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Questions:

  1. Is screening considered visit 1, or is it to include the subject into the study? SDTM team agreed to change to VISIT 1 instead of SCREENING.
  2. Are these Real World Evidence (RWE) studies only or clinical trials?
  3. Should both endpoints be shown in one efficacy dataset or two? I will be showing 3 datasets.
  4. What is a good surface area to use for the child subject?
  5. Should i use Male and 6 years? please advise.

In this section, This example illustrates example analysis datasets are shown for the following endpoints:

  • From CV domain
    • Percent change in ejection fraction

...

    • over time
    • Decline in ejection fraction

...

    • over a

...

    • time period (yearly) grouped by a decline greater than 10.0%.
  • From the LB domain
    • Percent change in NTproBNP

...

    • over a period of

...

    • time (yearly).

Source Data

The SDTM examples used as the source data are from Section 2.1, Basic CMR Tests - Systolic Function. The CV dataset contains 16 rows, 1-8 for visit 1 and 9-16 for visit 6. Of these rows, the ones where CVTESTCD = "LVEF_C" and CVTESTCD =  "RVEF_C" were used for analysis. In the LB dataset, the records representing the Ventricular Ejection Fraction, Calculated (%) for left and right were selected for the analysis. The LB dataset test where LBTESTCD = "BNPPRONT" were used was used to add the value of BNPPRONT to compute the percentage percent change over time, and then it was added as a potential ptential covariate in each row for the last analysis. The SDTM datasets were merged with a   As in all ADaM datasets, the Subject Level Analysis Dataset (ADSL) dataset was merged in to record the SDTM datasets to capture all the necessary demographics, treatments and other appropriate required variables for analysis of the data.

...

Analysis Datasets

The tables below show the example analysis datasets and unique parameters for this endpointdataset includes treatment and demographic information drawn from the ADSL, defined in the Metadata Table below. In this example, only some of the required variables, plus important stratification variables from ADSL, are shown for illustrative purposes. For example, one variable added; body surface area at baseline (BSABL)  was computed for baseline records in ADSL. However, since the subjects are children, the body surface area changes over time. Therefore, it would probably be necessary to have a separate dataset to represent this over time.

...

Multipletrue
LevelDataset
PurposeAnalysis

...

Dataset Name

...

Dataset Description

...

Structure

...

Location

...

Keys

...

ADSL

...

Subject-Level Analysis Dataset

...

BASIC DATA STRUCTURE

...

Analysis Dataset

ADSL Analysis Dataset

The ADSL includes The table below shows the example analysis datasets and unique parameters for this example. The Subject Level Analysis Dataset (ADSL)  is a necessary component in the creation process of subsequent analysis datasets for human trials. The ADSL incorporates demographics, treatment groups, study dates, and stratification variables. For In this example, the ADSL is not shown other than illustrated, but serves as a source for standard ADaM variables. See Additional information can be found in Section 2.3.1 of the ADaM Implementation Guide (ADaMIG) v1.3 for additional information.

ADCVNTP Analysis Dataset

The ADCVEF dataset includes tests pertinent to this analysis, those for which CVTESTCD is equal to "LVEF_C" or "RVEF_C". The relationship dataset RELREC illustrates the relationship between datasets. 

The ADCVNTRP dataset is a subset of the Laboratory Results (LB) SDTM dataset, for which LBTESTCD is equal to "BNPPRONT". ADCVNTP dataset is a subset of the Laboratory Results (LB) SDTM dataset, for which LBTESTCD is equal to "BNPPRONT". In this case, many lab draws may be conducted occur throughout the year, but only those linked to a specific visit are included. By subsetting the LB dataset with LBLNKID not missing, laboratory data that aligns with CV data can be filtered out and sorted using USUBJID and VISIT. If LBLNKID is not available, a windowing strategy could be used to select the laboratory draw closest to that visit for merging with CV, computed in AVISIT.

ADCMRI is an efficacy analysis dataset with only a few records for more complex modeling of changes in ejection fraction, plus the ProB-type test results. It is an ADaM Basic Data Structure (BDS) dataset, with additional variables added from ADCVEF.

Definexmltable
Multipletrue
LevelDataset
Definexmltable
OID
DatasetADCVNTP
LevelValue
PurposeAnalysis

Dataset Name

AVAL

Dataset Description

Class of Dataset

Structure

Location

Keys

Documentation

ADSL

Subject-Level Analysis Dataset

SUBJECT LEVEL ANALYSIS DATASETadsl.xptOne record per subjectUSUBJIDADaMIG v1.3 section 3.1.1
ADCVNTPCardiac Ejection Fraction and NTproBNP Analysis Dataset

BASIC DATA STRUCTURE

One record per subject per analysis visit per parameter.adcvntrp.xptUSUBJID, AVISITN, PARAMN

Analysis Dataset

Definexmltable
DatasetADCVNTP
LevelValue
PurposeAnalysis
OIDAVAL
DatasetVariableWhereTypeOriginDerivation/Comment
ADCVNTPAVALPARAMCD = "LVEFC
VariableWhereTypeOriginDerivation/Comment
ADCVNTPAVALPARAMCD = "LVEFC"NumPredecessorSet to CV.CVSTRESN where CV.CVTESTCD = "LVEF_C"
ADCVNTPAVALPARAMCD = "RVEFC"NumPredecessorSet to CV.CVSTRESN where CV.CVTESTCD = "RVEF_C"
ADCVNTPAVALPARAMCD = "BNPPRONT"NumPredecessorSet to LBCV.LBSTRESN CVSTRESN where LBCV.LBTESTCD CVTESTCD = "BNPPRONT"LVEF_C"
ADCVNTPAVALPARAMCD = "RVEFC"NumPredecessorSet to CV.CVSTRESN where CV.CVTESTCD = "RVEF_C"
ADCVNTPAVALPARAMCD = "BNPPRONT"NumPredecessorSet to LB.LBSTRESN where LB.LBTESTCD = "BNPPRONT"

Analysis Datasets

The subsequent section provides The subsequent section provides the data structures for the example ADaM datasets. In this example, columns for derived variables BASE, CHG, PCHG and CHGCAT1 have been added to facilitate analyses of the efficacy endpoints. Specifically, example demographic data for ADSL were created for an 8 year old male. Also, a custom variable for BSA at baseline (BSABASE) was added from ADSL.at baseline (BSABASE), was added from ADSL.

Definexmltable
DatasetADCVNTP
LevelVariable
PurposeAnalysis
NameVariable
Variable NameVariable LabelTypeCodelist/Controlled Terms/FormatSourceDerivation/Comment
STUDYIDStudy IdentifierChar

CV.STUDYID


USUBJIDUnique Subject IdentifierChar

CV.USUBJID

Select for records with RE data.
ASEQAnalysis Sequence NumberNum

CV.CVSEQ

Number records 1 to n after sorting by keys.
Definexmltable
DatasetADCVNTP
LevelVariable
PurposeAnalysis
NameVariable
ADSL.ITTFLCategorize the value of CHG for N-Terminal ProB-type Natriuretic Peptide (pg/mL) (BNPPRONT)
Variable NameVariable LabelTypeCodelist/Controlled Terms/FormatSourceDerivation/Comment
STUDYIDStudy IdentifierChar

CV.STUDYID

USUBJIDUnique Subject IdentifierChar

CV.USUBJID

Select for records with RE data.ASEQAnalysis Sequence NumberNum

CV.CVSEQ

Number records 1 to n after sorting by keys.
TRT01P

Planned Treatment for Period 01

CharTreatment AADSL.TRT01PFor this example we are using "Treatment A". In a Real World Evidence study this could be non-treatment related, e.g. "Group A".

ITTFL

Intent-To-Treat Population Flag

Char

Y; N

BSABASEBody Surface Area (m2) at BaselineNum
ADSL.BSABASECompute in ADSL where VS.VSTESTCD = "BSA".
PARAMParameterChar

Left Ventricular Ejection Fraction, Calculated (%);

Right Ventricular Ejection Fraction, Calculated (%);

N-Terminal ProB-type Natriuretic Peptide (pg/mL)


For tests from CV, set to the values of CV.CVTEST plus CV.CVTESTU with spaces and parentheses as shown. 

For tests from LB, set to the value of LB.LBTEST plus LB.LBTESTU with spaces and parentheses as shown. 

PARAMCDParameter CodeChar

LVEFC;

RVEFC;

BNPPRONT;




If CV.CVTESTCD = "LVEF_C" then PARAMCD = "LVEFC"

If CV.CVTESTCD = "RVEF_C" then PARAMCD = "RVEFC".

If LB.LBTESTDC = "BNPPRONT" then PARAMCD = "BNPPRONT".

Note: for this example dataset, select the records where the test values shown above are included.

PARAMNParameter Number(N)Num



Number PARAMCD as follows:

LVEFC = "1"

RVEFC = "2"

BNPPRONT = "3"

AVALAnalysis ValueNum


See Parameter Value List 

AVISITAnalysis VisitChar



If CV.VISIT = "VISIT 1" then AVISIT = "Visit 1 (Baseline)".

Else if CV.VISIT = "VISIT 6" then AVISIT = "Visit 6 (1 Year)".

AVISITNAnalysis Visit (N)Num

Set to value of CV.VISITNUM or LB.VISITNUM
VISITVisitNum

CV.VISIT

LB.VISIT


ADTAnalysis DateNumdate9.
Date portion of CV.CVDTC or LB.LBDTC converted to numeric and displayed in a format such as date9. 
ABLFLBaseline Record FlagCharY

If CV.VISIT = 1 then ABLFL = "Y".

BASEBaseline ValueNum

Set BASE to AVAL from the record for that subject and parameter where ABLFL = "Y".

Populate BASE for additional visits by copying the value of BASE in the baseline record by USUBJID and ADT. (Or by AVISIT if ADT varies for labs, where windowing is applied to select record closest to the visit)

CHGChange from BaselineNum

Compute CHG = AVAL - BASE for that record. Only compute for post-baseline records.
PCHGPercent Change from BaselineNum

Compute PCHG = (CHG / BASE) * 100. Only compute for post-baseline records.
CHGCAT1Change from Baseline Category 1Char

Decline >=10.0;

Decline < 10.0; Increase0; 

Increase


Categorize the value of CHG for Left Ventricular Ejection Fraction, and Calculated (%) (LVEFC) and for Right Ventricular Ejection Fraction, Calculated (%) (RVEFC)
CHGCAT2Change from Baseline Category 2Chart



Categorize the value of CHG for Left Ventricular Ejection Fraction, and Calculated (%) (LVEFC) and for Right Ventricular Ejection Fraction, Calculated (%) (RVEFC)CHGCAT2Change from Baseline Category 2ChartN-Terminal ProB-type Natriuretic Peptide (pg/mL) (BNPPRONT)
TRT01P

Planned Treatment for Period 01

CharTreatment AADSL.TRT01PFor this example we are using "Treatment A". In a Real World Evidence study this could be non-treatment related, e.g. "Group A".

ITTFL

Intent-To-Treat Population Flag

Char

Y; N

ADSL.ITTFL


AGEAgeNum
ADSL.AGE
AGEUAge UnitsChar(AGEU)ADSL.AGEU
SEXSexChar(SEX)ADSL.SEX
SRCDOMSource DataChar

CV; LB


Set to the SDTM domain name that relates to the analysis value.
SRCSEQSource Sequence NumberNum


CV.CVSEQ

LB.LBSEQ

Set to the SDTM domain sequence number that relates to the analysis value.


Example 1

This example dataset shows the findings and additional analysis variables associated with:

  • Left Ventricular Ejection Fraction, Calculated (%)
  • Right Ventricular Ejection Fraction, Calculated (%)
  • N-Terminal ProB-type Natriuretic Peptide (pg/mL)


Dataset wrap
Nameadcvntpadcvntpr
Rowcaps
Rows 1-2:Show the baseline CMR ejection fraction measurements for participant 101 at VISIT 1.
Row 3:Shows the baseline NTProbTest for participant 101 at VISIT 1.
Rows 4-5:Show the CMR ejection fraction measurements for participant 101 at VISIT 6.
Row 6:Shows the NTProbTest for participant 101 at VISIT 6.
ITTFL
Dataset2
tableidadcvntpadcvntpr
RowSTUDYIDUSUBJIDASEQ
TRT01P
BSABASEPARAMPARAMCDPARAMNAVALAVISITAVISITNVISITADTABLFLBASECHGPCHGCHGCAT1TRT01P
CHGCAT2
ITTFLAGEAGEUSEXSRCDOMSRCSEQ
1DMD-EFLGEDMD-EFLGE-1011
Treatment A
Y
0.65Left Ventricular Ejection Fraction, Calculated (%)LVEFC167Visit 1 (
Baseline
Month 1)1VISIT 1
16MAY2022
16May2022Y67


Treatment AY8YEARSMCV3
2DMD-EFLGEDMD-EFLGE-1012
Treatment AY
0.65Right Ventricular Ejection Fraction, Calculated (%)RVEFC274Visit 1 (
Baseline
Month 1)1VISIT 1
16MAY2022
16May2022Y74


Treatment AY8YEARSMCV7
3DMD-EFLGEDMD-EFLGE-1013
Treatment AY
0.65N-Terminal ProB-type Natriuretic Peptide (IU/L)BNPPRONT340Visit 1 (Baseline)1VISIT 1
16MAY2022
16May2022Y40


Treatment AY8YEARSMLB1
4DMD-EFLGEDMD-EFLGE-1014
Treatment A
Y
0.65Left Ventricular Ejection Fraction, Calculated (%)LVEFC160Visit 6 (
1 Year
Month 12)6VISIT 6
01JUN2023
01Jun2023
67-7-10.447761Decline >=10.0Treatment AY8YEARSMCV11
5DMD-EFLGEDMD-EFLGE-1015
Treatment A
Y
0.65Right Ventricular Ejection Fraction, Calculated (%)RVEFC261Visit 6 (
1 Year
Month 12)6VISIT 6
01JUN2023
01Jun2023
74-13-17.567568Decline >=10.0Treatment AY8YEARSMCV15
6DMD-EFLGEDMD-EFLGE-101
6Treatment A
Y
60.65N-Terminal ProB-type Natriuretic Peptide (IU/L)BNPPRONT3900Visit 6 (1 Year)6VISIT
6
1
01JUN2023
1Jun2023
408602,150
Treatment AY8YEARSMLB2

Example 2 

The dataset above can also be set up to provide multivariate analyses by taking the lab tests of interest, transposing and merging with the ADCVNTPP dataset. In that case, the records from LB are not needed as a row.

...

Dataset wrap
Nameadcvntp
Dataset2
tableidadcvntp
RowSTUDYIDUSUBJIDASEQ
TRT01PITTFLBSABASEBNPPRONTBNPCHGPARAMPARAMCDPARAMNAVALAVISITAVISITNVISITADTABLFLBASECHGPCHGAGEAGEUSEXSRCDOMSRCSEQ1DMD-EFLGEDMD-EFLGE-1011Treatment AY0.6540Left Ventricular Ejection Fraction, Calculated (%)LVEFC167Visit 1 (Baseline)1VISIT 116MAY2022Y678YEARSMCV3
BSABASEBNPPRONTBNPCHGPARAMPARAMCDPARAMNAVALAVISITAVISITNVISITADTABLFLBASECHGPCHGTRT01PITTFLAGEAGEUSEXSRCDOMSRCSEQ
1
2
DMD-EFLGEDMD-EFLGE-101
2
1
Treatment AY
0.6540
Right

Left Ventricular Ejection Fraction, Calculated (%)
RVEFC
LVEFC
2
1
74
67Visit 1 (
Baseline
Month 1)1VISIT 116MAY2022Y67

Treatment A
74
Y8YEARSMCV
7
3
3
2DMD-EFLGEDMD-EFLGE-101
3
2
Treatment AY
0.65
900Left
40
2150

Right Ventricular Ejection Fraction, Calculated (%)
LVEFC
RVEFC
1
2
60
74Visit
6
1 (Month 1
Year
)
6
1VISIT
6
116MAY2022
01JUN2023
Y
67
74
-7


Treatment AY
-10.447761
8YEARSMCV
11
7
4
3DMD-EFLGEDMD-EFLGE-101
4Treatment AY
30.659002150
Right
Left Ventricular Ejection Fraction, Calculated (%)
RVEFC
LVEFC
2
1
61
60Visit 6 (
1 Year
Month 12)6VISIT 601JUN2023
74

67-
13
7-
17.567568
10.447761Treatment AY8YEARSMCV
15

ADCVEF Analysis Dataset

The ADCVEF dataset includes tests pertinent to this analysis, those for which CVTESTCD is equal to "LVEF_C" or "RVEF_C". The relationship dataset RELREC illustrates the relationship between datasets. 

ADCVMRI Analysis Dataset

ADCMRI is an efficacy analysis dataset with only a few records for more complex modeling of changes in ejection fraction, plus the ProB-type test results. It is an ADaM Basic Data Structure (BDS) dataset, with additional variables added from ADCVEF.

11
4DMD-EFLGEDMD-EFLGE-10140.659002150Right Ventricular Ejection Fraction, Calculated (%)RVEFC261Visit 6 (Month 12)6VISIT 601JUN2023
74-13-17.567568Treatment AY8YEARSMCV15

Example Analysis Results Metadata (ARM) Tables

This is an example ARM table for the selected endpoint. Other endpoints can be represented in the same way describing the variables and procedures used. For more details on ARM, see the ADaMIG and the ARM implementation in Define-XML (available at https://www.cdisc.org/standards/foundational/define-xml/)table may be included in the submission package for regulatory agencies. It describes the analyses conducted for the study (usually limited to primary and secondary  endpoints) with details on data and analysis procedures used. The first example uses the dataset ADCVNTPR, selecting for the parameter "N-Terminal ProB-type Natriuretic Peptide (IU/L)".

Display

Table 14.xx.xx Percent change in NTproBNP over a period of time (yearly)

Analysis ResultComparison of Percent Change of NTproBNP for the Treatment Groups Over Time (quarterly or yearly)
Analysis Variables(s)PCHG
Analysis ReasonPrimary efficacy endpoint as prespecified in the SAP
Analysis PurposePrimary outcome measure

Data References

(incl. selection criteria)

PARAMCD = "BNPPRONT"

Where ITTFL = "Y"

Documentation

 The mixed model using lsmeans to compare treatment groups

Programming Statements 

(Add programming language statements here: SAS, R, etc.)

PROC MIXED DATA=ADCVNTPR;

WHERE PARAMCD = "BNPPRONT";

CLASS STUYDID TRT01P AVISITN;

MODEL PCHG=AVISITN*TRT01P/Solution;

RANDOM INTERCEPT / SUBJECT=STUYDID TYPE=UN;

LSMEANS TRT01P*AVISITN/ CL PDIFF;

RUN;

Display

Table 14.xx.xx Percent Change in Left Ventricular Ejection Fraction Over Time

Analysis ResultComparison of Percent Change of Ejection Fraction for the Treatment Groups Over Time (quarterly or yearly)
Analysis Variables(s)PCHG
Analysis ReasonPrimary efficacy endpoint as prespecified in the SAP
Analysis PurposePrimary outcome measure

Data References

(incl. selection criteria)

PARAMCD = "LVEFC"

Where ITTFL = "Y"

Documentation

 The mixed model using lsmeans to compare treatment groups

Programming Statements 

(Add programming language statements here: SAS, R, etc.)

PROC MIXED DATA=ADCVNTP;

CLASS STUYDID TRT01P AVISITN;

MODEL PCHG=AVISITN*TRT01P/Solution;

RANDOM INTERCEPT / SUBJECT=STUYDID TYPE=UN;

LSMEANS TRT01P*AVISITN/ CL PDIFF;

RUN;

)

PROC MIXED DATA=ADCVNTP;

CLASS STUYDID TRT01P AVISITN;

MODEL PCHG=AVISITN*TRT01P/Solution;

RANDOM INTERCEPT / SUBJECT=STUYDID TYPE=UN;

LSMEANS TRT01P*AVISITN/ CL PDIFF;

RUN;

Info

Ejection Fraction

  • change in ejection fraction, would expect a decline in EF 2-3% per year, would prefer an improvement or no change. Concerning if rapid progression, 10% decline or more, for example.

NTproBNP

  • % change over a period of time – a decrease would mean improvement, annually is appropriate

SDTM Examples: Basic CMR Tests - Systolic Function

Pagenav2