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title | Information for Reviewers |
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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. |
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Title | Columbia-Suicide Severity Rating Scale Baseline Version 1/14/2009 (C-SSRS BASELINE) |
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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 | Approved |
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Team | CDISC Questionnaires, Ratings, and Scales (QRS) Subteam |
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Supplement Version | 12.30 |
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Status | REVISION DRAFTFINAL |
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Date | 20222023-0802-1127 |
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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
| Known Issue | - The concept of “conditional branching” in QRS instruments is when the instrument directs the subject to another item of the instrument based on the result of a response compare for a given condition. This concept was reviewed with the CDISC standards teams and it was agreed to use this term instead of “logically skipped item” moving forward for this QRS instrument use case. A new QRS variable named “QSCBRFL” with the description of “Conditional Branched Item Indicator” has been requested for release in SDTMIG v4.0. This new variable will streamline the data representation of conditional branched items.
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Revision History
Date | Version | Summary of Changes |
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2023-02-27 | 2.0 | - Converted the supplement to the current WIKI QRS supplement template.
- Updated the annotated CRF per MSG V2.0 guidelines, including:
- Changing QSEVLINT to QSEVINTX for the Evaluation Interval Text of "LIFETIME"
- Adding annotations for QSSTRESC/QSSTRESN wherever applicable
- Added the first assumption to include details on every item of the instrument.
- The QSEVAL assumption and variable was removed from this supplement since it is not captured on the CRF and no assumptions are made on the potential values.
- Added assumptions 4, 5, and 6 for conditional branching. The example was updated to include records for these items.
- Added QSLOBXFL variable to the example to represent a baseline response for visit 1.
- Added example to represent skipped visit (VISITNUM = 2).
- Section 4, SDTM Mapping Strategy: Added an additional column in the table for "Most Recent Attempt", "Most Lethal Attempt, and "Initial/First Attempt" (QSTESTCD = "CSS0121B", "CSS0122B", and "CSS0123B") to indicate CRF text over 200 characters.
- Added example for SUPPQS dataset.
- Added Section 5, Supplemental Qualifier Name Codes.
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2014-09-03 | 1.2 |
Date | Version | Summary of Changes |
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2021-09-22 | 1.3 Draft | - Converted the supplement to the current WIKI QRS supplement template.
- Annotated CRF updated to the MSG V2.0 annotation guidelines, including following updates:
a. Change of QSEVLINT to QSEVINTX for the Evaluation Interval Text of "LIFETIME" b. Added annotations for QSSTRESC/QSSTRESN wherever applicable - Added the first assumption to include details on every item of the instrument.
- The QSEVAL and QSEVALID assumption and variables were removed from this supplement since it is not captured on the CRF and no assumptions are made on the potential values.
- Added assumptions 4, 5 and 6 for conditional branching. The example was updated to include records for these items.
- Added QSLOBXFL variable to the example to represent a baseline response for visit 1
- Added example to represent skipped visit (VISITNUM = 2)
- Added QSDRVFL variable to the example to represent items not done due to conditional branching.
- Section 4 (SDTM mapping strategy): Added an additional column in the table for "Most Recent Attempt", "Most Lethal Attempt" and "Initial/First Attempt" (QSTESTCD = "CSS0121B", "CSS0122B", and "CSS0123B") to indicate CRF Text over 200 characters
- Added example for SUPPQS dataset
- Added section 5 Supplemental Qualifier Name Codes.
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2014-09-03 | 1.2 | Columbia-Suicide Severity Rating Scale Baseline (C-SSRS BASELINE) Revised:
Updated references to QSCAT and questionnaire name throughout the document.Section 3.1: Assumption # 2 – Evaluation Interval mapped to QSEVINTX (from EVLINTTX).Section 3.2: Updated text above example table. Example table updated to include QSEVINTX in the QS table. Removed the SUPPQS.xpt table.Section 4: (SDTM Mapping Strategy) for QSTESTCD=CSS0111.
Old value: Completely to end or stop pain
New value: Completely to end or stop the pain2013-02-06 | 1.1 | Columbia-Suicide Severity Rating Scale Baseline (C-SSRS BASELINE) Revised: - QSSCAT added to be compatible with all CSSR-S questionnaires
- QSTPT replaced with QNAM=EVLINTTX to be compatible with all CSSR-S questionnaires using evaluation intervals
- Corrected "Dose not apply", associated with the Most Severe Ideation, Reasons on page 9 to "Does not apply".
- Added QS terminology reference
- Updated references to QSCAT and questionnaire name throughout the document.
- Section 3.1: Assumption # 2 – Evaluation Interval mapped to QSEVINTX (from EVLINTTX).
- Section 3.2: Updated text above example table. Example table updated to include QSEVINTX in the QS table. Removed the SUPPQS.xpt table.
- Section 4: (SDTM Mapping Strategy) for QSTESTCD=CSS0111.
- Old value: Completely to end or stop pain
- New value: Completely to end or stop the pain
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2013-02-06 | 1.1 | 2012-08-07 | 1.0 | Columbia-Suicide Severity Rating Scale Baseline (C-SSRS BASELINE) ReleasedRevised: - QSSCAT added to be compatible with all CSSR-S questionnaires
- QSTPT replaced with QNAM=EVLINTTX to be compatible with all CSSR-S questionnaires using evaluation intervals
- Corrected "Dose not apply", associated with the Most Severe Ideation, Reasons on page 9 to "Does not apply".
- Added QS terminology reference
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2012-08-07 | 1.0 | Columbia-Suicide Severity Rating Scale Baseline (C-SSRS BASELINE) Released |
2012-2012-03-03 | 0.1 | Columbia-Suicide Severity Rating Scale Baseline (C-SSRS BASELINE) Draft |
© 2021 2023 Clinical Data Interchange Standards Consortium, Inc. All rights reserved.
1 Introduction
This document describes the CDISC implementation of the Columbiathe Columbia-Suicide Severity Rating Scale Baseline Version 1/14/2009 (C-SSRS BASELINE) instrument.
CDISC does not modify questionnaires, ratings, and scales (QRS) instruments 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.
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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
The Research Foundation for Mental Hygiene, Inc. owns the copyright for the C-SSRS BASELINE instrument BASELINE instrument and has granted CDISC permission to include this supplement in the CDISC inventory of QRS data standards supplements. Hence Hence, CDISC developed QSTESTCD developed QSTESTCD and QSTEST for 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. |
No part of the C-SSRS BASELINE Version 1/14/2009 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 The Research Foundation for Mental Hygiene, Inc. and payment of any applicable fees. Copyright 2008 The Research Foundation for Mental Hygiene, Inc. All rights reserved.
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.
Note: CDISC Controlled Terminology is maintained by National Cancer Institute (NCI) Enterprise Vocabulary Services (EVS). 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 The Research Foundation for Mental Hygiene, Inc. for for the approval to include the C-SSRS BASELINE in BASELINE in the CDISC data standards.
Reference for the C-SSRS BASELINE:
- (C-SSRS) Since Last Visit Version Baseline 1/14/2009 (Posner, K.; Brent, D.; Lucas, C.; Gould, M.; Stanley, B.; Brown, G.; Fisher, P.; Zelazny, J.; Burke, A.; Oquendo, M.; Mann, J.; copyright 2008 The Research Foundation for Mental Hygiene, Inc.)
- No part of the C-SSRS SINCE LAST VISIT Version 1/14/2009 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 The Research Foundation for Mental Hygiene, Inc. and payment of any applicable fees. Copyright 2008 The Research Foundation for Mental Hygiene, Inc. All rights reserved.
3 The QS Domain Model
3.1 Assumptions for the QS Domain Model
3 The QS Domain Model
3.1 Assumptions for the QS Domain Model
All assumptions and business rules described All assumptions and business rules described in the SDTMIG QS domain are applicable to this supplement. Additional assumptions specific to the Cthe C-SSRS BASELINE are listed below.
The C-SSRS SINCE LAST VISIT is BASELINE is a suicidal ideation rating scale. It 's a is a standard questionnaire administered on a CRF that is typically used in clinical trials to identify subjects at risk for suicidal ideation and behavior.
- The questionnaire is divided into 3 sections namely : Suicidal Ideation, Intensity of Ideation, and Suicidal Behavior.
- The first section, "SUICIDAL IDEATION"Suicidal Ideation, contains 5 items (.
- QSTESTCD = "
CSS0201- CSS0101" - "
CSS0205- CSS0105"
) - with QSORRES = "Yes" or "No" and QSSTRESC = "Y" or "N".
- If QSORRES = "Yes", then descriptions
are represented in items - provided for QSTESTCD = "CSS0101A" - "CSS0105A" are represented in QSORRES and QSSTRESC. QSSTRESN is null for these items.
- The second section "INTENSITY OF IDEATION" , Intensity of Ideation, contains 6 items (.
- QSTESTCD = "CSS0106"
- "CSS0111") - is rating the most severe ideation with responses represented with a numeric
score (either "0-5" or "- score (1-5
"- )
and associated descriptive text. If "Most Severe - in QSORRES, QSSTRESC, and QSSTRESN.
- "Description of Ideation" (QSTESTCD = "
CSS0106- CSS0106A") is
present, "Description of Ideation" (QSTESTCD = "CSS0106A") is collected as - collected as free text.
For - For this section of the C-SSRS BASELINE, QSORRES and QSSTRESC are represented with the text description. QSSTRESN is null for this item.
- For QSTESTCD = "CSS0107" - "CSS0108", the scale points include a numeric rating (1-5) and a definition of what is represented by the rating (e.g., 1 = "Less than once a week"). QSORRES is populated with the text description
while - ; the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN.
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- For QSTESTCD = "CSS0109" - "CSS0111", the scale points include a numeric rating (0-5) and a definition of what is represented by the rating (e.g., 0 = "Does not attempt to control thoughts"). QSORRES is populated with the text description; the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN.
- The third section, Suicidal Behavior, contains 7 items.The third section, "SUICIDAL BEHAVIOR" contains 7 items (
- QSTESTCD = "CSS0112", "CSS0114", "CSS0115", "CSS0117", and "CSS0119"
, and "CSS0120") with QSORRES = "- with QSORRES = "Yes" or "No" and QSSTRESC = "Y" or "N". QSSTRESN is null.
- If QSORRES = "Yes", then descriptions
are represented in items - provided for QSTESTCD = "CSS0113A", "CSS0116A", "CSS0118A", and "CSS0119A" are represented in QSORRES and QSSTRESC. QSSTRESN is null for these items.
- For QSTESTCD = "CSS0120" QSORRES = "Yes" or "No" and QSSTRESC = "Y" or "N". QSSTRESN is null for these items.
A - "Total # of Attempts" (QSTESTCD = "CSS0113"), "Total # of interrupted" (QSTESTCD = "CSS0116") and "Total # of aborted" (QSTESTCD = "CSS0118") is
collected - represented in QSORRES, QSSTRESC, and QSSTRESN.
- The section "Answer for Actual Attempts Only" contains the following:
- "Most Recent Attempt Date" (CSS0121A), "Most Lethal Attempt Date" (QSTESTCD = "CSS0122A"), and "Initial/First Attempt Date" (CSS0123A)
collected - are represented in QSORRES and QSSTRESC and should be in ISO 8601 format.
- "Actual Lethality/Medical Damage" for "Most Recent Attempt", "Most Lethal Attempt" and "Initial/First Attempt"
- (QSTESTCD = "CSS0121B", "CSS0122B", and "CSS0123B"), and "Potential Lethality" (QSTESTCD = "CSS0121C", "CSS0122C", and "CSS0123C") are represented with a numeric score (either "0-5" or "0-2", respectively) and descriptive text. For this section of the C-SSRS BASELINE, QSORRES is populated with the text description
while - ; the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN.
- The time period of evaluation for the C-SSRS BASELINE is populated in the QSEVINTX field as an evaluation interval text value, since it cannot be precisely described as an ISO 8601 duration. The evaluation interval for the C-SSRS BASELINE is "Lifetime: Time He/She Felt Most SuicidalLIFETIME" (QSEVINTX = "LIFETIME").
- Items are divided into 3 subcategories represented in QSSCAT: "SUICIDAL IDEATION", "INTENSITY OF IDEATION", and "SUICIDAL BEHAVIOR".
- Some items on the C-SSRS BASELINE may be not done due to conditional branching. Items determined for conditional branching in the Cthe C-SSRS BASELINE are as follows:
- If QSTESTCD = "CSS0101" and "CSS0102" have QSORRES = "No", then the logic branches to QSTESTCD = "CSS0112" and QSTESTCD = "CSS0103" - "CSS010111" will not be done.
- If QSTESTCD = "CSS0101" has QSORRES ="Yes" and QSTESTCD = "CSS0102" has QSORRES = "No", then the logic branches to QSTESTCD = "CSS0112CSS0106" and QSTESTCD = "CSS0103" - "CSS0111CSS0105A" will not be done.
- Items QSTESTCD = "CSS0101A" - "CSS0105A" are only completed when the response to the preceding items (QSTESTCD = "CSS0101" - "CSS0105") is "Yes"; otherwise they are not done.
- If QSTESTCD = "CSS0112" has QSORRES = "No", then the logic branches to QSTESTCD = "CSS0114" and QSTESTCD = "CSS0113", "CSS0113A", "CSS0121A", "CSS0121B", "CSS0121C", "CSS0122A", "CSS0122B", "CSS0122C", and "CSS0123A", "CSS0123B", "CSS0123C", will not be done.
- If QSTESTCD = "CSS0115" has QSORRES = "No", then the logic branches to QSTESTCD = "CSS0117" and QSTESTCD = "CSS0116", and "CSS0116A" will not be done.
- If QSTESTCD = "CSS0117" has QSORRES = "No", then the logic branches to QSTESTCD = "CSS0119" and QSTESTCD = "CSS0118", and "CSS0118A" will not be done.
- If QSTESTCD = "CSS0119" has QSORRES = "No", then the logic branches to QSTESTCD = "CSS0120", and QSTESTCD = "CSS0119A" will not be done.
- If QSTESTCD = "CSS0121B", "CSS0122B", and "CSS0123B" have QSORRES QSSTRESC = "1", "2", "3", "4", or "5", then QSTESTCD = "CSS0121C", "CSS0122C", and "CSS0123C" will not be done.
A derived record is created and a QS supplemental qualifier variable is used to indicate an item was conditionally branched. When When an item is not done due to conditional branching, it is represented as follows:
QSDRVFL = "Y".
QNAM = “QSCBRFL”, QLABEL = “Conditional Branched Item Indicator “, QVAL = “Y” . (This is a QS supplemental qualifier variable.)
QSSTAT = "NOT DONE", and QSREASND is missing
- QSORRES, QSSTRESC, and QSSTRESN are set to null (missing)
- Records are created in qs.xpt for every item on the sponsor's version of the instrument.
- For items not done due to conditional branching, refer to assumptions 4 and 5.
- In the unexpected situation where the reason is unknown, then QSORRES, QSSTRESC and QSSTRESN are all missing, QSSTAT = "NOT DONE", and QSREASND is missing.
Some responses to the C-SSRS SINCE LAST VISITBASELINE items exceeded the 200-character limit for the QSORRES variable and needed to be reduced to fewer than 200 characters. Section 4, SDTM Mapping Strategy, indicates which item responses were revised in order to fit the 200-character limit.
Terminology
QSCAT, QSTESTCD, and QSTEST values QSTEST values are included in CDISC Controlled Terminology.
A full list of value sets for the qualifier, timing, and result fields result fields is provided in Section 4, SDTM Mapping Strategy.
3.2 Example for the C-SSRS BASELINE QS Domain Model
The CThe C-SSRS BASELINE example below shows the terminology used to implement the instrument in the QS domainthe QS domain. This example shows the data for 1 subject collected at the baseline visit and baseline (v1) and another subject at baseline (v1) and visit 2 for the C2 for the C-SSRS BASELINE instrumentBASELINE instrument. The example uses CDISC Controlled Terminology for QSTESTCDfor QSTESTCD, QSTEST, and QSCAT. All All original results, matching the CRF item response text, are represented in QSORRES. This in QSORRES. This result is then represented as a standard numeric score in QSSTRESN and in QSSTRESN and as a standard character representation in QSSTRESC. When in QSSTRESC. When a result is character only, the result is transformed into the standard character representation in QSSTRESC and QSSTRESN is null.
The table represents the items from the C-SSRS BASELINE instrumentBASELINE instrument.
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| qs.xpt | rowcapsRows 5-6: | Represent the conditional branching on data entry where Suicidal Ideation-No Intent is "No" and the associated description is missing. | Rows 9-10: | Represent the conditional branching on data entry where Ideation With Plan/Intent is "No" and the associated description is missing. | Rows 28-29: | Represent the conditional branching on data entry where Preparatory Acts/Behavior is "No" and the associated description is missing. | Rows 32-33 | -34: | Represent the conditional branching on data entry where Most | Lethal Recent Attempt Damage is " | 4 Lethal Recent Attempt Potential is missing. | Rows | 404136: | Represent the conditional branching on data entry where | Wish to be Dead Most Lethal Attempt Damage is " | No the associated description Most Lethal Attempt Potential is missing. | Rows | 42-43:Represent the conditional branching on data entry where Non-Specific Suicidal Thought is "No" and the associated description is missing. | Rows 4440-56: | Represents items missing due to conditional branching from the items Wish to be Dead and Non-Specific Suicidal Thought being "No". | Rows 57-59: | Represent the conditional branching on data entry where Actual Attempt is "No". The Number of Actual Attempts and the associated description are missing. | Rows 61-63: | Represent the conditional branching on data entry where Interrupted Attempt is "No". The Number of Interrupted Attempts and the associated description are missing. | Rows 64-66: | Represents items missing due to Represent the conditional branching | from on data entry where Aborted Attempt is "No". The Number of Aborted | Attempts Attempt and the associated description are missing. | Rows 70-78: | Represents items missing due to conditional branching from Actual Attempt being "No". | Rows 79-117: | Show the subject was not evaluated on this instrument at visit 2. A record for each item on the instrument is created with a status of | ''". Since the reason for not completing the visit was not collected, no date is assumed for when the visit would have occurred. | |
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ROW | STUDYID | DOMAIN | USUBJID | QSSEQ | QSTESTCD | QSTEST | QSCAT | QSSCAT | QSORRES | QSSTRESC | QSSTRESN | QSSTAT | QSREASND | QSLOBXFL | VISITNUM | QSDTC | QSEVINTX | 1 | STUDYX | QS | 2324-P0001 | 1 | CSS0101 | CSS01-Wish to be Dead | C-SSRS BASELINE | SUICIDAL IDEATION | Yes | Y |
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| Y | 1 | 2022-08-19 | LIFETIME | 2 | STUDYX | QS | 2324-P0001 | 2 | CSS0101A | CSS01-Wish to be Dead, Describe | C-SSRS BASELINE | SUICIDAL IDEATION | Fall asleep and not wake up | Fall asleep and not wake up |
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| Y | 1 | 2022-08-19 | LIFETIME | 3 | STUDYX | QS | 2324-P0001 | 3 | CSS0102 | CSS01-Non-Specific Suicidal Thought | C-SSRS BASELINE | SUICIDAL IDEATION | Yes | Y |
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| Y | 1 | 2022-08-19 | LIFETIME | 4 | STUDYX | QS | 2324-P0001 | 4 | CSS0102A | CSS01-Non-Specific Suicid Thought, Descr | C-SSRS BASELINE | SUICIDAL IDEATION | I thought about taking an overdose but I never made a specific plan as to when | I thought about taking an overdose but I never made a specific plan as to when |
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| Y | 1 | 2022-08-19 | LIFETIME | 5 | STUDYX | QS | 2324-P0001 | 5 | CSS0103 | CSS01-Suicidal Ideation-No Intent | C-SSRS BASELINE | SUICIDAL IDEATION | No | N |
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| Y | 1 | 2022-08-19 | LIFETIME | 6 | STUDYX | QS | 2324-P0001 | 6 | CSS0103A | CSS01-Suicidal Ideation-No Intent, Descr | C-SSRS BASELINE | SUICIDAL IDEATION |
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| NOT DONE |
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| 1 | 2022-08-19 | LIFETIME | 7 | STUDYX | QS | 2324-P0001 | 7 | CSS0104 | CSS01-Ideation With Intent, No Plan | C-SSRS BASELINE | SUICIDAL IDEATION | Yes | Y |
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| Y | 1 | 2022-08-19 | LIFETIME | 8 | STUDYX | QS | 2324-P0001 | 8 | CSS0104A | CSS01-Ideation With Intent No Plan Descr | C-SSRS BASELINE | SUICIDAL IDEATION | I’ve thought about killing myself and how | I’ve thought about killing myself and how |
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| Y | 1 | 2022-08-19 | LIFETIME | 9 | STUDYX | QS | 2324-P0001 | 9 | CSS0105 | CSS01-Ideation With Plan/Intent | C-SSRS BASELINE | SUICIDAL IDEATION | No | N |
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| Y | 1 | 2022-08-19 | LIFETIME | 10 | STUDYX | QS | 2324-P0001 | 10 | CSS0105A | CSS01-Ideation With Plan/Intent, Descr | C-SSRS BASELINE | SUICIDAL IDEATION |
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| NOT DONE |
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| 1 | 2022-08-19 | LIFETIME | 11 |
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Row | STUDYID | DOMAIN | USUBJID | QSSEQ | QSTESTCD | QSTEST | QSCAT | QSSCAT | QSORRES | QSSTRESC | QSSTRESN | QSSTAT | QSREASND | QSLOBXFL | QSDRVFL | VISITNUM | QSDTC | QSEVINTX | 11CSS0101Wish to be DeadMost Severe Ideation | C-SSRS BASELINE | SUICIDAL YesY//2022BASELINE22CSS0101AWish to be Dead, DescribeMost Severe Ideation, Description | C-SSRS BASELINE | SUICIDAL Fall asleep and not wake up | Wish to be Dead | Wish to be Dead | Fall asleep and not wake up//2022BASELINE33CSS0102Non-Specific Suicidal ThoughtMost Severe Ideation, Frequency | C-SSRS BASELINE |
SUICIDAL IDEATION | Yes | INTENSITY OF IDEATION | Once a week | 2 | 2 | Y//2022BASELINE44CSS0102A-Non-Specific Suicid Thought, Descr-Most Severe Ideation, Duration | C-SSRS BASELINE |
SUICIDAL IDEATION | I thought about taking an overdose but I never made a specific plan as to when | I thought about taking an overdose but I never made a specific plan as to whenINTENSITY OF IDEATION | 4-8 hours/most of day | 4 | 4 |
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| Y | 1 | 2022-08 | //2022BASELINE55CSS0103Suicidal Ideation-No IntentMost Severe Ideation, Control | C-SSRS BASELINE | SUICIDAL No | Does not attempt to control thoughts | 0 | 0 | N//2022BASELINE66CSS0103ASuicidal -No Intent DescrDeterrents | C-SSRS BASELINE |
SUICIDAL IDEATION | NOT DONE | INTENSITY OF IDEATION | Does not apply | 0 | 0 | Y//2022BASELINE77CSS0104CSS0111 | CSS01-Most Severe Ideation | With Intent No PlanSUICIDAL Yes | Mostly to get attention, revenge or a reaction from others | 2 | 2 | Y//2022BASELINE88CSS0104AIdeation With Intent No Plan DescrActual Attempt | C-SSRS BASELINE | SUICIDAL | IDEATIONI’ve thought about killing myself and how | I’ve thought about killing myself and how//2022BASELINE99CSS0105Ideation With Plan/IntentNumber of Actual Attempts | C-SSRS BASELINE | SUICIDAL | IDEATIONNoN//2022BASELINE1010CSS0105AIdeation With Plan/Intent, DescrActual Attempt, Describe | C-SSRS BASELINE | SUICIDAL | IDEATIONNOT DONE | BEHAVIOR | To feel better | To feel better | Y//2022BASELINE1111CSS0106-Most Severe Ideation-Non-suicidal Self-injurious Behav | C-SSRS BASELINE |
INTENSITY OF IDEATION | 1 | 1 | 1//2022BASELINE1212CSS0106AMost Severe Ideation, DescriptionInterrupted Attempt | C-SSRS BASELINE |
INTENSITY OF IDEATION | Wish to be Dead | Wish to be Dead//2022BASELINE1313CSS0107Most Severe Ideation, FrequencyNumber of Interrupted Attempts | C-SSRS BASELINE |
INTENSITY OF IDEATION | Once a week | 2 | 2//2022BASELINE1414CSS0108Most Severe Ideation, DurationInterrupted Attempt, Describe | C-SSRS BASELINE |
INTENSITY OF IDEATION | 4-8 hours/most of day | 4 | SUICIDAL BEHAVIOR | Stopped from overdose | Stopped from overdose | 4//2022BASELINE1515CSS0109Most Severe Ideation, ControlAborted Attempt | C-SSRS BASELINE |
INTENSITY OF IDEATION | Does not attempt to control thoughts | 0 | 0 | SUICIDAL BEHAVIOR | Yes | Y |
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| Y | 1 | 2022-08 | //2022BASELINE1616CSS0110Most Severe Ideation, DeterrentsNumber of Aborted Attempts | C-SSRS BASELINE |
INTENSITY OF IDEATION | Does not apply | 0 | 0//2022BASELINE1717CSS0111Most Severe Ideation, ReasonsAborted Attempt, Describe | C-SSRS BASELINE |
INTENSITY OF IDEATION | Mostly to get attention, revenge or a reaction from others | 2 | SUICIDAL BEHAVIOR | Parent found my letters | Parent found my letters | 2//2022BASELINE1818CSS0112Actual AttemptPreparatory Acts/Behavior | C-SSRS BASELINE | SUICIDAL BEHAVIOR | YesY//2022BASELINE1919CSS0113Number of Actual AttemptsPreparatory Acts/Behavior, Descr | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
5 | 5 | 5 | Y | //2022BASELINE2020CSS0113AActual Attempt, DescribeSuicidal Behavior | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
To feel better | To feel better//2022BASELINE2121CSS0114 | CSS01-Non-suicidal Self-injurious BehavCSS0121A | CSS01-Most Recent Attempt Date | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
No | N//2022BASELINE2222CSS0115Interrupted Most Recent Attempt Damage | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
Yes | | Moderately severe physical damage; medical hospitalization and likely intensive care required | 3 | 3 | Y//2022BASELINE2323CSS0116Number of Interrupted AttemptsMost Recent Attempt Potential | C-SSRS BASELINE | SUICIDAL BEHAVIOR | 11 | Y | 1 | 08/19/2022 | BASELINE | 2424CSS0116AInterrupted , DescribeDate | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
Stopped from overdose | Stopped from overdose//2022BASELINE2525CSS0117Aborted Most Lethal Attempt Damage | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
Yes | Severe physical damage; medical hospitalization with intensive care required | 4 | 4 | Y//2022BASELINE2626CSS0118Number of Aborted AttemptsMost Lethal Attempt Potential | C-SSRS BASELINE |
SUICIDAL BEHAVIOR | 3 | 3 | 3 | | SUICIDAL BEHAVIOR |
|
|
| NOT DONE | Y//2022BASELINE2727CSS0118AAborted , DescribeDate | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
Parent found my letters | Parent found my letters//2022BASELINE2828CSS0119Preparatory Acts/BehaviorFirst Attempt Damage | C-SSRS BASELINE | SUICIDAL BEHAVIOR | No |
physical damage or very minor physical damage | 0 | 0 | N//2022BASELINE2929CSS0119A-Preparatory Acts/Behavior, Descr-First Attempt Potential | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
NOT DONE | Behavior not likely to result in injury | 0 | 0 | Y//2022BASELINE30P000130CSS0120Suicidal BehaviorWish to be Dead | C-SSRS BASELINE | SUICIDAL | BEHAVIORYesY08/19/2022 | BASELINE | 31P000131CSS0121AMost Recent Attempt DateWish to be Dead, Describe | C-SSRS BASELINE | SUICIDAL | BEHAVIOR2/14/2016 | Y | 1 | 08/19/2022 | BASELINE | IDEATION |
|
|
| NOT DONE |
|
| 1 | 2022-07-13 | LIFETIME | 42 | 32P000132CSS0121B-Most Recent Attempt Damage-Non-Specific Suicidal Thought | C-SSRS BASELINE | SUICIDAL | BEHAVIORModerately severe physical damage; medical hospitalization and likely intensive care required | 3 | 3 | Y | 08/19/2022 | BASELINE | IDEATION | No | N |
|
|
| Y | 1 | 2022-07-13 | LIFETIME | 43 | 33P000133CSS0121CMost Recent Attempt PotentialNon-Specific Suicid Thought, Descr | C-SSRS BASELINE | SUICIDAL | BEHAVIORBehavior likely to result in death despite available medical care | 2 | 2 | Y | 08/19/2022 | BASELINE | IDEATION |
|
|
| NOT DONE |
|
| 1 | 2022-07-13 | LIFETIME | 44 | 34P000134CSS0122AMost Lethal Attempt DateSuicidal Ideation-No Intent | C-SSRS BASELINE | SUICIDAL | BEHAVIOR12/31/2013 | Y08/19/2022 | BASELINE | 35 | STUDYX | QS | 2324-P0001 | 35 | CSS0122B | CSS01-Most Lethal Attempt Damage | C-SSRS BASELINE | SUICIDAL BEHAVIOR | Severe physical damage; medical hospitalization with intensive care required | 4 | 4 | Y | 08/19/2022 | BASELINE | 2022-07-13 | LIFETIME | 45 | … | QS | … | … | … | … | … | … | … | … | … | … | … | … | … | … | ... | 46 | 36P000136CSS0122C Lethal Attempt PotentialSevere Ideation, Reasons | C-SSRS BASELINE |
SUICIDAL BEHAVIOR | Behavior likely to result in death despite available medical care | 2 | 2 | Y | 08/19/2022 | BASELINE | INTENSITY OF IDEATION |
|
|
| NOT DONE |
|
| 1 | 2022-07-13 | LIFETIME | 47 | 37P000137CSS0123AFirst Date | C-SSRS BASELINE | SUICIDAL BEHAVIOR | 3/27/200908/19/2022 | BASELINE | 38P000138CSS0123BFirst Attempt DamageNumber of Actual Attempts | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
No physical damage or very minor physical damage | 0 | 0 | Y | 08/19/2022 | BASELINE |
|
|
| NOT DONE |
|
| 1 | 2022-07-13 | LIFETIME | 49 | 39P000139CSS0123CFirst Potential, Describe | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
Behavior not likely to result in injury | 0 | 0 | Y | 08/19/2022 | BASELINE |
|
|
| NOT DONE |
|
| 1 | 2022-07-13 | LIFETIME | 50 | 401CSS0101 | CSS01-Wish to be DeadCSS0114 | CSS01-Non-suicidal Self-injurious Behav | C-SSRS BASELINE | SUICIDAL | IDEATION//2022BASELINE412CSS0201AWish to be Dead, DescribeInterrupted Attempt | C-SSRS BASELINE | SUICIDAL | IDEATIONNOT DONEY//2022BASELINE423CSS0102Non-Specific Suicidal ThoughtNumber of Interrupted Attempts | C-SSRS BASELINE | SUICIDAL | IDEATIONNo | N | Y//2022BASELINE434CSS0102ANon-Specific Suicid Thought, DescrInterrupted Attempt, Describe | C-SSRS BASELINE | SUICIDAL | IDEATIONY | Y//2022BASELINE445CSS0103Suicidal Ideation-No IntentAborted Attempt | C-SSRS BASELINE | SUICIDAL | IDEATIONNOT DONEY//2022BASELINE | … | … | … | … | … | … | … | … | … | … | … | … | … | … | … | … | … | 5617CSS0111Most Severe Ideation, ReasonsNumber of Aborted Attempts | C-SSRS BASELINE | INTENSITY OF IDEATIONSUICIDAL BEHAVIOR |
|
|
| NOT DONE |
Y | Y//2022BASELINE5718CSS0112Actual Aborted Attempt, Describe | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
No | N | Y | //2022BASELINE5819CSS0113Number of Actual AttemptsPreparatory Acts/Behavior | C-SSRS BASELINE | SUICIDAL BEHAVIOR | NOT DONE//2022BASELINE5920CSS0113AActual Attempt, DescribePreparatory Acts/Behavior, Descr | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
NOT DONE | Bought pills, Bought a gun, suicide note | Bought pills, Bought a gun, suicide note | Y//2022BASELINE6021CSS0114Non-suicidal Self-injurious BehavSuicidal Behavior | C-SSRS BASELINE | SUICIDAL BEHAVIOR | NoN//2022BASELINE6122CSS0115Interrupted YMost Recent Attempt Date | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
No | N | //2022BASELINE6223CSS0116Number of Interrupted AttemptsMost Recent Attempt Damage | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
|
|
| NOT DONE |
Y | Y | 1 | 07/13/2022 | BASELINE | 6324CSS0116AInterrupted , DescribePotential | C-SSRS BASELINE | SUICIDAL | BEHAVIORY | Y/13/2022-13 | LIFETIME | 63 | … | QS | … | … | … | … | … | … | … | … | … | … | … | … | … | … | … | BASELINE25CSS0117Aborted First Attempt Potential | C-SSRS BASELINE | SUICIDAL BEHAVIOR |
No | N | Y | 1 | 07/13/2022 | BASELINE |
|
|
| NOT DONE |
|
| 1 |
|
| 65 | STUDYX | QS | 2324-P0002 | 26CSS0118Number of Aborted AttemptsWish to be Dead | C-SSRS BASELINE | SUICIDAL | BEHAVIORBASELINEY | Y | 1 | 07/13/2022 | 27CSS0118AAborted AttemptWish to be Dead, Describe | C-SSRS BASELINE | SUICIDAL | BEHAVIORBASELINEY | Y | 1 | 07/13/2022 | 28CSS0119Preparatory Acts/BehaviorNon-Specific Suicidal Thought | C-SSRS BASELINE | SUICIDAL | BEHAVIORYes | Y | Y | 1 | 07/13/2022 | BASELINE |
|
|
| NOT DONE |
|
| 2 |
|
| 68 | STUDYX | QS | 2324-P0002 | 29CSS0119APreparatory Acts/BehaviorNon-Specific Suicid Thought, Descr | C-SSRS BASELINE | SUICIDAL | BEHAVIORBought pills, Bought a gun, suicide note | Bought pills, Bought a gun, suicide note | Y | 1 | 07/13/2022 | BASELINE | IDEATION |
|
|
| NOT DONE |
|
| 2 |
|
| 69 | STUDYX | QS | 2324-P0002 | 30CSS0120 BehaviorIdeation-No Intent | C-SSRS BASELINE | SUICIDAL | BEHAVIORYes | Y | Y | 1 | 07/13/2022 | BASELINE | IDEATION |
|
|
| NOT DONE |
|
| 2 |
|
| 70 | … | QS | … | … | … | … | … | … | … | … | … | … | … | … | … |
|
| 71 | 7031CSS0121AMost Recent DatePotential | C-SSRS BASELINE | SUICIDAL | BEHAVIORY | Y | 1 | 07/13/2022 | BASELINE | 71 | STUDYX | QS | 2324-P0002 | 32 | CSS0121B | CSS01-Most Recent Attempt Damage | C-SSRS BASELINE | SUICIDAL BEHAVIOR | NOT DONE | Y | Y | 1 | 07/13/2022 | BASELINE |
|
|
The SUPPQS dataset shows the items in the QS dataset which have assigned responses due to conditional branching.
Dataset wrap |
---|
|
Dataset2 |
---|
| STUDYID | RDOMAIN | USUBJID | IDVAR | IDVARVAL | QNAM | QLABEL | QVAL | QORIG | STUDYX | QS | 2324-P0001 | QSSEQ | 6 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | 72P000233 | CSS0121C | CSS01-Most Recent Attempt Potential | C-SSRS BASELINE | SUICIDAL IDEATION | NOT DONE | Y | Y | 1 | 07/13/2022 | BASELINE | … | … | … | … | … | … | … | … | … | … | … | … | … | … | … | … | … | 78P0001 | QSSEQ | 10 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0001 | QSSEQ | 29 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0001 | QSSEQ | 33 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0001 | QSSEQ | 36 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0002 | 39CSS0123C | CSS01-First Attempt Potential | C-SSRS BASELINE | SUICIDAL BEHAVIOR | NOT DONE | Y | Y | 1 | 07/13/2022 | BASELINE | 2 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | 7940CSS0101 | CSS01-Wish to be Dead | C-SSRS BASELINE | SUICIDAL IDEATION | NOT DONE | 2 | 804 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0002 |
41 | CSS0201A | CSS01-Wish to be Dead, Describe | C-SSRS BASELINE | SUICIDAL IDEATION | NOT DONE | 2 | 81 | QSSEQ | 5 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | … | … | … | … |
| … | … | … | … | STUDYX | QS | 2324-P0002 | 42CSS0102 | CSS01-Non-Specific Suicidal Thought | C-SSRS BASELINE | SUICIDAL IDEATION | NOT DONE | 2 | 8217 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0002 |
43 | CSS0102A | CSS01-Non-Specific Suicid Thought, Descr | C-SSRS BASELINE | SUICIDAL IDEATION | NOT DONE | 2 | | QSSEQ | 19 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | 8344CSS0103 | CSS01-Suicidal Ideation-No Intent | C-SSRS BASELINE | SUICIDAL IDEATION | NOT DONE | 2 | 20 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0002 | QSSEQ | 23 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0002 | QSSEQ | 24 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED |
… | … | … | … | … | … | … | … | … | … | … | … | … | … | … | … | 117 | STUDYX | QS | 2324-P0002 | QSSEQ | 26 |
78 | CSS0123C | CSS01-First Attempt Potential | C-SSRS BASELINE | SUICIDAL BEHAVIOR | NOT DONE | 2 | |
|
The suppqs dataset shows the items in the qs dataset which have assigned responses (QSDRVFL = "Y") due to conditional branching.
QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0002 | QSSEQ | 27 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0002 | QSSEQ | 31 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0002 | QSSEQ | 32 | QSCBRFL | Conditional Branching Item Indicator | Y | ASSIGNED | STUDYX | QS | 2324-P0002 | QSSEQ | 33 | QSCBRFL | Conditional Branching Item Indicator | Y | |
|
|
Info |
---|
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. Dataset wrap |
---|
| STUDYID | RDOMAIN | USUBJID | IDVAR | IDVARVAL | QNAM | QLABEL | QVAL | QORIG |
---|
STUDYX | QS | P0001 | QSSEQ | Sequence number corresponding to row of qs.xpt that supplemental qualifier is needed for (e.g., 8) | Appropriate variable name to provide more information about data in qs.xpt, no more than 8 characters long (e.g., CONTACT). | Label for QNAM (e.g., Contact Type) | Value of QNAM variable ( e.g., SUBJECT VISIT) | CRF |
|
|
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 for the QS Domain Model, items on the C-SSRS BASELINE are grouped into subcategories. The following table
...
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.
...
...
QSTESTCD |
---|
SUICIDAL IDEATION |
...
CSS0101 - CSS0105A |
INTENSITY OF IDEATION | CSS0106 - CSS0111 |
SUICIDAL BEHAVIOR | CSS0112 - CSS0123C |
...
QSTESTCD = "CSS0106"
...
QSTEST = "CSS01-Most Severe Ideation"
...
...
...
...
QSTESTCD = "CSS0101"
...
QSTEST = "CSS01-Wish to be Dead"
...
QSTESTCD = "CSS0102"
...
QSTEST = "CSS01-Non-Specific Suicidal Thought"
...
QSTESTCD = "CSS0103"
...
QSTEST = "CSS01-Suicidal Ideation-No Intent"
...
QSTESTCD = "CSS0104"
...
QSTEST = "CSS01-Ideation With Intent, No Plan"
...
QSTESTCD = "CSS0105"
...
QSTEST = "CSS01-Ideation With Plan/Intent"
...
QSTESTCD = "CSS0112"
...
QSTEST = "CSS01-Actual Attempt"
...
QSTESTCD = "CSS0114"
...
QSTEST = "CSS01-Non-suicidal Self-injurious Behav"
...
QSTESTCD = "CSS0115"
...
QSTEST = "CSS01-Interrupted Attempt"
...
QSTESTCD = "CSS0117"
...
QSTEST = "CSS01-Aborted Attempt"
...
QSTESTCD = "CSS0119"
...
QSTEST = "CSS01-Preparatory Acts/Behavior"
...
QSTESTCD = "CSS0120"
...
QSTEST= "CSS01-Suicidal Behavior"
...
...
...
QSTESTCD = "CSS0107"
...
QSTEST = "CSS01-Most Severe Ideation, Frequency"
...
...
...
QSSTRESN |
---|
Less than once a week | 1 | 1 |
Once a week | 2 | 2 |
2-5 times in week | 3 | 3 |
Daily or almost daily | 4 | 4 |
Many times each day | 5 | 5 |
...
QSTESTCD = "CSS0108"
...
QSTEST = "CSS01-Most Severe Ideation, Duration"
...
...
...
QSSTRESN |
---|
Fleeting – few seconds or minutes | 1 | 1 |
Less than 1 hour/some of the time | 2 | 2 |
1-4 hours/a lot of time | 3 | 3 |
4-8 hours/most of day | 4 | 4 |
More than 8 hours/persistent or continuous | 5 | 5 |
...
QSTESTCD = "CSS0109"
...
QSTEST = "CSS01-Most Severe Ideation, Control"
...
...
...
QSSTRESN |
---|
Easily able to control thoughts | 1 | 1 |
Can control thoughts with little difficulty | 2 | 2 |
Can control thoughts with some difficulty | 3 | 3 |
Can control thoughts with a lot of difficulty | 4 | 4 |
Unable to control thoughts | 5 | 5 |
Does not attempt to control thoughts | 0 | 0 |
...
QSTESTCD = "CSS0110"
...
QSTEST = "CSS01-Most Severe Ideation, Deterrents"
...
...
...
QSSTRESN |
---|
Deterrents definitely stopped you from attempting suicide | 1 | 1 |
Deterrents probably stopped you | 2 | 2 |
Uncertain that deterrents stopped you | 3 | 3 |
Deterrents most likely did not stop you | 4 | 4 |
Deterrents definitely did not stop you | 5 | 5 |
Does not apply | 0 | 0 |
...
QSTESTCD = "CSS0111"
...
QSTEST = "CSS01-Most Severe Ideation, Reasons"
...
...
...
QSSTRESN |
---|
Completely to get attention, revenge or a reaction from others | 1 | 1 |
Mostly to get attention, revenge or a reaction from others | 2 | 2 |
Equally to get attention, revenge or a reaction from others and to end/stop the pain | 3 | 3 |
Mostly to end or stop the pain (you couldn’t go on living with the pain or how you were feeling) | 4 | 4 |
Completely to end or stop the pain (you couldn’t go on living with the pain or how you were feeling) | 5 | 5 |
Does not apply | 0 | 0 |
...
QSTESTCD = "CSS0121B"
...
QSTEST = "CSS01-Most Recent Attempt Damage"
...
QSTESTCD = "CSS0122B"
...
QSTEST = "CSS01-Most Lethal Attempt Damage"
...
QSTESTCD = "CSS0123B"
...
QSTEST = "CSS01-First Attempt Damage
...
...
--ORRES
...
--STRESC
...
--STRESN
...
C-SSRS SINCE LAST VISIT CRF Text over 200 characters | QSORRES Value | QSSTRESC | QSSTRESN |
---|
| No physical damage or very minor physical damage (e.g., surface scratches) | 0 | 0 |
| Minor physical damage (e.g., lethargic speech; first-degree burns; mild bleeding; sprains) | 1 | 1 |
| Moderate physical damage; medical attention needed (e.g., conscious but sleepy, somewhat responsive; second-degree burns; bleeding of major vessel) | 2 | 2 |
Moderately severe physical damage; medical hospitalization and likely intensive care required (e.g., comatose with reflexes intact; third-degree burns less than 20% of body; extensive blood loss but can recover; major fractures |
Moderately severe physical damage; medical hospitalization and likely intensive care required | 3 | 3 |
Severe physical damage; medical hospitalization with intensive care required (e.g., comatose without reflexes; third-degree burns over 20% of body; extensive blood loss with unstable vital signs; major damage to a vital area) | Severe physical damage; medical hospitalization with intensive care required | 4 | 4 |
| Death | 5 | 5 |
...
QSTESTCD = "CSS0121C"
...
QSTEST = "CSS01-Most Recent Attempt Potential"
...
QSTESTCD = "CSS0122C"
...
QSTEST = "CSS01-Most Lethal Attempt Potential"
...
QSTESTCD = "CSS0123C"
...
QSTEST = "CSS01-First Attempt Potential"
...
...
...
QSSTRESN |
---|
Behavior not likely to result in injury |
...
5 Supplemental Qualifier Name Codes
...
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.
| 0 | 0 |
Behavior likely to result in injury but not likely to cause death | 1 | 1 |
Behavior likely to result in death despite available medical care | 2 | 2 |
5 Supplemental Qualifier Name Codes
...
The following table contains additional standard name codes for use in the Supplement Qualifiers for Questionnaires the Questionnaires (SUPPQSSUPPQS) special purpose dataset.
Dataset wrap |
---|
|
QNAM | QLABEL | QVAL |
---|
QSCBRFL | Conditional Branching Item Indicator | Y | |
End of Document