Patient
Review of systems
Symptoms organized by body system.
Format definition
Represent present, absent, unknown, and unasked symptoms explicitly.
Scenario standard · Execution capabilities
Unable to obtain ROS reasons (Suite authoring profile)
usim:unavailable-ros@1.0.0 stores the selected statement in reliabilityNote on a canonical symptom observation with code usim:ros:Unable%20to%20obtain and status not-assessed. These are explicit author selections, never inferred negative findings.
| Dropdown label | Stored value |
|---|---|
| Reason not specified | Unable to obtain review of systems. |
| Clinical condition / acuity | Unable to obtain review of systems due to clinical condition or acuity. |
| Altered mental status | Unable to obtain review of systems due to altered mental status. |
| Unconsciousness | Unable to obtain review of systems due to unconsciousness. |
| Intubation / sedation | Unable to obtain review of systems due to intubation or sedation. |
| Developmental limitations | Unable to obtain review of systems due to developmental limitations. |
| Cognitive impairment | Unable to obtain review of systems due to cognitive impairment. |
| Communication barrier | Unable to obtain review of systems due to a communication barrier. |
| Patient declined | Unable to obtain review of systems due to the patient declining assessment. |
| Collateral historian unavailable | Unable to obtain review of systems due to an unavailable collateral historian. |
| Other limitation | Unable to obtain review of systems due to another limitation. |
Parameters
patients[].reviewOfSystems[]
object
Optional; omitted means unspecified
Groups symptom observations by authored system heading without duplicating their values.
observations[].reportedByActorId
string
Optional; omitted means unspecified
Identifies the patient actor, relative, or colleague supplying the history.
observations[].reliabilityNote
string
Optional; omitted means unspecified
Facilitator context on conflicting or incomplete history; visibility follows the observation's disclosure policy.
Behavior and validation
- Suite offers Unable to obtain beside Default. Selecting it replaces the whole ROS record with a single "Unable to obtain" entry. Its reason dropdown stores the explicit statement from usim:unavailable-ros@1.0.0, initially Reason not specified. Existing custom reason strings remain valid and selectable. Default removes this entry and materializes age-specific normal findings; removing the entry leaves ROS unspecified. Import and playback must preserve the statement without inferring negative symptoms.
- Author-selected normal findings use usim:age-based-normal-findings@1.1.0 in authoringProfiles. Select by age in years: infant [0,1), child [1,12), adolescent [12,18), adult [18,65), older adult [65,infinity); missing or invalid age uses age-neutral text. Materialize selected text as explicit authored observations linked to the system. Preserve existing values, including blanks, unknown and not assessed. Age changes never rewrite saved findings. Omission never implies normal; do not inject templates during import or playback. Selected templates are stored as canonical observations: symptom entries for ROS and finding entries for examination, linked by patientId and system code.
- For a boolean symptom concept, known/false means explicitly absent and known/true means present. Not-assessed omits value. Unselected symptoms remain unspecified.
- Conflicting reports use separate observation IDs and reporters; the format does not silently select a true version.
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