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Revision History

© 2023 Clinical Data Interchange Standards Consortium, Inc. All rights reserved. 

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• Boerlage AA, Ista E, Duivenvoorden HJ, de Wildt SN, Tibboel D, van Dijk M. The COMFORT behaviour scale detects clinically meaningful effects of analgesic and sedative treatment. Eur J Pain. 2015 Apr;19(4):473-9.
• Van Dijk M, Peters JW, van Deventer P, Tibboel D. The COMFORT Behavior Scale: a tool for assessing pain and sedation in infants. Am J Nurs 2005; 105 (1): 33-6.

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This is an example only.  Use the reference from the CDISC definition of the --CAT.

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• .

If there are multiple references, please use the following format:

References for the QRS Short_Name:

• CDISC Controlled Terminology reference.
• additional reference.

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1. Include a description of scale score or other possible responses (You may need multiple numbered points for this, though the IDS-SR did not.). For scale scores use the following language: The scale points include a numeric rating (1-5) and a definition of what is represented by the rating (e.g., 1 = "deeply asleep (eyes closed, no response to changes in the environment)"). For the COMFORT-B SCALE, RSORRES is populated with the text description while the numeric rating is represented in the standardized character and numeric result variables RSSTRESC and RSSTRESN. 

2. The RSREPNUM variable is used to indicate the same FTTESTSs RSTESTSs are used in trial 1, 2, 3, and 4.

3. Records are created in rs.xpt for every instrument item: 

   1. For items with no data, RSORRES, RSSTRESC, and RSSTRESN are all missing and RSSTAT = "NOT DONE". If the reason is known then that reason is represented in RSREASND (e.g., RSREASND = "PREFER NOT TO ANSWER"). If the reason is unknown, then RSSTAT = "NOT DONE" and RSREASND is missing.

   2. Due to the variability of copyright holder and public domain derived score generation processes, records are not included for derived subscores or total scores that are not provided.

4. Some items on the COMFORT-B SCALE may be conditionally branched per the instrument instructions. Only Respiratory Ventilation or Crying (RSTESTCD = "CBS0103" or "CBS0104") is completed for each subject. The other will be treated as a conditionally branched item. A record is created in rs.xpt for all items. When an item is considered a conditionally branched item, it is represented as follows:

   When assigned with conditionally branched responses are not documented in the instrument’s instructions or a user manual:

   1. QNAM = “RSCBRFL”, QLABEL = “Conditional Branched Item Flag“, QVAL = “Y” (this is a RS supplemental qualifier variable related to the record).
   2. RSORRES, RSSTRESC, and RSSTRESN are set to null (missing).

   When assigned conditionally branched responses are documented in instructions or a user manual:

   1. QNAM = “QSCBRFL”, QLABEL = “Conditional Branched Item Flag“, QVAL = “Y” (this is a QS supplemental qualifier variable).
   2. The QSORRES responses are represented as follows:
   1. For severity items, QSORRES = "None".
   2. For interference items, QSORRES = "Not at all".
   3. If numeric response values are assigned, they are represented here: QSSTRESC = 0 and QSSTRESN = 0.

      or if no numeric responses are assigned: QSSTRESC = NULL and QSSTRESN = NULL.

5. Include this point if score(s) are submitted to SDTM. Update blue text: The QRS Short_Name instrument includes a total score (and subscores or other scores as needed.  If so, change "that is" to "that are") that is considered as captured data on the instrument and is 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 [Insert copyright holder's name or other source.].

   1. Subtotal and total scores are represented in--ORRES, --STRESC, and --STRESN.
   2. If scores are received or derived by the sponsor, it is recommended that they are submitted to SDTM and verified in ADaM whenever feasible. It is the sponsors repsonsibility to do this verification based on the instrument's user manual or instructions from the copyright owner.

6. Please review the decision on not including –EVAL and --EVALID in the QRS Supplement Best Practices topic “--EVAL/–EVALID not included in QRS domains/datasets”.Now we only represent administrative information if it is explicitly collected on an instrument. No assumptions are made for this data; if it's not on the instrument, it's not in the data.

   The SUPPQUAL variables used are a series of non-standard variables that represent collected administrator information, administration device, etc., and these updated SUPPQUAL variables are included in the WIKI non-standard variable registry (Non-standard Variable Registry). For example:

   1. PPRAID which is "Preprinted Administrator Identifier".
   2. COLAVL which is "Collected Administrator Value".

   The supplement version 1.0 of the FAS-NACC UDS V3.0 instrument shows an implementation example.

   The QRS Short_Name instrument collects administrative information as the preprinted examiner’s initials and the collected response. This is represented in the SUPPQUAL variable QNAM = --PPRAID” with QNAM = “Preprinted Administrator Identifier” and QVAL = “EXAMINER’S INITIALS”. The collected initials response is represented with QNAM = “--COLAID” and QNAM = “Collected Administrator Identifier” and QVAL = “ADM1”.

   This is part of the data example for the SUPPQUAL variables.

   The SUPPRS table represents the preprinted and collected administrative items represented on the CRF. 

    supprs.xpt

   STUDYID	RDOMAIN	USUBJID	IDVAR	IDVARVAL	QNAM	QLABEL	QVAL	QORIG
   STUDYX	RS	100-10001	RSCAT	FAS-NACC UDS V3.0	RSPPRAID	Preprinted Administrator Identifier	EXAMINER'S INITIALS	CRF
   STUDYX	RS	100-10001	RSCAT	FAS-NACC UDS V3.0	RSCOLAID	Collected Administrator Identifier	ADM1	CRF

7. Include this point if there are comments at the end of the instrument. Remove this point if it does not apply.: Comments located at the end of the QRS Short_Name will be recorded in the Comments domain (CO). All assumptions and business rules described in the SDTMIG CO domain are applicable.

8. Include this point if there are responses over 200 characters. Remove this point if it does not apply: Some responses to the QRS Short_Name items exceeded the 200-character limit for the QSORRES variable and needed to be reduced to fewer than 200 characters. Section 4, SDTM Mapping Strategy, indicates which item responses were revised in order to fit the 200-character limit.
   

9. Terminology

   1. RSCAT, RSTESTCD, RSTEST values are included in CDISC Controlled Terminology.

   2. A full list of value sets for the qualifier, timing, result, and unit fields is provided in Section 4, SDTM Mapping Strategy. (Note: Only the result field is always used. Include qualifier, timing, and unit fields as needed and remove this note.)

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This section is used for reference regarding the CRF data capture and to understand the alignment of the instrument to the SDTM QS RS domain. It also provides guidance on how the result variables (QSORRESRSORRES, QSSTRESCRSSTRESC, and QSSTRESNRSSTRESN) should be populated.

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