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There is no known standard case report form (CRF) available for this instrument. CDISC created this CRF to represent the instrument, which CDISC believes is in the public domain. This is not an endorsement of the instrument. The creation of this instrument was based on input from Duchenne muscular dystrophy subject matter experts. Sponsors may create this instrument’s CRF using their style guidelines, but they need to maintain the wording and order of the questions/items and responses (text and numeric) as described on the CRF.
The representation of data collected for this instrument is based on the Study Data Tabulation Model Implementation Guide (SDTMIG) Functional Tests (FT) domain model, which can be found on the CDISC website at: https://www.cdisc.org/standards/foundational/sdtmig.
These specific implementation details for this instrument are meant to be used in conjunction with the SDTMIG. All CDISC questionnaires, ratings, and scales (QRS) documentation packages can be found on the CDISC website at: https://www.cdisc.org/foundational/qrs.
The CDISC Intellectual Property Policy can be found on the CDISC website at: https://www.cdisc.org/about/bylaws.
1.1 Representations and Warranties, Limitations of Liability, and Disclaimers
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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
CDISC believes this instrument to be in the public domain, but you should perform your own assessment. CDISC has included the 4 STAIR DESCEND in the library of QRS data standards supplements. Hence, CDISC developed FTTESTCD and FTTEST for each item based on the actual text on the instrument. There may be many versions of this instrument in the public domain or copyrighted. CDISC has chosen to use this version as the data standard.
The CDISC documentation of this instrument consists of: (1) controlled terminology, (2) standard database structure with examples, and (3) CRF(s) annotated with the CDISC SDTMIG variables with submission values.
Note: CDISC Controlled Terminology is maintained by National Cancer Institute (NCI) Enterprise Vocabulary Services (EVS). The most recent version should be accessed through the CDISC website at: https://www.cdisc.org/standards/terminology/controlled-terminology.
Reference for the 4 STAIR DESCEND:
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The table represents the items from the 4 STAIR DESCEND form. USUBJID = "1001-001" did not perform the test due to the use of a wheelchair; however, the grade and orthoses question are still completed.
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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 FT domain. It also provides guidance on how the result and unit variables (FTORRES, FTSTRESC, FTSTRESN, FTORRESU, and FTSTRESU) should be populated.
All responses for 4 STAIR DESCEND are numeric and units are predetermined for those result variables that have units. This section shows which units should be used for each FTTESTCD and FTTEST.
FTTESTCD = "D4STR101" FTTEST = "D4STR1-Was 4 Stair Descend Performed"
FTORRES | FTSTRESC |
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Yes | Y |
No, Due to disease under study | No, Due to disease under study |
FTTESTCD = "D4STR103FTTESTCD = "D4STR101" FTTEST = "D4STR1-Time to Descend 4 Stairs"Wear Orthoses"
FTORRES | FTSTRESC |
---|---|
Yes | Y |
No | N |
FTTESTCD = "D4STR102D4STR104" FTTEST = "D4STR1-Test Grade"
FTORRES | FTSTRESC | FTSTRESN |
---|---|---|
Unable to descend 4 standard stairs. | 1 | 1 |
Descends 4 standard stairs “marking time” (descends 1 foot at a time, with both feet on a step before moving to next step), using both arms on one or both handrails. | 2 | 2 |
Descends 4 standard stairs “marking time” (descends 1 foot at a time, with both feet on a step before moving to next step), using one arm on one handrail. | 3 | 3 |
Descends 4 standard stairs “marking time” (descends 1 foot at a time, with both feet on a step before moving to next step), not needing handrail. | 4 | 4 |
Descends 4 standard stairs alternating feet, needs handrail for support. | 5 | 5 |
Descends 4 standard stairs alternating feet, not needing handrail support. | 6 | 6 |
FTTESTCD = "D4STR103" FTTEST = "D4STR1-Wear Orthoses"
FTORRES | FTSTRESC |
---|---|
Yes | Y |
No | N
End of Document