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title | Instructions on how to use this template |
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- ******ITEMS IN RED: Needs to be discussed with Team.*******
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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 | Chronic Respiratory Questionnaire - Self-Administered Standardized Format Follow-up Administration Version (CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION) |
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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 | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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QRS Permission Status | ApprovedAuthor Permission Required |
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Team | CDISC Questionnaires, Ratings, and Scales (QRS) Subteam |
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Supplement Version | 2.0 |
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Status | REVISION DRAFT |
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Date | 2023-0304-2313 |
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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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Date | Version | Summary of Changes |
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2023-0304-2313 | 2.0 | - Converted the supplement to the current WIKI QRS supplement template.
- Annotated CRF updated to the MSG V2.0 annotation guidelinesthe 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.
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2015-02-18 | 1.0 | Initial Final Version |
© 2023 Clinical Data Interchange Standards Consortium, Inc. All rights reserved.
This document describes the CDISC implementation of the Chronic Respiratory Questionnaire - Self-Administered Standardized Format Follow-up Administration Version instrument.
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The CDISC Intellectual Property Policy can be found on the CDISC website at: https://www.cdisc.org/about/bylaws.
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 instrumentor 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.
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- The Chronic Respiratory Questionnaire Self-Administered including the standardized Dyspnea Domain (CRQSAS), Principal authors G.H. Guyatt and Dr. H.J. Schunemann
- http://milo.mcmaster.ca/questionnaires/questionnaires
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845220/
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, users need to follow the scoring Solution in their approved copyright permission.
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").
Records Records are created in qs.xpt for for every collected item on the the instrument:
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.
- 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.
Terminology
QSCAT, QSTESTCD, QSTEST, QSORRES, QSSTRESC, and QSSTRESN values are included in CDISC Controlled Terminology.
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 QSCAT. All original results, matching the CRF item response text, are represented in QSORRES. This result is then represented as a standard numeric score in QSSTRESN and as a standard character representation in QSSTRESC.
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Dataset2 |
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Row | STUDYID | DOMAIN | USUBJID | QSSEQ | QSTESTCD | QSTEST | QSCAT | QSORRES | QSSTRESC | QSSTRESN | QSSTAT | VISITNUM | QSDTC | QSEVLINT |
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1 | STUDYX | QS | 2324-P0001 | 1 | CRQ0201 | CRQ02-Feeling Emotional | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Extremely short of breath | 1 | 1 |
| 3 | 2022-05-15 | -P2W | 2 | STUDYX | QS | 2324-P0001 | 2 | CRQ0202 | CRQ02-Take Care of Basic Needs | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Very short of breath | 2 | 2 |
| 3 | 2022-05-15 | -P2W | 3 | STUDYX | QS | 2324-P0001 | 3 | CRQ0203 | CRQ02-Walking | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Moderate shortness of breath | 4 | 4 |
| 3 | 2022-05-15 | -P2W | 4 | STUDYX | QS | 2324-P0001 | 4 | CRQ0204 | CRQ02-Performing Chores | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Not at all short of breath | 7 | 7 |
| 3 | 2022-05-15 | -P2W | 5 | STUDYX | QS | 2324-P0001 | 5 | CRQ0205 | CRQ02-Participate in Social Activities | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Not Done | 8 | 8 |
| 3 | 2022-05-15 | -P2W | 6 | STUDYX | QS | 2324-P0001 | 6 | CRQ0206 | CRQ02-Felt Frustrated or Impatient | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | A good bit of the time | 3 | 3 |
| 3 | 2022-05-15 | -P2W | 7 | STUDYX | QS | 2324-P0001 | 7 | CRQ0207 | CRQ02-Feeling of Fear or Panic | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Some of the time | 4 | 4 |
| 3 | 2022-05-15 | -P2W | 8 | STUDYX | QS | 2324-P0001 | 8 | CRQ0208 | CRQ02-Fatigue | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Extremely tired | 1 | 1 |
| 3 | 2022-05-15 | -P2W | 9 | STUDYX | QS | 2324-P0001 | 9 | CRQ0209 | CRQ02-Embarrassed by Coughing | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | A little of the time | 5 | 5 |
| 3 | 2022-05-15 | -P2W | 10 | STUDYX | QS | 2324-P0001 | 10 | CRQ0210 | CRQ02-Confident to Deal With Illness | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | A little of the time | 2 | 2 |
| 3 | 2022-05-15 | -P2W | 11 | STUDYX | QS | 2324-P0001 | 11 | CRQ0211 | CRQ02-Energy | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Full of energy | 7 | 7 |
| 3 | 2022-05-15 | -P2W | 12 | STUDYX | QS | 2324-P0001 | 12 | CRQ0212 | CRQ02-Feel Upset, Worried or Depressed | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Hardly any of the time | 6 | 6 |
| 3 | 2022-05-15 | -P2W | 13 | STUDYX | QS | 2324-P0001 | 13 | CRQ0213 | CRQ02-Control of Breathing Problems | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Most of the time | 5 | 5 |
| 3 | 2022-05-15 | -P2W | 14 | STUDYX | QS | 2324-P0001 | 14 | CRQ0214 | CRQ02-Feel Relaxed and Free of Tension | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | A good bit of the time | 4 | 4 |
| 3 | 2022-05-15 | -P2W | 15 | STUDYX | QS | 2324-P0001 | 15 | CRQ0215 | CRQ02-Felt Low in Energy | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | A good bit of the time | 3 | 3 |
| 3 | 2022-05-15 | -P2W | 16 | STUDYX | QS | 2324-P0001 | 16 | CRQ0216 | CRQ02-Felt Discouraged or Down | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Most of the time | 2 | 2 |
| 3 | 2022-05-15 | -P2W | 17 | STUDYX | QS | 2324-P0001 | 17 | CRQ0217 | CRQ02-Felt Worn Out or Sluggish | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | All of the time | 1 | 1 |
| 3 | 2022-05-15 | -P2W | 18 | STUDYX | QS | 2324-P0001 | 18 | CRQ0218 | CRQ02-Happy, Satisfied or Pleased | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Happy most of the time | 5 | 5 |
| 3 | 2022-05-15 | -P2W | 19 | STUDYX | QS | 2324-P0001 | 19 | CRQ0219 | CRQ02-Feel Upset Diff Getting Breath | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Most of the time | 2 | 2 |
| 3 | 2022-05-15 | -P2W | 20 | STUDYX | QS | 2324-P0001 | 20 | CRQ0220 | CRQ02-Felt Restless, Tense or Uptight | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION | Some of the time | 4 | 4 |
| 3 | 2022-05-15 | -P2W | 21 | STUDYX | QS | 2324-P0001 | 21 | CRQ0201 | CRQ02-Feeling Emotional | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 22 | STUDYX | QS | 2324-P0001 | 22 | CRQ0202 | CRQ02-Take Care of Basic Needs | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 23 | STUDYX | QS | 2324-P0001 | 23 | CRQ0203 | CRQ02-Walking | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 24 | STUDYX | QS | 2324-P0001 | 24 | CRQ0204 | CRQ02-Performing Chores | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 25 | STUDYX | QS | 2324-P0001 | 25 | CRQ0205 | CRQ02-Participate in Social Activities | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 26 | STUDYX | QS | 2324-P0001 | 26 | CRQ0206 | CRQ02-Felt Frustrated or Impatient | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 27 | STUDYX | QS | 2324-P0001 | 27 | CRQ0207 | CRQ02-Feeling of Fear or Panic | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 28 | STUDYX | QS | 2324-P0001 | 28 | CRQ0208 | CRQ02-Fatigue | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 29 | STUDYX | QS | 2324-P0001 | 29 | CRQ0209 | CRQ02-Embarrassed by Coughing | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 30 | STUDYX | QS | 2324-P0001 | 30 | CRQ0210 | CRQ02-Confident to Deal With Illness | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 31 | STUDYX | QS | 2324-P0001 | 31 | CRQ0211 | CRQ02-Energy | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 32 | STUDYX | QS | 2324-P0001 | 32 | CRQ0212 | CRQ02-Feel Upset, Worried or Depressed | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 33 | STUDYX | QS | 2324-P0001 | 33 | CRQ0213 | CRQ02-Control of Breathing Problems | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 34 | STUDYX | QS | 2324-P0001 | 34 | CRQ0214 | CRQ02-Feel Relaxed and Free of Tension | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 35 | STUDYX | QS | 2324-P0001 | 35 | CRQ0215 | CRQ02-Felt Low in Energy | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 36 | STUDYX | QS | 2324-P0001 | 36 | CRQ0216 | CRQ02-Felt Discouraged or Down | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 37 | STUDYX | QS | 2324-P0001 | 37 | CRQ0217 | CRQ02-Felt Worn Out or Sluggish | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 38 | STUDYX | QS | 2324-P0001 | 38 | CRQ0218 | CRQ02-Happy, Satisfied or Pleased | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 39 | STUDYX | QS | 2324-P0001 | 39 | CRQ0219 | CRQ02-Feel Upset Diff Getting Breath | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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| 40 | STUDYX | QS | 2324-P0001 | 40 | CRQ0220 | CRQ02-Felt Restless, Tense or Uptight | CRQ-SAS FOLLOW-UP ADMINISTRATION VERSION |
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| NOT DONE | 4 |
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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.
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