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The NATIONAL CANCER INSTITUTE at the NATIONAL INSTITUTES OF HEALTH (NCI) owns the copyright for the PRO-CTCAE V1.0 VERSION DATE 4/26/2020 instrument and has made the it exempt from copyright restrictions. Use of the the PRO-CTCAE V1.0 VERSION DATE 4/26/2020 is subject to NCI terms of use (See https://healthcaredelivery.cancer.gov/pro-ctcae/terms_of_use.html). CDISC has included this supplement in the CDISC inventory of QRS data standards supplements. Hence, CDISC developed QSTESTCD and QSTEST for each item based on the actual text on the instrument. 

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The PRO-CTCAE V1.0 VERSION DATE 4/26/2020 a is a patient-reported outcome (PRO) instrument developed to capture symptomatic adverse events of patients in patients on cancer clinical trials. The PRO-CTCAE V1.0 VERSION DATE 4/26/2020 was designed to be used in conjunction with the Common Terminology Criteria for Adverse Events (CTCAE).[1] It consists of an item library rather than a static/fixed question type of instrument. You should use the form builder at: https://healthcaredelivery.cancer.gov/pro-ctcae/instrument.html and and instructions provided by NCI to select the items to implement in your clinical study. The PRO-CTCAE V1.0 VERSION DATE 4/26/2020 includes multiple choice questions multiple choice questions on the frequency. , severity, interference, presence/absence and/or amount of specific adverse events. The items are rated on a a 5-point scale ("0-4"). Total scoring instructions have not yet been developed.

Administration of PRO-CTCAE V1.0 VERSION DATE 4/26/2020 may be conducted via different modes, including screen-based, interactive voice response, and paper, offers flexibility for patients and for study operations personnel.

[1] National Institutes of Health – National Cancer Institute, Division of Cancer Control & Population Sciences. (2017, July 2) https://healthcaredelivery.cancer.gov/pro-ctcae/overview.html

  1. As a CDISC QRS standard, the instrument name is PRO-CTCAE V1.0 VERSION DATE 4/26/2020, as provided in this supplement. As an item library, sponsors may select items from the overall library as a subset of items with the same CDISC controlled terminology Controlled Terminology as appropriate for the condiction condition being studied. It is the users responsibility to identify the subset of items used from the ovearll overall PRO-CTCAE V1.0 Item Library (Version 1.0) for this use case. The subsetted PROsubsetted PRO-CTCAE V1.0 VERSION DATE 4/26/2020 user's instrument can be named named  (subtitled??) based on the user's descretion discretion when they identify the specifc specific items being used.

  2. The PRO-CTCAE V1.0 VERSION DATE 4/26/2020, QSORRES is populated with the text description and the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN. Please reference the PRO-CTCAE website for more details on the scoring criteria at: https://healthcaredelivery.cancer.gov/pro-ctcae/faqs.html. The responses for the PRO-CTCAE V1.0 VERSION DATE 4/26/2020 are as follows:

    1. Depending on the symptomatic AE being measured, items assessing symptom presence/absence are rated as follows:
      1. Items rated on a binary response scale and scored from "0-1" (e.g., "0 = “No” and "1" = “Yes”);
      2. Items rated on a polytomous response scale and scored from "0-1" (e.g.,  "0" = “No”, "1 " =“Yes”, and “Not applicable”and “Not applicable” or "Not Applicable"); or
      3. Items rated on a polytomous response scale and scored from "0-1" (e.g., "0" = “No”, "1" = “Yes”, “Not sexually active”, and “Prefer not to answer”).
    2. Items assessing symptom amount are rated on a 5-point Likert scale and scored from "0-4" (e.g., "0" = “Not at all”, "1" = “A little bit”, "2" = “Somewhat”, "3" = “Quite a bit”, and '4 ' = “Very much”).
    3. Items assessing symptom frequency are rated on a 5-point Likert scale and are scored from "0-4" (e.g., "0" = “Never”, "1" = “Rarely”, "2" =“Occasionally”, "3" = “Frequently”, and "4" = “Almost constantly”).
    4. Items assessing symptom severity are rated on a 5-point Likert scale and are scored from "0-4" (e.g., "0" = “None”, "1" = “Mild”, "2" = “Moderate”, "3" = “Severe”, and "4" = “Very severe”).
    5. Items assessing symptom interference are rated on a 5-point Likert scale and are scored from "0-4" (e.g., "0" = “Not at all”, "1" = “A little bit”, "2" = “Somewhat”, "3 ' = “Quite a bit”, and "4" = “Very much”). 
    6. Item-level scores are not combined (i.e.g., no total score nor symptom-specific scores are calculated).
  3. The time period of evaluation for the PRO-CTCAE V1.0 VERSION DATE 4/26/2020 is populated in the QSEVLINT field in ISO 8601 format when the evaluation interval can be precisely described as duration. The recommended evaluation interval for the PRO-CTCAE V1.0 VERSION DATE 4/26/2020 is the past 7 days (QSEVLINT = "-P7D". Please reference the PRO-CTCAE website for more details on the evaluation interval at: https://healthcaredelivery.cancer.gov/pro-ctcae/faqs.html.
  4. Items are divided into 14 subcategories represented in the QSSCAT variable. These categorizations represent how the symptom terms are catgroized categorized in the PRO-CTCAE V1.0 Item Library (Version 1.0). See Section 4, SDTM Mapping Strategy, for a list of these subcategory values. 
    1. The symptomatic AE being measured by a given item (e.g., the Symptom Term represented on the CRF corresponding to a given item) is stored in the SUPPQS dataset with the QNAM = "QSSYMTRM". This matches the symptom term identified in the PRO-CTCAE V1.0 Item Library (Version 1.0).

  5. Conditional branching is used in the conduct of the PRO-CTCAE V1.0 VERSION DATE 4/26/2020 for symptom terms that have two or more items. The logic branches from frequency, then to severity, then to interference. For example, if frequency is > (greater than) never, you next pose the severity question, and if severity>none, you pose the interference question. Please reference the PRO-CTCAE website for more details on the conditional branching approach at: https://healthcaredelivery.cancer.gov/pro-ctcae/faqs.html.

    1. These branching items on the PRO-CTCAE V1.0 VERSION DATE 4/26/2020 may be logically skipped per the instrument instructions. For example, If the item "In the last 7 days, how OFTEN did you have PAIN IN THE ABDOMEN (BELLY AREA)? (QSTESTCD = "PT01017A") is answered as "Never". The related symptom items for severity and interference are logically skipped (QSTESTCD = "PT01017B" and "PT01017C"), since the symptom did not occur. A record is created in qs.xpt for all items. When an item is considered a logically skipped item, it is represented as follows:

      1. RSSTAT = "NOT DONE".

      2. RSREASND = "LOGICALLY SKIPPED ITEM".

      3. RSORRES, is set to null (missing).

      4. RSSTRESC and RSSTRESN are represented with the numeric value 0 as specified in the scoring criteria. Please reference the FAQ "How is the PRO-CTCAE scored" on the website at: https://healthcaredelivery.cancer.gov/pro-ctcae/faqs.html.
  6. The language in which the PRO-CTCAE V1.0 VERSION DATE 4/26/2020 was administered (e.g., English, Spanish, Japanese) is collected with the Form Builder application and may be represented as a supplemental qualifier with QNAM = "QSLANG". Reference the PRO-CTCAE V1.0 website for a list of available translations at: https://healthcaredelivery.cancer.gov/pro-ctcae/.
  7. Terminology

    1. QSCAT, QSTESTCD, and QSTEST values are included in CDISC Controlled Terminology.

    2. A full list of value sets for the qualifier, timing, and result fields is provided in Section 4, SDTM Mapping Strategy.

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