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Information for Reviewers

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

Title

Hamilton Depression Rating Scale 17-Item (HAMD 17)

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

HAMD 17

QRS Permission StatusPublic Domain
TeamMajor Depressive Disorder (MDD) Standards Team and CDISC Questionnaires, Ratings, and Scales (QRS) Subteam
Supplement Version2.1
StatusDRAFT
Date2021-03-19
NotesThis supplement is intended to be used with other CDISC user guides for specific therapeutic/disease areas and follows the CDISC Study Data Tabulation Model Implementation Guide for Human Clinical Trials.


Revision History

DateVersionSummary of Changes
2021-03-192.1 Draft
  • The HAMD 17 v2.0 supplement was updated to the wiki Clinical Classifications supplement template.
  • Annotated CRF was revised to a CDISC CRF to avoid complications with HAMD 17 CRFs included in copyrighted publications.
  • The RSEVAL assumption and variable was removed from this supplement, because it is not captured on the CRF and no assumptions are made on the potential values.
  • Section 3.1 reference to the total score of 54 was revised to 53.
  • Revised assumption 2 to to be a sponsor's stated evaluation interval. 
  • Added assumption 4 describing how item 16A and 16B are handled and included with the “logically skipped item” data rule.
  • The example replaced the RSBLFL variable with RSLOBXFL, added the RSDTC variable, and uses the RSTAT and RSREASND variables for the unanswered item 16B.
  • All responses were updated to end in a period (".") to reflect punctuation on the CRF.
  • The following example row values were revised:

    • Row 3 RSTESTCD = “HAMD103" original RSORRES = “Ideas or gestures suicide.” was revised to “Ideas or gestures of suicide.”
    • Row 8 RSTESTCD = “HAMD108" original RSORRES = “Complete stupor.” RSSTRESC = 4 and RSSTRESN = 4 was revised to RSORRES = “Slight retardation during the interview.” RSSTRESC = 1 and RSSTRESN = 1.
  • Updated the data example to include a missing visit 2 set of "NOT DONE" records for each item.
2016-05-232.0
  • This measure was re-evaluated to fit the definition of a clinical classification measure.  The domain was changed from the QS to RS domain.
2013-05-151.1
  • Q16 only uses Part A or Part B and not both items
  • Revised annotated CRF to meet annotation font standards
2012-08-071.0

Final

© 2021 Clinical Data Interchange Standards Consortium, Inc. All rights reserved. 

1 Introduction

This document describes the CDISC implementation of the Hamilton Depression Rating Scale 17-Item (HAMD 17) instrument.

CDISC created this case report form (CRF) to represent the instrument, which CDISC believes is in the public domain. This is not an endorsement of the instrument. The creation of this instrument was based on published articles describing the instrument. Sponsors may create this instrument’s CRF using their style guidelines, but they need to maintain the wording and order of the questions/items and responses as described on the CRF. 

The representation of data collected for this instrument is based on the Study Data Tabulation Model Implementation Guide (SDTMIG) Disease Response and Clin Classification (RS) domain model, which can be found on the CDISC website at: https://www.cdisc.org/standards/foundational/sdtmig.

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

The CDISC Intellectual Property Policy can be found on the CDISC website at: https://www.cdisc.org/about/bylaws.

1.1 Representations and Warranties, Limitations of Liability, and Disclaimers

This document is a supplement to the SDTMIG for Human Clinical Trials and is covered under Appendix F of that document, which describes representations, warranties, limitations of liability, and disclaimers. Please see Appendix F of the SDTMIG for a complete version of this material.

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

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 believes this instrument to be in the public domain, but you should perform your own assessment. CDISC has included the HAMD 17 in the CDISC library of QRS data standards supplements. Hence, CDISC developed RSTESTCD and RSTEST for each item based on the actual text on the instrument. There may be many versions of this instrument. CDISC has chosen to use this version as the data standard.

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.

Information for Reviewers

The CRF is attached at the top of the Wiki. When you click the paperclip image, you will find the file for the annotated CRF.

Note: CDISC Controlled Terminology is maintained by National Cancer Institute (NCI) Enterprise Vocabulary Services (EVS). The most recent version should be accessed through the CDISC website at: https://www.cdisc.org/standards/terminology/controlled-terminology.

Reference for the HAMD 17:

  • Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23:56–62.

  • Development of a Rating Scale for Primary Depressive Illness BY MAX HAMILTON, Department of Psychiatry, University of Lee, Brit. J. soc. Clin. Psychol. (1967), 6, pp. 278-296, Printed in Great Britain.

  • Assessment Scales in Depression, Mania and Anxiety, Raymond W Lam, MD, FRCPC, Erin E. Michalak, PhD, Richard P Swinson, MD, FRCPsych, FRCPC, Copyright 2005 Taylor & Francis, an imprint of the Taylor & Francis Group.

  • Guy W, ECDEU Assessment Manual for Psychopharmacology. Rockville, MD: US Department of Health, Education, and Welfare, 1976.

  • The Hamilton Rating Scale for Depression: The making of a ‘‘gold standard’’ and the unmaking of a chronic illness, 1960–1980.

3 The RS Domain Model

3.1 Assumptions for the RS Domain Model

All assumptions and business rules described in the SDTMIG RS domain are applicable to this supplement. Additional assumptions specific to the HAMD 17 are listed below.

The HAMD 17 is a multiple-choice instrument that clinicians may use to assess the severity of major depression. Max Hamilton originally published the scale in 1960 and reviewed and evaluated it in 1966, 1967, 1969, and 1980. The measure, which is designed for adult subjects, rates the severity of symptoms observed in depression (e.g., low mood, insomnia, agitation, anxiety, weight loss). It consists of 17 items, each rated on a 3-, 4-, or 5-point scale. A total score between 0-53 is also captured.

  1. The scale points include a numeric rating (0-2, 0-3, or 0-4) and a definition of what is represented by the rating (e.g., 0 = "Absent.", 4 = "Incapacitating."). For the HAMD 17, RSORRES is populated with the text description while the numeric rating is represented in the standardized character and numeric result variables RSSTRESC and RSSTRESN.

  2. The time period of evaluation for the HAMD 17 is populated in the RSEVLINT field as an evaluation interval text value, since it cannot be precisely described as an ISO 8601 duration. The evaluation interval for the HAMD 17 is determined based on the sponsor's stated evaluation interval.

  3. The HAMD 17 instrument includes a total score that is considered as captured data on the CRF and is not considered as derived in the example below.

    1. If operationally defined by the sponsor, it is the sponsor's responsibility to set the --DRVFL flag based on their eCRF process to derive subtotals and total scores. An investigator-derived score will be considered a captured score and not flagged. When subtotal and total scores are derived by the sponsor, the derived flag (--DRVFL) is set to Y. However, when the subtotal and total scores are received from a central provider or vendor, the value would go into --ORRES and --DRVFL would be null (see SDTMIG Section 4.1.8.1, Origin Metadata for Variables).

  4. Item 16 contains 2 components, Part A “Loss of weight according to the patient” and Part B “Loss of weight according to weekly measurements.” Only 1 of these items is answered when administering the HAMD 17 instrument. A record is created in rs.xpt for all items. The unanswered component is considered as a logically skipped item in the data and is represented as follows:

    1. RSSTAT = "NOT DONE"      

    2. RSREASND = "LOGICALLY SKIPPED ITEM"

    3. RSORRES, RSSTRESC, and RSSTRESN are set to null

  5. Terminology

    1. RSCAT, RSTESTCD, and RSTEST values are included in CDISC Controlled Terminology.

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

3.2 Example for the HAMD 17 RS Domain Model

The HAMD 17 example below shows the terminology used to implement the instrument in the RS domain. This example shows the data for 1 subject collected at the baseline visit and a visit 2 represented as not being collected for the HAMD 17 instrument. The example uses CDISC Controlled Terminology for RSTESTCD, RSTEST, and RSCAT. All original results are represented with preferred terminology in RSORRES. This result is then transformed into the standard numeric score in RSSTRESN and a character representation of the standard numeric score in RSSTRESCThe sponsor's evaluation interval for the example is the past week (RSEVLINT = "-P1W").

We are unable to make the example consistently show blue in the Wiki. All examples are updated for each QRS instrument so we ask that you please review the example below.

The table represents the items from the HAMD 17 instrument. Note that visit 2 is represented as a missing visit.

Row 16:Represents item 16 Part A when the subject answered the weight loss according to the patient.
Row 17:Represents item 16 Part B as a logically skipped item when the 16 Part A item is answered.
Row 19:Represents the total score. All total scores are considered as captured data unless the sponsor operationally derives it via an EDC system.
Rows 20-38:Represent all items are missing since the instrument was not filled out at visit 2.

rs.xpt

rs.xpt

ROWSTUDYIDDOMAINUSUBJIDRSSEQRSTESTCDRSTESTRSCATRSORRESRSSTRESCRSSTRESNRSSTATRSREASNDRSLOBXFLVISITNUMRSDTCRSEVLINT
1STUDYXRS2324-P00011HAMD101HAMD1-Depressed MoodHAMD 17Absent.00

Y12019-11-16-P1W
2STUDYXRS2324-P00012HAMD102HAMD1-Feelings of GuiltHAMD 17Self reproach, feels he/she has let people down.11

Y12019-11-16-P1W
3STUDYXRS2324-P00013HAMD103HAMD1-SuicideHAMD 17Ideas or gestures of suicide.33

Y12019-11-16-P1W
4STUDYXRS2324-P00014HAMD104HAMD1-Insomnia Early - Early NightHAMD 17No difficulty falling asleep.00

Y12019-11-16-P1W
5STUDYXRS2324-P00015HAMD105HAMD1-Insomnia Middle - Middle NightHAMD 17No difficulty.00

Y12019-11-16-P1W
6STUDYXRS2324-P00016HAMD106HAMD1-Insomnia Early Hours -MorningHAMD 17No difficulty.00

Y12019-11-16-P1W
7STUDYXRS2324-P00017HAMD107HAMD1-Work and ActivitiesHAMD 17No difficulty.00

Y12019-11-16-P1W
8STUDYXRS2324-P00018HAMD108HAMD1-RetardationHAMD 17Slight retardation during the interview.11

Y12019-11-16-P1W
9STUDYXRS2324-P00019HAMD109HAMD1-AgitationHAMD 17Fidgetiness.11

Y12019-11-16-P1W
10STUDYXRS2324-P000110HAMD110HAMD1-Anxiety PsychicHAMD 17No difficulty.00

Y12019-11-16-P1W
11STUDYXRS2324-P000111HAMD111HAMD1-Anxiety SomaticHAMD 17Moderate.22

Y12019-11-16-P1W
12STUDYXRS2324-P000112HAMD112HAMD1-Somatic Symptoms GIHAMD 17None.00

Y12019-11-16-P1W
13STUDYXRS2324-P000113HAMD113HAMD1-General Somatic SymptomsHAMD 17None.00

Y12019-11-16-P1W
14STUDYXRS2324-P000114HAMD114HAMD1-Genital SymptomsHAMD 17Mild.11

Y12019-11-16-P1W
15STUDYXRS2324-P000115HAMD115HAMD1-HypochondriasisHAMD 17Not present.00

Y12019-11-16-P1W
16STUDYXRS2324-P000116HAMD116AHAMD1-Loss of WT According to PatientHAMD 17Definite (according to patient) weight loss.22

Y12019-11-16-P1W
17STUDYXRS2324-P000117HAMD116BHAMD1-Loss of WT According to WK MeasHAMD 17


NOT DONELOGICALLY SKIPPED ITEMY12019-11-16-P1W
18STUDYXRS2324-P000118HAMD117HAMD1-InsightHAMD 17Denies being ill at all.22

Y12019-11-16-P1W
19STUDYXRS2324-P000119HAMD118HAMD1-Total ScoreHAMD 17161616

Y12019-11-16-P1W
20STUDYXRS2324-P000120HAMD101HAMD1-Depressed MoodHAMD 17


NOT DONE

22019-11-23-P1W
21STUDYXRS2324-P000121HAMD102HAMD1-Feelings of GuiltHAMD 17


NOT DONE

22019-11-23-P1W
22STUDYXRS2324-P000122HAMD103HAMD1-SuicideHAMD 17


NOT DONE

22019-11-23-P1W
23STUDYXRS2324-P000123HAMD104HAMD1-Insomnia Early - Early NightHAMD 17


NOT DONE

22019-11-23-P1W
24STUDYXRS2324-P000124HAMD105HAMD1-Insomnia Middle - Middle NightHAMD 17


NOT DONE

22019-11-23-P1W
25STUDYXRS2324-P000125HAMD106HAMD1-Insomnia Early Hours -MorningHAMD 17


NOT DONE

22019-11-23-P1W
26STUDYXRS2324-P000126HAMD107HAMD1-Work and ActivitiesHAMD 17


NOT DONE

22019-11-23-P1W
27STUDYXRS2324-P000127HAMD108HAMD1-RetardationHAMD 17


NOT DONE

22019-11-23-P1W
28STUDYXRS2324-P000128HAMD109HAMD1-AgitationHAMD 17


NOT DONE

22019-11-23-P1W
29STUDYXRS2324-P000129HAMD110HAMD1-Anxiety PsychicHAMD 17


NOT DONE

22019-11-23-P1W
30STUDYXRS2324-P000130HAMD111HAMD1-Anxiety SomaticHAMD 17


NOT DONE

22019-11-23-P1W
31STUDYXRS2324-P000131HAMD112HAMD1-Somatic Symptoms GIHAMD 17


NOT DONE

22019-11-23-P1W
32STUDYXRS2324-P000132HAMD113HAMD1-General Somatic SymptomsHAMD 17


NOT DONE

22019-11-23-P1W
33STUDYXRS2324-P000133HAMD114HAMD1-Genital SymptomsHAMD 17


NOT DONE

22019-11-23-P1W
34STUDYXRS2324-P000134HAMD115HAMD1-HypochondriasisHAMD 17


NOT DONE

22019-11-23-P1W
35STUDYXRS2324-P000135HAMD116AHAMD1-Loss of WT According to PatientHAMD 17


NOT DONE

22019-11-23-P1W
36STUDYXRS2324-P000136HAMD116BHAMD1-Loss of WT According to WK MeasHAMD 17


NOT DONE

22019-11-23-P1W
37STUDYXRS2324-P000137HAMD117HAMD1-InsightHAMD 17


NOT DONE

22019-11-23-P1W
38STUDYXRS2324-P000138HAMD118HAMD1-Total ScoreHAMD 17


NOT DONE

22019-11-23-P1W
$warningHtml

Dataset Wrapper Debug Message

Please add a row column to your dataset.

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 RS domain. It also provides guidance on how the result variables (RSORRES, RSSTRESC, and RSSTRESN) should be populated.

RSTESTCD = "HAMD101" RSTEST = "HAMD1-Depressed Mood"

RSORRES

RSSTRESC

RSSTRESN

Absent.00
These feeling states indicated only on questioning.11
These feeling states spontaneously reported verbally.22
Communicates feeling states non-verbally, i.e. through facial expression, posture, voice and tendency to weep.33
Patient reports virtually only these feeling states in his/her spontaneous verbal and non-verbal communication.44

RSTESTCD = "HAMD102" RSTEST = "HAMD1-Feelings of Guilt"

RSORRES

RSSTRESC

RSSTRESN

Absent.00
Self reproach, feels he/she has let people down.11
Ideas of guilt or rumination over past errors or sinful deeds.22
Present illness is a punishment. Delusions of guilt.33
Hears accusatory or denunciatory voices and/or experiences threatening visual hallucinations.44

RSTESTCD = "HAMD103" RSTEST = "HAMD1-Suicide"

RSORRES

RSSTRESC

RSSTRESN

Absent.00
Feels life is not worth living.11
Wishes he/she were dead or any thoughts of possible death to self.22
Ideas or gestures of suicide.33
Attempts at suicide (any serious attempt rates 4).44

RSTESTCD = "HAMD104" RSTEST = "HAMD1-Insomnia Early - Early Night"

RSORRES

RSSTRESC

RSSTRESN

No difficulty falling asleep.00
Complains of occasional difficulty falling asleep, i.e. more than ½ hour.11
Complains of nightly difficulty falling asleep.22

RSTESTCD = "HAMD105" RSTEST = "HAMD1-Insomnia Middle - Middle Night"

RSORRES

RSSTRESC

RSSTRESN

No difficulty.00
Patient complains of being restless and disturbed during the night.11
Waking during the night – any getting out of bed rates 2 (except for purposes of voiding).22

RSTESTCD = "HAMD106" RSTEST = "HAMD1-Insomnia Early Hours - Morning"

RSORRES

RSSTRESC

RSSTRESN

No difficulty.00
Waking in early hours of the morning but goes back to sleep.11
Unable to fall asleep again if he/she gets out of bed.22

RSTESTCD = "HAMD107" RSTEST = "HAMD1-Work and Activities"

RSORRES

RSSTRESC

RSSTRESN

No difficulty.00
Thoughts and feelings of incapacity, fatigue or weakness related to activities, work or hobbies.11
Loss of interest in activity, hobbies or work – either directly reported by patient or indirect in listlessness, indecision and vacillation (feels he/she has to push self to work or activities).22
Decrease in actual time spent in activities or decrease in productivity. Rate 3 if the patient does not spend at least three hours a day in activities (job or hobbies) excluding routine chores.33
Stopped working because of present illness. Rate 4 if patient engages in no activities except routine chores, or if patient fails to perform routine chores unassisted.44

RSTESTCD = "HAMD108" RSTEST = "HAMD1-Retardation"

RSORRES

RSSTRESC

RSSTRESN

Normal speech and thought.00
Slight retardation during the interview.11
Obvious retardation during the interview.22
Interview difficult.33
Complete stupor.44

RSTESTCD = "HAMD109" RSTEST = "HAMD1-Agitation"

RSORRES

RSSTRESC

RSSTRESN

None.00
Fidgetiness.11
Playing with hands, hair, etc.22
Moving about, can’t sit still.33
Hand wringing, nail biting, hair-pulling, biting of lips.44

RSTESTCD = "HAMD110" RSTEST = "HAMD1-Anxiety Psychic"

RSORRES

RSSTRESC

RSSTRESN

No difficulty.00
Subjective tension and irritability.11
Worrying about minor matters.22
Apprehensive attitude apparent in face or speech.33
Fears expressed without questioning.44

RSTESTCD = "HAMD111" RSTEST = "HAMD1-Anxiety Somatic"

RSORRES

RSSTRESC

RSSTRESN

Absent.00
Mild.11
Moderate.22
Severe.33
Incapacitating.44

RSTESTCD = "HAMD112" RSTEST = "HAMD1-Somatic Symptoms GI"

RSORRES

RSSTRESC

RSSTRESN

None.00
Loss of appetite but eating without staff encouragement. Heavy feelings in abdomen.11
Difficulty eating without staff urging. Requests or requires laxatives or medications for bowels or medication for gastro-intestinal symptoms.22

RSTESTCD = "HAMD113" RSTEST = "HAMD1-General Somatic Symptoms"

RSORRES

RSSTRESC

RSSTRESN

None.00
Heaviness in limbs, back or head. Backaches, headaches, muscle aches. Loss of energy and fatigability.11
Any clear-cut symptom rates 2.22

RSTESTCD = "HAMD114" RSTEST = "HAMD1-Genital Symptoms"

RSORRES

RSSTRESC

RSSTRESN

Absent.00
Mild.11
Severe.22

RSTESTCD = "HAMD115" RSTEST = "HAMD1-Hypochondriasis"

RSORRES

RSSTRESC

RSSTRESN

Not present.00
Self-absorption (bodily).11
Preoccupation with health.22
Frequent complaints, requests for help, etc.33
Hypochondriacal delusions.44

RSTESTCD = "HAMD116A" RSTEST = "HAMD1-Loss of WT According to Patient"

RSORRES

RSSTRESC

RSSTRESN

No weight loss.00
Probable weight loss associated with present illness.11
Definite (according to patient) weight loss.22
Not assessed.33

RSTESTCD = "HAMD116B" RSTEST = "HAMD1-Loss of WT According to WK Meas"

RSORRES

RSSTRESC

RSSTRESN

Less than 1 lb weight loss in week.00
Greater than 1 lb weight loss in week.11
Greater than 2 lb weight loss in week.22
Not assessed.33

RSTESTCD = "HAMD117" RSTEST = "HAMD1-Insight"

RSORRES

RSSTRESC

RSSTRESN

Acknowledges being depressed and ill.00
Acknowledges illness but attributes cause to bad food, climate, overwork, virus, need for rest, etc.11
Denies being ill at all.22




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