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Description/Overview

Adverse Events (AE) represents data describing untoward medical occurrences in subjects which may or may not have a causal relationship with the product. Events represented in the AE domain will be consistent with scientific and regulatory requirements. It is the applicant's responsibility to define an event and the appropriate collection period for events. This definition may vary based on characterization and reporting of product safety. In consultation with regulatory authorities, applicants may extend or limit the scope of event collection. 

It is assumed that applicants will add collection fields to the following metadata specification as needed to meet scientific and regulatory requirements using guidance in Section x.x, How to Extend Metadata.

Specification

TIG v1.0 Metadata Check for CDASH Domain Specification Table Beta 2

Metadata check macro is applied and detected issue(s). Please address finding(s) listed below the specification table. An FAQ is available to aid troubleshooting. Release Notes

Observation ClassDomainData Collection ScenarioImplementation OptionsOrder NumberCollection VariableCollection Variable LabelDRAFT Collection DefinitionQuestion TextPromptData TypeCollection CoreCase Report Form Completion InstructionsTabulation Target

Mapping Instructions

Controlled Terminology Codelist NameSubset Controlled Terminology/CDASH Codelist NameImplementation Notes
EventsAEN/AN/A1STUDYIDStudy IdentifierA unique identifier for a study.What is the study identifier?[Protocol/Study]CharHRN/ASTUDYIDMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/AAlthough this field is not typically captured on a CRF, it should be displayed clearly on the CRF and/or the EDC system. This field can be included into the database or populated during tabulation dataset creation.
EventsAEN/AN/A2SITEIDStudy Site IdentifierA unique identifier for a site within a study.What is the site identifier?Site (Identifier)CharHRN/ADM.SITEIDMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/A

Paper: This is typically pre-printed in the header of each CRF page for single-site studies. For studies with multiple sites, this field may be left blank so that the number can be recorded by the site, or it may be pre-printed for the CRFs that are shipped to each site.

EDC: This should be pre-populated.

EventsAEN/AN/A3SUBJIDSubject Identifier for the StudyA unique subject identifier within a site and a study.What [is/was] the (study) [subject/participant] identifier?[Subject/Participant] (Identifier)CharHRRecord the identifier for the subject.DM.SUBJIDMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/A

Paper: This is typically recorded in the header of each CRF page. EDC: The subject identifiers may be system generated. This collection variable is typically collected for all domains. However, this collection variable is populated only in the tabulation DM dataset.

EventsAEN/AN/A4AEYNAny Adverse ExperienceAn indication of whether any AEs were experienced during the study.Were any adverse events experienced?Any Adverse ExperiencesCharOIndicate if the subject had any adverse experiences. If Yes, include the appropriate details where indicated on the CRF.N/ADoes not map to an tabulation variable.(NY)N/AThe intent/purpose of collecting this field is to help with data cleaning and monitoring. It provides verification that all other fields on the CRF were deliberately left blank.
EventsAEN/AN/A5AECATCategory for Adverse ExperienceA grouping of topic-variable values based on user-defined characteristics.What is the category of the adverse experience?[Adverse Experience Category]; NULLCharORecord the adverse experience category, if not pre-printed on the CRF.AECATMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/AApplicant-defined controlled terminology. This would most commonly be either a heading or a pre-printed category value on the CRF, and not a question to which the site would provide an answer. If a question is asked, the response would typically be an applicant-defined codelist. If the form is laid out as a grid, then words such as "Category" can be included as the column heading.
EventsAEN/AN/A6AESCATSubcategory for Adverse ExperienceA sub-division of the AECAT values based on user-defined characteristics.What is the subcategory of the adverse experience?[Adverse Experience Subcategory]; NULLCharORecord the adverse experience subcategory, if not pre-printed on the CRF.AESCATMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/AApplicant-defined controlled terminology. This would most commonly be pre-printed on the CRF or screen and pre-populated in the data management system. This is not typically a question to which the site would provide an answer. AESCAT can only be used if there is an AECAT and it must be a subcategorization of AECAT.
EventsAEN/AN/A7AESPIDAE Applicant-Defined IdentifierA applicant-defined identifier. This is typically used for pre-printed or auto-generated numbers on the CRF, or any other type of identifier that does not already have a defined identifier field.

[Applicant-defined question]

[Applicant defined]CharOIf collected on the CRF, applicant may insert instructions to ensure each record has a unique identifier.AESPIDMaps directly to the tabulation variable listed in the Tabulation Target column. May be used to create RELREC to link this record with a record in another domain.N/AN/ABecause SPID is an applicant-defined identifier, conformance to Question Text or Item Prompt is not applicable. Typically used as an identifier in a data query to communicate clearly to the site the specific record in question or to reconcile concomitant medications, procedures and/or medical history records with AEs. If CMAENO or PRAENO is used, this is the identifier to which CMAENO or PRAENO refers. May be used to record pre-printed number (e.g., line number, record number) on the CRF. This field may be populated by the applicant's data collection system.
EventsAEN/AN/A8AETERMReported Term for the Adverse ExperienceThe reported or pre-specified name of the adverse experience.What is the adverse experience term?Adverse ExperienceCharHRRecord only 1 diagnosis, sign, or symptom per line (e.g., nausea and vomiting should not be recorded in the same entry, but as 2 separate entries). Using accepted medical terminology, enter the diagnosis (if known); otherwise enter a sign or symptom.AETERMMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/ACan be represented either as an open-entry field to capture verbatim terms reported by subjects or pre-printed, in the situation where solicited AEs of interest are captured. In most cases, the verbatim term (i.e., investigator-reported term) will be coded to a standard medical dictionary (e.g., MedDRA, WHO ART) after the data have been collected on the CRF.
EventsAEN/AN/A9AEOCCURAdverse Experience OccurrenceAn indication of whether a pre-specified adverse experience or a group of adverse experiences occurred when information about the occurrence of a specific experience is solicited.Did the subject have [pre-specified adverse experience/group of adverse experiences]?[Specific Adverse Experience ]CharOIndicate if [specific adverse experience] has occurred/is occurring, by checking Yes or No.FA.FAORRESThis does not map directly to an tabulation variable. Because the tabaulation AE domain is intended to hold only adverse experiences that actually happen, all values collected in AEOCCUR for pre-specified AEs should be represented in a Findings About Adverse Experiences data set (FAAE) where FAORRES=the value of AEOCCUR where FATESTCD="OCCUR". In addition, where AEOCCUR="Y", there should be a corresponding record in the AE domain.(NY)N/AThe collection variable AEOCCUR is used to indicate the occurrence of pre-specified adverse experiences (e.g., "Did the subject have high blood pressure?"). AEOCCUR should not be used for spontaneously reported adverse experiences. The site should be able to indicate that the response was not asked or answered.
EventsAEN/AN/A10AEPRESPPre-specified Adverse ExperienceAn indication that a specific experience or group of experiences are pre-specified on a CRF.N/AN/ACharON/AAEPRESPMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AA hidden field on a CRF defaulted to "Y", or added during tabulation dataset creation, when the AE is pre-specified. Null for spontaneously reported experiences. If a study collects both pre-specified and free-text adverse experiences, the value of AEPRESP should be "Y" for all pre-specified experiences and null for experiences reported as free-text. AEPRESP is a permissible field and may be omitted from the tabulation dataset if all experiences were collected as free text.
EventsAEN/AN/A11AESTDATAdverse Experience Start DateThe start date of the adverse experience, represented in an unambiguous date format (e.g., DD-MON-YYYY).What is the adverse experience start date?Start DateCharHRRecord the start date of the adverse experience using this format (DD-MON-YYYY).AESTDTCThis does not map directly to an tabulation variable. For the tabulation dataset, concatenate all collected START DATE and TIME components and populate the tabulation variable AESTDTC in ISO 8601 format.N/AN/AN/A
EventsAEN/AN/A12AESTTIMStart Time of Adverse ExperienceThe start time of the adverse experience, represented in an unambiguous time format (e.g., hh:mm:ss).What is the adverse experience start time?Start TimeCharR/CRecord the start time (as complete as possible) of the adverse experience.AESTDTCThis does not map directly to a tabulation variable. For the tabulation dataset, concatenate all collected START DATE and TIME components and populate the tabulation variable AESTDTC in ISO 8601 format.N/AN/ACollecting the time an AE started is only appropriate if it can be realistically determined and if there is a scientific reason for needing to know this level of detail.
EventsAEN/AN/A13AELOCAE Location of ExperienceA description of the anatomical location relevant for the adverse experience.What is the anatomical location of the adverse experience?Anatomical LocationCharOIndicate the anatomical location of the adverse experience.AELOCMaps directly to the tabulation variable listed in the Tabulation Target column.(LOC)N/ACollected or pre-printed when the applicant needs to identify the specific anatomical location. applicants may collect the data using a subset list of controlled terminology on the CRF. LAT, DIR, PORTOT are used to further describe the anatomical location.
EventsAEN/AN/A14AELATAdverse Experience LateralityQualifier for anatomical location, further detailing the side of the body relevant for the experience.What is the side of the anatomical location of the adverse experience?SideCharORecord the side of the anatomical location of the adverse experience.AELATMaps directly to the tabulation variable listed in the Tabulation Target column.(LAT)N/AMay be pre-printed or collected when the applicant needs to identify the specific side of the anatomical location. applicants may collect the data using a subset list of controlled terminology on the CRF.
EventsAEN/AN/A15AEDIRAdverse Experience DirectionalityQualifier further detailing the position of the anatomical location, relative to the center of the body, organ, or specimen.What is the directionality of the anatomical location of the adverse experience?DirectionalityCharORecord the directionality of the anatomical location of the adverse experience.AEDIRMaps directly to the tabulation variable listed in the Tabulation Target column.(DIR)N/AMay be pre-printed or collected when the applicant needs to identify the directionality of the anatomical location. applicants may collect the data using a subset list of controlled terminology on the CRF.
EventsAEN/AN/A16AEPORTOTAE Location Portion or TotalityQualifier for anatomical location, further detailing the distribution (i.e., arrangement of, apportioning of).What is the portion or totality of the anatomical location of the adverse experience?Portion or TotalityCharOIndicate the portion or totality anatomical location of the adverse experience.AEPORTOTMaps directly to the tabulation variable listed in the Tabulation Target column.(PORTOT)N/ACollected when the applicant needs to identify the specific portionality for the anatomical locations. applicants may collect the data using a subset list of controlled terminology on the CRF.
EventsAEN/AN/A17AEONGOOngoing Adverse ExperienceIndication that an adverse experience is ongoing when no end date is provided.Is the adverse experience ongoing (as of [the study-specific time point or period])?Ongoing (as of [the study-specific time point or period])CharOIndicate if the adverse experience has not resolved at the time of data collection; leave the End Date blank.AEENRTPT; AEENRFThis does not map directly to an tabulation variable. May be used to populate a value into a tabulation relative timing variable such as AEENRF or AEENRTPT. When populating AEENRF, if the value of AEONGO is "Y", the value of "DURING", "AFTER" or "DURING/AFTER" may be used. When populating AEENRTPT, if the value of AEONGO is "Y", the value of "ONGOING" may be used. When AEONGO refers to the Reference Period (defined in DM.RFSTDTC to DM.RFENDTC) the tabulation variable AEENRF should be populated. When AEONGO is compared to another time point, the tabulation variables AEENRTPT and AEENTPT should be used. Note: AEENRTPT must refer to a time-point anchor described in AEENTPT.(NY)N/ACompleted to indicate that the AE has not resolved at the time of data collection, when no end date is collected. In some cases the ongoing status may be determined from AE Outcome. The purpose of collecting this field is to help with data cleaning and monitoring; this field provides further confirmation that End Date was deliberately left blank. Often used as a tick/checkbox.
EventsAEN/AN/A18AEENDATAdverse Experience End DateThe date when the adverse experience resolved/ended, represented in an unambiguous date format (e.g., DD-MON-YYYY).What was the adverse experience end date?End DateCharR/CRecord the date that the adverse experience. resolved using this format (DD-MON-YYYY). If the AE is ongoing, leave the field blank.AEENDTCThis does not map directly to a tabulation variable. For the tabulation dataset, concatenate all collected END DATE and TIME components and populate the tabulation variable AEENDTC in ISO 8601 format.N/AN/AThe definition of resolved is applicant-specific. The preferred method is to collect a complete end date (if applicable). Partial dates (e.g., providing year only, month and year only) may be acceptable.
EventsAEN/AN/A19AEENTIMEnd Time of Adverse ExperienceThe time when the adverse experience ended/resolved, represented in an unambiguous time format (e.g., hh:mm:ss).What was the adverse experience end time?End TimeCharR/CRecord the time (as complete as possible) that the adverse experience resolved.AEENDTCThis does not map directly to a tabulation variable. For the tabulation dataset, concatenate all collected END DATE and TIME components and populate the tabulation variable AEENDTC in ISO 8601 format.N/AN/ACollecting the time an AE resolved is only appropriate if it can be realistically determined and if there is a scientific reason for needing to know this level of detail.
EventsAEN/AN/A20AESEVAE Severity/IntensityThe severity or intensity of the experience.What is the severity of the adverse experience?SeverityCharR/CThe reporting physician/healthcare professional will assess the severity of the experience using the applicant-defined categories. This assessment is subjective and the reporting physician/ healthcare professional should use medical judgment to compare the reported adverse experience to similar type experiences observed in clinical practice. Severity is not equivalent to seriousness.AESEVMaps directly to the tabulation variable listed in the Tabulation Target column.(AESEV)N/AEither AESEV or AETOXGR must appear on the CRF. Some studies may mandate the collection of both.
EventsAEN/AN/A21AETOXGRAE Standard Toxicity GradeThe grade of the severity of the experience using a standard "toxicity" scale (e.g., NCI CTCAE).What is the [NCI CTCAE/Name of scale (toxicity) grade] of the adverse experience?[NCI CTCAE/ Name of the scale] (Toxicity) GradeCharR/CThe reporting physician/healthcare professional will assess the severity of the adverse experience using the specified grades scale.AETOXGRMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the toxicity scale name and version used to map the terms utilizing the Define-XML external codelist attributes.N/AN/AEither AESEV or AETOXGR must appear on the CRF. Some studies may mandate the collection of both. Published toxicity-like scales can be used.
EventsAEN/AN/A22AESERAE Serious ExperienceAn indication of whether the adverse experience is determined to be "serious," based on what is defined in the protocol.Was the adverse experience serious?SeriousCharR/CAssess if the adverse experience should be classified as "serious," based on the criteria defined in the protocol.AESERMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AThis field is related to the individual SAE-type fields, which may or may not be collected on the CRF. Either AESER or all the SAE-type fields must be present on the CRF. Applicants should consult with regulatory agencies regarding the collection of this data.
EventsAEN/AN/A23AESDTHResults in DeathAn indication the serious adverse experience resulted in death.Did the adverse experience result in death?DeathCharR/CRecord whether the serious adverse experience resulted in death.AESDTHMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/A

If details regarding SAEs are collected in the clinical database, then it is recommended that a separate Yes/No variable be defined for each SAE type. applicants may only collect the AESER field when collecting individual SAE types in a separate database. Applicants should consult with regulatory agencies regarding the collection of this data.

EventsAEN/AN/A24DTHDATDeath DateDate of death for any subject who died.What [is/was] the subject's date of death?Death DateCharORecord the date of death.DM.DTHDTCThis field does not map directly to an tabulation variable. For the tabulation dataset, concatenate all collected DATE and TIME components and populate the tabulation variable DTHDTC in ISO 8601 format.N/AN/AIn the CDASH model, Death Date is a timing variable; it is not included as a timing variable in the SDTM. It may be collected on any CRF deemed appropriate by the applicant, but should only be collected once. The tabulation variable DTHDTC is mapped to the DM domain during the tabulation dataset creation process. The tabulation variable DM.DTHFLG is not a collection variable, but it is typically populated during the tabulation dataset creation process. Death Date may be mapped to other tabulation domains, as deemed appropriate by the applicant (e.g., DS).

Events TOBA-351 - Getting issue details... STATUS

AEN/AN/A25AESLIFEIs Life ThreateningAn indication the serious adverse experience was life threatening.Was the adverse experience life threatening?Life ThreateningCharR/CRecord whether the serious adverse experience is life threatening.AESLIFEMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AIf details regarding SAEs are collected in the clinical database, then it is recommended that a separate Yes/No variable be defined for each SAE type. applicants may only collect the AESER field when collecting individual SAE types in a separate pharmacovigilance database. applicants should consult with regulatory agencies regarding the collection of this data.
EventsAEN/AN/A26AESHOSPRequires or Prolongs HospitalizationAn indication the serious adverse experience resulted in an initial or prolonged hospitalization.Did the adverse experience result in initial or prolonged hospitalization for the subject?Hospitalization (initial or prolonged)CharR/CRecord whether the serious adverse experience resulted in an initial or prolonged hospitalization.AESHOSPMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AIf details regarding SAEs are collected in the clinical database, then it is recommended that a separate Yes/No variable be defined for each SAE type. applicants may only collect the AESER field when collecting individual SAE types in a separate pharmacovigilance database. applicants should consult with regulatory agencies regarding the collection of this data.
EventsAEN/AN/A27AESDISABPersist or Signif Disability/IncapacityAn indication the serious adverse experience was associated with a persistent or significant disability or incapacity.Did the adverse experience result in disability or permanent damage?Disability or Permanent DamageCharR/CRecord whether the serious adverse experience resulted in a persistent or significant disability or incapacity.AESDISABMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AIf details regarding SAEs are collected in the clinical database, then it is recommended that a separate Yes/No variable be defined for each SAE type. applicants may only collect the AESER field when collecting individual SAE types in a separate pharmacovigilance database. applicants should consult with regulatory agencies regarding the collection of this data.
EventsAEN/AN/A28AESCONGCongenital Anomaly or Birth DefectAn indication the serious adverse experience was associated with a congenital anomaly or birth defect.Was the adverse experience associated with a congenital anomaly or birth defect?Congenital Anomaly or Birth DefectCharR/CRecord whether the serious adverse experience was associated with congenital anomaly or birth defect.AESCONGMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AIf details regarding SAEs are collected in the clinical database, then it is recommended that a separate Yes/No variable be defined for each SAE type. Applicants may only collect the AESER field when collecting individual SAE types in a separate pharmacovigilance database. applicants should consult with regulatory agencies regarding the collection of this data.
EventsAEN/AN/A29AESINTVNeeds Intervention to Prevent ImpairmentAn indication an adverse experience required medical or surgical intervention to preclude permanent impairment of a body function, or prevent permanent damage to a body structure, due to the use of a medical product.Did the adverse experience require intervention to prexperience permanent impairment or damage resulting from the use of a medical product?Needs Intervention to Prevent ImpairmentCharORecord whether the serious adverse experience required intervention to prevent permanent impairment or damage due to the use of a medical product.SUPPAE.QVALThis does not map directly to an tabulation variable. applicants should see requirements for the reporting of adverse experiences involving medical devices.(NY)N/AIf details regarding SAEs are collected in the clinical database, then it is recommended that a separate Yes/No variable be defined for each SAE type. Applicants may only collect the AESER field when collecting individual SAE types in a separate database. Applicants should consult with regulatory agencies regarding the collection of this data.
EventsAEN/AN/A30AESMIEOther Medically Important Serious ExperienceAn indication additional categories for seriousness apply.Was the adverse experience a medically important event not covered by other serious criteria?Other Serious (Important Medical experiences)CharR/CRecord whether the serious adverse experience is an "important medical exvent," which may be defined in the protocol or in the investigator brochure.AESMIEMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AIf details regarding SAEs are collected in the clinical database, then it is recommended that a separate Yes/No variable be defined for each SAE type. Applicants may only collect the AESER field when collecting individual SAE types in a separate database. Applicants should consult with regulatory agencies regarding the collection of this data.
EventsAEN/AN/A31AESCANInvolves CancerAn indication the serious experience was associated with the development of cancer.Was the adverse experience associated with the development of cancer?CancerCharORecord whether the serious adverse experience was associated with development of cancer.AESCANMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AIf details regarding SAEs are collected in the clinical database, then it is recommended that a separate Yes/No variable be defined for each SAE type. Applicants may only collect the AESER field when collecting individual SAE types in a separate database. Applicants should consult with regulatory agencies regarding the collection of this data.
EventsAEN/AN/A32AESODOccurred with OverdoseAn indication the serious experience occurred with an overdose.Did the adverse experience occur with an overdose?OverdoseCharORecord whether the serious adverse experience occurred with an overdose.AESODMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AIf details regarding SAEs are collected in the clinical database, then it is recommended that a separate Yes/No variable be defined for each SAE type. Applicants may only collect the AESER field when collecting individual SAE types in a separate pharmacovigilance database. Applicants should consult with regulatory agencies regarding the collection of this data.
EventsAEN/AN/A33AERELAE CausalityAn indication the study product had a causal effect on the adverse experience, as determined by the clinician/investigator.Was this adverse experience related to study product?

Relationship to Study Product

CharHRIndicate if the cause of the adverse experience is related to the study product and cannot be reasonably explained by other factors (e.g., subject's clinical state, concomitant therapy, other interventions).AERELMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/AApplicant-defined controlled terminology is used to indicate the relationship between the AE and the study product. It is recommended that applicants check with the regulatory authority for population of this variable to ensure it meets expectations for submission. There is no industry-wide controlled terminology for relationship to product exposure. It is recommended that applicants establish terminology and apply it consistently.
EventsAEN/AN/A34AEACNAction Taken with Study ProductA description of the action taken with study product as a result of the experience.What action was taken with study product?Action Taken with Study ProductCharR/CRecord changes made to the study product resulting from the adverse experience.AEACNMaps directly to the tabulation variable listed in the Tabulation Target column.(TPACN)N/ACDISC Controlled Terminology is used to indicate the action taken with the product in response to the AE. How to handle multiple actions taken is up to the applicant. If this information is collected elsewhere (e.g., on the Exposure CRF), then it is not required to be collected on the AE CRF. This variable is not to be used for actions taken with devices.
EventsAEN/AN/A35AEACNDEVActions Taken with DeviceA description of the action taken, with respect to a device used in a study (which may or may not be the device under study), as a result of the experience.What action was taken with a device used in the study?Action Taken with DeviceCharORecord actions taken resulting from the adverse experience that are related to a study or non-study device.SUPPAE.QVALThis does not map directly an tabulation variable. The applicant may represent this data in a SUPPAE dataset where SUPPAE.QNAM = "AEACNDEV" and SUPPAE.QLABEL = "Actions Taken with Device".N/AN/AApplicant-defined controlled terminology for actions that are related to the device.
EventsAEN/AN/A36AEACNOTHOther Action TakenA description of other action taken as a result of the experience that is unrelated to dose adjustments of the study product.What other action was taken?Other Action TakenCharORecord all other action(s) taken resulting from the adverse experience that are unrelated to study products given because of this AE.AEACNOTHMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/AThis is usually collected as a free-text field. If possible/desired, the applicant can create controlled terminology.
EventsAEN/AN/A37AEOUTOutcome of Adverse ExperienceA description of the outcome of an experience.What is the outcome of this adverse experience?OutcomeChar

R/C

Record the appropriate outcome of the experience in relation to the subject's status.AEOUTMaps directly to the tabulation variable listed in the Tabulation Target column.(OUT)N/A

CDISC Controlled Terminology is used to indicate the outcome of the experience as it relates to the subject's status. The use of this field is the recommended way to describe whether and how the AE resolved. Because the outcome of an AE may be death, if this field is NOT used, be sure to provide another form, such as Disposition, with clear instructions to record deaths there.

EventsAEN/AN/A38AEDISAE Caused Study DiscontinuationAn indication of whether the experience caused the subject to discontinue from the study.Did the adverse experience cause the subject to be discontinued from the study?Caused Study DiscontinuationCharORecord if the adverse experience caused the subject to discontinue from the study.SUPPAE.QVALThis does not map directly an tabulation variable. May be used to create a RELREC tabulation dataset to link the AE to the DS dataset record. The applicant may also represent this data in a SUPPAE dataset where SUPPAE.QNAM = "AEDIS" and SUPPAE.QLABEL = "Caused Study Discontinuation", if appropriate.(NY)N/ABecause the Action Taken field was defined to only collect changes made in relation to the study product due to the AE, an additional field was created to identify the AE(s) that caused the subject to discontinue from the study. Some applicants opt to capture this information only on the Subject Disposition CRF, whereas others choose to collect this data on both the Subject Disposition and AE CRFs, so the specific AE term(s) and related data can be identified. If the CRF is designed to link the DS and AE tabulation records, then RELREC can be used to identify that relationship.
EventsAEN/AN/A39AERLNSYNAE Relationship to Non-Study Trtmnt or ProdAn indication whether, in the investigator's opinion, the experience may have been due to a product other than study product.Was this adverse experience due to product other than study product?Related to Non-Study ProductCharOIndicate if this adverse experience was due to product other than study product. If Yes, briefly describe this non-study product relationship.N/ADoes not map to a tabulation variable.(NY)N/AThe intent/purpose of collecting this field is to help with data cleaning and monitoring. It provides verification that the AERELNST collection field on the CRF was deliberately left blank.
EventsAEN/AN/A40AERELNSTAE Relationship to Non-Study Trtmnt or ProdDescription of the investigator's opinion as to whether the adverse experience may have been due to a product other than study product.What is the relationship to non-study product?Relationship to Non-Study ProductCharORecord the investigator's opinion as to whether the experience may have been due to a product other than study product.AERELNSTMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/AMay be reported as free text (e.g., "MORE LIKELY RELATED TO ASPIRIN USE"). If possible/desired, applicants can create controlled terminology.
EventsAEN/AN/A41AESIAdverse Experience of Special InterestAn adverse experience of special interest (serious or non-serious) is one of scientific and medical concern specific to the applicant's product or program, for which ongoing monitoring and rapid communication by the investigator to the applicant can be appropriate. Such an experience might warrant further investigation in order to characterize and understand it. Depending on the nature of the experience, rapid communication by the study applicant to other parties (e.g., regulators) might also be warranted.Is this experience of special interest?Adverse Experience of Special InterestCharORecord the investigator's opinion as to whether the experience is an adverse experience of special interest by the applicant.N/ADoes not map to a tabulation variable.(NY)N/AThis collection field may be used just to trigger other CRF pages, or populate a value in AECAT or AESCAT. This information could be represented in a SUPPAE dataset where SUPPAE.QNAM = "AESI" and SUPPAE.QLABEL = "Adverse experience of Special Interest.

Events

AEN/AN/A42AEPATTPattern of Adverse ExperienceUsed to indicate the pattern of the experience over time.What is the adverse experience pattern?PatternCharOFor each adverse experience, check the pattern of the AE. If a single experience, choose Single.AEPATTMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/AUsed to report the pattern of the AE (e.g., "INTERMITTENT", "CONTINUOUS", "SINGLE EVENT"). For crossover studies, it is NOT recommended to capture this field for intermittent AEs. Instead, the AE should have corresponding start and stop dates to capture when the AE started and stopped.
EventsAEN/AN/A43AECONTRTConcomitant or Additional Product GivenAn indication whether a concomitant or additional product given because of the occurrence of the experience.

Was a concomitant or additional product given due to this adverse experience?

Concomitant or Additional Product Given Due to This AE

CharOIndicate if any non-study treatments or products were received because of this adverse experience. If Yes, medications should be recorded on the ConMed CRF and procedures recorded on the Procedures CRF.AECONTRTMaps directly to the tabulation variable listed in the Tabulation Target column.(NY)N/AIf medication data are reported, the CMAENO variable (on the CM CRF) may be used to collect the associated AE Identifier in order to populate RELREC. If procedures are reported, the PRAENO variable (on the PR CRF) may be used to collect the associated AE Identifier in order to populate RELREC.
EventsAEN/AN/A44AEMODIFYAE Modified Reported TermIf the value for AETERM is modified to facilitate coding, then AEMODIFY will contain the modified text.N/AN/ACharR/CN/AAEMODIFYMaps directly to the tabulation variable listed in the Tabulation Target column.N/AN/AThis is not a data collection field that would appear on the CRF. applicants will populate this through the coding process.
EventsAEN/AN/A45AEDECODAE Dictionary-Derived TermThe dictionary or standardized text description of AETERM or the modified topic variable (AEMODIFY), if applicable.N/AN/ACharON/AAEDECODMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes.N/AN/AThis is typically not a data collection field that would appear on the CRF. applicants will populate this through the coding process. Equivalent to the Preferred Term (PT) in MedDRA.
EventsAEN/AN/A46AELLT

AE Lowest Level Term

The dictionary-derived text description of the lowest level term.N/AN/ACharR/CN/AAELLTMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes. applicants should include an Origin in the define metadata document to indicate that the data was "ASSIGNED".N/AN/AThis field does not typically appear on the CRF. applicants will populate this through the coding process. This is applicable to items using MedDRA coding.
EventsAEN/AN/A47AELLTCDAE Lowest Level Term CodeThe dictionary-derived code for the lowest level term.N/AN/ANumR/CN/AAELLTCDMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes. applicants should include an Origin in the define metadata document to indicate that the data was "ASSIGNED".N/AN/AThis field does not typically appear on the CRF. applicants will populate this through the coding process. This is applicable to items using MedDRA coding.
EventsAEN/AN/A48AEPTCDAE Preferred Term CodeThe dictionary-derived code for the preferred term.N/AN/ANumR/CN/AAEPTCDMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes. applicants should include an Origin in the define metadata document to indicate that the data was "ASSIGNED".N/AN/AThis field does not typically appear on the CRF. applicants will populate this through the coding process. This is applicable to items using MedDRA coding.
EventsAEN/AN/A49AEHLTAE High Level TermThe dictionary-derived text description of the high level term for the primary system organ class (SOC).N/AN/ACharR/CN/AAEHLTMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes. applicants should include an Origin in the define metadata document to indicate that the data was "ASSIGNED".N/AN/AThis field does not typically appear on the CRF. applicants will populate this through the coding process. This is applicable to items using MedDRA coding.
EventsAEN/AN/A50AEHLTCDAE High Level Term CodeThe dictionary-derived code for the high level term for the primary system organ class (SOC).N/AN/ANumR/CN/AAEHLTCDMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes. applicants should include an Origin in the define metadata document to indicate that the data was "ASSIGNED".N/AN/AThis field does not typically appear on the CRF. applicants will populate this through the coding process. This is applicable to items using MedDRA coding.
EventsAEN/AN/A51AEHLGTAE High Level Group TermThe dictionary-derived text description of the high level group term for the primary system organ class (SOC).N/AN/ACharR/CN/AAEHLGTMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes. applicants should include an Origin in the define metadata document to indicate that the data was "ASSIGNED".N/AN/AThis field does not typically appear on the CRF. applicants will populate this through the coding process. This is applicable to items using MedDRA coding.
EventsAEN/AN/A52AEHLGTCDAE High Level Group Term CodeThe dictionary-derived code for the high level group term for the primary system organ class (SOC).N/AN/ANumR/CN/AAEHLGTCDMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes. applicants should include an Origin in the define metadata document to indicate that the data was "ASSIGNED".N/AN/AThis field does not typically appear on the CRF. applicants will populate this through the coding process. This is applicable to items using MedDRA coding.
EventsAEN/AN/A53AESOCAE Primary System Organ ClassThe dictionary-derived text description of the primary system organ class (SOC).N/AN/ACharR/CN/AAESOCMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes. applicants should include an Origin in the define metadata document to indicate that the data was "ASSIGNED".N/AN/AThis field does not typically appear on the CRF. applicants will populate this through the coding process. This is applicable to items using MedDRA coding. Will be the same as the AEBODSYS if the primary SOC was used for analysis.
EventsAEN/AN/A54AESOCCDAE Primary System Organ Class CodeThe dictionary-derived code for the primary system organ class (SOC).N/AN/ANumR/CN/AAESOCCDMaps directly to the tabulation variable listed in the Tabulation Target column. The applicant is expected to provide the dictionary name and version used to map the terms utilizing the Define-XML external codelist attributes. Applicants should include an Origin in the define metadata document to indicate that the data was "ASSIGNED".N/AN/AThis field does not typically appear on the CRF. Applicants will populate this through the coding process. This is applicable to items using MedDRA coding. Will be the same as AEBDSYCD if the primary SOC was used for analysis.
EventsAEN/AN/A55AEACNOYNAny Other Actions TakenAn indication whether any other actions were taken in response to the adverse experience that were unrelated to study product changes or other treatments/products given because of this adverse experience.Were any other actions taken in response to this adverse experience?Any Other Action(s) TakenCharOIndicate whether any other action(s) were taken in response to the adverse experience that are unrelated to study product changes or other treatments/products given because of this experience. If Yes, briefly describe these actions.N/ADoes not map to a tabulation variable.(NY)N/AThe intent/purpose of collecting this field is to help with data cleaning and monitoring. It provides verification that the AEACNOTH field on the CRF was deliberately left blank.

Metadata Checks Findings

Metadata Check User Macros FAQ
  • For variable N/A / N/A / AELAT, AELAT is a not a recognized tabulation variable in Tabulation Target
  • For variable N/A / N/A / AEDIR, AEDIR is a not a recognized tabulation variable in Tabulation Target
  • For variable N/A / N/A / AEPORTOT, AEPORTOT is a not a recognized tabulation variable in Tabulation Target
  • For variable N/A / N/A / AEACN, codelist TPACN is a not a recognized CDASH or SDTM CT short name

Assumptions

  1. The AEYN variable with the question text “Were any adverse events experienced?” is intended to assist in the cleaning of data and in confirming that there are no missing values. This collection variable will not be represented in the tabulation dataset.
  2. Categories AECAT and AESCAT
    1. AECAT and AESCAT should not be redundant with the dictionary coding provided by AEDECOD and AESOC (i.e., they should provide a different means of defining or classifying AE records).
    2. AECAT and AESCAT are intended for categorizations that are defined in advance. For example, an applicant may have a separate CRF page for AEs of special interest and then another page for all other AEs. In cases where a category of AEs of special interest resembles a part of the dictionary hierarchy (e.g., "CARDIAC EVENTS"), the categorization represented by AECAT and AESCAT may differ from the categorization derived from the coding dictionary.
  3. Presence or Absence of Adverse Experiences
    1. AEs are most often collected as free-text, spontaneously reported adverse events. There may be cases where the occurrences of specific adverse experiences are solicited, per protocol requirements. In that case, the prespecified adverse experiences would be listed on the CRF with a "Yes/No" question (AEOCCUR) asking about the occurrence of each.
    2. Collection variable AEOCCUR does not map directly to a tabulation variable. Because the tabulation AE domain is intended will only represent adverse experiences that actually happen, all values collected in AEOCCUR for pre-specified AEs should be represented in a tabulation Findings About Adverse Events domain (FAAE), where FAORRES = the value of AEOCCUR where FATESTCD = "OCCUR". In addition, where AEOCCUR = "Y", there should be a corresponding record in the AE domain. 
  4. Coding 
    1. AEDECOD is the preferred term derived by the applicant from the coding dictionary. It is a required tabulation variable and must have a value. It is expected that the reported term (AETERM) will be coded using a standard dictionary such as MedDRA. 
    2. AEMODIFY is a permissible tabulation variable and should be included if the applicant’s coding procedure permits modification of a verbatim term. The modified term is listed in AEMODIFY. The variable should be populated per the applicants’s coding procedure.
    3. The collection elements AELLT, AELLTCD, AEPTCD, AEHLT, AEHLTCD, AEHLGT, AEHLGTCD, AEBDSYCD, AESOC, and AESOCCD are only applicable to events coded in MedDRA. These items are not expected for non-MedDRA coding.
  5. Relative Timing Variables
    1. The AEONGO field does not map directly to a tabulation variable, but it may be used to derive a value into a tabulation relative timing variable such as AEENRF or AEENRTPT. When populating AEENRF, if the AEONGO field is checked, a value of "DURING", "AFTER", or "DURING/AFTER" may be derived, as appropriate. When populating AEENRTPT, if the AEONGO field is checked, the value of "ONGOING" may be derived. AEENRTPT must refer to a time-point anchor as described in AEENTPT.
    2. AEONGO is a special-use case of "Yes/No", where the question is usually presented as a single possible response of "Yes" when there is no applicable end date at the time of collection.
      1. In this case, if the box is checked and the end date is blank, the desired tabulation relative timing variable can be derived according to assumption 5a.
      2. If the box is not checked (AEONGO is NULL) and an end date is present, no tabulation relative timing variable will be derived.
      3. In some cases, unique to AE, the ongoing status may be determined from AE Outcome. AEONGO is only used to derive an appropriate tabulation relative timing variable and should not be represented on its own in the AE or SUPPAE dataset. 
  6. Collection Action Taken Variables
    1. Collection variables AEACN, AECONTRT, AEACNDEV, AEACNOYN, and AEACNOTH are used to collect the action taken as the result of an AE.
    2. AEACN describes action taken with study product as a result of the experience. It is expected that a response will be provided for this question for all AEs. When a study includes exposure to multiple products, then corresponding variables should be created to capture the action taken for each product. 
    3. AEACNOTH describes Other Action(s) taken in response to an adverse experience that are unrelated to study product exposure changes or interventions given because of this adverse experience. This field is usually collected as a free-text field. If possible/desired, the applicant can create their own internal terminology. The collection variable AEACNOYN is used in conjunction with AEACNOTH to assist in the cleaning of data and in confirming that AEACNOTH is not missing. AEACNOYN is not included as part of the tabulation AE domain for submission and is annotated as "NOT SUBMITTED" on the CRF. The collection variable AEACNOYN should only be used on the AE CRF.
    4. AECONTRT indicates if any interventions were received because of this adverse experience. If "Yes" is answered for this question, any drugs used are recorded on the Concomitant Medications CRF and any procedures performed are recorded on the Procedure CRF. The collection variables CMAENO (on the CM CRF) can be collected to identify the adverse experience associated with this intervention by recording the appropriate AESPID. The RELREC dataset can be used to identify this relationship. 
    5. AEACNDEV describes action taken with respect to a device in a study, which may or may not be the device under study. This field is usually collected as a free-text field. If possible/desired, the applicant can create applicant-defined controlled terminology.
  7. Serious Adverse Experiences 
    1. If details regarding serious adverse events are collected, then it is recommended that a separate "Yes/No" variable be defined for each SAE type (AESCAN, AESCONG, AESDISAB, AESDTH, AESHOSP, AESLIFE, AESOD, AESMIE). 
    2. Applicants should consult with the regulatory agencies regarding the collection of this data.
  8. Collection Variables AESEV, AETOXGR
    1. In studies using a standard toxicity scale, AETOXGR should be used instead of AESEV. In most cases, either AESEV or AETOXGR is populated, but not both. 
    2. There may be cases in which an applicant may need to populate both variables. 
  9. Collection variable DTHDAT
    1. The CDASH Model allows the date of death to be collected on any CRF deemed appropriate by the applicant The death date should only be collected on 1 form.

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