-Compulsive Disorder (OCD)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_panic
text:
  v: Panic Disorder
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_ptsd
text:
  v: Post-Traumatic Stress Disorder (PTSD)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_schizophrenia
text:
  v: Schizophrenia
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_soc_anx_dis
text:
  v: Social Anxiety Disorder
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_other_psych
text:
  v: Other psychiatric disorder
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_asthma
text:
  v: Respiratory disorders: Asthma
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_airway_stenosis
text:
  v: Airway stenosis (for example: subglottic stenosis; laryngeal stenosis)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_chronic_cough
text:
  v: Chronic Cough
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_copd
text:
  v: COPD
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_osa
text:
  v: Obstructive Sleep Apnea (OSA)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_autism
text:
  v: Pediatric disorders: Autism Spectrum Disorder (ASD)
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_speech_delay
text:
  v: Speech Delay
type:
  v: choice
answer option:
  value:
    v: Unchecked
answer option:
  value:
    v: Checked

link id:
  v: ef_eligible_studies
text:
  v: Eligible Studies: Eligible Studies
type:
  v: string

link id:
  v: ef_learn_about_this_study
text:
  v: How did you learn about this study?: How did you learn about this study?
type:
  v: choice
answer option:
  value:
    v: Through my physician/provider
answer option:
  value:
    v: A flyer
answer option:
  value:
    v: Social Media
answer option:
  value:
    v: Bridge2AI Website
answer option:
  value:
    v: At an event
answer option:
  value:
    v: Other

link id:
  v: ef_learn_about_this_study_event
text:
  v: If "At an event", please specify:
type:
  v: string
enable when:
  question:
    v: ef_learn_about_this_study
  operator:
    v: =
  answer:
    v: 'event'

link id:
  v: ef_learn_about_this_study_other
text:
  v: If "Other", please specify:
type:
  v: string
enable when:
  question:
    v: ef_learn_about_this_study
  operator:
    v: =
  answer:
    v: 'other'

link id:
  v: ef_first_name
text:
  v: Contact Information: First Name
type:
  v: string

link id:
  v: ef_last_name
text:
  v: Last Name
type:
  v: string

link id:
  v: ef_phone_number
text:
  v: Phone Number
type:
  v: string

link id:
  v: ef_email
text:
  v: Email
type:
  v: string

link id:
  v: ef_contact_info_stored
text:
  v: I want my contact information to be kept in a repository for this study which can be used to contact me to ask me to enroll in further studies or return important results. My information will not be shared with third parties.
type:
  v: choice
answer option:
  value:
    v: Yes
answer option:
  value:
    v: No

link id:
  v: ef_enrollment
text:
  v: Review and Enroll:: Please review your answers reading all the way through the bottom and select an option.If you have any questions, you can still proceed with enrollment and ask or make changes at a later time.
type:
  v: choice
answer option:
  value:
    v: Enroll
answer option:
  value:
    v: Decline

link id:
  v: ef_is_control_participant
text:
  v: Is Control Participant?
type:
  v: choice
answer option:
  value:
    v: Yes
answer option:
  value:
    v: No

link id:
  v: ef_reason_decline_enroll
text:
  v: Please select a reason for declining
type:
  v: choice
enable when:
  question:
    v: ef_enrollment
  operator:
    v: =
  answer:
    v: 'Decline'
answer option:
  value:
    v: I am not interested in having my voice recorded
answer option:
  value:
    v: I do not have enough time today and want to be contacted later
answer option:
  value:
    v: I do not have enough time and do not want to be contacted later
answer option:
  value:
    v: I prefer not to share any health information for research
answer option:
  value:
    v: Other (Please specify)

link id:
  v: ef_other_reason_decline
text:
  v: If "Other" reason for declining enrollment, please specify:
type:
  v: string
enable when:
  question:
    v: ef_reason_decline_enroll
  operator:
    v: =
  answer:
    v: '5'

link id:
  v: ef_enrollment_institution
text:
  v: Enrollment Institution
type:
  v: choice
answer option:
  value:
    v: BCH
answer option:
  value:
    v: MIT
answer option:
  value:
    v: Mt. Sinai
answer option:
  value:
    v: USF
answer option:
  value:
    v: VUMC
answer option:
  value:
    v: WCM

link id:
  v: ef_researcher_email
text:
  v: Researcher Email
type:
  v: string

link id:
  v: ef_enrollment_origin
text:
  v: Enrollment Origin
type:
  v: choice
answer option:
  value:
    v: Bridge2AI App
answer option:
  value:
    v: Bridge2AI Enrollment Website

link id:
  v: ef_started_at
text:
  v: Enrollment Form - Metadata: Enrollment Form Started At
type:
  v: string

link id:
  v: ef_completed_at
text:
  v: Enrollment Form Completed At
type:
  v: string

link id:
  v: ef_duration
text:
  v: Enrollment Form Duration (seconds)
type:
  v: string