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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.

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Title

Columbia-Suicide Severity Rating Scale Baseline Version 1/14/2009 (C-SSRS BASELINE)

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

C-SSRS BASELINE

QRS Permission StatusApproved
TeamCDISC Questionnaires, Ratings, and Scales (QRS) Subteam
Supplement Version2.0
StatusREVISION DRAFTFINAL
Date20222023-0802-1127
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

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.


Revision History

DateVersionSummary of Changes
2023-02-272.0 
  • 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
DateVersionSummary of Changes
2022-08-222.0 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 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)
  • 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 text over 200 characters.
  • Added example for SUPPQS dataset.
  • Added section Section 5, Supplemental Qualifier Name Codes.
2014-09-031.2

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 pain
2013-02-061.1

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
2012-08-071.0

Columbia-Suicide Severity Rating Scale Baseline (C-SSRS BASELINE) Released

2012-03-030.1Columbia-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.

...

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.

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

.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.

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 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.

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. owns the copyright for the C-SSRS BASELINE 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 instrumentAll 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. 

...

titleInformation for Reviewers

...

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

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 BASELINE 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. 

  1. The questionnaire is divided into 3 sections namely : Suicidal Ideation, Intensity of Ideation and Suicidal Behavior.of Ideation, and Suicidal Behavior.
    1. The first section, Suicidal Ideation, contains 5 items.
      1. QSTESTCD = "CSS0101" - "CSS0105" with QSORRES = "Yes" or "No" and QSSTRESC = "Y" or "N".
        1. If QSORRES = "Yes", then descriptions provided for QSTESTCD = "CSS0101A" - "CSS0105A" are represented in QSORRES and QSSTRESC. QSSTRESN is null for these items.
    2. The second section, Intensity of Ideation, contains 6
    3. The first section, "SUICIDAL IDEATION", contains 5 items.
      1. QSTESTCD = "CSS0101" - "CSS0105" with QSORRES = "Yes" or "No" and QSSTRESC = "Y" or "N".
        1. If QSORRES = "Yes", then descriptions provided for QSTESTCD = "CSS0101A" - "CSS0105A" are represented in QSORRES and QSSTRESC. QSSTRESN is null for these items.
    4. The second section "INTENSITY OF IDEATION" contains 6 items.
      1. QSTESTCD = "CSS0106" is rating the most severe ideation with responses represented with a numeric score (1-5) in QSORRES, QSSTRESC, and QSSTRESN.
        1. "Description of Ideation" (QSTESTCD = "CSS0106A") is collected as free text. For this section of the C-SSRS BASELINE, QSORRES and QSSTRESC are represented with the text description.
      1. CSS0106" is rating the most severe ideation with responses represented with a numeric score (1-5) in QSORRES, QSSTRESC, and QSSTRESN.
        1. "Description of Ideation" (QSTESTCD = "CSS0106A") is collected as free text. For this section of the C-SSRS BASELINE, QSORRES and QSSTRESC are represented with the text description. QSSTRESN is null for this item.
      2. 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; the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN.  
      3. 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.
    5. The third section, Suicidal Behavior, contains 7 items.The third section, "SUICIDAL BEHAVIOR" contains 7 items (
        1. QSTESTCD = "CSS0112", "CSS0114", "CSS0115", "CSS0117", and "CSS0119"
        , and "CSS0120")
        1. with QSORRES = "Yes" or "No" and QSSTRESC = "Y" or "N". QSSTRESN is null.
          1. If QSORRES = "Yes", then descriptions provided for QSTESTCD = "CSS0113A", "CSS0116A", "CSS0118A", and "CSS0119A" are represented in QSORRES and QSSTRESC. QSSTRESN is null for these items.
        2. For QSTESTCD =
        "CSS0113A", "CSS0116A", "CSS0118A", and "CSS0119A". QSSTRESN
        1. "CSS0120" QSORRES = "Yes" or "No" and QSSTRESC = "Y" or "N". QSSTRESN is null for these items.
        A
        1. "Total # of Attempts" (QSTESTCD = "CSS0113"), "Total # of interrupted" (QSTESTCD = "CSS0116") and "Total # of aborted" (QSTESTCD = "CSS0118") is
        collected
        1. represented in QSORRES, QSSTRESC, and QSSTRESN.
        2. The section "Answer for Actual Attempts Only" contains the following:
          1. "Most Recent Attempt Date" (CSS0121A), "Most Lethal Attempt Date" (QSTESTCD = "CSS0122A"), and "Initial/First Attempt Date" (CSS0123A)
        collected
          1. are represented in QSORRES and QSSTRESC and should be in ISO 8601 format.
          2. "Actual Lethality/Medical Damage" for "Most Recent Attempt", "Most Lethal Attempt" and "Initial/First Attempt"
         
          1. (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
          1. ; the numeric rating is represented in the standardized character and numeric result variables QSSTRESC and QSSTRESN.
    6. 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" (QSEVINTX = "LIFETIME").
    7. Items are divided into 3 subcategories represented in QSSCAT: "SUICIDAL IDEATION", "INTENSITY OF IDEATION", and "SUICIDAL BEHAVIOR".
    8. Some items on the C-SSRS BASELINE may be not done due to conditional branching. Items determined for conditional branching in the C-SSRS BASELINE are as follows:the C-SSRS BASELINE are as follows:
      1. If QSTESTCD = "CSS0101" and "CSS0102" have QSORRES = "No", then the logic branches to QSTESTCD = "CSS0112" and QSTESTCD = "CSS0103" - "CSS010111" will not be done.
      2. If QSTESTCD = "CSS0101" has QSORRES ="Yes" and QSTESTCD = "CSS0102" have has QSORRES = "No", then the logic branches to QSTESTCD   = "CSS0112CSS0106" and QSTESTCD = "CSS0103" - "CSS0111CSS0105A" will not be done.
      3. Items QSTESTCD = "CSS0101A" - "CSS0105A" are only completed when the response to the preceding items (QSTESTCD = "CSS0101" - "CSS0105") is "Yes"; otherwise they are not done.
      4. 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.
      5. If QSTESTCD = "CSS0115" has QSORRES = "No", then the logic branches to QSTESTCD = "CSS0117" and QSTESTCD = "CSS0116", and "CSS0116A" will not be done.
      6. If QSTESTCD = "CSS0117" has QSORRES =  "No", then the logic branches to QSTESTCD = "CSS0119" and QSTESTCD = "CSS0118", and "CSS0118A" will not be done.
      7. If QSTESTCD = "CSS0119" has QSORRES =  "No", then the logic branches to QSTESTCD = "CSS0120", and QSTESTCD = "CSS0119A" will not be done.
      8. 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.
    9. 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:

      1. QSDRVFL = "Y".

      2. QNAM = “QSCBRFL”, QLABEL = “Conditional Branched Item Indicator “, QVAL = “Y” . (This is a QS supplemental qualifier variable.)      

      3. QSSTAT = "NOT DONE", and QSREASND is missing

      4. QSORRES, QSSTRESC, and QSSTRESN are set to null (missing)
    10. Records are created in qs.xpt for every item on the sponsor's version of the instrument.
      1. For items not done due to conditional branching, refer to assumptions 4 and 5.
      2. In the unexpected situation where the reason is unknown, then QSORRES, QSSTRESC and QSSTRESN are all missing, QSSTAT = "NOT DONE", and QSREASND is missing.
    11. 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. 

    12. Terminology

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

      2. 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.

    Rows 28-29
    Dataset wrap
    Nameqs
    Dataset wrap
    Nameqs

    qs.xpt

    Rows 5-6
    Rows 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 11-12:Represent the QSORRES as "Wish to be Dead" when Most Severe Ideation is "1".
    :Represent the conditional branching on data entry where
    Preparatory Acts/Behavior
    Suicidal Ideation-No Intent is "No" and the associated description is missing.
    Row 33
    Rows 9-10:
    Represents items missing due to conditional branching from Most Recent Attempt Damage not being "0".
    Represent the conditional branching on data entry where Ideation With Plan/Intent is "No" and the associated description is missing.
    Rows 28-29
    Row 36:Represents items missing due to conditional branching from Most Lethal Attempt Damage not being "0".Rows 40-41
    :Represent the conditional branching on data entry where
    Wish to be Dead
    Preparatory Acts/Behavior is "No" and the associated description is missing.
    Rows
    42
    32-
    43
    33:Represent the conditional branching on data entry where
    Non-Specific Suicidal Thought is "No" and the associated description
    Most Recent Attempt Damage is "3" and Most Recent Attempt Potential is missing.
    Rows 35-36:Represent the conditional branching on data entry where Most Lethal Attempt Damage is "4" and Most Lethal Attempt Potential is missing.
    Rows
    44
    40-56: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

    '

    "NOT DONE

    '

    ". Since the reason for not completing the visit was not collected, no date is assumed for when the visit would have occurred. 

    Y
    Dataset2
    Row
    ROWSTUDYIDDOMAINUSUBJIDQSSEQQSTESTCDQSTESTQSCATQSSCATQSORRESQSSTRESCQSSTRESNQSSTATQSREASNDQSLOBXFL
    QSDRVFL
    VISITNUMQSDTCQSEVINTX
    1STUDYXQS2324-P00011CSS0101CSS01-Wish to be DeadC-SSRS BASELINESUICIDAL IDEATIONYesY


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    2STUDYXQS2324-P00012CSS0101ACSS01-Wish to be Dead, DescribeC-SSRS BASELINESUICIDAL IDEATIONFall asleep and not wake upFall asleep and not wake up


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    3STUDYXQS2324-P00013CSS0102CSS01-Non-Specific Suicidal ThoughtC-SSRS BASELINESUICIDAL IDEATIONYesY


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    4STUDYXQS2324-P00014CSS0102ACSS01-Non-Specific Suicid Thought, DescrC-SSRS BASELINESUICIDAL IDEATIONI thought about taking an overdose but I never made a specific plan as to whenI thought about taking an overdose but I never made a specific plan as to when


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    5STUDYXQS2324-P00015CSS0103CSS01-Suicidal Ideation-No IntentC-SSRS BASELINESUICIDAL IDEATIONNoN


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    6STUDYXQS2324-P00016CSS0103ACSS01-Suicidal Ideation-No Intent, DescrC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE
    Y


    12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    7STUDYXQS2324-P00017CSS0104CSS01-Ideation With Intent, No PlanC-SSRS BASELINESUICIDAL IDEATIONYesY


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    8STUDYXQS2324-P00018CSS0104ACSS01-Ideation With Intent No Plan DescrC-SSRS BASELINESUICIDAL IDEATIONI’ve thought about killing myself and howI’ve thought about killing myself and how


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    9STUDYXQS2324-P00019CSS0105CSS01-Ideation With Plan/IntentC-SSRS BASELINESUICIDAL IDEATIONNoN


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    10STUDYXQS2324-P000110CSS0105ACSS01-Ideation With Plan/Intent, DescrC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE
    YY


    12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    11STUDYXQS2324-P000111CSS0106CSS01-Most Severe IdeationC-SSRS BASELINEINTENSITY OF IDEATION111

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    12STUDYXQS2324-P000112CSS0106ACSS01-Most Severe Ideation, DescriptionC-SSRS BASELINEINTENSITY OF IDEATIONWish to be DeadWish to be Dead


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    13STUDYXQS2324-P000113CSS0107CSS01-Most Severe Ideation, FrequencyC-SSRS BASELINEINTENSITY OF IDEATIONOnce a week22

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    14STUDYXQS2324-P000114CSS0108CSS01-Most Severe Ideation, DurationC-SSRS BASELINEINTENSITY OF IDEATION4-8 hours/most of day44

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    15STUDYXQS2324-P000115CSS0109CSS01-Most Severe Ideation, ControlC-SSRS BASELINEINTENSITY OF IDEATIONDoes not attempt to control thoughts00

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    16STUDYXQS2324-P000116CSS0110CSS01-Most Severe Ideation, DeterrentsC-SSRS BASELINEINTENSITY OF IDEATIONDoes not apply00

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    17STUDYXQS2324-P000117CSS0111CSS01-Most Severe Ideation, ReasonsC-SSRS BASELINEINTENSITY OF IDEATIONMostly to get attention, revenge or a reaction from others22

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    18STUDYXQS2324-P000118CSS0112CSS01-Actual AttemptC-SSRS BASELINESUICIDAL BEHAVIORYesY


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    19STUDYXQS2324-P000119CSS0113CSS01-Number of Actual AttemptsC-SSRS BASELINESUICIDAL BEHAVIOR555

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    20STUDYXQS2324-P000120CSS0113ACSS01-Actual Attempt, DescribeC-SSRS BASELINESUICIDAL BEHAVIORTo feel betterTo feel better


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    21STUDYXQS2324-P000121CSS0114CSS01-Non-suicidal Self-injurious BehavC-SSRS BASELINESUICIDAL BEHAVIORNoN


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    22STUDYXQS2324-P000122CSS0115CSS01-Interrupted AttemptC-SSRS BASELINESUICIDAL BEHAVIORYesY


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    23STUDYXQS2324-P000123CSS0116CSS01-Number of Interrupted AttemptsC-SSRS BASELINESUICIDAL BEHAVIOR111

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    24STUDYXQS2324-P000124CSS0116ACSS01-Interrupted Attempt, DescribeC-SSRS BASELINESUICIDAL BEHAVIORStopped from overdoseStopped from overdose


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    25STUDYXQS2324-P000125CSS0117CSS01-Aborted AttemptC-SSRS BASELINESUICIDAL BEHAVIORYesY


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    26STUDYXQS2324-P000126CSS0118CSS01-Number of Aborted AttemptsC-SSRS BASELINESUICIDAL BEHAVIOR333

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    27STUDYXQS2324-P000127CSS0118ACSS01-Aborted Attempt, DescribeC-SSRS BASELINESUICIDAL BEHAVIORParent found my lettersParent found my letters


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    28STUDYXQS2324-P000128CSS0119CSS01-Preparatory Acts/BehaviorC-SSRS BASELINESUICIDAL BEHAVIORNoN


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    29STUDYXQS2324-P000129CSS0119ACSS01-Preparatory Acts/Behavior, DescrC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    YY


    12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    30STUDYXQS2324-P000130CSS0120CSS01-Suicidal BehaviorC-SSRS BASELINESUICIDAL BEHAVIORYesY


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    31STUDYXQS2324-P000131CSS0121ACSS01-Most Recent Attempt DateC-SSRS BASELINESUICIDAL BEHAVIOR
    2/14/2016
    2022-07-172022-07-17


    Y1
    2022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    32STUDYXQS2324-P000132CSS0121BCSS01-Most Recent Attempt DamageC-SSRS BASELINESUICIDAL BEHAVIORModerately severe physical damage; medical hospitalization and likely intensive care required33

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    33STUDYXQS2324-P000133CSS0121CCSS01-Most Recent Attempt PotentialC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    Y


    12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    34STUDYXQS2324-P000134CSS0122ACSS01-Most Lethal Attempt DateC-SSRS BASELINESUICIDAL BEHAVIOR2021-12-24
    12/31/2013
    2021-12-24


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    35STUDYXQS2324-P000135CSS0122BCSS01-Most Lethal Attempt DamageC-SSRS BASELINESUICIDAL BEHAVIORSevere physical damage; medical hospitalization with intensive care required44

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    36STUDYXQS2324-P000136CSS0122CCSS01-Most Lethal Attempt PotentialC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    Y


    12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    37STUDYXQS2324-P000137CSS0123ACSS01-First Attempt DateC-SSRS BASELINESUICIDAL BEHAVIOR
    3/27/2009
    2017-02-142017-02-14


    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    38STUDYXQS2324-P000138CSS0123BCSS01-First Attempt DamageC-SSRS BASELINESUICIDAL BEHAVIORNo physical damage or very minor physical damage00

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    39STUDYXQS2324-P000139CSS0123CCSS01-First Attempt PotentialC-SSRS BASELINESUICIDAL BEHAVIORBehavior not likely to result in injury00

    Y12022-08
    /
    -19
    /2022
    BASELINE
    LIFETIME
    40STUDYXQS2324-P00021CSS0101CSS01-Wish to be DeadC-SSRS BASELINESUICIDAL IDEATIONNoN


    Y12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    41STUDYXQS2324-P00022CSS0101ACSS01-Wish to be Dead, DescribeC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    42STUDYXQS2324-P00023CSS0102CSS01-Non-Specific Suicidal ThoughtC-SSRS BASELINESUICIDAL IDEATIONNoN


    Y12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    43STUDYXQS2324-P00024CSS0102ACSS01-Non-Specific Suicid Thought, DescrC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    44STUDYXQS2324-P00025CSS0103CSS01-Suicidal Ideation-No IntentC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    LIFETIME
    BASELINE
    45
    QS
    ...
    56
    46STUDYXQS2324-P000217CSS0111CSS01-Most Severe Ideation, ReasonsC-SSRS BASELINEINTENSITY OF IDEATION


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    57
    47STUDYXQS2324-P000218CSS0112CSS01-Actual AttemptC-SSRS BASELINESUICIDAL BEHAVIORNoN


    Y1
    2022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    58
    48STUDYXQS2324-P000219CSS0113CSS01-Number of Actual AttemptsC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    Y
    Y


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    59
    49STUDYXQS2324-P000220CSS0113ACSS01-Actual Attempt, DescribeC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    60
    50STUDYXQS2324-P000221CSS0114CSS01-Non-suicidal Self-injurious BehavC-SSRS BASELINESUICIDAL BEHAVIORNoN


    Y12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    61
    51STUDYXQS2324-P000222CSS0115CSS01-Interrupted AttemptC-SSRS BASELINESUICIDAL BEHAVIORNoN


    Y12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    62
    52STUDYXQS2324-P000223CSS0116CSS01-Number of Interrupted AttemptsC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    63
    53STUDYXQS2324-P000224CSS0116ACSS01-Interrupted Attempt, DescribeC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    64
    54STUDYXQS2324-P000225CSS0117CSS01-Aborted AttemptC-SSRS BASELINESUICIDAL BEHAVIORNoN


    Y12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    65
    55STUDYXQS2324-P000226CSS0118CSS01-Number of Aborted AttemptsC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    66
    56STUDYXQS2324-P000227CSS0118ACSS01-Aborted Attempt, DescribeC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    67
    57STUDYXQS2324-P000228CSS0119CSS01-Preparatory Acts/BehaviorC-SSRS BASELINESUICIDAL BEHAVIORYesY


    Y12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    68
    58STUDYXQS2324-P000229CSS0119ACSS01-Preparatory Acts/Behavior, DescrC-SSRS BASELINESUICIDAL BEHAVIORBought pills, Bought a gun, suicide noteBought pills, Bought a gun, suicide note


    Y12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    69
    59STUDYXQS2324-P000230CSS0120CSS01-Suicidal BehaviorC-SSRS BASELINESUICIDAL BEHAVIORYesY


    Y12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    70
    60STUDYXQS2324-P000231CSS0121ACSS01-Most Recent Attempt DateC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    Y
    Y


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    71
    61STUDYXQS2324-P000232CSS0121BCSS01-Most Recent Attempt DamageC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    BASELINE
    LIFETIME
    72
    62STUDYXQS2324-P000233CSS0121CCSS01-Most Recent Attempt PotentialC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE
    YY


    12022-07
    /
    -13
    /2022
    LIFETIME
    BASELINE
    63
    QS
    78
    64STUDYXQS2324-P000239CSS0123CCSS01-First Attempt PotentialC-SSRS BASELINESUICIDAL BEHAVIOR


    NOT DONE
    Y
    Y


    1
    07/13/2022BASELINE79


    65STUDYXQS2324-P000240CSS0101CSS01-Wish to be DeadC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE

    2
    80


    66STUDYXQS2324-P000241CSS0101ACSS01-Wish to be Dead, DescribeC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE

    2
    81


    67STUDYXQS2324-P000242CSS0102CSS01-Non-Specific Suicidal ThoughtC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE

    2
    82


    68STUDYXQS2324-P000243CSS0102ACSS01-Non-Specific Suicid Thought, DescrC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE

    2
    83


    69STUDYXQS2324-P000244CSS0103CSS01-Suicidal Ideation-No IntentC-SSRS BASELINESUICIDAL IDEATION


    NOT DONE

    2


    70
    QS
    117


    71STUDYXQS2324-P000278
    CSS0123C
    CSS0103CCSS01-First Attempt PotentialC-SSRS BASELINESUICIDAL
    BEHAVIOR
    IDEATION


    NOT DONE

    2



The suppqs dataset shows The SUPPQS dataset shows the items in the qs QS dataset which have assigned responses (QSDRVFL = "Y") due to conditional branching.

27
Dataset wrap
Namesuppqs
Dataset2
tableidsuppqs.xpt
STUDYIDRDOMAINUSUBJIDIDVARIDVARVALQNAMQLABELQVALQORIG
STUDYXQS2324-P0001QSSEQ6QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0001QSSEQ10QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0001QSSEQ29QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0001QSSEQ33QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0001QSSEQ36QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ2QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ4QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ5QSCBRFLConditional Branching Item IndicatorYASSIGNED

STUDYXQS2324-P0002QSSEQ17QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ19QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ20QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ23QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ24QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ26
QSCBRFLConditional Branching Item IndicatorYASSIGNEDSTUDYXQS2324-P0002QSSEQ
QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ
31
27QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ
32
31QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ
33
32QSCBRFLConditional Branching Item IndicatorYASSIGNED
STUDYXQS2324-P0002QSSEQ
39
33QSCBRFLConditional Branching Item IndicatorY

ASSIGNED

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 for the QS Domain Model, items on the C-SSRS BASELINE are grouped into subcategories. The following table below includes the subcategory names along with the applicable item numbers for each category. The values of the subcategories are used to populate QSSCAT and are annotated on the CRF.

QSSCATQSTESTCD
SUICIDAL IDEATIONQSSS0101 CSS0101 - CSS0105A
INTENSITY OF IDEATIONCSS0106 - CSS0111
SUICIDAL BEHAVIORCSS0112 - CSS0123C


QSTESTCD = "CSS0106" QSTEST = "CSS01-Most Severe Ideation"

QSORRES

QSSTRESC

QSSTRESN

111
222
333
444
555


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"

QSORRES

QSSTRESC

YesY
NoN


QSTESTCD = "CSS0107" QSTEST = "CSS01-Most Severe Ideation, Frequency"

QSORRES

QSSTRESC

QSSTRESN

Less than once a week11
Once a week22
2-5 times in week33
Daily or almost daily44
Many times each day55


QSTESTCD = "CSS0108" QSTEST = "CSS01-Most Severe Ideation, Duration"

QSORRES

QSSTRESC

QSSTRESN

Fleeting – few seconds or minutes11
Less than 1 hour/some of the time22
1-4 hours/a lot of time33
4-8 hours/most of day44
More than 8 hours/persistent or continuous55


QSTESTCD = "CSS0109" QSTEST = "CSS01-Most Severe Ideation, Control"

QSORRES

QSSTRESC

QSSTRESN

Easily able to control thoughts11
Can control thoughts with little difficulty22
Can control thoughts with some difficulty33
Can control thoughts with a lot of difficulty44
Unable to control thoughts55
Does not attempt to control thoughts00


QSTESTCD = "CSS0110" QSTEST = "CSS01-Most Severe Ideation, Deterrents"

QSORRES

QSSTRESC

QSSTRESN

Deterrents definitely stopped you from attempting suicide11
Deterrents probably stopped you22
Uncertain that deterrents stopped you33
Deterrents most likely did not stop you44
Deterrents definitely did not stop you55
Does not apply00


QSTESTCD = "CSS0111" QSTEST = "CSS01-Most Severe Ideation, Reasons"

QSORRES

QSSTRESC

QSSTRESN

Completely to get attention, revenge or a reaction from others11
Mostly to get attention, revenge or a reaction from others22
Equally to get attention, revenge or a reaction from others and to end/stop the pain33
Mostly to end or stop the pain (you couldn’t go on living with the pain or how you were feeling)44
Completely to end or stop the pain (you couldn’t go on living with the pain or how you were feeling)55
Does not apply00


QSTESTCD = "CSS0121B" QSTEST = "CSS01-Most Recent Attempt Damage"

QSTESTCD = "CSS0122B" QSTEST = "CSS01-Most Lethal Attempt Damage"

QSTESTCD = "CSS0123B" QSTEST = "CSS01-First Attempt Damage"QSTEST = "CSS01-First Attempt Damage

QSORRES

QSSTRESC

QSSTRESN

No physical damage or very minor physical damage00Minor physical damage11Moderate physical damage; medical attention needed22
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)00

Minor physical damage (e.g., lethargic speech; first-degree burns; mild bleeding; sprains)11

Moderate physical damage; medical attention needed (e.g., conscious but sleepy, somewhat responsive; second-degree burns; bleeding of major vessel)22
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 required33
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 required44

Death55


QSTESTCD = "CSS0121C" QSTEST = "CSS01-Most Recent Attempt Potential"

QSTESTCD = "CSS0122C" QSTEST = "CSS01-Most Lethal Attempt Potential"

QSTESTCD = "CSS0123C" QSTEST = "CSS01-First Attempt Potential"

QSORRES

QSSTRESC

QSSTRESN

Behavior not likely to result in injury00
Behavior likely to result in injury but not likely to cause death11
Behavior likely to result in death despite available medical care22


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
Namesuppqs
QNAMQLABELQVAL
QSCBRFLConditional Branching Item IndicatorY


End of Document