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  • Arabic numerals (0, 1, 2, 3, etc.)are used to express numbers in most circumstances. Exceptions are the following: 
    • Numbers that begin a sentence, title, subtitle, or heading 
    • Common fractions 

    • Accepted usage such as idiomatic expressions and numbers used as pronouns 

    • Other uses of “one” in running text (e.g., when meaning "a")
    • Ordinals first through ninth
    • Numbers spelled out in quotes or published titles
  • ******ITEMS IN RED: Needs to be discussed with Steve/Dana.*******
  • Info
    titleInstructions on how to use this template
    Info
    titleInformation for Reviewers

    Text in black is part of the template used to create this document and is not under review. Please review the blue text; this text represents the changes made to the template that are specific to this QRS instrument.

    ...

    Chronic Respiratory Questionnaire - Self-Administered Standardized Format Follow-up Administration Version (CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION)

    ...

    CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION

    ...

    • 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

    ...

    • Converted the supplement to the current WIKI QRS supplement template.
    • Annotated CRF updated to the MSG V2.0 annotation guidelines
    • Removed the QSEVAL assumption and variables as this is not captured on the CRF and no assumptions are made on potential values.

    ...

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

    1 Introduction

    This document describes the CDISC implementation of the Chronic Respiratory Questionnaire - Self-Administered Standardized Format Follow-up Administration Version 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 representation of data collected for this instrument is based on the Study Data Tabulation Model Implementation Guide (SDTMIG) Questionnaires (QS) domain model, which can be found on the CDISC website at: https://www.cdisc.org/standards/foundational/sdtmig.

    These specific implementation details for this instrument are meant to be used in conjunction with the SDTMIG. All CDISC QRS documentation packages can be found on the CDISC website at: https://www.cdisc.org/standards/foundational/qrs.

    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.

    CDISC specifies how to structure the data that has been collected in a database, not what should be collected or how to conduct clinical assessments or implement protocols. CDISC disclaims any liability for your use 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

    McMaster University owns the copyright for the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION instrument and has granted CDISC permission to include this supplement in the CDISC inventory of QRS data standards supplements. McMaster University will distribute the CDISC supplement package to sponsors when they are approved to use this instrument.) 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.

    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 has developed this documentation at no cost to the copyright holder or any additional cost to users of the instrument beyond the normal license fees charged by the copyright holder.

    ...

    Reference for the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION:

    Info

    Notes on the use of quotation marks:

    • Use for text values of a Likert scale: e.g., ...with response options ranging from “never” to “daily."
    • Actual numbers of the scale (e.g., 0-3) do not appear in quotation marks while the definitions of these anchors (e.g., 5 = “I always fall asleep”) do.
    • Enclose values for variables within quotation marks (e.g., QSTESTCD = "IPA0102")

    3 The QS Domain Model

    3.1 Assumptions for the QS Domain Model

    All assumptions and business rules described in the SDTMIG QS domain are applicable to this supplement. Additional assumptions specific to the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION are listed below.

    The CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION is a multiple-choice instrument that clinicians may use to measure health-related quality of life (HRQL) in patients with chronic respiratory diseases.  It consists of 20 items with each item graded on a 7-point or 8-point Likert scale.

    ...

    The scale points include a numeric rating (1-7) and a definition of what is represented by the rating (e.g., 1 = "All of the time"). For the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION, QSORRES is populated with the text description while the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN.
           a.  The first 5 questions have a questionnaire choice of “8 = Not Done”. The result of “8” is included in QSSTRESC and QSSTRESN; however, the sponsor’s analysis plan should determine whether this value is considered a score for purposes of summary statistic calculations.

    ...

    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 the reason is known then that reason is represented in QSREASND (e.g., QSREASND = "PREFER NOT TO ANSWER"). If the reason is unknown, then QSSTAT = "NOT DONE" and QSREASND is missing.

    ...

    Terminology

    1. QSCAT, QSTESTCD, QSTEST, QSORRES, QSSTRESC, and QSSTRESN values are included in CDISC Controlled Terminology.

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

    3.2 Example for the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION QS Domain Model

    The CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION 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 CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION instrument. The example uses CDISC Controlled Terminology for QSTESTCD, QSTEST, and QSCATAll original results, matching the CRF item response text, are represented in QSORRES. When there are numeric results, then use this sentence next, "This result is then represented as a standard numeric score in QSSTRESN and as a standard character representation in QSSTRESC." When the results are character only, then use these sentences next, "This result is then transformed into the standard character representation in QSSTRESC. QSSTRESN is null as there are no standardized numeric results for this instrument."

    ...

    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:

    ...

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

    ...

    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.

    ...

    Nameqs

    ...

    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.

    ...

    Namesuppqs

    ...

    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.

    Info

    Include mappings for all sets of result values. For ease of use of this template, the complete set of response values for the example in Section 3.2 is not included.

    If the instrument has been entered into QRS Maker (all instruments should be), then the complete set of response values can be copied from QRS Maker and pasted into this supplement.

    Some example mappings are below.

    ...

    For QRS instruments with subcategories:

    When subcategories are used on an instrument, a table with the following introduction information should appear before the mappings for results.

    QSSCAT alignment with QSTESTCD

    As stated in Section 3.1 assumptions, items on the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION are grouped into subcategories. The 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.

    ...

    Info
    titleFor public domain instrument's published QRS responses
    • If this is a public domain instrument that has an individual item with published QRS responses, include the following sentence above the—TESTCDs listed with their responses.

      • The controlled response terminology for the tests below is named QSTESTCDOR for the variable RSORRES and QSTESTCDSTR for the variables RSSTRESN and RSSTTRESC.

    • If this is a public domain instrument with published QRS responses, include the following sentence above the—TESTCDs listed with their responses.
      • The controlled response terminology for the tests below is named QSTESTCDTXXXOR for the variable RSORRES and QSTESTCDTXXXTSTR for the variables RSSTRESN and RSSTTRESC.

    ...

    If all items have the same original result values, with the same standardized character and numeric values, then only include one table showing the values of QSORRES/QSSTRESC/QSSTRESN and put "All QSTESTCDs" (title case "All", and in quotes) above the table:

    "All QSTESTCDs"

    ...

    Similarly, if some, but not all, QSTESTCDs share the same original result and standardized values, then the QSTESTCD and corresponding QSTEST values are put in a list above the table rather than providing a separate table for each QSTESTCD/QSTEST.

    Info
    titleFor public domain instrument's published QRS responses

    If this is a public domain instrument with published QRS responses, include the following sentence above the—TESTCDs listed with their responses. This approach used the CDISC QRS CT instrument's SYNONYM as part of the codelist name.

    The controlled response terminology for the tests below is named SYNONYMSET1OR for the variable RSORRES and SYNONYMSET1STR for the variables RSSTRESN and RSSTTRESC.

    ...

    If there are responses that correspond to non-consecutive items or 1-7 consecutive items, include the test codes and test names above the table with the responses as follows:

    QSTESTCD = "test code 1" QSTEST = "test name 1"

    QSTESTCD = "test code 4" QSTEST = "test name 4"

    QSTESTCD = "test code 5" QSTEST = "test name 5"

    QSTESTCD = "test code 6" QSTEST = "test name 6"

    QSTESTCD = "test code 7" QSTEST = "test name 7"

    QSTESTCD = "test code 8" QSTEST = "test name 8"

    QSTESTCD = "test code 15" QSTEST = "test name 15"

    QSTESTCD = "test code 22" QSTEST = "test name 22"

    QSTESTCD = "test code 27" QSTEST = "test name 27"

    QSTESTCD = "test code 29" QSTEST = "test name 29"

    Information for Reviewers

    Text in black is part of the template used to create this document and is not under review. Please review the blue text; this text represents the changes made to the template that are specific to this QRS instrument.

    Page properties
    Title

    Chronic Respiratory Questionnaire - Self-Administered Standardized Format Follow-up Administration Version (CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION)

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

    CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION

    QRS Permission StatusAuthor Permission Required
    TeamCDISC Questionnaires, Ratings, and Scales (QRS) Subteam
    Supplement Version2.0
    StatusREVISION DRAFT
    Date2023-04-13
    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

    DateVersionSummary of Changes

    2023-04-13

    2.0
    • Converted the supplement to the current WIKI QRS supplement template.
    • Annotated CRF updated to the MSG V2.0 annotation guidelines
    • Copyright Status section was updated based on the latest Memorandum of Understanding signed between McMaster
      University and CDISC.
    • Reference for the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION was updated to retain only the valid hyperlinks.
    • Updated the assumption to clarify that the CRQ-SAS First Administration consists of 20 items with each item graded on a 7-point or 8-point Likert scale.
    • Updated assumption 1.a to specify users need to follow the scoring solution in their approved copyright permission when the result is“8 = Not Done”.
    • Removed the QSEVAL assumption and variables as this is not captured on the CRF and no assumptions are made on potential values.
    • An additional subject was added to the data example to show how missing data is handled when the instrument was not completed.
    2015-02-181.0Initial Final Version

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

    1 Introduction

    This document describes the CDISC implementation of the Chronic Respiratory Questionnaire - Self-Administered Standardized Format Follow-up Administration Version 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 representation of data collected for this instrument is based on the Study Data Tabulation Model Implementation Guide (SDTMIG) Questionnaires (QS) domain model, which can be found on the CDISC website at: https://www.cdisc.org/standards/foundational/sdtmig.

    These specific implementation details for this instrument are meant to be used in conjunction with the SDTMIG. All CDISC QRS documentation packages can be found on the CDISC website at: https://www.cdisc.org/standards/foundational/qrs.

    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.

    CDISC specifies how to structure the data that has been collected in a database, not what should be collected or how to conduct clinical assessments or protocols. CDISC disclaims any liability for your use of this material.

    2 Copyright Status

    McMaster University owns the copyright for the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION instrument and has granted CDISC permission to include this supplement in the CDISC inventory of QRS data standards supplements. McMaster University will distribute the CDISC supplement package to sponsors when they are approved to use this instrument. Hence, CDISC developed QSTESTCD and QSTEST for each item based on the actual text on the instrument.

    The “Chronic Respiratory Disease Questionnaire Self-Administered Standardized (CRQ-SAS)”, authored by Drs. Gordon Guyatt and Holger Schünemann, was made under license from McMaster University, Hamilton, Canada (Copyright ©2001, McMaster University). The CRQ-SAS is provided under license from McMaster University and may not be copied, distributed or used in any way without the prior written consent of McMaster University. Contact the McMaster Industry Liaison Office at: milo@mcmaster.ca for licensing details

    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.org/standards/terminology/controlled-terminology.

    CDISC has developed this documentation at no cost to the copyright holder or any additional cost to users of the instrument beyond the normal license fees charged by the copyright holder.

    CDISC acknowledges Gay Yuyitung, Executive Director, McMaster University, Hamilton, Ontario, Canada for the approval to include the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION in the CDISC data standards.

    Reference for the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION:

    3 The QS Domain Model

    3.1 Assumptions for the QS Domain Model

    All assumptions and business rules described in the SDTMIG QS domain are applicable to this supplement. Additional assumptions specific to the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION are listed below.

    The CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION is a multiple-choice instrument that clinicians may use to measure health-related quality of life (HRQL) in patients with chronic respiratory diseases.  It consists of 20 items with each item graded on a 7-point or 8-point Likert scale.

    1. The scale points include a numeric rating (1-7) and a definition of what is represented by the rating (e.g., 1 = "All of the time"). For the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION, QSORRES is populated with the text description while the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN.
             a.  The first 5 questions have a questionnaire choice of “8 = Not Done”. The result of “8” is included in QSSTRESC and QSSTRESN; however, users need to follow the scoring Solution in their approved copyright permission.

    2. The time period of evaluation for theCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION is populated in the QSEVLINTfield in ISO 8601 format when the evaluation interval can be precisely described as duration. The evaluation interval for the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION is the LAST 2 WEEKS (QSEVLINT = "-P2W").

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

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

      2. Due to the variability of copyright holder and public domain derived score generation processes, records are not included for derived subscores or total scores that are not provided.
    4. Terminology

      1. QSCAT, QSTESTCD, QSTEST, QSORRES, QSSTRESC, and QSSTRESN values are included in CDISC Controlled Terminology.

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

    3.2 Example for the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION QS Domain Model

    The CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION example below shows the terminology used to implement the instrument in the QS domain. This example shows the data for 1 subject collected at visit 3 and visit 4 for the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION 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.


    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.


    The table represents the items from the CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION instrument. Rows 21-40 show the subject was not evaluated on this instrument at visit 4. A record for each item on the instrument is created with a status of "NOT DONE". Since the reason for not completing the visit was not collected, no date is assumed for when the visit would have occurred. 

    Dataset wrap
    Nameqs
    Dataset2
    RowSTUDYIDDOMAINUSUBJIDQSSEQQSTESTCDQSTESTQSCATQSORRESQSSTRESCQSSTRESNQSSTATVISITNUMQSDTCQSEVLINT
    1STUDYXQS2324-P00011CRQ0201CRQ02-Feeling EmotionalCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONExtremely short of breath11
    32022-05-15-P2W
    2STUDYXQS2324-P00012CRQ0202CRQ02-Take Care of Basic NeedsCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONVery short of breath22
    32022-05-15-P2W
    3STUDYXQS2324-P00013CRQ0203CRQ02-WalkingCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONModerate shortness of breath44
    32022-05-15-P2W
    4STUDYXQS2324-P00014CRQ0204CRQ02-Performing ChoresCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONNot at all short of breath77
    32022-05-15-P2W
    5STUDYXQS2324-P00015CRQ0205CRQ02-Participate in Social ActivitiesCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONNot Done88
    32022-05-15-P2W
    6STUDYXQS2324-P00016CRQ0206CRQ02-Felt Frustrated or ImpatientCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONA good bit of the time33
    32022-05-15-P2W
    7STUDYXQS2324-P00017CRQ0207CRQ02-Feeling of Fear or PanicCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONSome of the time44
    32022-05-15-P2W
    8STUDYXQS2324-P00018CRQ0208CRQ02-FatigueCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONExtremely tired11
    32022-05-15-P2W
    9STUDYXQS2324-P00019CRQ0209CRQ02-Embarrassed by CoughingCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONA little of the time55
    32022-05-15-P2W
    10STUDYXQS2324-P000110CRQ0210CRQ02-Confident to Deal With IllnessCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONA little of the time22
    32022-05-15-P2W
    11STUDYXQS2324-P000111CRQ0211CRQ02-EnergyCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONFull of energy77
    32022-05-15-P2W
    12STUDYXQS2324-P000112CRQ0212CRQ02-Feel Upset, Worried or DepressedCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONHardly any of the time66
    32022-05-15-P2W
    13STUDYXQS2324-P000113CRQ0213CRQ02-Control of Breathing ProblemsCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONMost of the time55
    32022-05-15-P2W
    14STUDYXQS2324-P000114CRQ0214CRQ02-Feel Relaxed and Free of TensionCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONA good bit of the time44
    32022-05-15-P2W
    15STUDYXQS2324-P000115CRQ0215CRQ02-Felt Low in EnergyCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONA good bit of the time33
    32022-05-15-P2W
    16STUDYXQS2324-P000116CRQ0216CRQ02-Felt Discouraged or DownCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONMost of the time22
    32022-05-15-P2W
    17STUDYXQS2324-P000117CRQ0217CRQ02-Felt Worn Out or SluggishCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONAll of the time11
    32022-05-15-P2W
    18STUDYXQS2324-P000118CRQ0218CRQ02-Happy, Satisfied or PleasedCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONHappy most of the time55
    32022-05-15-P2W
    19STUDYXQS2324-P000119CRQ0219CRQ02-Feel Upset Diff Getting BreathCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONMost of the time22
    32022-05-15-P2W
    20STUDYXQS2324-P000120CRQ0220CRQ02-Felt Restless, Tense or UptightCRQ-SAS FOLLOW-UP ADMINISTRATION VERSIONSome of the time44
    32022-05-15-P2W
    21STUDYXQS2324-P000121CRQ0201CRQ02-Feeling EmotionalCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    22STUDYXQS2324-P000122CRQ0202CRQ02-Take Care of Basic NeedsCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    23STUDYXQS2324-P000123CRQ0203CRQ02-WalkingCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    24STUDYXQS2324-P000124CRQ0204CRQ02-Performing ChoresCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    25STUDYXQS2324-P000125CRQ0205CRQ02-Participate in Social ActivitiesCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    26STUDYXQS2324-P000126CRQ0206CRQ02-Felt Frustrated or ImpatientCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    27STUDYXQS2324-P000127CRQ0207CRQ02-Feeling of Fear or PanicCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    28STUDYXQS2324-P000128CRQ0208CRQ02-FatigueCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    29STUDYXQS2324-P000129CRQ0209CRQ02-Embarrassed by CoughingCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    30STUDYXQS2324-P000130CRQ0210CRQ02-Confident to Deal With IllnessCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    31STUDYXQS2324-P000131CRQ0211CRQ02-EnergyCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    32STUDYXQS2324-P000132CRQ0212CRQ02-Feel Upset, Worried or DepressedCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    33STUDYXQS2324-P000133CRQ0213CRQ02-Control of Breathing ProblemsCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    34STUDYXQS2324-P000134CRQ0214CRQ02-Feel Relaxed and Free of TensionCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    35STUDYXQS2324-P000135CRQ0215CRQ02-Felt Low in EnergyCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    36STUDYXQS2324-P000136CRQ0216CRQ02-Felt Discouraged or DownCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    37STUDYXQS2324-P000137CRQ0217CRQ02-Felt Worn Out or SluggishCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    38STUDYXQS2324-P000138CRQ0218CRQ02-Happy, Satisfied or PleasedCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    39STUDYXQS2324-P000139CRQ0219CRQ02-Feel Upset Diff Getting BreathCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4

    40STUDYXQS2324-P000140CRQ0220CRQ02-Felt Restless, Tense or UptightCRQ-SAS FOLLOW-UP ADMINISTRATION VERSION


    NOT DONE4


    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.


    QSTESTCD = "CRQ0201" QSTEST = "CRQ02-Feeling Emotional"

    QSTESTCD = "CRQ0202" QSTEST = "CRQ02-Take Care of Basic Needs"

    QSTESTCD = "CRQ0203" QSTEST = "CRQ02-Walking"

    QSTESTCD = "CRQ0204" QSTEST = "CRQ02-Performing Chores"

    QSTESTCD = "CRQ0205" QSTEST = "CRQ02-Participate in Social Activities"

    QSORRES

    QSSTRESC

    QSSTRESN

    Extremely short of breath11
    Very short of breath22
    Quite a bit short of breath33
    Moderate shortness of breath44
    Some shortness of breath55
    A little shortness of breath66
    Not at all short of breath77
    Not Done88

    QSTESTCD = "CRQ0206" QSTEST = "CRQ02-Felt Frustrated or Impatient"

    QSTESTCD = "CRQ0207" QSTEST = "CRQ02-Feeling of Fear or Panic"

    QSTESTCD = "CRQ0209" QSTEST = "CRQ02-Embarrassed by Coughing"

    QSTESTCD = "CRQ0212" QSTEST = "CRQ02-Feel Upset, Worried or Depressed"

    QSTESTCD = "CRQ0215" QSTEST = "CRQ02-Felt Low in Energy"

    QSTESTCD = "CRQ0216" QSTEST = "CRQ02-Felt Discouraged or Down"

    QSTESTCD = "CRQ0217" QSTEST = "CRQ02-Felt Worn Out or Sluggish"

    QSTESTCD = "CRQ0219" QSTEST = "CRQ02-Feel Upset Diff Getting Breath"

    QSTESTCD = "CRQ0220" QSTEST = "CRQ02-Felt Restless, Tense or Uptight"

    QSORRES

    QSSTRESC

    QSSTRESN

    All of the time11
    Most of the time22
    A good bit of the time33
    Some of the time44
    A little of the time55
    Hardly any of the time66
    None of the time77

    QSTESTCD = "CRQ0208" QSTEST = "CRQ02-Fatigue"

    QSORRES

    QSSTRESC

    QSSTRESN

    Extremely tired11
    Very tired22
    Quite a bit of tiredness33
    Moderately tired44
    Somewhat tired55
    A little tired66
    Not at all tired77

    QSTESTCD = "CRQ0210" QSTEST = "CRQ02-Confident to Deal With Illness"

    QSTESTCD = "CRQ0213" QSTEST = "CRQ02-Control of Breathing Problems"

    QSTESTCD = "CRQ0214" QSTEST = "CRQ02-Feel Relaxed and Free of Tension"

    QSORRES

    QSSTRESC

    QSSTRESN

    None of the time11
    A little of the time22
    Some of the time33
    A good bit of the time44
    Most of the time55
    Almost all of the time66
    All of the time77

    QSTESTCD = "CRQ0211" QSTEST = "CRQ02-Energy"

    QSORRES

    QSSTRESC

    QSSTRESN

    No energy at all11
    A little energy22
    Some energy33
    Moderately energetic44
    Quite a bit of energy55
    Very energetic66
    Full of energy77

    QSTESTCD = "CRQ0218" QSTEST = "CRQ02-Happy, Satisfied or Pleased"

    QSORRES

    QSSTRESC

    QSSTRESN

    Very dissatisfied, unhappy most of the time11
    Generally dissatisfied, unhappy22
    Somewhat dissatisfied, unhappy33
    Generally satisfied, pleased44
    Happy most of the time55
    Very happy most of the time66
    Extremely happy, could not be more satisfied or pleased77

    ...

    Omit the QSSTRESN column when it is not applicable to the dataset.

    QSTESTCD = "test code" QSTEST = "test name"

    ...

    Info
    titleFor public domain instrument's published QRS responses

    If this is a public domain instrument with published QRS responses, include the following sentence above the—TESTCDs listed with their responses.

      • The controlled response terminology for the tests below is named QSTESTCDTXXXOR for the variable RSORRES and QSTESTCDTXXXTSTR for the variables RSSTRESN and RSSTTRESC.

    ...

    For responses that are for 8 or more consecutive items, an override label should be used in QRS Maker to show the items that are included as follows:

    QSTESTCD = "first test code in sequence" QSTEST = "first test name in sequence" through

    QSTESTCD = "last test code in sequence" QSTEST = "last test name in sequence"

    ...

    5 Supplemental Qualifier Name Codes

    Info

    The instrument used as an example in this template did not require supplemental qualifiers, but this section has been included to provide guidance on those instruments which do require supplemental qualifiers. (Many instruments do not require it.) Text that always will be in the section when it is included has been left black.

    Additional rows will be required in the suppqs.xpt dataset for each supplemental qualifier needed.

    Remove Section 5 if it does not apply to the new instrument.

    The following table contains additional standard name codes for use in the Supplement Qualifiers for Questionnaires (SUPPQS) special purpose dataset.

    ...

    Namesuppqs

    ...


    End of Document