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titleTU Domain Definition and Scope

The Tumor/Lesion domains (TU, TR) represent data collected in clinical trials where sites of disease (e.g., tumors/lesions/locations of interest, lymph nodes, organs of interest in the assessment of the disease) are identified and then repeatedly measured/assessed at subsequent time points and often used in an evaluation of disease response(s).

Tumor/Lesion Identification (TU)


Dataset wrap
titlecv.xpt
NamePR


Dataset2


Row

STUDYID

DOMAIN

USUBJID

PRSEQ

PRTRT

VISIT

 1  ABCPR  ABC-4561TRANSTHORACIC ECHOCARDIOGRAPHYBASELINE




The below example shows examples show the identification of calcification in the mitral valve annulus as well as mitral valve stenosis (TU). It also shows mitral valve regurgitation . Technically,  regurgitation is not considered as a lesion, however it is the direct result of the lesion (mitral valve stenosis/narrowing and structural change, caused by the annular calcification). Should this be mapped to TU as well?  I suppose you could consider this as a site of disease, specifically locations of interest where you identify then repeatedly assess?

Agreed modeling approach allows us to represent the variety of lesions and abnormal findings associated with said lesions into TUORRES. It also allows us to represent other abnormal findings associated with that lesion.

(CV).

Dataset wrap
titlecv.xpt
NameTU


Rowcaps


Rows 1-3:Examination of the heart indicates calcified mitral valve annulus and mitral valve stenosis.
Rows 4-5:Examination of the heart indicates regurgitation at the mitral valve, blood is regurgitating from the left ventricle into the left atrium.



Dataset2


4

Row

STUDYID

DOMAIN

USUBJID

TUSEQTULNKIDTUTESTCD

TUTEST

TULOC

TUORRES

TUSTRESCTURESLOCTURESLOC Detail

TUMETHOD

VISITNUM

VISIT

TUDTC

1ABCTUABC-4561
LESIONIND

Lesion IndicatorPathological Finding Indicator

Abnormality Indicator

HEARTY


TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27
2ABCTUABC-4562mv calcification 1ABNEXAMExamination for AbnormalityHEARTValvular CalcificationValvular CalcificationMitral Valve Annulus
TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27
3ABCTUABC-4563mv stenosis 1ABNEXAMExamination for AbnormalityHEARTValvular StenosisValvular StenosisMitral Valve
TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27




Dataset wrap
titlecv.xpt
NameCV



Cardiac Valvular Regurgitation Indicator

Pathological Finding Indicator

Dataset2


Row

STUDYID

DOMAIN

USUBJID

CVSEQCVLNKIDCVTESTCD

CVTEST

CVLOC

CVORRES

CVSTRESCCVRESLOCCVRESLOC Detail

CVMETHOD

VISITNUM

VISIT

TUDTC

1ABC
TU
CVABC-456
4This is not a lesion so we can't use lesion indicator
1

Abnormality Indicator

Abnormality Indicator

HEARTY


TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27
5
2ABC
TU
CVABC-456
5
2
regurgitation  1
mv regurgitationABNEXAMExamination for AbnormalityHEARTBlood RegurgitationBlood RegurgitationMitral ValveFrom left ventricle into the left atriumTRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27

...




Alternatively modeling

...

all of the above in CV:

identified
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titlecv.xpt
NameTUcv


Rowcaps


Rows 1-24:I examined the TTE image Examination of the heart (test location) and found indicates calcified mitral valve annulus (result location)and mitral valve stenosis, as well as regurgitation.
Rows 35-48:Show the various measurements of the regurgitant jet, which are used for the MV regurgitation severity assessment in RS.
Rows 9-11:Examination of the heart indicates flail aortic cusp and aortic valve stenosis, as well as regurgitation.
Rows 5-8:Show the various measurements of the regurgitant jet, which are used for the MV regurgitation severity assessment in RSI examined the TTE image of the heart (test location) and found that the mitral valve (result location) had become stenotic.Rows 5-6:I examined the TTE image of the heart (test location) and regurgitation of blood in the mitral valve back into the left atrium.



TUMETHOD
Dataset2


Row

STUDYID

DOMAIN

USUBJID

TUSEQ

TUGRPID

TULNKID

TUTEST

TULOC

TUORRES

TURESLOCTURESLOC Detail

CVSEQCVLNKIDCVGRPIDCVTESTCD

CVTEST

CVLOC

CVORRES

CVSTRESCCVSTRESNCVRESLOCCVRESLOC Detail

CVMETHOD

VISITNUM

VISIT

TUDTC

CVDTC

1ABC
TU
CVABC-4561

ABNIND
1

Abnormality Indicator

CAL 1
HEART
Calcification Indicator
Y
HEART
YY

TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27
2ABC
TU
CVABC-4562
1CAL 1Calcification Location IdentificationHEART

mvABNEXAMExamination for AbnormalityHEARTValvular CalcificationValvular CalcificationValvular CalcificationMitral Valve Annulus
TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27
3ABC
TU
CVABC-4563
2STEN 1Cardiac Valvular Stenosis IndicatorHEART
1mvABNEXAMExamination for AbnormalityHEARTValvular StenosisValvular StenosisValvular StenosisMitral Valve
Y

TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27
4ABC
TU
CVABC-45642
STEN 1Cardiac Valvular Stenosis Location IdentificationHEARTidentified
mvABNEXAMExamination for AbnormalityHEARTBlood RegurgitationBlood RegurgitationBlood RegurgitationMitral ValveFrom left ventricle into the left atrium
Mitral Valve
TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27
5ABC
TU
CVABC-4565
3

av
REGUR 1Cardiac Valvular Regurgitation Indicator
ABNEXAMExamination for AbnormalityHEART
Flail CuspFlail CuspFlail Cusp

Aortic Valve, Right Coronary Cusp

Y


TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27
6ABC
TU
CVABC-45663
REGUR 1Cardiac Valvular Regurgitation Location IdentificationHEARTidentifiedMitral Valve
avABNEXAMExamination for AbnormalityHEARTValvular StenosisValvular StenosisValvular StenosisAortic Valve
TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27
7ABCCVABC-45674avABNEXAMExamination for AbnormalityHEARTBlood RegurgitationBlood RegurgitationBlood RegurgitationAortic ValveFrom aorta to left ventricle
Into the left atrium
TRANSTHORACIC ECHOCARDIOGRAPHY1BASELINE2020-04-27





The following example shows how to model severity assessments of the identified lesions and abnormalities based on peer-reviewed, validated and published instruments (either copyrighted or public domain). Note these tests were originally created as a CVTESTs, if users are using SDTMIG versions prior to 3.4.  Per SDTMIG 3.4, this is now considered as a grading scale and therefore should now be represented as CC/RS.

Dataset wrap
NameRS


Rowcaps


Row 1:Mitral valve stenosis is moderate.
Row 2:Mitral valve regurgitation is severemoderate.
Rows 3-4:Aortic valve regurgitation and stenosis are mild.



Dataset2


Row

STUDYID

DOMAIN

USUBJID

RSSEQRSLNKID

RSTEST

RSCAT

RSORRES

VISITNUM

VISIT

RSDTC

1ABCRS(CC)ABC-4561REGUR 1VSC-Cardiac Valvular Stenosis Severity: Mitral ValveVALVE STENOSIS CLASSIFICATION 2009 VERSIONModerate1BASELINE2020-04-27
2ABCRS(CC)ABC-4562STEN 12SNVRC-Cardiac Valvular Regurgitation Severity: Mitral ValveSEVERITY OF NATIVE VALVULAR REGURGITATION CLASSIFICATION 2003SevereModerate1BASELINE2020-04-27

The below example shows how to represent calcification severity from a sponsor defined criteria using the TR domain. The Mitral Valve Annulus identified in TU is severely calcified.

Severe
3ABCRS(CC)ABC-45633VSC-Cardiac Valvular Stenosis Severity: Aortic ValveVALVE STENOSIS CLASSIFICATION 2009 VERSIONMild1BASELINE2020-04-27
4ABCRS(CC)
Dataset wrap
NameTR
TR
Dataset2

Row

STUDYID

DOMAIN

USUBJID

RSSEQTRLNKID

TRTEST

TRCAT

TRORRES

VISITNUM

VISIT

RSDTC

1ABC
ABC-456
1
4
CAL 1Calcification SeveritySponsor-defined Criteria
4SNVRC-Cardiac Valvular Regurgitation Severity: Aortic ValveSEVERITY OF NATIVE VALVULAR REGURGITATION CLASSIFICATION 2003Mild1BASELINE2020-04-27






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