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Dataset wrap
Nameqs
Rowcaps
Rows 13-14:Items 11 and 12 are presented for illustrative purposes only. When the instrument is conducted, only one will be represented based on the CRF instructions. In this example, Item 12 would not appear in the actual dataset and has result values of "XXX".
Rows 15-16:Items 13 and 14 are presented for illustrative purposes only. When the instrument is conducted, only one will be represented based on the CRF instructions. In this example, Item 14 would not appear in the actual dataset and has result values of "XXX".
Row 33:The total score does not have an evaluation interval value represented, since there is a mixture of evaluation interval values with items 13 and 14 that differ from the remaining items on the CRF.
Dataset2
RowSTUDYIDDOMAINUSUBJIDQSSEQQSTESTCDQSTESTQSCATQSORRESQSSTRESCQSSTRESNQSSTATQSREASNDQSLOBXFLVISITNUMQSDTCQSEVLINT
1STUDYXQS2324-P00011
IDSR101
MTWSR101
IDSR1-Falling AsleepIDS-SRI never take longer than 30 minutes to fall asleep0
MTWSR1-Angry, Irritable, FrustratedMTWS-RSlight11
0


Y1
2015
2023-
05
08-
15
13-
P7D
P24H
2STUDYXQS2324-P00012
IDSR102
MTWSR102
IDSR1-Sleep During the NightIDS-SRI do not wake up at night0
MTWSR1-Anxious, NervousMTWS-RModerate33
0


Y1
2015
2023-
05
08-
15
13-
P7D
P24H
3STUDYXQS2324-P00013
IDSR103
MTWSR103
IDSR1-Waking Up Too EarlyIDS-SRMost of the time, I awaken no more than 30 minutes before I need to get up0
MTWSR1-Depressed Mood, SadMTWS-RMild22
0


Y1
2015
2023-
05
08-
15
13-
P7D
P24H
4STUDYXQS2324-P00014
IDSR104
MTWSR104
IDSR1-Sleeping Too MuchIDS-SRI sleep no longer than 7-8 hours/night, without napping during the day0
MTWSR1-Difficulty ConcentratingMTWS-RMild22
0


Y1
2015
2023-
05
08-
15
13-
P7D
P24H
5STUDYXQS2324-P00015
IDSR105
MTWSR105
IDSR1-Feeling SadIDS-SR
MTWSR1-Inc Appetite, Hungry, Weight GainMTWS-RSlight
I feel sad less than half the time
11

Y1
2015
2023-
05
08-
15
13-
P7D
P24H
6STUDYXQS2324-P00016
IDSR106
MTWSR106
IDSR1- Feeling IrritableIDS-SR
MTWSR1-Sleep Problems/Awakening at NightMTWS-RSlight
I feel irritable less than half the time
11

Y1
2015
2023-
05
08-
15
13-
P7D
P24H
7STUDYXQS2324-P00017
IDSR107
MTWSR107
IDSR1-Feeling Anxious or TenseIDS-SRI feel anxious (tense) less than half the time1
MTWSR1-RestlessMTWS-RModerate33
1


Y1
2015
2023-
05
08-
15
13-
P7D
P24H
8STUDYXQS2324-P00018
IDSR108
MTWSR108
IDSR1-Your Mood to Good/Desired EventsIDS-SRMy mood brightens but I do not feel like my normal self when good events occur
MTWSR1-ImpatientMTWS-RSlight11

Y1
2015
2023-
05
08-
15
13-
P7D
P24H
9STUDYXQS2324-P00019
IDSR109
MTWSR109
IDSR1
MTWSR1-
Mood in Relation to Time of DayIDS-SRMy mood often relates to the time of day because of environmental events (e.g., being alone, working)1
Craving to SmokeMTWS-RSevere44
1


Y1
2015
2023-
05
08-
15
13-
P7D
P24H
10STUDYXQS2324-P000110
IDSR109A
MTWSR110
IDSR1-Mood Worse Morn/Afternoon/NightIDS-SRAfternoon
MTWSR1-ConstipationMTWS-RSlight11
Afternoon


Y1
2015
2023-
05
08-
15
13-
P7D
P24H
Rows
11
-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
STUDYXQS2324-P0001
33
11
IDSR131
MTWSR111
IDSR1
MTWSR1-
Score
Dizziness
IDS
MTWS-
SR
R
18
None
18
0
18
0

Y1
2015-05-15
2023-08-13-P24H
12STUDYXQS2324-P000112MTWSR112MTWSR1-CoughingMTWS-RSlight11

Y12023-08-13-P24H
13STUDYXQS2324-P000113MTWSR113MTWSR1-Dreaming or NightmaresMTWS-RSlight11

Y12023-08-13-P24H
14STUDYXQS2324-P000114MTWSR114MTWSR1-NauseaMTWS-RNone00

Y12023-08-13-P24H
15STUDYXQS2324-P000115MTWSR115MTWSR1-Sore ThroatMTWS-RNone00

Y12023-08-13-P24H
16STUDYXQS2324-P000116MTWSR116MTWSR1-Total Withdrawal Discomfort ScoreMTWS-R141414

Y12023-08-13-P24H
17STUDYXQS2324-P000117MTWSR101MTWSR1-Angry, Irritable, FrustratedMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
18STUDYXQS2324-P000118MTWSR102MTWSR1-Anxious, NervousMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
19STUDYXQS2324-P000119MTWSR103MTWSR1-Depressed Mood, SadMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
20STUDYXQS2324-P000120MTWSR104MTWSR1-Difficulty ConcentratingMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
21STUDYXQS2324-P000121MTWSR105MTWSR1-Inc Appetite, Hungry, Weight GainMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
22STUDYXQS2324-P000122MTWSR106MTWSR1-Sleep Problems/Awakening at NightMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
23STUDYXQS2324-P000123MTWSR107MTWSR1-RestlessMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
24STUDYXQS2324-P000124MTWSR108MTWSR1-ImpatientMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
25STUDYXQS2324-P000125MTWSR109MTWSR1-Craving to SmokeMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
26STUDYXQS2324-P000126MTWSR110MTWSR1-ConstipationMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
27STUDYXQS2324-P000127MTWSR111MTWSR1-DizzinessMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
28STUDYXQS2324-P000128MTWSR112MTWSR1-CoughingMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
29STUDYXQS2324-P000129MTWSR113MTWSR1-Dreaming or NightmaresMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
30STUDYXQS2324-P000130MTWSR114MTWSR1-NauseaMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
31STUDYXQS2324-P000131MTWSR115MTWSR1-Sore ThroatMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10
32STUDYXQS2324-P000132MTWSR116MTWSR1-Total Withdrawal Discomfort ScoreMTWS-R


NOT DONEPATIENT MISSED FORM AT VISIT. FILLED OUT ELECTRONICALLY FEW DAYS LATER AS UNSCHEDULED.
22023-09-10



Info

The following is for illustrative purposes and would not really be included for the IDS-SR instrument in this template. It provides an example of what would need to be included if the instrument required supplemental qualifiers (see Section 5 Supplemental Qualifier Name Codes):

Text that would remain unchanged has been left in black:

The evaluation interval text value for data collection needs to be populated in SUPPQS as follows. The standard terminology for QNAM and QLABEL are listed below.

Dataset wrap
Namesuppqs
STUDYIDRDOMAINUSUBJIDIDVARIDVARVALQNAMQLABELQVALQORIG
STUDYXQSP0001QSSEQSequence number corresponding to row of qs.xpt that supplemental qualifier is needed for (e.g., 8)Appropriate variable name to provide more information about data in qs.xpt, no more than 8 characters long (e.g., CONTACT).Label for QNAM (e.g., Contact Type)Value of QNAM variable ( e.g., SUBJECT VISIT)CRF

...