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Title | Functional Assessment of Cancer Therapy-Hepatobiliary Anorexia/Cachexia Treatment Version 4 (FACT-HEP FAACT V4) |
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CDISC Reference | Questionnaire Supplement to the Study Data Tabulation Model Implementation Guide for Human Clinical Trials |
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QRS Short Name | |
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QRS Permission Status | ApproveApproved |
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Team | Pancreatic Cancer Standards Team and CDISC Questionnaires, Ratings, and Scales (QRS) Subteam |
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Supplement Version | 1.0 |
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Status | DRAFT |
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Date | 20022023-1107-0128 |
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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.
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Revision History
Date | Version |
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20222023-1107-0128 | 1.0 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.
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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.
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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.
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title | Information for Reviewers |
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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.
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title | Information for Reviewers |
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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.
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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.
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.
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 |
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showSummary | false |
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server | Issue Tracker (JIRA) |
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serverId | 85506ce4-3cb3-3d91-85ee-f633aaaf4a45 |
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key | QRSSUPP-665 |
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, this is noted with QSSTAT = "NOT DONE" and QSREASND = "PREFER NOT TO ANSWER". QSORRES, QSSTRESC, and QSSTRESN are all missing.
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").
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".
Records are created in qs.xpt for every item on the instrument:
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.
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.
Subscores and total scores are represented in QSORRES.
- If scores are received or derived by the sponsor, it is recommended that they are submitted to SDTM and verified in ADaM whenever feasible.
- Terminology
QSCAT, QSTESTCD, and QSTEST values are included in CDISC Controlled Terminology.
A full list of value sets for the result field is provided in Section 4, SDTM Mapping Strategy.
3.2 Example for the QRS
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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 QSCAT. All 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.
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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:
Rows 49-60: | 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, 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.
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When the reason is collected for a not done visit, information or a row description should be added as follows:
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Dataset2 |
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Row | STUDYID | DOMAIN | USUBJID | QSSEQ | QSTESTCD | QSTEST | QSCAT | QSSCAT | QSORRES | QSSTRESC | QSSTRESN | QSSTAT | QSREASND | QSLOBXFL | VISITNUM | QSDTC | QSEVLINT |
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1 | STUDYX | QS | 2324-P0001 | 1 | FAC06501 | FAC065-I Have a Lack of Energy | FAACT V4 | PHYSICAL WELL-BEING | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 2 | STUDYX | QS | 2324-P0001 | 2 | FAC06502 | FAC065-I Have Nausea | FAACT V4 | PHYSICAL WELL-BEING | Not at all | 0 | 0 |
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| Y | 1 | 2015-05-15 | -P7D | 3 | STUDYX | QS | 2324-P0001 | 3 | FAC06503 | FAC065-Trouble Meeting Needs of Family | FAACT V4 | PHYSICAL WELL-BEING | Somewhat | 2 | 2 |
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| Y | 1 | 2015-05-15 | -P7D | 4 | STUDYX | QS | 2324-P0001 | 4 | FAC06504 | FAC065-I Have Pain | FAACT V4 | PHYSICAL WELL-BEING | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 5 | STUDYX | QS | 2324-P0001 | 5 | FAC06505 | FAC065-Bothered by Treatment Side Effect | FAACT V4 | PHYSICAL WELL-BEING | Not at all | 0 | 0 |
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| Y | 1 | 2015-05-15 | -P7D | 6 | STUDYX | QS | 2324-P0001 | 6 | FAC06506 | FAC065-I Feel Ill | FAACT V4 | PHYSICAL WELL-BEING | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 7 | STUDYX | QS | 2324-P0001 | 7 | FAC06507 | FAC065-I Am Forced to Spend Time in Bed | FAACT V4 | PHYSICAL WELL-BEING | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 8 | STUDYX | QS | 2324-P0001 | 8 | FAC06508 | FAC065-I Feel Close to My Friends | FAACT V4 | SOCIAL/FAMILY WELL-BEING | Quite a bit | 3 | 3 |
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| Y | 1 | 2015-05-15 | -P7D | 9 | STUDYX | QS | 2324-P0001 | 9 | FAC06509 | FAC065-Get Emotional Support From Family | FAACT V4 | SOCIAL/FAMILY WELL-BEING | Quite a bit | 3 | 3 |
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| Y | 1 | 2015-05-15 | -P7D | 10 | STUDYX | QS | 2324-P0001 | 10 | FAC06510 | FAC065-I Get Support From My Friends | FAACT V4 | SOCIAL/FAMILY WELL-BEING | Somewhat | 2 | 2 |
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| Y | 1 | 2015-05-15 | -P7D | 11 | STUDYX | QS | 2324-P0001 | 11 | FAC06511 | FAC065-My Family Has Accepted My Illness | FAACT V4 | SOCIAL/FAMILY WELL-BEING | Quite a bit | 3 | 3 |
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| Y | 1 | 2015-05-15 | -P7D | 12 | STUDYX | QS | 2324-P0001 | 12 | FAC06512 | FAC065-Satisfied Communication Illness | FAACT V4 | SOCIAL/FAMILY WELL-BEING | Very much | 4 | 4 |
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| Y | 1 | 2015-05-15 | -P7D | 13 | STUDYX | QS | 2324-P0001 | 13 | FAC06513 | FAC065-I Feel Close to My Partner | FAACT V4 | SOCIAL/FAMILY WELL-BEING | Very much | 4 | 4 |
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| Y | 1 | 2015-05-15 | -P7D | 14 | STUDYX | QS | 2324-P0001 | 14 | FAC06514 | FAC065-I Am Satisfied With My Sex Life | FAACT V4 | SOCIAL/FAMILY WELL-BEING |
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| NOT DONE | PREFER NOT TO ANSWER | Y Jira |
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showSummary | false |
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server | Issue Tracker (JIRA) |
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serverId | 85506ce4-3cb3-3d91-85ee-f633aaaf4a45 |
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key | QRSSUPP-693 |
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| 1 | 2015-05-15 | -P7D | 15 | STUDYX | QS | 2324-P0001 | 15 | FAC06515 | FAC065-I Feel Sad | FAACT V4 | EMOTIONAL WELL-BEING | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 16 | STUDYX | QS | 2324-P0001 | 16 | FAC06516 | FAC065-Satisfied With How I Am Coping | FAACT V4 | EMOTIONAL WELL-BEING | Quite a bit | 3 | 3 |
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| Y | 1 | 2015-05-15 | -P7D | 17 | STUDYX | QS | 2324-P0001 | 17 | FAC06517 | FAC065-Losing Hope Against Illness | FAACT V4 | EMOTIONAL WELL-BEING | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 18 | STUDYX | QS | 2324-P0001 | 18 | FAC06518 | FAC065-I Feel Nervous | FAACT V4 | EMOTIONAL WELL-BEING | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 19 | STUDYX | QS | 2324-P0001 | 19 | FAC06519 | FAC065-I Worry About Dying | FAACT V4 | EMOTIONAL WELL-BEING | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 20 | STUDYX | QS | 2324-P0001 | 20 | FAC06520 | FAC065-Worry My Condition Will Get Worse | FAACT V4 | EMOTIONAL WELL-BEING | Somewhat | 2 | 2 |
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| Y | 1 | 2015-05-15 | -P7D | 21 | STUDYX | QS | 2324-P0001 | 21 | FAC06521 | FAC065-I Am Able to Work | FAACT V4 | FUNCTIONAL WELL-BEING | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 22 | STUDYX | QS | 2324-P0001 | 22 | FAC06522 | FAC065-My Work Is Fulfilling | FAACT V4 | FUNCTIONAL WELL-BEING | Quite a bit | 3 | 3 |
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| Y | 1 | 2015-05-15 | -P7D | 23 | STUDYX | QS | 2324-P0001 | 23 | FAC06523 | FAC065-I Am Able to Enjoy Life | FAACT V4 | FUNCTIONAL WELL-BEING | Quite a bit | 3 | 3 |
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| Y | 1 | 2015-05-15 | -P7D | 24 | STUDYX | QS | 2324-P0001 | 24 | FAC06524 | FAC065-I Have Accepted My Illness | FAACT V4 | FUNCTIONAL WELL-BEING | Somewhat | 2 | 2 |
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| Y | 1 | 2015-05-15 | -P7D | 25 | STUDYX | QS | 2324-P0001 | 25 | FAC06525 | FAC065-I Am Sleeping Well | FAACT V4 | FUNCTIONAL WELL-BEING | Somewhat | 2 | 2 |
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| Y | 1 | 2015-05-15 | -P7D | 26 | STUDYX | QS | 2324-P0001 | 26 | FAC06526 | FAC065-Enjoy Things I Usually Do for Fun | FAACT V4 | FUNCTIONAL WELL-BEING | Somewhat | 2 | 2 |
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| Y | 1 | 2015-05-15 | -P7D | 27 | STUDYX | QS | 2324-P0001 | 27 | FAC06527 | FAC065-Content With Quality of My Life | FAACT V4 | FUNCTIONAL WELL-BEING | Quite a bit | 3 | 3 |
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| Y | 1 | 2015-05-15 | -P7D | 28 | STUDYX | QS | 2324-P0001 | 28 | FAC06528 | FAC065-I Have a Good Appetite | FAACT V4 | ADDITIONAL CONCERNS | Somewhat | 2 | 2 |
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| Y | 1 | 2015-05-15 | -P7D | 29 | STUDYX | QS | 2324-P0001 | 29 | FAC06529 | FAC065-Amount I Eat Is Sufficient | FAACT V4 | ADDITIONAL CONCERNS | Not at all | 0 | 0 |
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| Y | 1 | 2015-05-15 | -P7D | 30 | STUDYX | QS | 2324-P0001 | 30 | FAC06530 | FAC065-I Am Worried About My Weight | FAACT V4 | ADDITIONAL CONCERNS | Quite a bit | 3 | 3 |
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| Y | 1 | 2015-05-15 | -P7D | 31 |
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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. |
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Rowcaps |
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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 |
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Row | STUDYID | DOMAIN | USUBJID | QSSEQ | QSTESTCD | QSTEST | QSCAT | QSORRES | QSSTRESC | QSSTRESN | QSSTAT | QSREASND | QSLOBXFL | VISITNUM | QSDTC | QSEVLINT |
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1 | STUDYX | QS | 2324-P0001 | 131 | FAC01501FAC06531 | FAC015-I Have a Lack of Energy | FACT-HEP V4 | A little bit | 1 | FAC065-Most Food Tastes Unpleasant to Me | FAACT V4 | ADDITIONAL CONCERNS | Quite a bit | 3 | 31 |
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| Y | 1 | 2015-05-15 | -P7D | 232 | STUDYX | QS | 2324-P0001 | 232 | FAC01502 | FAC015-I Have Nausea | FACT-HEP V4 | Not at all | 0 | FAC06532 | FAC065-I Am Concerned How Thin I Look | FAACT V4 | ADDITIONAL CONCERNS | A little bit | 1 | 10 |
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| Y | 1 | 2015-05-15 | -P7D | 333 | STUDYX | QS | 2324-P0001 | 333 | FAC01503FAC06533 | FAC015-Trouble Meeting Needs of Family | FACT-HEP V4 | Somewhat | 2 | FAC065-Interest in Food Drops Try to Eat | FAACT V4 | ADDITIONAL CONCERNS | Quite a bit | 3 | 32 |
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| Y | 1 | 2015-05-15 | -P7D | 434 | STUDYX | QS | 2324-P0001 | 434 | FAC01504FAC06534 | FAC015FAC065-I Have Pain | FACT-HEP V4 | A little bit | 1 | Difficulty Eating Rich Foods | FAACT V4 | ADDITIONAL CONCERNS | Not at all | 0 | 01 |
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| Y | 1 | 2015-05-15 | -P7D | 535 | STUDYX | QS | 2324-P0001 | 535 | FAC01505FAC06535 | FAC015-Botheredby Treatment Side Effect | FACT-HEP V4 | Not at all | 0 | FAC065-My Family Pressuring Me to Eat | FAACT V4 | ADDITIONAL CONCERNS | A little bit | 1 | 10 |
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| Y | 1 | 2015-05-15 | -P7D | 636 | STUDYX | QS | 2324-P0001 | 636 | FAC01506FAC06536 | FAC015FAC065-I Feel IllHave Been Vomiting | FAACT FACT-HEP V4 | ADDITIONAL CONCERNS | A little bit | 1 | 1 |
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| Y | 1 | 2015-05-15 | -P7D | 737 | STUDYX | QS | 2324-P0001 | 737 | FAC01507FAC06537 | FAC015FAC065-I Am Forced to Spend Time in Bed | FACT-HEP V4 | A little bit | 1 | Seem to Get Full Quickly | FAACT V4 | ADDITIONAL CONCERNS | Somewhat | 2 | 21 |
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| Y | 1 | 2015-05-15 | -P7D | 838 | STUDYX | QS | 2324-P0001 | 838 | FAC01508FAC06538 | FAC015FAC065-I Feel Close to My Friends | FACT-HEP V4 | Quite a bit | 3 | Have Pain in My Stomach Area | FAACT V4 | ADDITIONAL CONCERNS | A little bit | 1 | 13 |
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| Y | 1 | 2015-05-15 | -P7D | 939 | STUDYX | QS | 2324-P0001 | 9 | FAC01509 | FAC015-Get Emotional Support From Family | FACT-HEP V4 | Quite a bit | 3 | 39 | FAC06539 | FAC065-My General Health Is Improving | FAACT V4 | ADDITIONAL CONCERNS | A little bit | 1 | 13 |
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| Y | 1 | 2015-05-15 | -P7D | 1040 | STUDYX | QS | 2324-P0001 | 1040 | FAC01510FAC06540 | FAC015-I Get Support From Friends | FACT-HEP V4 | Somewhat | 2 | FAC065-Physical Subscale Score | FAACT V4 |
| 22 | 22 | 222 |
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| Y | 1 | 2015-05-15 | -P7D | 1141 | STUDYX | QS | 2324-P0001 | 1141 | FAC01511FAC06541 | FAC015FAC065-My Family Has Accepted My Illness | FACT-HEP V4 | Quite a bit | 3 | Social/Family Subscale Score | FAACT V4 |
| 22 | 22 | 223 |
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| Y | 1 | 2015-05-15 | -P7D | 1242 | STUDYX | QS | 2324-P0001 | 1242 | FAC01512FAC06542 | FAC015-Satisfied Communication Illness | FACT-HEP V4 | Very much | 4 | FAC065-Emotional Subscale Score | FAACT V4 |
| 17 | 17 | 174 |
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| Y | 1 | 2015-05-15 | -P7D | 1343 | STUDYX | QS | 2324-P0001 | 1343 | FAC01513FAC06543 | FAC015-I Feel close to My Partner | FACT-HEP V4 | Very much | 4 | FAC065-Functional Subscale Score | FAACT V4 |
| 16 | 16 | 164 |
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| Y | 1 | 2015-05-15 | -P7D | 1444 | STUDYX | QS | 2324-P0001 | 14 | FAC01514 | FAC015-I Am Satisfied With My Sex Life | FACT-HEP V4 | NOT DONE | 44 | FAC06544 | FAC065-Additional Concern Subscale Score | FAACT V4 |
| 24 | 24 | 24PREFER NOT TO ANSWER |
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| Y | 1 | 2015-05-15 | -P7D | 1545 | STUDYX | QS | 2324-P0001 | 1545 | FAC01515FAC06545 | FAC015-I Feel Sad | FACT-HEP V4 | A little bit | 1 | FAC065-Trial Outcome Index Score | FAACT V4 |
| 62 | 62 | 621 |
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| Y | 1 | 2015-05-15 | -P7D | 1646 | STUDYX | QS | 2324-P0001 | 1646 | FAC01516FAC06546 | FAC015-Satisfied With How I Am Coping | FACT-HEP V4 | Quite a bit | 3 | FAC065-FACT-G Total Score | FAACT V4 |
| 77 | 77 | 773 |
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| Y | 1 | 2015-05-15 | -P7D | 1747 | STUDYX | QS | 2324-P0001 | 1747 | FAC01517FAC06547 | FAC015-Losing Hope Against Illness | FACT-HEP V4 | A little bit | 1 | FAC065-Total Score | FAACT V4 |
| 101 | 101 | 1011 |
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| Y | 1 | 2015-05-15 | -P7D | 1848 | STUDYX | QS | 2324-P0001 | 1848 | FAC01518FAC06501 | FAC015FAC065-I Feel Nervous | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | 2015-05-15 | -P7D | Have a Lack of Energy | FAACT V4 | PHYSICAL WELL-BEING |
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| NOT DONE |
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| 4919 | STUDYX | QS | 2324-P0001 | 1949 | FAC01519FAC06502 | FAC015FAC065-I Worry About Dying | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | 2015-05-15 | -P7D | 20 | Have Nausea | FAACT V4 | PHYSICAL WELL-BEING |
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| NOT DONE |
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| 50 | STUDYX | QS | 2324-P0001 | 2050 | FAC01520FAC06503 | FAC015-Worry My Condition Will Get Worse | FACT-HEP V4 | FAC065-Trouble Meeting Needs of Family | FAACT V4 | PHYSICAL WELL-BEING |
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| NOT DONESomewhat |
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| 22 |
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| 51 | YSTUDYX | 1QS | 2015-05-15 | 2324-P0001 | 51 | FAC06504 | FAC065-I Have Pain | FAACT V4 | PHYSICAL WELL-BEING |
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| NOT DONE |
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| 2 |
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| 52 | -P7D | 21 | STUDYX | QS | 2324-P0001 | 2152 | FAC01521FAC06505 | FAC015-I Am Able to Work | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | 2015-05-15 | FAC065-Bothered by Treatment Side Effect | FAACT V4 | PHYSICAL WELL-BEING |
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| NOT DONE |
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| 2 |
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| 53 | -P7D | 22 | STUDYX | QS | 2324-P0001 | 2253 | FAC01522FAC06506 | FAC015-My Work Is Fulfilling | FACT-HEP V4 | Quite a bit | 3 | 3 | Y | 1 | 2015-05-15 | -P7D | FAC065-I Feel Ill | FAACT V4 | PHYSICAL WELL-BEING |
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| NOT DONE |
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| 2 |
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| 54 | STUDYX | QS | 2324-P0001 | 54 | FAC06507 | FAC065-I Am Forced to Spend Time in Bed | FAACT V4 | PHYSICAL WELL-BEING |
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| NOT DONE |
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| 2 |
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| 5523 | STUDYX | QS | 2324-P0001 | 2355 | FAC01523FAC06508 | FAC015FAC065-I Am Able to Enjoy Life | FACT-HEP V4 | Quite a bit | 3 | 3 | Y | 1 | 2015-05-15 | -P7D | Feel Close to My Friends | FAACT V4 | SOCIAL/FAMILY WELL-BEING |
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| NOT DONE |
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| 2 |
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| 56 | STUDYX | QS | 2324-P0001 | 56 | FAC06509 | FAC065-Get Emotional Support From Family | FAACT V4 | SOCIAL/FAMILY WELL-BEING |
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| NOT DONE |
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| 2 |
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| 5724 | STUDYX | QS | 2324-P0001 | 2457 | FAC01524FAC06510 | FAC015FAC065-I Have Accepted My Illness | FACT-HEP V4 | Get Support From My Friends | FAACT V4 | SOCIAL/FAMILY WELL-BEING |
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| NOT DONESomewhat |
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| 22 |
|
| 58 | YSTUDYX | 1QS | 2015-05-15 | 2324-P0001 | 58 | FAC06511 | FAC065-My Family Has Accepted My Illness | FAACT V4 | SOCIAL/FAMILY WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 59 | -P7D | 25 | STUDYX | QS | 2324-P0001 | 2559 | FAC01525FAC06512 | FAC015-I Am Sleeping Well | FACT-HEP V4 | Somewhat | FAC065-Satisfied Communication Illness | FAACT V4 | SOCIAL/FAMILY WELL-BEING |
|
|
| NOT DONE2 |
|
| 2 | Y | 1 | 2015-05-15 | -P7D | 26 |
|
| 60 | STUDYX | QS | 2324-P0001 | 2660 | FAC01526FAC06513 | FAC015FAC065-Enjoy Things I Usually Do for Fun | FACT-HEP V4 | Somewhat | 2 | 2 | Y | 1 | 2015-05-15 | -P7D | I Feel Close to My Partner | FAACT V4 | SOCIAL/FAMILY WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 6127 | STUDYX | QS | 2324-P0001 | 2761 | FAC01527FAC06514 | FAC015FAC065-Content I Am Satisfied With Quality of My Sex Life | FACT-HEP V4 | Quite a bit | 3 | 3 | Y | 1 | 2015-05-15 | -P7D | FAACT V4 | SOCIAL/FAMILY WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 62 | STUDYX | QS | 2324-P0001 | 62 | FAC06515 | FAC065-I Feel Sad | FAACT V4 | EMOTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 6328 | STUDYX | QS | 2324-P0001 | 2863 | FAC01528FAC06516 | FAC015-Swelling/Cramps in Stomach Area | FACT-HEP V4 | Somewhat | 2 | 2 | Y | 1 | 2015-05-15 | -P7D | FAC065-Satisfied With How I Am Coping | FAACT V4 | EMOTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 64 | STUDYX | QS | 2324-P0001 | 64 | FAC06517 | FAC065-Losing Hope Against Illness | FAACT V4 | EMOTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 6529 | STUDYX | QS | 2324-P0001 | 2965 | FAC01529FAC06518 | FAC015FAC065-I Am Losing Weight | FACT-HEP V4 | Not at all | 0 | 0 | Y | 1 | 2015-05-15 | -P7D | 30 | Feel Nervous | FAACT V4 | EMOTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 66 | STUDYX | QS | 2324-P0001 | 3066 | FAC01530FAC06519 | FAC015-I Have Control of My Bowels | FACT-HEP V4 | Quite a bit | 3 | 3 | Y | 1 | 2015-05-15 | -P7D | FAC065-I Worry About Dying | FAACT V4 | EMOTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 67 | STUDYX | QS | 2324-P0001 | 67 | FAC06520 | FAC065-Worry My Condition Will Get Worse | FAACT V4 | EMOTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 6831 | STUDYX | QS | 2324-P0001 | 3168 | FAC01531FAC06521 | FAC015FAC065-I Can Digest My Food Well | FACT-HEP V4 | Quite a bit | 3 | 3 | Y | 1 | 2015-05-15 | -P7D | Am Able to Work | FAACT V4 | FUNCTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 69 | STUDYX | QS | 2324-P0001 | 69 | FAC06522 | FAC065-My Work Is Fulfilling | FAACT V4 | FUNCTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 7032 | STUDYX | QS | 2324-P0001 | 3270 | FAC01532FAC06523 | FAC015FAC065-I Have Diarrhea | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | 2015-05-15 | -P7D | Am Able to Enjoy Life | FAACT V4 | FUNCTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 7133 | STUDYX | QS | 2324-P0001 | 3371 | FAC01533FAC06524 | FAC015FAC065-I Have a Good Appetite | FACT-HEP V4 | Quite a bit | 3 | 3 | Y | 1 | 2015-05-15 | -P7D | Accepted My Illness | FAACT V4 | FUNCTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 72 | STUDYX | QS | 2324-P0001 | 72 | FAC06525 | FAC065-I Am Sleeping Well | FAACT V4 | FUNCTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 7334 | STUDYX | QS | 2324-P0001 | 3473 | FAC01534FAC06526 | FAC015-Unhappy About Change in My Appear | FACT-HEP V4 | Not at all | 0 | 0 | Y | 1 | 2015-05-15 | -P7D | 35 | FAC065-Enjoy Things I Usually Do for Fun | FAACT V4 | FUNCTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 74 | STUDYX | QS | 2324-P0001 | 35 | FAC01535 | FAC015-I Have Pain in My Back | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | | 74 | FAC06527 | FAC065-Content With Quality of My Life | FAACT V4 | FUNCTIONAL WELL-BEING |
|
|
| NOT DONE |
|
| 2 |
|
| 75 | 2015-05-15 | -P7D | 36 | STUDYX | QS | 2324-P0001 | 3675 | FAC01536FAC06528 | FAC015FAC065-I Am Bothered by Constipation | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | 2015-05-15 | -P7D | Have a Good Appetite | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 7637 | STUDYX | QS | 2324-P0001 | 3776 | FAC01537FAC06529 | FAC015FAC065-Amount I Feel FatiguedEat Is Sufficient | FAACT FACT-HEP V4 | SomewhatADDITIONAL CONCERNS |
|
|
| 2NOT DONE |
|
| 2 | Y | 1 | 2015-05-15 | -P7D | 38 |
|
| 77 | STUDYX | QS | 2324-P0001 | 3877 | FAC01538FAC06530 | FAC015-Able to Do My Usual Activities | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | 2015-05-15 | -P7D | FAC065-I Am Worried About My Weight | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 78 | STUDYX | QS | 2324-P0001 | 78 | FAC06531 | FAC065-Most Food Tastes Unpleasant to Me | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 7939 | STUDYX | QS | 2324-P0001 | 3979 | FAC01539FAC06532 | FAC015-Bothered by Jaundice/Yellow Skin | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | 2015-05-15 | -P7D | FAC065-I Am Concerned How Thin I Look | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 8040 | STUDYX | QS | 2324-P0001 | 4080 | FAC01540FAC06533 | FAC015-I Have Had Fevers | FACT-HEP V4 | Not at all | 0 | 0 | Y | 1 | 2015-05-15 | -P7D | 41 | FAC065-Interest in Food Drops Try to Eat | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 81 | STUDYX | QS | 2324-P0001 | 41 | FAC01541 | FAC015-I Have Had Itching | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | 2015-05-15 | -P7D | -P0001 | 81 | FAC06534 | FAC065-Have Difficulty Eating Rich Foods | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 8242 | STUDYX | QS | 2324-P0001 | 4282 | FAC01542FAC06535 | FAC015-Had Change in the Way Food Tastes | FACT-HEP V4 | Not at all | 0 | 0 | Y | 1 | 2015-05-15 | -P7D | FAC065-My Family Pressuring Me to Eat | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 8343 | STUDYX | QS | 2324-P0001 | 4383 | FAC01543FAC06536 | FAC015FAC065-I Have Had Chills | FACT-HEP V4 | Not at all | 0 | 0 | Y | 1 | 2015-05-15 | -P7D | 44 | Been Vomiting | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 84 | STUDYX | QS | 2324-P0001 | 4484 | FAC01544FAC06537 | FAC015-My Mouth Is Dry | FACT-HEP V4 | A little bit | 1 | 1 | Y | 1 | 2015-05-15 | -P7D | FAC065-I Seem to Get Full Quickly | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 85 | 45 | STUDYX | QS | 2324-P0001 | 4585 | FAC01545FAC06538 | FAC015FAC065-Discomfort/I Have Pain in My Stomach Area | FACT-HEP FAACT V4 | SomewhatADDITIONAL CONCERNS |
|
|
| 2NOT DONE |
|
| 2 | Y | 1 | 2015-05-15 | -P7D | 46 |
|
| 86 | STUDYX | QS | 2324-P0001 | 46 | FAC01546 | FAC015-Physical Subscale Score | FACT-HEP V4 | 6 | -P0001 | 86 | FAC06539 | FAC065-My General Health Is Improving | FAACT V4 | ADDITIONAL CONCERNS |
|
|
| NOT DONE |
|
| 2 |
|
| 87 | 6 | 6 | Y | 1 | 2015-05-15 | -P7D | 47 | STUDYX | QS | 2324-P0001 | 4787 | FAC01547FAC06540 | FAC015FAC065-Social/Family Physical Subscale Score | FACT-HEP FAACT V4 | 22.2 | 22.2 | 22.2 | Y | 1 | 2015-05-15 |
|
|
|
| NOT DONE |
|
| 2 |
|
| 88 | -P7D | 48 | STUDYX | QS | 2324-P0001 | 4888 | FAC01548FAC06541 | FAC015FAC065-Emotional Social/Family Subscale Score | FACT-HEP FAACT V4 |
|
|
|
| 9NOT DONE9 |
|
| 2 |
|
| 989 | YSTUDYX | 1QS | 2015-05-15 | 2324-P0001 | 89 | FAC06542 | FAC065-Emotional Subscale Score | FAACT V4 |
|
|
|
| NOT DONE |
|
| 2 |
|
| 90 | -P7D | 49 | STUDYX | QS | 2324-P0001 | 4990 | FAC01549FAC06543 | FAC015FAC065-Functional Subscale Score | FACT-HEP V4 | 16 | 16 | 16 | Y | 1 | 2015-05-15 | -P7D | FAACT V4 |
|
|
|
| NOT DONE |
|
| 2 |
|
| 9150 | STUDYX | QS | 2324-P0001 | 5091 | FAC01550FAC06544 | FAC015FAC065-Additional Concern Subscale Score | FACT-HEP FAACT V4 |
|
|
|
| 22NOT DONE | 22 | 22 | Y | 1 | 2015-05-15 | -P7D | 51 |
|
| 2 |
|
| 92 | STUDYX | QS | 2324-P0001 | 5192 | FAC01551FAC06545 | FAC015FAC065-Trial Outcome Index Score | FACT-HEP FAACT V4 |
|
|
|
| YNOT DONE | 1 | 2015-05-15 | -P7D | 52 |
|
| 2 |
|
| 93 | STUDYX | QS | 2324-P0001 | 5293 | FAC01552FAC06546 | FAC015FAC065-FACT-G Total ScoreFACT-HEP | FAACT V4 |
|
|
|
| YNOT DONE | 1 | 2015-05-15 | -P7D | 53 |
|
| 2 |
|
| 94 | STUDYX | QS | 2324-P0001 | 5394 | FAC01553FAC06547 | FAC015FAC065-Total Score | FACT-HEP FAACT V4 |
|
|
|
| YNOT DONE | 1 | 2015-05-15 | -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.
QSSCAT | QSTESTCD |
---|
PHYSICAL WELL-BEING | FAC01501 FAC06501 - FAC01507FAC06507 |
SOCIAL/FAMILY WELL-BEING | FAC01508 FAC06508 - FAC01514FAC06514 |
EMOTIONAL WELL-BEING | FAC01515 FAC06515 - FAC01520FAC06520 |
FUNCTIONAL WELL-BEING | FAC01521 FAC06521 - FAC01527FAC06527 |
ADDITIONAL CONCERNS | FAC01528 FAC06528 - FAC01545FAC06539 |
All QSTESTCDs
QSORRES | QSSTRESC | QSSTRESN |
---|
Not at all | 0 | 0 |
A little bit | 1 | 1 |
Somewhat | 2 | 2 |
Quite a bit | 3 | 3 |
Very much | 4 | 4 |
End of Document