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The CDISC Intellectual Property Policy can be found on the CDISC website at: https://www.cdisc.org/about/bylaws.
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CDISC would appreciate supplement reviewers' input on their experience in using the PASI FEDLMAN instrument regarding what responses are being used for symptoms "erythema/redness", "thickness/induration" and "desquamation/scaling". There are 3 possible references that were found to explain PASI:
CDISC would appreciate reviewer help regarding which list of responses are used (those that mirror Feldman, Fredriksson, EMA, or some other combination). If the responses list is not in a majority (per public comment), it will be considered “undetermined.” The supplement will allow a sponsor’s list of responses, as was done in the CDISC PGI and CGI supplements. |
1.1 Representations and Warranties, Limitations of Liability, and Disclaimers
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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 PASI V2FELDMAN:
Feldman SR, Krueger GG. Psoriasis assessment tools in clinical trials. Ann Rheum Dis. 2005;64(Suppl 2):ii65–ii68.
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All assumptions and business rules described in the SDTMIG RS domain are applicable to this supplement. Additional assumptions specific to the PASI V2 are FELDMAN are listed below.
The PASI V2 is a tool used to assess the severity of psoriasis. The PASI V2 FELDMAN is a tool used to assess the severity of psoriasis. However, there is no standard set of responses for the PASI that is used throughout the industry. This supplement uses the Feldman article as the standard for responses. The PASI FELDMAN divides the body into 4 sections (i.e., headhead, trunk, upper extremities, lower extremities) and assesses symptom severity and the percentage of each area affected by psoriasis. The symptoms are rated on a 5-point scale and the area is rated on a 7-point scale. Subscores for each section of the body and a total score are also captured.
The scale points for the symptoms include a numeric rating (0-4) and a definition of what is represented by the rating (e.g., 0 = "None"). For the PASI V2FELDMAN, RSORRES is populated with the text description; the numeric rating is represented in the standardized character and numeric result variables RSSTRESC and RSSTRESN.
- CDISC created a CRF based on the Feldman article using the symptom terms "erythema/redness", "thickness/induration", and "desquamation/scaling". Per subject-matter expert recommendations, desquamation was included with scaling even though desquamation is not referenced in the Feldman article.
- CDISC created a CRF based on the Feldman article using the symptom terms "erythema/redness", "thickness/induration", and "desquamation/scaling". Per subject-matter expert recommendations, desquamation was included with scaling even though desquamation is not referenced in the Feldman article.
- The scale points for the area include a numeric rating (0-6) and a definition of what is represented by the rating (e.g., 0 = "0 (clear)"). For the area, RSORRES is populated with the text description; the numeric rating is represented in the standardized character and numeric result variables RSSTRESC and RSSTRESN.
The PASI V2 instrument FELDMAN instrument includes subscores and a total score that are considered as captured data on the CRF and are not considered as derived in the example below. These scores may be submitted in SDTM or derived in the Analysis Data Model (ADaM) per scoring instructions from the Feldman reference.
If operationally defined by the sponsor, it is the sponsor's responsibility to set the --DRVFL flag based on their eCRF process to derive subtotals and total scores. An investigator-derived score will be considered a captured score and not flagged. When subtotal and total scores are derived by the sponsor, the derived flag (--DRVFL) is set to "Y". However, when the subtotal and total scores are received from a central provider or vendor, the value would go into --ORRES and --DRVFL would be null (see SDTMIG Section 4.1.8.1, Origin Metadata for Variables).
If scores are received by the sponsor, it is recommended that they are submitted to SDTM and verified in ADaM.
Records are created in rs.xpt for every item on the instrument:
For items with no data, RSORRES, RSSTRESC, and RSSTRESN are all missing and RSSTAT = "NOT DONE". If the reason is known, that reason is represented in RSREASND (e.g., RSREASND = "REFUSED"). If the reason is unknown, RSSTAT = "NOT DONE" and RSREASND is missing.
Terminology
RSCAT, RSTESTCD, and RSTEST 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.
3.2 Example for the PASI
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FELDMAN RS Domain Model
The PASI V2 FELDMAN example below shows the terminology used to implement the instrument in the RS domain. This example shows the data for 1 subject collected at the baseline visit for the PASI V2 instrument. The example uses CDISC Controlled Terminology for RSTESTCD, RSTEST, and RSCAT. All original results, matching the CRF item response text, are represented in RSORRES. This result is then represented as a standard numeric score in RSSTRESN and as a standard character representation in RSSTRESC.
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The table represents the items from the PASI V2 instrumentFELDMAN instrument.
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