Row | STUDYID | DOMAIN | USUBJID | QSSEQ | QSTESTCD | QSTEST | QSCAT | QSORRES | QSSTRESC | QSSTRESN | QSSTAT | QSREASND | QSLOBXFL | VISITNUM | QSDTC | QSEVLINT | 1 | STUDYX | QS | 2324-P0001 | 1 | IDSR101IDSR1-Falling Asleep | IDS-SR | I never take longer than 30 minutes to fall asleep | 0 | MTWSR1-Angry, Irritable, Frustrated | MTWS-R | Slight | 1 | 1 | 020150515P7DIDSR102IDSR1-Sleep During the Night | IDS-SR | I do not wake up at night | 0 | MTWSR1-Anxious, Nervous | MTWS-R | Moderate | 3 | 3 | 020150515P7DIDSR103IDSR1-Waking Up Too Early | IDS-SR | Most of the time, I awaken no more than 30 minutes before I need to get up | 0 | MTWSR1-Depressed Mood, Sad | MTWS-R | Mild | 2 | 2 | 020150515P7DIDSR104IDSR1-Sleeping Too Much | IDS-SR | I sleep no longer than 7-8 hours/night, without napping during the day | 0 | MTWSR1-Difficulty Concentrating | MTWS-R | Mild | 2 | 2 | 020150515P7DIDSR105IDSR1-Feeling Sad | IDS-SR | MTWSR1-Inc Appetite, Hungry, Weight Gain | MTWS-R | Slight | I feel sad less than half the time20150515P7DIDSR106IDSR1- Feeling Irritable | IDS-SR | MTWSR1-Sleep Problems/Awakening at Night | MTWS-R | Slight | I feel irritable less than half the time20150515P7DIDSR107IDSR1-Feeling Anxious or Tense | IDS-SR | I feel anxious (tense) less than half the time | 1 | MTWSR1-Restless | MTWS-R | Moderate | 3 | 3 | 120150515P7DIDSR108IDSR1-Your Mood to Good/Desired Events | IDS-SR | My mood brightens but I do not feel like my normal self when good events occurMTWSR1-Impatient | MTWS-R | Slight | 1 | 1 |
|
| Y | 1 | 20150515P7DIDSR109IDSR1Mood in Relation to Time of DayIDS-SR | My mood often relates to the time of day because of environmental events (e.g., being alone, working) | 1 | Craving to Smoke | MTWS-R | Severe | 4 | 4 | 120150515P7DP24H | 10 | STUDYX | QS | 2324-P0001 | 10 | IDSR109AIDSR1-Mood Worse Morn/Afternoon/Night | IDS-SR | Afternoon | MTWSR1-Constipation | MTWS-R | Slight | 1 | 1 | Afternoon20150515P7DRows -32 removed for ease of use of template. (fyi, this row has merged cells so don't try to overwrite it when using the template; just delete it.)33 | 33IDSR131IDSR1ScoreIDSSR1818182015-05-152023-08-13 | -P24H | 12 | STUDYX | QS | 2324-P0001 | 12 | MTWSR112 | MTWSR1-Coughing | MTWS-R | Slight | 1 | 1 |
|
| Y | 1 | 2023-08-13 | -P24H | 13 | STUDYX | QS | 2324-P0001 | 13 | MTWSR113 | MTWSR1-Dreaming or Nightmares | MTWS-R | Slight | 1 | 1 |
|
| Y | 1 | 2023-08-13 | -P24H | 14 | STUDYX | QS | 2324-P0001 | 14 | MTWSR114 | MTWSR1-Nausea | MTWS-R | None | 0 | 0 |
|
| Y | 1 | 2023-08-13 | -P24H | 15 | STUDYX | QS | 2324-P0001 | 15 | MTWSR115 | MTWSR1-Sore Throat | MTWS-R | None | 0 | 0 |
|
| Y | 1 | 2023-08-13 | -P24H | 16 | STUDYX | QS | 2324-P0001 | 16 | MTWSR116 | MTWSR1-Total Withdrawal Discomfort Score | MTWS-R | 14 | 14 | 14 |
|
| Y | 1 | 2023-08-13 | -P24H | 17 | STUDYX | QS | 2324-P0001 | 17 | MTWSR101 | MTWSR1-Angry, Irritable, Frustrated | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 18 | STUDYX | QS | 2324-P0001 | 18 | MTWSR102 | MTWSR1-Anxious, Nervous | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 19 | STUDYX | QS | 2324-P0001 | 19 | MTWSR103 | MTWSR1-Depressed Mood, Sad | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 20 | STUDYX | QS | 2324-P0001 | 20 | MTWSR104 | MTWSR1-Difficulty Concentrating | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 21 | STUDYX | QS | 2324-P0001 | 21 | MTWSR105 | MTWSR1-Inc Appetite, Hungry, Weight Gain | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 22 | STUDYX | QS | 2324-P0001 | 22 | MTWSR106 | MTWSR1-Sleep Problems/Awakening at Night | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 23 | STUDYX | QS | 2324-P0001 | 23 | MTWSR107 | MTWSR1-Restless | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 24 | STUDYX | QS | 2324-P0001 | 24 | MTWSR108 | MTWSR1-Impatient | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 25 | STUDYX | QS | 2324-P0001 | 25 | MTWSR109 | MTWSR1-Craving to Smoke | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 26 | STUDYX | QS | 2324-P0001 | 26 | MTWSR110 | MTWSR1-Constipation | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 27 | STUDYX | QS | 2324-P0001 | 27 | MTWSR111 | MTWSR1-Dizziness | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 28 | STUDYX | QS | 2324-P0001 | 28 | MTWSR112 | MTWSR1-Coughing | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 29 | STUDYX | QS | 2324-P0001 | 29 | MTWSR113 | MTWSR1-Dreaming or Nightmares | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 30 | STUDYX | QS | 2324-P0001 | 30 | MTWSR114 | MTWSR1-Nausea | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 31 | STUDYX | QS | 2324-P0001 | 31 | MTWSR115 | MTWSR1-Sore Throat | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
| 32 | STUDYX | QS | 2324-P0001 | 32 | MTWSR116 | MTWSR1-Total Withdrawal Discomfort Score | MTWS-R |
|
|
| NOT DONE | PATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED. |
| 2 | 2023-09-10 |
|
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