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Title | European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire - Palliative Care Version 1.0 (EORTC QLQ-C15-PAL V1.0)
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CDISC Reference | Questionnaire Supplement to the Study Data Tabulation Model Implementation Guide for Human Clinical Trials |
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QRS Short Name | |
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QRS Permission Status | Approved |
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Team | Prostate Cancer Standards Team and CDISC Questionnaires, Ratings, and Scales (QRS) Subteam |
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Supplement Version | 1.0 |
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Status | DRAFT |
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Date | 2021-0309-0121 |
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Notes | - This supplement is intended to be used with other CDISC User Guides user guides for specific therapeutic/disease areas and follows the CDISC Study Data Tabulation Model Implementation Guide for Human Clinical Trials.
- This instrument is a US FDA Qualified Clinical Outcome Assessment (COA) instrument.
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Revision History
Date | Version |
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2021-0309-0121 | 1.0 Draft |
© 2021 Clinical Data Interchange Standards Consortium, Inc. All rights reserved.
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This document is a supplement to the SDTMIG for Human Clinical Trials and is covered under Appendix F of that document, which describes representations, warranties, limitations of liability, and disclaimers. Please see Appendix F of the SDTMIG for a complete version of this material.
CDISC specifies how to structure the data that has been collected in a database, not what should be collected or how to conduct clinical assessments or protocols. CDISC disclaims any liability for your use of this material.
Although the United States Food and Drug Administration (US FDA) has provided input with regard to this supplement, this input does not constitute US FDA endorsement of any particular instrument.
2 Copyright Status
EORTC owns the copyright for the EORTC QLQ-C15-PAL V1.0 instrument and has granted CDISC permission to include this supplement in the CDISC library of QRS data standards supplements. EORTC will distribute the CDISC supplement package to sponsors when they are approved to use this instrument. Hence, CDISC developed QSTESTCD and QSTEST for each item based on the actual text on the instrument.
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The EORTC QLQ-C15-PAL V1.0 is a multiple-choice instrument that that clinicians may use to assess the quality of life of palliative cancer care subjects. It consists of 14 items, each rated on a 4-point Likert scale, plus 1 item rated on a 7-point numeric rating scale.
The scale points include a 4-point Likert scale (1-4) and a 7-point numeric rating (1-7) and , with a definition of what is represented by the rating (e.g., 1 = "Not at all"). For the EORTC QLQ-C15-PAL V1.0, QSORRES is populated with the text description while the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN.
The time period of evaluation for the EORTC QLQ-C15-PAL V1.0 is populated in the QSEVLINT field in ISO 8601 format when the evaluation interval can be precisely described as duration. The evaluation interval for the EORTC QLQ-C15-PAL V1.0 is the past week for QSTESTCD="EOR0204" thru "EOR0215".
Terminology
QSCAT, QSTESTCD, and QSTEST values are included in CDISC Controlled Terminology.
A full list of value sets for the result field is provided in Section 4, SDTM Mapping Strategy.
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Dataset wrap |
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Dataset2 |
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Row | STUDYID | DOMAIN | USUBJID | QSSEQ | QSTESTCD | QSTEST | QSCAT | QSORRES | QSSTRESC | QSSTRESN | QSSTAT | QSLOBXFL | VISITNUM | QSDTC | QSEVLINT | 1 | STUDYX | QS | 2324-P0001 | 1 | EOR0201 | EOR02-Trouble Taking Short Walk Outside | EORTC QLQ-C15-PAL V1.0 | Not at All | 1 | 1 |
| Y | 1 | 2015-11-1 |
| 2 | STUDYX | QS | 2324-P0001 | 2 | EOR0202 | EOR02-Stay in Bed/Chair During the Day | EORTC QLQ-C15-PAL V1.0 | A Little | 2 | 2 |
| Y | 1 | 2015-11-1 |
| 3 | STUDYX | QS | 2324-P0001 | 3 | EOR0203 | EOR02-Need Help Eating/Dressing/Washing | EORTC QLQ-C15-PAL V1.0 | Quite a Bit | 3 | 3 |
| Y | 1 | 2015-11-1 |
| 4 | STUDYX | QS | 2324-P0001 | 4 | EOR0204 | EOR02-Were You Short of Breath | EORTC QLQ-C15-PAL V1.0 | Very Much | 4 | 4 |
| Y | 1 | 2015-11-1 | -P1W | 5 | STUDYX | QS | 2324-P0001 | 5 | EOR0205 | EOR02-Have You Had Pain | EORTC QLQ-C15-PAL V1.0 | Not at All | 1 | 1 |
| Y | 1 | 2015-11-1 | -P1W | 6 | STUDYX | QS | 2324-P0001 | 6 | EOR0206 | EOR02-Have You Had Trouble Sleeping | EORTC QLQ-C15-PAL V1.0 | A Little | 2 | 2 |
| Y | 1 | 2015-11-1 | -P1W | 7 | STUDYX | QS | 2324-P0001 | 7 | EOR0207 | EOR02-Have You Felt Weak | EORTC QLQ-C15-PAL V1.0 | Quite a Bit | 3 | 3 |
| Y | 1 | 2015-11-1 | -P1W | 8 | STUDYX | QS | 2324-P0001 | 8 | EOR0208 | EOR02-Have You Lacked Appetite | EORTC QLQ-C15-PAL V1.0 | Very Much | 4 | 4 |
| Y | 1 | 2015-11-1 | -P1W | 9 | STUDYX | QS | 2324-P0001 | 9 | EOR0209 | EOR02-Have You Felt Nauseated | EORTC QLQ-C15-PAL V1.0 | Not at All | 1 | 1 |
| Y | 1 | 2015-11-1 | -P1W | 10 | STUDYX | QS | 2324-P0001 | 10 | EOR0210 | EOR02-Have You Been Constipated | EORTC QLQ-C15-PAL V1.0 | A Little | 2 | 2 |
| Y | 1 | 2015-11-1 | -P1W | 11 | STUDYX | QS | 2324-P0001 | 11 | EOR0211 | EOR02-Were You Tired | EORTC QLQ-C15-PAL V1.0 | Quite a Bit | 3 | 3 |
| Y | 1 | 2015-11-1 | -P1W | 12 | STUDYX | QS | 2324-P0001 | 12 | EOR0212 | EOR02-Pain Interfere Daily Activities | EORTC QLQ-C15-PAL V1.0 | Very Much | 4 | 4 |
| Y | 1 | 2015-11-1 | -P1W | 13 | STUDYX | QS | 2324-P0001 | 13 | EOR0213 | EOR02-Did You Feel Tense | EORTC QLQ-C15-PAL V1.0 | Not at All | 1 | 1 |
| Y | 1 | 2015-11-1 | -P1W | 14 | STUDYX | QS | 2324-P0001 | 14 | EOR0214 | EOR02-Did You Feel Depressed | EORTC QLQ-C15-PAL V1.0 | A Little | 2 | 2 |
| Y | 1 | 2015-11-1 | -P1W | 15 | STUDYX | QS | 2324-P0001 | 15 | EOR0215 | EOR02-Rate Your Overall Quality of Life | EORTC QLQ-C15-PAL V1.0 | Excellent | 7 | 7 |
| Y | 1 | 2015-11-1 | -P1W | 16 | STUDYX | QS | 2324-P0001 | 16 | EOR0201 | EOR02-Trouble Taking Short Walk Outside | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 |
| 17 | STUDYX | QS | 2324-P0001 | 17 | EOR0202 | EOR02-Stay in Bed/Chair During the Day | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 |
| 18 | STUDYX | QS | 2324-P0001 | 18 | EOR0203 | EOR02-Need Help Eating/Dressing/Washing | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 |
| 19 | STUDYX | QS | 2324-P0001 | 19 | EOR0204 | EOR02-Were You Short of Breath | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 20 | STUDYX | QS | 2324-P0001 | 20 | EOR0205 | EOR02-Have You Had Pain | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 21 | STUDYX | QS | 2324-P0001 | 21 | EOR0206 | EOR02-Have You Had Trouble Sleeping | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 22 | STUDYX | QS | 2324-P0001 | 22 | EOR0207 | EOR02-Have You Felt Weak | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 23 | STUDYX | QS | 2324-P0001 | 23 | EOR0208 | EOR02-Have You Lacked Appetite | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 24 | STUDYX | QS | 2324-P0001 | 24 | EOR0209 | EOR02-Have You Felt Nauseated | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 25 | STUDYX | QS | 2324-P0001 | 25 | EOR0210 | EOR02-Have You Been Constipated | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 26 | STUDYX | QS | 2324-P0001 | 26 | EOR0211 | EOR02-Were You Tired | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 27 | STUDYX | QS | 2324-P0001 | 27 | EOR0212 | EOR02-Pain Interfere Daily Activities | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 28 | STUDYX | QS | 2324-P0001 | 28 | EOR0213 | EOR02-Did You Feel Tense | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 29 | STUDYX | QS | 2324-P0001 | 29 | EOR0214 | EOR02-Did You Feel Depressed | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W | 30 | STUDYX | QS | 2324-P0001 | 30 | EOR0215 | EOR02-Rate Your Overall Quality of Life | EORTC QLQ-C15-PAL V1.0 |
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| NOT DONE |
| 2 | 2015-11-8 | -P1W |
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4 SDTM Mapping Strategy
This section is used for reference regarding the CRF data capture and to understand the alignment of the instrument to the SDTM QS domain. It also provides guidance on how the result variables (QSORRES, QSSTRESC, and QSSTRESN) should be populated.
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