CDISC creates supplements for three types of instruments:
• Questionnaires: Questionnaire instruments are stored in the Questionnaires (QS) domain and are named, standalone instruments designed to provide an assessment of a concept. Questionnaires often have a defined standard structure, format, and content; consist of conceptually related items that are typically scored; and usually document methods for administration and analysis. Questionnaires consist of defined questions with a defined set of potential answers. Most often, the primary purpose of questionnaires is to generate quantitative statistic to assess a qualitative concept.
• Functional Tests: Functional Test instruments are stored in the Functional Tests (FT) domain and are named, standalone task-based evaluations, designed to provide an assessment of mobility, dexterity, and/or cognitive ability. A Functional Test is not a subjective assessment of how the subject generally performs a task. Rather, it is an objective measurement of the performance of the task by the subject in a specific instance. Functional Tests have documented methods for administration and analysis and require a subject to perform specific activities that are evaluated and recorded. Most often, Functional Tests are direct, quantitative measurements.
• Clinical Classifications: Named instruments whose output is an ordinal or categorical score that serves as a surrogate for, or ranking of, disease status, or other physiological or biological status. Usually the instrument will be published in a professional journal or on a website.
Clinical Classifications are based on a trained healthcare professional’s observation of a subject’s health condition or status with input from associated clinical records review. Clinical Classifications may be based solely on objective data from clinical records, or may involve a clinical judgment or interpretation of the directly observable signs, behaviors, or other physical manifestations related to a condition or subject status. These physical manifestations may be findings that are typically represented in other SDTM domains, such as labs, vital signs, or clinical events. Therefore, Clinical Classifications may be composite scores based on diverse inputs. This assessment method differs from a more traditional question-and-answer interview commonly seen in questionnaires.
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CDISC and Mapi Research Trust work together to ensure copyrighted instruments are available to CDISC to create QRS supplements by leveraging PROQOLID™, Mapi Research Trust’s comprehensive online database designed to assist academic researchers, physicians, students, pharmaceutical companies, health authorities, and international organizations in the search and evaluation of COAs.
QRS supplements to the SDTMIG include instrument-specific Controlled Terminology and an SDTM example illustrating the use, applicable supplemental qualifiers and item-level mapping instructions for the results. Assumptions for implementing the instrument in SDTM are also included.
QRS supplements to the ADaMIG describe how to structure the questionnaire analysis dataset based on data structures described in the ADaMIG. Included in ADaMIG supplements are sample analysis descriptions, scoring for the statistical analysis plan, data checks, and examples of analysis dataset metadata, analysis variable metadata, and value-level metadata. Also included is an example of the final analysis dataset to be used for analysis and regulatory submission.
Yes, the following are examples of QRS-like instruments represented in other domains:
- Microscopic Findings (MI) domain: If the data is based on microscopic data, those types of scoring instruments would be represented in the MI domain (see the Prostate Cancer TAUG – Gleason Score example).
- Findings About Events or Interventions (FA) domain: Sponsor-defined general single-Item assessment concepts. There are no published CDISC QRS Supplements for the evaluation of sponsor-defined general single-item assessments as they are not considered standard QRS instruments, but assess symptoms or other disease related items like overall quality of life, etc. These assessments may be evaluated using sponsor-defined general codelist scales, visual analog scales (VAS) or numeric rating scales (NRS). VAS and NRS Scales use various methods for describing the anchor points and may have descriptor anchors (e.g., beginning, middle and end) for various gradations or numbers). There may be examples of these assessments in the literature, but they are not considered CDISC QRS standard instruments, due to the extreme variability in the methods of capturing these types of assessments. These assessments may be in the public domain or may be copyrighted. Sponsors are responsible for the appropriate usage of any copyrighted assessments.
- General single-Item assessments are represented in the Finding About (FA) domain as they relate to a finding about a disease condition as an event. This concept meets one of the following criteria on when to use the FA domain:
- Data or observations that have different timing from an associated event or intervention as a whole.
- An observation about an Event or Intervention which requires more than one variable for its representation, particularly when the observation may be represented with findings class variables (e.g., units, method).
- More information on the use of the FA domain can be found in the SDTMIG.
- ADaM Basic Data Structure (BDS): An analysis dataset that contains one or more records per subject, per analysis parameter, per analysis time point. The parameters are mapped from –TEST and –TESTCD, and additional parameters are created as needed for derived scores.
- ADAM Other may also be used when the analysis has special needs that are not met by the BDS structure.
CDISC Controlled Terminology is maintained and distributed as part of the National Cancer Institute (NCI) Thesaurus and available in Excel, text, odm.xml, pdf, html and OWL/RDF formats. QRS SDTM terminology is included in the SDTM terminology download.
- Here’s an example using the Excel format of CDISC Controlled Terminology to find categories:
- In the SDTM CT spreadsheet, locate the category of the instrument in the following codelists: Category of Clinical Classification, Category of Functional Test, or Category of Questionnaire.
- Next, search for the instrument’s –TESTCD and –TEST codelists by using category’s CDISC Synonym(s) value in searching all CDISC Submission Values. The instrument’s “test code” and “test name” codelists will be provided.
- Here’s an example using the Excel format of CDISC Controlled Terminology to find terminology for The Satisfaction With Life Scale:
- Go to the top of the spreadsheet and search for ‘Satisfaction With Life’.
- This brings you to the instrument’s entry in the Category of Questionnaire (QSCAT) codelist.
- The cells in this row starting at the far left:
- EVS and Codelist C-codes for NCI reference use.
- Codelist Name for the name of the codelist (“Category of Questionnaire”).
- CDISC Submission Value which is the value of QSCAT for the instrument (SWLS).
- CDISC Synonym(s) value used to locate the –TESTCD and –TEST codelists (SWLS01).
- CDISC definition for this instrument.
- If you now search for SWLS01, you will find the –TESTCD and –TEST codelists (SWLS01TC and SWLS01TN) for The Satisfaction With Life Scale.
- The QRS Terminology Naming Rules are in the QRS Implementation Documents panel on this page.
CDISC must obtain permission to create a QRS supplement for copyrighted instruments. If this permission is not obtained, the supplement is not created.
Rights of Copyright Holders
- CDISC recognizes the copyright of all instrument copyright holders. All instrument owners maintain full copyright status when granting permission to CDISC to develop QRS supplements for the instrument. A QRS supplement does not, in any way, affect copyright holder licensing fees or procedures.
Creating QRS Supplements
- Granting CDISC the right to create supplements to represent an instrument in CDISC QRS domains is not a license for CDISC standards users to use the instrument without complying with the copyright holders licensing requirements.
- No part of a copyrighted instrument or accompanying guidelines may be reproduced, distributed, or transmitted in any form, or by any means, including photocopying, recording, or other electronic or mechanical methods without the permission of the copyright holder and payment of applicable fees.
You can request a QRS supplement be developed by completing the QRS Supplement Request Form located in the QRS Implementation Documents green box on this page.
Please note, if a copyrighted instrument does not have a supplement, CDISC may not have received permission to develop it. These instruments have Permission values of either “Denied” or “No response received”.
- Clinician-reported outcome (ClinRO)
- Observer-reported outcome (ObsRO)
- Patient-reported outcome (PRO)
- Performance outcome (PerfO)
|CDISC SDTM QRS Supplements||ClinRO||ObsRO||PRO||PerfO|
QRS supplements are developed following the CDISC Standards Development Process defined in COP-001 and further described in the QRS Addendum. The related QRS development process documents include:
- QRS Standard Request Form
- QRS Public Domain Copyright Verification Document
- CDISC Copyright Letter
- QRS Supplement Template (Based on appropriate domains, such as QS, FT, and RS)
- QRS Terminology Spreadsheet Example
- QRS Naming Rules
- QRS Supplement QC Checklist v2
QRS supplements are developed on the CDISC Wiki. Once developed and released, each QRS supplement can be downloaded freely from the QRS webpage to implement for data submissions.
Where permitted by the copyright holder, the supplement is accompanied by a CRF annotated with SDTMIG submission values. In addition, a supplement to the ADaMIG may be included to provide the documentation to prepare the QRS supplement analysis dataset.
Accessing the Published Supplements
The QRS standards package is available on the QRS web page. The following is a description of the column headings in the QRS published supplements table and how to access the package.
- QRS Name: Click on QRS Name to access the SDTMIG QRS Supplement, ADaMIG QRS Supplement, and/or an annotated CRF.
- Short Name: (--CAT): SDTM Short Name used to identify the QRS instrument within the SDTMIG and in Controlled Terminology.
- SDTM Domain / ADaM Dataset: Indicates the SDTM FINDINGS domain in which the SDTMIG supplement is represented. A designation of ADaM indicates an ADaMIG supplement exists for the instrument.
- Permission: Indicates the CDISC permission status of the instrument.
- Public Domain: The instrument is in the public domain; no permission is necessary.
- Granted: The copyright holder has granted CDISC permission to develop a supplement. Controlled Terminology for --CAT, --TEST, --TESTCD can also be developed. Where applicable, the SDTMIG supplement includes response values in --ORRES and scored values in –STRESC/--STRESN. This means that meaningful examples of data from the instrument can be included in supplements. Sponsors still need to obtain copyright permission from the copyright holder to use the instrument in their clinical trials.
- Author Permission Required: This permission level requires the user to obtain the CDISC QRS Supplements from the copyright holder. A README file is provided that explains how to obtain the instrument and CDISC QRS supplement(s).
- Denied: The copyright holder has denied permission to implement the QRS supplement. No supplement was developed.
- No response received: The copyright holder has not responded to attempted contacts. No supplement was developed.
- Pending: The QRS instrument’s copyright status is in review, but there is no resolution at this point in time.
- Version: Each Supplement version has a unique number.
- Release Date: Date CDISC published the QRS supplement.
All Published QRS Supplements
|QRS Name||Short Name (--CAT)||SDTM Domain/ADaM Dataset||Permission||Version Release Date|
|Karnofsky Performance Scale||KPS SCALE||QS||Public Domain||
7 Aug 2012
|Kurtzke Expanded Disability Status Scale||EDSS||ADaM||Public Domain||
27 Jul 2020
|Kurtzke Expanded Disability Status Scale||EDSS||QS||Public Domain||
23 Oct 2013
|Kurtzke Functional Systems Scores||KFSS||QS||Public Domain||
13 Nov 2013
19 Feb 2014
|Life Events Checklist for DSM-5, Standard Version||LEC-5 STANDARD VERSION||QS||Public Domain||
10 Mar 2020
|Mayo-Portland Adaptability Inventory||MPAI-4||QS||Public Domain||
30 Jun 2014
|Menstrual Distress Questionnaire Form-T (Today)||MDQ-T||No Response Received||
29 Sep 2020
|Michigan Neuropathy Screening Instrument||MNSI||QS||Public Domain||
7 Aug 2012
|Mini International Neuropsychiatric Interview (MINI)||MINI||No Response Received||
29 Sep 2020
|Model for End Stage Liver Disease||MELD||RS||Public Domain||
1 Apr 2015
6 Jan 2016
|Modified Fatigue Impact Scale||MFIS||QS||Granted||
18 Dec 2013
|Modified Hachinski Ischemic Scale NACC Version||MHIS-NACC||QS||Granted||
18 Sep 2013
|Modified Medical Research Council Dyspnea Scale||MMRC||QS||Public Domain||
9 Oct 2013
|Modified Rankin Scale||MRS||QS||Granted||
21 Aug 2013
|Montgomery-Asberg Depression Rating Scale||MADRS||No Response Received||
29 Sep 2020
|Montreal Cognitive Assessment||MOCA||Denied||
29 Sep 2020
|Movement Disorder Society Version of the Unified Parkinson's Disease Rating Scale||MDS-UPDRS||QS||Granted||
9 Aug 2012
|MS Quality of Life - 54||MSQOL-54||QS||Granted||
15 Jan 2014
9 May 2014
|Multiple Sclerosis Impact Scale version 1||MSIS-29v1||No Response Received||
29 Sep 2020
|Multiple Sclerosis Impact Scale version 2||MSIS-29v2||No Response Received||
29 Sep 2020