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This is an example CRF used to collect the protocol milestonemilestones, and informed consent. Example CRF:  Protocol milestones


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titleaCRF: Protocol Milestones (e.g.,

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Informed Consent)

 In this study, subjects were randomized to a trial, which contain three epochs. A screening epoch, a product exposure epoch,, where subjects were required to use the tobacco product as described in the protocol, and a follow-up epoch. The Disposition Event CRF was collected at the end of each epoch of the trial. The sponsor may select the the Completion/Reason for Non-Completion terms from Controlled Terminology.    

Xformpusher
CDASH VariableOrderQuestion TextPromptCRF Completion InstructionsTypeSDTMIG Target ValueSDTMIG Target MappingControlled Terminology Code List NameCRF Implementation NotesPermissible ValuesPre-Populated ValueQuery DisplayList StyleHidden
DSCAT1What was the category of the disposition?Disposition CategoryIf collected on the CRF, the sponsor provides instructions to ensure the data is entered as intended.TextDSCATDSCAT="PROTOCOL MILESTONE" where DSDECOD and DSTERM="INFORMED CONSENT OBTAINED"(DSCAT)Refer to the SDTMIG for guidelines for assigning DSCAT, DSTERM, and DSDECOD for events considered protocol milestones.
PROTOCOL MILESTONEprompt
Yes
DSSTDAT2What was the informed consent date?Informed Consent DateRecord the date of informed consent as defined in the protocol and/or CRF completion instructions using this format (DD-MON-YYYY).DateDSSTDTC




qtext

DSSTTIM3What was the informed consent time?Informed Consent TimeRecord the time (as complete as possible) of informed consent as defined in the protocol and/or CRF completion instructions.TimeDSSTDTC




qtext

This is an example CRF used to collect Disposition Events. In this study, subjects were randomized to a trial, which contain three epochs. A screening epoch, a product exposure epoch,, where subjects were required to use the tobacco product as described in the protocol, and a follow-up epoch. The Disposition Event CRF was collected at the end of each epoch of the trial. The sponsor may select the the Completion/Reason for Non-Completion terms from Controlled Terminology.   Example CRF :Study


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titleaCRF: Participation Disposition Event
Xformpusher
CDASH VariableOrderQuestion TextPromptCRF Completion InstructionsTypeSDTMIG Target VariableSDTM Target MappingControlled Terminology Code List NamePermissible ValuesPre-Populated ValueQuery DisplayList StyleHidden
DSCAT1What was the category of the disposition?Disposition CategoryIf collected on the CRF, the sponsor provides instructions to ensure the data is entered as intended.TextDSCAT
(DSCAT)
DISPOSITION EVENTprompt
Yes
EPOCH2What is the trial epoch for this disposition event?EpochSelect the trial epoch for which disposition is being recorded.TextEPOCH
(EPOCH)SCREENING; PRODUCT EXPOSURE;  FOLLOW-UP;
promptradio
DSSTDAT3What 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.DateDSSTDTC






DSSTTIM4What was the completion/discontinuation time?Completion/Discontinuation TimeRecord 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).TimeDSSTDTC






DSDECOD5What was the subject's status?StatusDocument the subject's status for the study or trial period. If the subject discontinued prematurely, record the primary reason for discontinuation.TextDSDECOD
(NCOMPLT)COMPLETED; ADVERSE EVENT; DEATH; LOST TO FOLLOW-UP; NON-COMPLIANCE WITH STUDY PRODUCT; PHYSICIAN DECISION; PREGNANCY;  PROTOCOL DEVIATION; SITE TERMINATED BY SPONSOR; STUDY TERMINATED BY SPONSOR;  WITHDRAWAL BY SUBJECT; OTHER

radio
DSTERM6If other, specifySpecifyIf Adverse Event, Death, Protocol Deviation or Other is selected from the Status list, provide the verbatim reason.TextDSTERM



prompt

DSCONT7Will the subject continue?Continue

Record if the subject will be continuing to the next trial period of this study.

TextSUPPDS.QVALSUPPDS.QVAL when SUPPDS.QNAM= "DSCONT" and SUPPDS.QLABEL="Subject Continue".(NY)No; Yes

radio
DSNEXT8What is the next epoch the subject will continue to enter?Next epochRecord the planned subsequent trial epoch in which the subject intends to participate.TextN/A
(EPOCH)PRODUCT EXPOSURE;  FOLLOW-UP;




This is an example of an SDTM dataset used to represent the data collected on the above example CRFs. 

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