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| Xformpusher |
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| CDASH Variable | Order | Question Text | Prompt | CRF Completion Instructions | Type | SDTMIG Target Variable | SDTM Target Mapping | Controlled Terminology Code List Name | Permissible Values | Pre-Populated Value | Query Display | List Style | Hidden |
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| DSCAT | 1 | What was the category of the disposition? | Disposition Category | If collected on the CRF, the sponsor provides instructions to ensure the data is entered as intended. | Text | DSCAT |
| (DSCAT) |
| DISPOSITION EVENT | prompt |
| Yes | | EPOCH | 2 | What is the trial epoch for this disposition event? | Epoch | Select the trial epoch for which disposition is being recorded. | Text | EPOCH |
| (EPOCH) | SCREENING; TREATMENT; FOLLOW-UP; |
| prompt | radio |
| | DSSTDAT | 3 | What was the completion/discontinuation date? | Completion/Discontinuation Date | Record the date that the subject completed the study or trial period using this format (DD-MON-YYYY). If the subject did not complete the study or trial period, record the date that the subject discontinued. | Date | DSSTDTC |
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| | DSSTTIM | 4 | What was the completion/discontinuation time? | Completion/Discontinuation Time | Record the time (as complete as possible) that the subject completed the study or trial period as defined in the protocol. If the subject did not complete the study or trial period, record the time (as complete as possible). | Time | DSSTDTC |
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| | DSDECOD | 5 | What was the subject's status? | Status | Document the subject's status for the study or trial period. If the subject discontinued prematurely, record the primary reason for discontinuation. | Text | DSDECOD |
| (NCOMPLT) | COMPLETED; ADVERSE EVENT; DEATH; LACK OF EFFICACY; LOST TO FOLLOW-UP; NON-COMPLIANCE WITH STUDY DRUG; PHYSICIAN DECISION; PREGNANCY; PROTOCOL DEVIATION; SITE TERMINATED BY SPONSOR; STUDY TERMINATED BY SPONSOR; WITHDRAWAL BY SUBJECT; OTHER |
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| radio |
| | DSTERM | 6 | If other, specify | Specify | If Adverse Event, Death, Protocol Deviation or Other is selected from the Status list, provide the verbatim reason. | Text | DSTERM |
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| prompt |
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| | DSCONT | 7 | Will the subject continue? | Continue | Record if the subject will be continuing to the next trial period of this study. | Text | SUPPDS.QVAL | SUPPDS.QVAL when SUPPDS.QNAM= "DSCONT" and SUPPDS.QLABEL="Subject Continue". | (NY) | No; Yes |
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| radio |
| | DSNEXT | 8 | What is the next epoch the subject will continue to enter? | Next epoch | Record the planned subsequent trial epoch in which the subject intends to participate. | Text | N/A |
| (EPOCH) | TREATMENT; FOLLOW-UP; |
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This is an examples example of an SDTM dataset used to represent the data collected on the above example CRFs.
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