Illustrates Domains
CM
FA
Illustrates Variables
CMDOSFRQ
FAORRES
Content
This CRF was used to record both (1) insulin therapy used before the start of the study and (2) insulin used as background therapy during the study. The CRF uses CMSTRF and CMENRF, but could have used CMSTRTPT and CMENRTPT. See CDASHIG v2.0 Section 3.7, Mapping Relative Times from Collection to Submissions, and SDTMIG v3.2 Section 4.1.4.7, Use of Relative Timing Variables, for more information (available at https://www.cdisc.org/standards).
Title: Insulin Management Prior to Study/Background Therapy
Enter a separate record for each type of insulin that was used. If the frequency of use was changed, enter each frequency as a separate record.
Record the specific type of insulin used by the subject, 1 type of insulin per line. Refer to the protocol for a list of insulins to be recorded. |
CMTRT
|
_________________ | |
---|---|---|---|
Provide the route of administration for the medication. |
Route
CMROUTE
|
<From ROUTE codelist> |
|
Record the usual frequency of injections or inhalations per day, or choose "Continuous" if subject was using an insulin pump. |
Frequency
CMDOSFRQ
|
<From FREQ codelist> |
|
If available, record the date the insulin was first taken using this format (DD-MON-YYYY). If the subject has been taking insulin for a considerable amount of time prior to the start of the study, it is acceptable to have an incomplete date. Prior concomitant medications that are exclusionary should have both a start date and an end date. |
CMSTDAT CMSTDTC
|
_ _ / _ _ _ / _ _ _ _ | |
If a start date is not available, indicate if the concomitant insulin was started before the study. |
Prior to Study
CMPRIOR CMSTRF
|
<From NY codelist> |
|
Indicate if the insulin is ongoing (i.e., the subject has not stopped taking this type of insulin at the end of the study). The end date should be left blank. |
Is the medication ongoing?
CMONGO CMENRF
|
<From NY codelist> |
|
If available, record the date insulin stopped using this format (DD-MON-YYYY). If the subject has not stopped taking insulin, leave this field blank. |
CMENDAT CMENDTC
|
_ _ / _ _ _ / _ _ _ _ |
This example CRF was used at each visit, including the baseline visit, to record the mean total daily dose of insulin over the previous 7 days for each type of insulin treatment that was ongoing.
Title: Insulin Management - Mean Total Daily Dose
Enter the medication identifier for the ongoing insulin treatment. |
FACMNO FALNKID
|
_________________ | |
---|---|---|---|
If insulin is ongoing, record the mean total daily dose of insulin taken in the last 7 days. |
DOSTOT_FAORRES FAORRES where FATESTCD = "DOSTOT" and FAOBJ = CMTRT and NSFA.FACOLSRT = "MEAN" and FAEVLINT = "-P7D"
|
. __.__ |