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Title

Functional Assessment of Cancer Therapy-Hepatobiliary Anorexia/Cachexia Treatment Version 4 (FACT-HEP FAACT V4)

CDISC ReferenceQuestionnaire Supplement to the Study Data Tabulation Model Implementation Guide for Human Clinical Trials
QRS Short Name

FACT-HEP FAACT V4

QRS Permission StatusApproveApproved
TeamPancreatic Cancer Standards Team and CDISC Questionnaires, Ratings, and Scales (QRS) Subteam
Supplement Version1.0
StatusDRAFT
Date20022023-1107-0128
Notes
  • This supplement is intended to be used with other CDISC user guides for specific therapeutic/disease areas and follows the CDISC Study Data Tabulation Model Implementation Guide for Human Clinical Trials.

...

Revision History

DateVersion
20222023-1107-01281.0 Draft

© 2022 2023 Clinical Data Interchange Standards Consortium, Inc. All rights reserved. 

1 Introduction

This document describes the CDISC implementation of the Functional Assessment of Cancer Therapy-Hepatobiliary instrumentAnorexia/Cachexia Treatment Version 4 (FAACT V4) instrument.

CDISC did not modify this questionnaires, ratings, and scales (QRS) instrument to meet Clinical Data Acquisition Standards Harmonization (CDASH) case report form (CRF) standards.

...

The CDISC Intellectual Property Policy can be found on the CDISC website at: https://www.cdisc.org/about/bylaws.

1.1 Representations and Warranties, Limitations of Liability, and Disclaimers

This document is a supplement to the SDTMIG for Human Clinical Trials and is covered under Appendix F of that document, which describes representations, warranties, limitations of liability, and disclaimers. Please see Appendix F of the SDTMIG for a complete version of this material.

...

Although the United States Food and Drug Administration (US FDA) has provided input with regard to this supplement, this input does not constitute US FDA endorsement of any particular instrument.  

2 Copyright Status

David Cella, PhD, owns the copyright for the FACT-HEP FAACT V4 instrument and has granted CDISC permission to include this supplement in the CDISC inventory of QRS data standards supplements. Hence, CDISC developed QSTESTCD and QSTEST for each item based on the actual text on the instrument.

The CDISC documentation of this instrument consists of: (1) controlled terminology, (2) standard database structure with examples, and (3) CRF(s) annotated with the CDISC SDTMIG variables with submission values. 

Info
titleInformation for Reviewers

The CRF is attached at the top of the Wiki. When you click the paperclip image, you will find the file for the annotated CRF.

These materials discuss and/or include the FACIT Measurement System, which is owned exclusively by Dr. David Cella. No part of the FACIT Measurement System may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of Dr. David Cella and payment of any applicable fees. Copyright Dr. David Cella. All rights reserved. Copyright 1987, 1997 David Cella, PhD.

The CDISC documentation of this instrument consists of: (1) controlled terminology, (2) standard database structure with examples, and (3) CRF(s) annotated with the CDISC SDTMIG variables with submission values. 

Info
titleInformation for Reviewers

The CRF is attached at the top of the Wiki. When you click the paperclip image, you will find the file for the annotated CRF.

Note: CDISC Controlled Terminology is maintained by National Cancer Institute (NCI) Enterprise Vocabulary Services (EVS). The most recent version should be accessed through the CDISC website at: https://www.cdisc.Note: CDISC Controlled Terminology is maintained by National Cancer Institute (NCI) Enterprise Vocabulary Services (EVS). The most recent version should be accessed through the CDISC website at: https://www.cdisc.org/standards/terminology/controlled-terminology.

...

CDISC acknowledges Dr. David Cella and FACIT.org, for the approval to include the FACT-HEP FAACT V4 in the CDISC data standards.

Reference for the FACT-HEP FAACT V4:

  • Copyright 1987, 1997 David Cella, Ph.D.
  • These materials discuss and/or include FACIT Measurement System, which is owned exclusively by Dr. David Cella. No part of the FACIT Measurement System may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of Dr. David Cella and payment of any applicable fees. Copyright Dr. David Cella. All rights reserved.

3 The QS Domain Model

3.1 Assumptions for the QS Domain Model

  • FACIT.org for more information as well as the scoring guide.

3 The QS Domain Model

3.1 Assumptions for the QS Domain Model

All assumptions and All assumptions and business rules described in the SDTMIG QS domain are applicable to this supplement. Additional assumptions specific to the FACT-HEP FAACT V4 are listed below.

The FACT-HEP FAACT V4 is a multiple-choice health-related quality of life questionnaire about problems associated with hepatobiliary cancer. It consists of 45 39 items rated on a 5-point scale. The FACT-G is included as the first 27 items in the FAACT V4. 

  1. All items rated on a 5-point scale include a numeric rating (0-4) and a definition of what is represented by the rating (e.g., 0 = "Not at all", 4 = "Very much"). For the FACT-HEP FAACT V4, QSORRES is populated with the text description; the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN.

    1. FAC01514 FAC06514 may be rated on a 5-point scale or the subject may prefer not to answer. When the checkbox is marked that the subject prefers not to rate the itemanswer the item

      Jira
      showSummaryfalse
      serverIssue Tracker (JIRA)
      serverId85506ce4-3cb3-3d91-85ee-f633aaaf4a45
      keyQRSSUPP-665
      , this is noted with QSSTAT = "NOT DONE" and QSREASND = "PREFER NOT TO ANSWER". QSORRES, QSSTRESC, and QSSTRESN are all missing.

  2. The time period of evaluation for the FACT-HEP FAACT V4 is populated in the QSEVLINT field in ISO 8601 format when the evaluation interval can be precisely described as duration. The evaluation interval for the FACT-HEP FAACT V4 is the past 7 days (QSEVLINT = "-P7D").

  3. Items are divided into 5 subcategories represented in QSSCAT: "PHYSICAL WELL-BEING", "SOCIAL/FAMILY WELL-BEING", "EMOTIONAL WELL-BEING", "FUNCTIONAL WELL-BEING", and "ADDITIONAL CONCERNS".

  4. Records are created in qs.xpt for every item on the instrument

    1. For items with no data, QSORRES, QSSTRESC, and QSSTRESN are all missing and QSSTAT = "NOT DONE".  If If the reason is known then that reason is represented in QSREASND (e.g., QSREASND = "LOGICALLY SKIPPED ITEM " or QSREASND = "PREFER NOT TO ANSWER"). If the reason is unknown, then QSSTAT = "NOT DONE" and QSREASND is missing.

  5. The FACT-HEP FAACT V4 instrument includes subscale scores for each subcategory in addition to trial outcome index, FACT-G, and total scores per FACIT.org's scoring materials and are considered as captured data on the CRF and are 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 FACIT.org.

    1. Subscores and total scores are represented in QSORRES.

    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.
  6. Terminology
    1. QSCAT, QSTESTCD, and QSTEST values are included in CDISC Controlled Terminology.

    2. A full list of value sets for the result field is provided in Section 4, SDTM Mapping Strategy.

3.2 Example for the QRS

...

FAACT V4 QS Domain Model

The FACT-HEP V4  FAACT V4 example below shows the terminology used to implement the instrument in the QS domain. This example shows the data for 1 subject collected at the baseline visit for the FACT-HEP FAACT V4 instrument. The example uses CDISC Controlled Terminology for QSTESTCD, QSTEST, and QSCATAll original results, matching the CRF item response text, are represented in QSORRES. This result is then represented as a standard numeric score in QSSTRESN and as a standard character representation in QSSTRESC.


Update the data in the table below to the current instrument. Include row descriptions as needed to highlight idiosyncrasies or items otherwise of note in this particular instrument. If only 1 or 2 row descriptions are needed, then the information should be included as a paragraph instead.

For the not done visit that is now being included in all QRS supplements, when no reason is collected, information should be included, either in the paragraph before, or as a row description as follows:

Show the subject was not evaluated on this instrument at visit 2. Since the visit was missed, the reason for not completing the visit was not collected,
Info
Rows 49-60:

We are unable to make the example consistently show blue in the Wiki. All examples are updated for each QRS instrument so we ask that you please review the example below.


The following table represents the items from the FAACT V4 instrument. The subject was not evaluated on this instrument at visit 2. Since the visit was missed, the reason for not completing the visit was not collected, and no date is assumed for when the visit would have occurred.

...

When the reason is collected for a not done visit, information or a row description should be added as follows:

Dataset wrap
Nameqs
Dataset2
RowSTUDYIDDOMAINUSUBJIDQSSEQQSTESTCDQSTESTQSCATQSSCATQSORRESQSSTRESCQSSTRESNQSSTATQSREASNDQSLOBXFLVISITNUMQSDTCQSEVLINT
1STUDYXQS2324-P00011FAC06501FAC065-I Have a Lack of EnergyFAACT V4PHYSICAL WELL-BEINGA little bit11

Y12015-05-15-P7D
2STUDYXQS2324-P00012FAC06502FAC065-I Have NauseaFAACT V4PHYSICAL WELL-BEINGNot at all00

Y12015-05-15-P7D
3STUDYXQS2324-P00013FAC06503FAC065-Trouble Meeting Needs of FamilyFAACT V4PHYSICAL WELL-BEINGSomewhat22

Y12015-05-15-P7D
4STUDYXQS2324-P00014FAC06504FAC065-I Have PainFAACT V4PHYSICAL WELL-BEINGA little bit11

Y12015-05-15-P7D
5STUDYXQS2324-P00015FAC06505FAC065-Bothered by Treatment Side EffectFAACT V4PHYSICAL WELL-BEINGNot at all00

Y12015-05-15-P7D
6STUDYXQS2324-P00016FAC06506FAC065-I Feel IllFAACT V4PHYSICAL WELL-BEINGA little bit11

Y12015-05-15-P7D
7STUDYXQS2324-P00017FAC06507FAC065-I Am Forced to Spend Time in BedFAACT V4PHYSICAL WELL-BEINGA little bit11

Y12015-05-15-P7D
8STUDYXQS2324-P00018FAC06508FAC065-I Feel Close to My FriendsFAACT V4SOCIAL/FAMILY WELL-BEINGQuite a bit33

Y12015-05-15-P7D
9STUDYXQS2324-P00019FAC06509FAC065-Get Emotional Support From FamilyFAACT V4SOCIAL/FAMILY WELL-BEINGQuite a bit33

Y12015-05-15-P7D
10STUDYXQS2324-P000110FAC06510FAC065-I Get Support From My FriendsFAACT V4SOCIAL/FAMILY WELL-BEINGSomewhat22

Y12015-05-15-P7D
11STUDYXQS2324-P000111FAC06511FAC065-My Family Has Accepted My IllnessFAACT V4SOCIAL/FAMILY WELL-BEINGQuite a bit33

Y12015-05-15-P7D
12STUDYXQS2324-P000112FAC06512FAC065-Satisfied Communication IllnessFAACT V4SOCIAL/FAMILY WELL-BEINGVery much44

Y12015-05-15-P7D
13STUDYXQS2324-P000113FAC06513FAC065-I Feel Close to My PartnerFAACT V4SOCIAL/FAMILY WELL-BEINGVery much44

Y12015-05-15-P7D
14STUDYXQS2324-P000114FAC06514FAC065-I Am Satisfied With My Sex LifeFAACT V4SOCIAL/FAMILY WELL-BEING


NOT DONEPREFER NOT TO ANSWERY
Jira
showSummaryfalse
serverIssue Tracker (JIRA)
serverId85506ce4-3cb3-3d91-85ee-f633aaaf4a45
keyQRSSUPP-693
12015-05-15-P7D
15STUDYXQS2324-P000115FAC06515FAC065-I Feel SadFAACT V4EMOTIONAL WELL-BEINGA little bit11

Y12015-05-15-P7D
16STUDYXQS2324-P000116FAC06516FAC065-Satisfied With How I Am CopingFAACT V4EMOTIONAL WELL-BEINGQuite a bit33

Y12015-05-15-P7D
17STUDYXQS2324-P000117FAC06517FAC065-Losing Hope Against IllnessFAACT V4EMOTIONAL WELL-BEINGA little bit11

Y12015-05-15-P7D
18STUDYXQS2324-P000118FAC06518FAC065-I Feel NervousFAACT V4EMOTIONAL WELL-BEINGA little bit11

Y12015-05-15-P7D
19STUDYXQS2324-P000119FAC06519FAC065-I Worry About DyingFAACT V4EMOTIONAL WELL-BEINGA little bit11

Y12015-05-15-P7D
20STUDYXQS2324-P000120FAC06520FAC065-Worry My Condition Will Get WorseFAACT V4EMOTIONAL WELL-BEINGSomewhat22

Y12015-05-15-P7D
21STUDYXQS2324-P000121FAC06521FAC065-I Am Able to WorkFAACT V4FUNCTIONAL WELL-BEINGA little bit11

Y12015-05-15-P7D
22STUDYXQS2324-P000122FAC06522FAC065-My Work Is FulfillingFAACT V4FUNCTIONAL WELL-BEINGQuite a bit33

Y12015-05-15-P7D
23STUDYXQS2324-P000123FAC06523FAC065-I Am Able to Enjoy LifeFAACT V4FUNCTIONAL WELL-BEINGQuite a bit33

Y12015-05-15-P7D
24STUDYXQS2324-P000124FAC06524FAC065-I Have Accepted My IllnessFAACT V4FUNCTIONAL WELL-BEINGSomewhat22

Y12015-05-15-P7D
25STUDYXQS2324-P000125FAC06525FAC065-I Am Sleeping WellFAACT V4FUNCTIONAL WELL-BEINGSomewhat22

Y12015-05-15-P7D
26STUDYXQS2324-P000126FAC06526FAC065-Enjoy Things I Usually Do for FunFAACT V4FUNCTIONAL WELL-BEINGSomewhat22

Y12015-05-15-P7D
27STUDYXQS2324-P000127FAC06527FAC065-Content With Quality of My LifeFAACT V4FUNCTIONAL WELL-BEINGQuite a bit33

Y12015-05-15-P7D
28STUDYXQS2324-P000128FAC06528FAC065-I Have a Good AppetiteFAACT V4ADDITIONAL CONCERNSSomewhat22

Y12015-05-15-P7D
29STUDYXQS2324-P000129FAC06529FAC065-Amount I Eat Is SufficientFAACT V4ADDITIONAL CONCERNSNot at all00

Y12015-05-15-P7D
30STUDYXQS2324-P000130FAC06530FAC065-I Am Worried About My WeightFAACT V4ADDITIONAL CONCERNSQuite a bit33

Y12015-05-15-P7D
31

...

Info

We are unable to make the example consistently show blue in the Wiki. All examples are updated for each QRS instrument so we ask that you please review the example below.

...

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-P0001131FAC01501FAC06531FAC015-I Have a Lack of EnergyFACT-HEP V4A little bit1FAC065-Most Food Tastes Unpleasant to MeFAACT V4ADDITIONAL CONCERNSQuite a bit331

Y12015-05-15-P7D
232STUDYXQS2324-P0001232FAC01502FAC015-I Have NauseaFACT-HEP V4Not at all0FAC06532FAC065-I Am Concerned How Thin I LookFAACT V4ADDITIONAL CONCERNSA little bit110

Y12015-05-15-P7D
333STUDYXQS2324-P0001333FAC01503FAC06533FAC015-Trouble Meeting Needs of FamilyFACT-HEP V4Somewhat2FAC065-Interest in Food Drops Try to EatFAACT V4ADDITIONAL CONCERNSQuite a bit332

Y12015-05-15-P7D
434STUDYXQS2324-P0001434FAC01504FAC06534FAC015FAC065-I Have PainFACT-HEP V4A little bit1Difficulty Eating Rich FoodsFAACT V4ADDITIONAL CONCERNSNot at all001

Y12015-05-15-P7D
535STUDYXQS2324-P0001535FAC01505FAC06535FAC015-Botheredby Treatment Side EffectFACT-HEP V4Not at all0FAC065-My Family Pressuring Me to EatFAACT V4ADDITIONAL CONCERNSA little bit110

Y12015-05-15-P7D
636STUDYXQS2324-P0001636FAC01506FAC06536FAC015FAC065-I Feel IllHave Been VomitingFAACT FACT-HEP V4ADDITIONAL CONCERNSA little bit11

Y12015-05-15-P7D
737STUDYXQS2324-P0001737FAC01507FAC06537FAC015FAC065-I Am Forced to Spend Time in BedFACT-HEP V4A little bit1Seem to Get Full QuicklyFAACT V4ADDITIONAL CONCERNSSomewhat221

Y12015-05-15-P7D
838STUDYXQS2324-P0001838FAC01508FAC06538FAC015FAC065-I Feel Close to My FriendsFACT-HEP V4Quite a bit3Have Pain in My Stomach AreaFAACT V4ADDITIONAL CONCERNSA little bit113

Y12015-05-15-P7D
939STUDYXQS2324-P00019FAC01509FAC015-Get Emotional Support From FamilyFACT-HEP V4Quite a bit339FAC06539FAC065-My General Health Is ImprovingFAACT V4ADDITIONAL CONCERNSA little bit113

Y12015-05-15-P7D
1040STUDYXQS2324-P00011040FAC01510FAC06540FAC015-I Get Support From FriendsFACT-HEP V4Somewhat2FAC065-Physical Subscale ScoreFAACT V4
2222222

Y12015-05-15-P7D
1141STUDYXQS2324-P00011141FAC01511FAC06541FAC015FAC065-My Family Has Accepted My IllnessFACT-HEP V4Quite a bit3Social/Family Subscale ScoreFAACT V4
2222223

Y12015-05-15-P7D
1242STUDYXQS2324-P00011242FAC01512FAC06542FAC015-Satisfied Communication IllnessFACT-HEP V4Very much4FAC065-Emotional Subscale ScoreFAACT V4
1717174

Y12015-05-15-P7D
1343STUDYXQS2324-P00011343FAC01513FAC06543FAC015-I Feel close to My PartnerFACT-HEP V4Very much4FAC065-Functional Subscale ScoreFAACT V4
1616164

Y12015-05-15-P7D
1444STUDYXQS2324-P000114FAC01514FAC015-I Am Satisfied With My Sex LifeFACT-HEP V4NOT DONE44FAC06544FAC065-Additional Concern Subscale ScoreFAACT V4
242424PREFER NOT TO ANSWER

Y12015-05-15-P7D
1545STUDYXQS2324-P00011545FAC01515FAC06545FAC015-I Feel SadFACT-HEP V4A little bit1FAC065-Trial Outcome Index ScoreFAACT V4
6262621

Y12015-05-15-P7D
1646STUDYXQS2324-P00011646FAC01516FAC06546FAC015-Satisfied With How I Am CopingFACT-HEP V4Quite a bit3FAC065-FACT-G Total ScoreFAACT V4
7777773

Y12015-05-15-P7D
1747STUDYXQS2324-P00011747FAC01517FAC06547FAC015-Losing Hope Against IllnessFACT-HEP V4A little bit1FAC065-Total ScoreFAACT V4
1011011011

Y12015-05-15-P7D
1848STUDYXQS2324-P00011848FAC01518FAC06501FAC015FAC065-I Feel NervousFACT-HEP V4A little bit11Y12015-05-15-P7DHave a Lack of EnergyFAACT V4PHYSICAL WELL-BEING


NOT DONE

2

4919STUDYXQS2324-P00011949FAC01519FAC06502FAC015FAC065-I Worry About DyingFACT-HEP V4A little bit11Y12015-05-15-P7D20Have NauseaFAACT V4PHYSICAL WELL-BEING


NOT DONE

2

50STUDYXQS2324-P00012050FAC01520FAC06503FAC015-Worry My Condition Will Get WorseFACT-HEP V4FAC065-Trouble Meeting Needs of FamilyFAACT V4PHYSICAL WELL-BEING


NOT DONESomewhat

22

51YSTUDYX1QS2015-05-152324-P000151FAC06504FAC065-I Have PainFAACT V4PHYSICAL WELL-BEING


NOT DONE

2

52-P7D21STUDYXQS2324-P00012152FAC01521FAC06505FAC015-I Am Able to WorkFACT-HEP V4A little bit11Y12015-05-15FAC065-Bothered by Treatment Side EffectFAACT V4PHYSICAL WELL-BEING


NOT DONE

2

53-P7D22STUDYXQS2324-P00012253FAC01522FAC06506FAC015-My Work Is FulfillingFACT-HEP V4Quite a bit33Y12015-05-15-P7DFAC065-I Feel IllFAACT V4PHYSICAL WELL-BEING


NOT DONE

2

54STUDYXQS2324-P000154FAC06507FAC065-I Am Forced to Spend Time in BedFAACT V4PHYSICAL WELL-BEING


NOT DONE

2

5523STUDYXQS2324-P00012355FAC01523FAC06508FAC015FAC065-I Am Able to Enjoy LifeFACT-HEP V4Quite a bit33Y12015-05-15-P7DFeel Close to My FriendsFAACT V4SOCIAL/FAMILY WELL-BEING


NOT DONE

2

56STUDYXQS2324-P000156FAC06509FAC065-Get Emotional Support From FamilyFAACT V4SOCIAL/FAMILY WELL-BEING


NOT DONE

2

5724STUDYXQS2324-P00012457FAC01524FAC06510FAC015FAC065-I Have Accepted My IllnessFACT-HEP V4Get Support From My FriendsFAACT V4SOCIAL/FAMILY WELL-BEING


NOT DONESomewhat

22

58YSTUDYX1QS2015-05-152324-P000158FAC06511FAC065-My Family Has Accepted My IllnessFAACT V4SOCIAL/FAMILY WELL-BEING


NOT DONE

2

59-P7D25STUDYXQS2324-P00012559FAC01525FAC06512FAC015-I Am Sleeping WellFACT-HEP V4SomewhatFAC065-Satisfied Communication IllnessFAACT V4SOCIAL/FAMILY WELL-BEING


NOT DONE2

2Y12015-05-15-P7D26

60STUDYXQS2324-P00012660FAC01526FAC06513FAC015FAC065-Enjoy Things I Usually Do for FunFACT-HEP V4Somewhat22Y12015-05-15-P7DI Feel Close to My PartnerFAACT V4SOCIAL/FAMILY WELL-BEING


NOT DONE

2

6127STUDYXQS2324-P00012761FAC01527FAC06514FAC015FAC065-Content I Am Satisfied With Quality of My Sex LifeFACT-HEP V4Quite a bit33Y12015-05-15-P7DFAACT V4SOCIAL/FAMILY WELL-BEING


NOT DONE

2

62STUDYXQS2324-P000162FAC06515FAC065-I Feel SadFAACT V4EMOTIONAL WELL-BEING


NOT DONE

2

6328STUDYXQS2324-P00012863FAC01528FAC06516FAC015-Swelling/Cramps in Stomach AreaFACT-HEP V4Somewhat22Y12015-05-15-P7DFAC065-Satisfied With How I Am CopingFAACT V4EMOTIONAL WELL-BEING


NOT DONE

2

64STUDYXQS2324-P000164FAC06517FAC065-Losing Hope Against IllnessFAACT V4EMOTIONAL WELL-BEING


NOT DONE

2

6529STUDYXQS2324-P00012965FAC01529FAC06518FAC015FAC065-I Am Losing WeightFACT-HEP V4Not at all00Y12015-05-15-P7D30Feel NervousFAACT V4EMOTIONAL WELL-BEING


NOT DONE

2

66STUDYXQS2324-P00013066FAC01530FAC06519FAC015-I Have Control of My BowelsFACT-HEP V4Quite a bit33Y12015-05-15-P7DFAC065-I Worry About DyingFAACT V4EMOTIONAL WELL-BEING


NOT DONE

2

67STUDYXQS2324-P000167FAC06520FAC065-Worry My Condition Will Get WorseFAACT V4EMOTIONAL WELL-BEING


NOT DONE

2

6831STUDYXQS2324-P00013168FAC01531FAC06521FAC015FAC065-I Can Digest My Food WellFACT-HEP V4Quite a bit33Y12015-05-15-P7DAm Able to WorkFAACT V4FUNCTIONAL WELL-BEING


NOT DONE

2

69STUDYXQS2324-P000169FAC06522FAC065-My Work Is FulfillingFAACT V4FUNCTIONAL WELL-BEING


NOT DONE

2

7032STUDYXQS2324-P00013270FAC01532FAC06523FAC015FAC065-I Have DiarrheaFACT-HEP V4A little bit11Y12015-05-15-P7DAm Able to Enjoy LifeFAACT V4FUNCTIONAL WELL-BEING


NOT DONE

2

7133STUDYXQS2324-P00013371FAC01533FAC06524FAC015FAC065-I Have a Good AppetiteFACT-HEP V4Quite a bit33Y12015-05-15-P7DAccepted My IllnessFAACT V4FUNCTIONAL WELL-BEING


NOT DONE

2

72STUDYXQS2324-P000172FAC06525FAC065-I Am Sleeping WellFAACT V4FUNCTIONAL WELL-BEING


NOT DONE

2

7334STUDYXQS2324-P00013473FAC01534FAC06526FAC015-Unhappy About Change in My AppearFACT-HEP V4Not at all00Y12015-05-15-P7D35FAC065-Enjoy Things I Usually Do for FunFAACT V4FUNCTIONAL WELL-BEING


NOT DONE

2

74STUDYXQS2324-P000135FAC01535FAC015-I Have Pain in My BackFACT-HEP V4A little bit11Y174FAC06527FAC065-Content With Quality of My LifeFAACT V4FUNCTIONAL WELL-BEING


NOT DONE

2

752015-05-15-P7D36STUDYXQS2324-P00013675FAC01536FAC06528FAC015FAC065-I Am Bothered by ConstipationFACT-HEP V4A little bit11Y12015-05-15-P7DHave a Good AppetiteFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

7637STUDYXQS2324-P00013776FAC01537FAC06529FAC015FAC065-Amount I Feel FatiguedEat Is SufficientFAACT FACT-HEP V4SomewhatADDITIONAL CONCERNS


2NOT DONE

2Y12015-05-15-P7D38

77STUDYXQS2324-P00013877FAC01538FAC06530FAC015-Able to Do My Usual ActivitiesFACT-HEP V4A  little bit11Y12015-05-15-P7DFAC065-I Am Worried About My WeightFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

78STUDYXQS2324-P000178FAC06531FAC065-Most Food Tastes Unpleasant to MeFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

7939STUDYXQS2324-P00013979FAC01539FAC06532FAC015-Bothered by Jaundice/Yellow SkinFACT-HEP V4A little bit11Y12015-05-15-P7DFAC065-I Am Concerned How Thin I LookFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

8040STUDYXQS2324-P00014080FAC01540FAC06533FAC015-I Have Had FeversFACT-HEP V4Not at all00Y12015-05-15-P7D41FAC065-Interest in Food Drops Try to EatFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

81STUDYXQS2324-P000141FAC01541FAC015-I Have Had ItchingFACT-HEP V4A little bit11Y12015-05-15-P7D-P000181FAC06534FAC065-Have Difficulty Eating Rich FoodsFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

8242STUDYXQS2324-P00014282FAC01542FAC06535FAC015-Had Change in the Way Food TastesFACT-HEP V4Not at all00Y12015-05-15-P7DFAC065-My Family Pressuring Me to EatFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

8343STUDYXQS2324-P00014383FAC01543FAC06536FAC015FAC065-I Have Had ChillsFACT-HEP V4Not at all00Y12015-05-15-P7D44Been VomitingFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

84STUDYXQS2324-P00014484FAC01544FAC06537FAC015-My Mouth Is DryFACT-HEP V4A little bit11Y12015-05-15-P7DFAC065-I Seem to Get Full QuicklyFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

8545STUDYXQS2324-P00014585FAC01545FAC06538FAC015FAC065-Discomfort/I Have Pain in My Stomach AreaFACT-HEP FAACT V4SomewhatADDITIONAL CONCERNS


2NOT DONE

2Y12015-05-15-P7D46

86STUDYXQS2324-P000146FAC01546FAC015-Physical Subscale ScoreFACT-HEP V46-P000186FAC06539FAC065-My General Health Is ImprovingFAACT V4ADDITIONAL CONCERNS


NOT DONE

2

8766Y12015-05-15-P7D47STUDYXQS2324-P00014787FAC01547FAC06540FAC015FAC065-Social/Family Physical Subscale ScoreFACT-HEP FAACT V422.222.222.2Y12015-05-15



NOT DONE

2

88-P7D48STUDYXQS2324-P00014888FAC01548FAC06541FAC015FAC065-Emotional Social/Family Subscale ScoreFACT-HEP FAACT V4



9NOT DONE9

2

989YSTUDYX1QS2015-05-152324-P000189FAC06542FAC065-Emotional Subscale ScoreFAACT V4



NOT DONE

2

90-P7D49STUDYXQS2324-P00014990FAC01549FAC06543FAC015FAC065-Functional Subscale ScoreFACT-HEP V4161616Y12015-05-15-P7DFAACT V4



NOT DONE

2

9150STUDYXQS2324-P00015091FAC01550FAC06544FAC015FAC065-Additional Concern Subscale ScoreFACT-HEP FAACT V4



22NOT DONE2222Y12015-05-15-P7D51

2

92STUDYXQS2324-P00015192FAC01551FAC06545FAC015FAC065-Trial Outcome Index ScoreFACT-HEP FAACT V4



YNOT DONE12015-05-15-P7D52

2

93STUDYXQS2324-P00015293FAC01552FAC06546FAC015FAC065-FACT-G Total ScoreFACT-HEP FAACT V4



YNOT DONE12015-05-15-P7D53

2

94STUDYXQS2324-P00015394FAC01553FAC06547FAC015FAC065-Total ScoreFACT-HEP FAACT V4



YNOT DONE12015-05-15-P7D

2


4 SDTM Mapping Strategy

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

QSSCAT alignment with QSTESTCD

As stated in Section 3.1 assumptions, Assumptions, items on the FACT-HEP FAACT V4 are grouped into subcategories. The following table below includes the subcategory names along with the applicable item numbers for each category. The values of the subcategories are used to populate QSSCAT and are annotated on the CRF.

QSSCATQSTESTCD
PHYSICAL WELL-BEINGFAC01501 FAC06501 - FAC01507FAC06507
SOCIAL/FAMILY WELL-BEINGFAC01508 FAC06508 - FAC01514FAC06514
EMOTIONAL WELL-BEINGFAC01515 FAC06515 - FAC01520FAC06520
FUNCTIONAL WELL-BEINGFAC01521 FAC06521 - FAC01527FAC06527
ADDITIONAL CONCERNSFAC01528 FAC06528 - FAC01545FAC06539


All QSTESTCDs

QSORRES

QSSTRESC

QSSTRESN

Not at all00
A little bit11
Somewhat22
Quite a bit33
Very much44





End of Document