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PharmaSUG2014 - Paper DS03
Considerations in Creating SDTM Trial Design Datasets
Jerry Salyers, Accenture Life Sciences, Berwyn, PA
Richard Lewis, Accenture Life Sciences, Berwyn, PA
Kim Minkalis, Accenture Life Sciences, Berwyn, PA
Fred Wood, Accenture Life Sciences, Berwyn, PA
ABSTRACT
Many sponsors are now submitting clinical trials data to the FDA in the format of the CDISC SDTM. The Trial Design
Model (TDM) datasets can be especially challenging because, in most cases, they are being created retrospectively
from the protocol, and cannot be created from electronic data. From the most recent Common Data Standards Issues
document, it is clear that FDA is placing a greater emphasis on incorporating the trial design datasets into any SDTM
based submission.
This paper will discuss some of the considerations and challenges in creating the TDM datasets, using case studies
of both relatively simple and more complex trials. We will highlight a number of the pitfalls and misconceptions that
are commonly seen when sponsors and their vendors attempt to create the TDM datasets for the first time. Included
will be practical advice on which datasets should be created first, which datasets drive the creation of others, and how
the trial-level and subject-level datasets relate to each other. The presentation will conclude with a list of resources
for TDM dataset creation.
INTRODUCTION
Since the time of one of the author’s first paper on the creation of the trial design datasets in 2011 (Wood and
Lenzen), these datasets have increasingly become a part of most SDTM-based submissions. As a general rule, most
of the creation of the standard “T” tables continues to be “retrospective”, performed after the supporting data is
already collected. This retrospective creation can lead to difficult, or even incorrect, presentations of the planned
conduct of the study. We are, however, starting to see more occasions where sponsors and their vendors are
developing the “T” tables earlier in the data specification process and thus are seeing the benefit of this prospective
approach. Although this is definitely a step in the right direction, there continues to be a lack of basic understanding of
many facets of trial design. This paper will provide an overview of the Trial Design datasets, and present a number of
case studies that illustrate some of the challenges we have seen.
TRIAL DESIGN OVERVIEW
The Trial Design Model, described in the SDTM and the SDTM Implementation Guide (SDTMIG), provides a
standardized way to represent the basic aspects of the “planned” conduct of a clinical trial. The purpose of
standardizing the plan from the protocol is to allow reviewers (and others) to do the following:
 Clearly and quickly grasp the design of a clinical trial
 Understand the rules for how subjects transition through various periods or phases of a trial
 Compare the designs of different trials
 As Trial Design creates a machine-readable version of the protocol, it allows reviewers to search a
data warehouse for clinical trials with similar features
 Compare planned and actual treatments for subjects in a clinical trial.
The Trial Design Model (TDM) is built on the concepts and identification of Elements, Arms, Epochs, and Visits.
These are illustrated in Figure 1 below.
Figure 1. Trial Design Basic Concepts
Considerations in Creating SDTM Trial Design Datasets, Continued
2
Trial Elements represent the “building blocks” of the clinical trial. In the Trial Elements (TE) dataset, each Element is
represented by an Element Code (ETCD) and an Element description (ELEMENT). The TE dataset also contains
variables providing “rules” for each Element that describe how a subject transitions into (TESTRL) and out of the
Element (TEENRL). There is never a time within the trial that a subject is not in one of the trial Elements, so the rules
have to be created in such a way that a “gap” (or an “overlap”) is not created. Put another way, while the Element
“End Rule” may indicate when an element should end, the Start Rule of any Element drives the transition from the
previous Element. TE also contains a “duration” variable (TEDUR) that can be used either in lieu of, or in addition to,
the Element End Rule, to indicate a protocol-defined duration for the Element. For the simple trial design shown in the
diagram above, the TE dataset might look like this:
STUDYID DOMAIN ETCD ELEMENT TESTRL TEENRL TEDUR
1999001 TE SCREEN Screen Date of Informed Consent First dose of run-
in medication
1999001 TE RUNIN Run-in Frist dose of run-in
medication
First dose of
blinded trial
medication
P1W
1999001 TE PLAC Placebo First dose of blinded trial
medication when
randomized to placebo
Last dose of trial
medication
P2W
1999001 TE DRUGA Drug A First dose of blinded trial
medication when
randomized to Drug A
Last dose of trial
medication
P2W
1999001 TE DRUGB Drug B First dose of blinded trial
medication when
randomized to Drug B
Last dose of trial
medication
P2W
The TA dataset shows the planned order of Elements (TAETORD) within each of the Arms along with identifying
“decision points” where subjects may “branch” (TABRANCH) into an Element that is unique for their assigned Arm, or
“rules” by which a subject may “skip” (TATRANS, not shown) the next Element(s) in their assigned sequence. Epoch
is defined in TA as a vertical slice of time that is independent of Arm and provides a way to describe what is
happening across Elements while a trial is blinded. “Decision points” or “branches” always occur between Epochs.
The Arm (and ARMCD) values defined in TA must be the same as those used in the Demographics (DM) dataset.
For one of the Arms in the trial above, the dataset may look like:
STUDYID DOMAIN ARMCD ARM TAETORD ETCD TABRANCH EPOCH
1999001 TA DRUGA Drug A 1 SCREEN Randomized to
Drug A
SCREENING
1999001 TA DRUGA Drug A 2 RUNIN RUN-IN
1999001 TA DRUGA Drug A 3 DRUGA TREATMENT
The TV table represents the planned visits, or “clinical encounters” that are defined with the protocol’s time and event
schedule. To facilitate data collection and to satisfy constraints inherent in some data management systems, data
such as AEs or concomitant medications may be collected in a type of “Log” visit. However, these “visits” should not
be accounted for in TV. Just as with TE, TV contains a “start rule” (TVSTRL) that is used to indicate when, according
to the protocol, a visit is scheduled to occur. Most visits are assumed to last only a single day and thus a visit’s “end
rule” (TVENRL) is often not populated. While ARMCD is an “Expected” variable, ARM and ARMCD are only
populated if the visit schedule varies by Arm. As the SDTM IG explains, “If the timing of Visits…does not depend on
which Arm a subject is in, ARMCD should be null. The TV table for our example study might look something like this:
STUDYID DOMAIN VISITNUM VISIT ARMCD TVSTRL TVENRL
1999001 TV 1 Visit 1 Informed Consent date; Start of Visit 1
assessments
End of Visit 1
assessments
1999001 TV 2 Visit 2 Subject dispensed one week supply of
run-in medication and takes first dose
1999001 TV 3 Visit 3 Subject dispensed 2 week supply of
study medication and takes first dose
1999001 TV 4 Visit 4 Visit 4 assessments, 1 week after
starting study medication +/- 1 day
1999001 TV 5 Visit 5 Visit 5 assessments, 2 weeks after
starting study medication +/- 1 day
At Trial Exit
Additionally, there are the Trial Inclusion (TI) and Trial Summary (TS) datasets. TI represents the inclusion/exclusion
criteria as detailed either in the protocol or in the CRF and is trial level data. If the study data only collects an over-
arching question regarding a subject’s eligibility, then TI will come from the protocol and/or any amendments that
impact subject inclusion/exclusion. It is imperative that the text in IETEST within the TI domain match the IETEST in
Considerations in Creating SDTM Trial Design Datasets, Continued
3
the subject-level IE domain which records any criteria that a subject may have failed. If the protocol has amendments
that impact study inclusion/exclusion, complete sets of the inclusion/exclusion criteria must be included for each
version of the protocol.
The Trial Summary (TS) dataset represents key information about the trial as a whole. This dataset, if constructed
first, will often help to establish the treatment specific trial elements as well as define the number of Arms for the
study. The TS domain has been substantially changed with the release of the SDTM IG v3.1.3. Prior to this release,
there was no real concept of “Required” trial summary parameters. If a parameter such as AGEMAX (Maximum Age
of Subjects) had no protocol-defined value, the parameter was simply omitted. With the advent of the “null-flavor”
variable in TS, the AGEMAX parameter has become “Required” whether or not the maximum age is defined in the
protocol. In cases where the maximum age is not defined, the parameter is retained, but with the Null Flavor value of
‘PINF’ (positive infinity). Later in this paper, we will look more closely at the TS dataset along with several specific
parameters. It should be noted that there is an extensible CDISC Controlled Terminology (CT) codelist for Trial
Summary parameters as well as CT for a number of parameter values or choices.
TRIAL DESIGN CASE STUDIES
The design of different types of clinical trials that may not be as routine or as simple as the trial in our illustration
above. As the design of clinical trials can change dramatically depending on the “Phase” of the study or the
indication, how the trial is modeled within the trial design datasets also changes dramatically. In the following
examples, we will examine some challenges sponsors may face in the creation of Trial Design datasets for more-
complicated studies.
Example Trial 1
This is a study involving “Drug A” which has a placebo-controlled 12-week double-blind period followed by a 4-week
open-label extension where all subjects take active medication. A diagram of this trial is shown in Figure 2.
Figure 2. Double Blind into Open Label – Design Based on Protocol
The sponsor’s initial attempt at developing the TA dataset is shown in the table below (for ease of display, we’ve left
out the STUDYID column), which would have resulted in the design shown in Figure 3:
DOMAIN ARMCD ARM TAETORD ETCD ELEMENT TABRANCH EPOCH
TA A Drug A 50
mg
1 SCRN Screen Randomized
to Drug A
SCREENING
TA A Drug A 50
mg
2 DRGA50 Drug A 50
mg
TREATMENT
TA A Drug A 50
mg
3 FU Follow Up FOLLOW-UP
TA B Placebo 1 SCRN Screen Randomized
to Placebo
SCREENING
TA B Placebo 2 PLAC Placebo TREATMENT
TA B Placebo 3 DRGA50OL Drug A 50
mg OL
OPEN LABEL
TREATMENT
TA B Placebo 4 FU Follow Up FOLLOW-UP
Figure 3. Double Blind into Open Label – Design Based on Sponsor TA Dataset
With this (mis)representation, subjects who were initially randomized to active treatment have only a single
TREATMENT Epoch while subjects who were initially randomized to placebo have a TREATMENT Epoch and an
Considerations in Creating SDTM Trial Design Datasets, Continued
4
OPEN LABEL TREATMENT Epoch. However, based on the protocol, as well as the collected data, both treatment
groups should have the same study Epochs, even though, for the subjects initially randomized to 12 weeks of active
drug, their medication doesn’t change over the course of the 16-week dosing period. Our modified TA dataset (which
reflects the design in Figure 2, shows the following rows:
DOMAIN ARMCD ARM TAETORD ETCD ELEMENT TABRANCH EPOCH
TA A Drug A
50 mg
1 SCRN Screen Randomized
to Drug A
SCREENING
TA A Drug A
50 mg
2 DRGA50 Drug A 50
mg
TREATMENT
TA A Drug A
50 mg
3 DRGA50OL Drug A 50
mg OL
OPEN LABEL
TREATMENT
TA A Drug A
50 mg
4 FU Follow Up FOLLOW-UP
TA B Placebo 1 SCRN Screen Randomized
to Placebo
SCREENING
TA B Placebo 2 PLAC Placebo TREATMENT
TA B Placebo 3 DRGA50OL Drug A 50
mg OL
OPEN LABEL
TREATMENT
TA B Placebo 4 FU Follow Up FOLLOW-UP
Example Trial 2
This study is a three-period crossover trial where subjects receive a single dose of Drug B at 2 mg, 6 mg, or placebo
in a crossover fashion. The following is an excerpt (STUDYID, ARM, and TABRANCH left out) of the initial TA
dataset, highlighting two of the sequences where P = Placebo, A = 2 mg, and B = 6 mg:
DOMAIN ARMCD TAETORD ETCD ELEMENT EPOCH
TA P-A-B 1 SCREEN Screen SCREENING
TA P-A-B 2 S1P1 Seq 1, Period 1, Placebo TREATMENT 1
TA P-A-B 3 WASHOUT Washout WASHOUT
TA P-A-B 4 S1P2 Seq 1, Period 2, 2 mg TREATMENT 2
TA P-A-B 5 WASHOUT Washout WASHOUT
TA P-A-B 6 S1P3 Seq 1, Period 3, 6 mg TREATMENT 3
TA A-P-B 1 SCREEN Screen SCREENING
TA A-P-B 2 S2P1 Seq 2, Period 1, 2 mg TREATMENT 1
TA A-P-B 3 WASHOUT Washout WASHOUT
TA A-P-B 4 S2P2 Seq 2, Period 2, Placebo TREATMENT 2
TA A-P-B 5 WASHOUT Washout WASHOUT
TA A-P-B 6 S2P3 Seq 2, Period 3, 6 mg TREATMENT 3
In this table, individual Elements have been assigned based on where they occur in the dosing sequence, instead of
there simply being one placebo Element, one 2 mg Element, and one 6 mg Element. The remaining Arms or
sequences were similarly modeled. Thus the TE dataset contains many more rows than are necessary. Our feedback
to the sponsor was to create a single Element for each possible dose, regardless of when it occurs in the subject’s
assigned sequence:
DOMAIN ARMCD TAETORD ETCD ELEMENT EPOCH
TA P-A-B 1 SCREEN Screen SCREENING
TA P-A-B 2 PLACEBO Placebo TREATMENT 1
TA P-A-B 3 WASHOUT Washout WASHOUT
TA P-A-B 4 DRUGB2MG Drug B 2 mg TREATMENT 2
TA P-A-B 5 WASHOUT Washout WASHOUT
TA P-A-B 6 DRUGB6MG Drug B 6 mg TREATMENT 3
TA A-P-B 1 SCREEN Screen SCREENING
TA A-P-B 2 DRUGB2MG Drug B 2 mg TREATMENT 1
TA A-P-B 3 WASHOUT Washout WASHOUT
TA A-P-B 4 PLACEBO Placebo TREATMENT 2
TA A-P-B 5 WASHOUT Washout WASHOUT
TA A-P-B 6 DRUGB6MG Drug B 6 mg TREATMENT 3
Example Trial 3
Consider this more complicated “single-sequence” crossover study (See Figure 4 below for a graphic representation
of the study design). In this trial, subjects receive the following:
Considerations in Creating SDTM Trial Design Datasets, Continued
5
 On Day 1, a single dose of “Drug S, followed by PK sample collections for 48 hours
 On Day 3, a single dose of “Drug R” followed by PK evaluations for 72 hours
 On Day 6, BID dosing of “Drug X’ for a total of 9 days
 On Day 10, a single dose of Drug S in conjunction with the continued BID dosing of Drug X, followed by PK
evaluations for 48 hours (analogous to the single dose of Drug S given at Day 1)
 On Day 12, a single dose of Drug R in conjunction with their continued BID dosing of Drug X, followed by PK
evaluations for 72 hours (analogous to the single dose of Drug R given at Day 3)
Figure 4. “Single sequence” crossover design
The following represents two possible TA tables:
DOMAIN ARMCD TAETORD ETCD ELEMENT EPOCH
TA A 1 SCREEN Screen SCREENING
TA A 2 DRUGS Drug S, Single 10 mg Dose TREATMENT
TA A 3 DRUGR Drug R, single 10 mg Dose TREATMENT
TA A 4 DRUGX1 Drug X, 400 mg BID, Days 6-9 TREATMENT
TA A 5 DRUGXS Drug S 10 mg in combination with Drug X TREATMENT
TA A 6 DRUGX2 Drug X, 400 mg BID, Day 11 TREATMENT
TA A 7 DRUGXR Drug R 10 mg in combination with Drug X TREATMENT
TA A 8 DRUGX3 Drug X, 400 mg BID, Days 13-14 TREATMENT
TA A 9 FOLLOWUP Follow-Up FOLLOW-UP
OR
DOMAIN ARMCD TAETORD ETCD ELEMENT EPOCH
TA A 1 SCREEN Screen SCREENING
TA A 2 DRUGS Drug S, Single 10 mg Dose TREATMENT
TA A 3 DRUGR Drug R, single 10 mg Dose TREATMENT
TA A 4 DRUGX Drug X, 400 mg BID, Days 6-9 TREATMENT
TA A 5 DRUGXS Drug S 10 mg in combination with Drug X TREATMENT
TA A 6 DRUGXR Drug R 10 mg in combination with Drug X TREATMENT
TA A 7 FOLLOWUP Follow-Up FOLLOW-UP
Note the two extra Elements in the first version of the table where the continued BID dosing on Day 11 and Days 13
and 14 are broken out into separate Elements.
We consider the second version of TA to be the more correct version for the above study. The former table was the
design originally favored by the sponsor. We provided the latter TA table back to them along with the TE table below.
DOMAIN ETCD ELEMENT TESTRL TEENRL
TE SCRN Screen Date/time of Informed
Consent
Date/time of first single dose of
Drug S
TE DRUGS Drug S, Single 10 mg
Dose
Date/time of first single
dose of Drug S
Date/time of first single dose of
Drug R
TE DRUGR Drug R, single 10 mg
Dose
Date/time of first single
dose of Drug R
Date/time of first BID dose of
Drug X
Considerations in Creating SDTM Trial Design Datasets, Continued
6
TE DRUGX Drug X, 400 mg BID, Days
6-9
Date/time of first BID
dose of Drug X
Date/time of second single dose
of Drug S while subject is
receiving Drug X
TE DRUGXS Drug S 10 mg in
combination with Drug X
Date/time of second
single dose of Drug S
while subject is
receiving Drug X
Date/time of second single dose
of Drug R while subject is
receiving Drug X
TE DRUGX
R
Drug R 10 mg in
combination with Drug X
Date/time of second
single dose of Drug R
while subject is
receiving Drug X
Final PK sample collected at Day
15
TE FOLLOW
UP
Follow-Up Discharge from unit
after final PK sample
collection
At Trial Exit
As we see, the sponsor had originally wanted to split out into separate Elements the continued BID dosing of Drug X
following the second single dose of Drug S and Drug R, respectively. Our explanation was basically that trial design is
less concerned with these specific “protocol-defined” days than it is with defining a “treatment strategy”. We also
advised them that we felt it was very important that the Element “start rules” (and by default, the “end rules”) be
consistent between the initial single dose of either Drug R or Drug S and the second single dose of the two
drugs. The evaluation period for each should remain the same. When subjects continue to receive study drug on
Study Day 11 and on Study Day 13-14, these should not represent additional Elements in the study. Subjects are
continuing to take the study drug during this time simply to remain at steady state while the pharmacokinetic profiles
of Drug S and Drug R are being evaluated in the presence of Drug X.
COMMON ISSUES
As our previous trial design paper (Wood and Lenzen, 2011) pointed out, often constructing the T tables is more a
matter of art than it is pure science. To be sure, as shown in the above examples, there are instances where some
representations are “more correct”. There are also occasions, however where there may be more than one “correct”
design. Consider information in Figure 4: does the Element reflecting the dose of Drug A last all the way to the dose
of Drug B? Or is there an Element in between? The decision will be based upon how one wants to analyze the in-
between period. Is this a continuation of the Drug A dosing period that will contain evaluations related to Drug A, or is
it considered to be a washout period with no assessments related to Drug A? Often there is no single correct answer
that’s appropriate for all trials. Again, it comes down to the strategy and the analysis.
Figure 5. Determining the Best Representation of Trial Elements
Let’s take a moment and look at each trial design domain and highlight just a few of the more important issues and
problems that we often see when reviewing some sponsors attempts at trial design.
TA:
 Branching statements should be included on the line of the Element where, at its conclusion, it
leads into the Element that makes the Arm unique.
 Transition “rules” should be present when the protocol indicates that subjects may qualify for a
“shortened path” within their assigned Arm. As with branching, statements should be included on
the line of the Element where, at its conclusion, leads to the transition.
 All values for ETCD and ELEMENT should be present in TE.
 The values of ARMCD and ARM should be those used in DM.
Considerations in Creating SDTM Trial Design Datasets, Continued
7
TE
 The Element Start Rules and End Rules should point to events for which there is collected data. An
example of an issue is when the protocol states that an Element ends when the subject leaves the
clinic, but the CRF did not collect the date this occurred. As a result, one may have to define a
surrogate Element End Rule that’s different from what the sponsor intended in the protocol. The
earlier trial design is created, the more likely that the required data points will be part of the data
collection.
 A Start Rule should be specific enough to ensure there is no confusion as in:
o If a subject participates in two Elements of the same drug with different dose levels, the
dose level needs to be included in the Start Rule.
o When there are actually multiple Arms with one or more unique treatments, an Element of
“Treatment” alone is not sufficient.
 TEDUR should not be populated for Elements of variable lengths. An example of such a misuse
would be for a Screening Element with TEDUR = ‘P28D’ where the Screening period is defined in
the protocol as simply “within 28 days of randomization”.
TV
 An End Rule should be present for visits that are likely to last more than one day. An example
would be for an oncology trial where a visit equates to a cycle of treatment.
 Unscheduled visits should not be included in TV, since TV is only for planned visits. Unscheduled
visits would only be present in Subject Visits.
 When study visits vary, even slightly, between Arms of the study, a full set of the Visit structure
should be supplied for each Arm with ARMCD populated in each instance.
TI
 Versions of TI should be included when an amendment has affected any of the inclusion/exclusion
criteria.
 There should be a 1:1 relationship between IETESTCD and IETEST. Sometimes sponsors fail to
update the IETEST after updating IETESTCD as the result of an amendment.
TS
The TS domain underwent some significant changes in SDTM-IG v3.1.3 compared to previous versions. To illustrate
these changes as well as provide an example of a TS dataset, we’ll use the following study description:
This open label Phase II study will randomize approximately 138 subjects (18 years of age and older) with
metastatic bladder or urethra cancer into 3 treatment ARMs: Docetaxel (75 mg/m2), Docetaxel + Drug A (10
mg/kg), and Docetaxel + Drug B (12 mg/kg).
Obviously, there’s much more to the study than this, such as specifying the primary and secondary study objectives,
where the study is to be conducted, etc., but just this short description is enough to start with.
STUDYID DOMAIN TSSEQ TSGRPID TSPARMCD TSPARM TSVAL TSVALNF TSVALCD TSVCDREF
2014015 TS 1 ACTSUB Actual Number
of Subjects
130
2014015 TS 1 ADAPT Adaptive
Design
N C49487 CDISC
2014015 TS 1 ADDON Added onto
Existing
Treatments
Y C49488 CDISC
2014015 TS 1 AGEMIN Planned
Minimum Age
P18Y ISO 8601
2014015 TS 1 AGEMAX Planned
Maximum Age
PINF ISO 21090
2014015 TS 1 DOC CURTRT Current
Therapy or
Treatment
Docetaxel 15H5577C
QD
UNII
2014015 TS 1 DOC DOSE Dose per
Administration
75
2014015 TS 2 DRUGA DOSE Dose per
Administration
10
2014015 TS 3 DRUGB DOSE Dose per
Administration
12
2014015 TS 1 DOC DOSU Dose Units mg/m2 C67402 CDISC
2014015 TS 2 DRUGA DOSU Dose Units mg/kg C67401 CDISC
2014015 TS 3 DRUGB DOSU Dose Units mg/kg C67401 CDISC
2014015 TS 1 INDIC Trial Indication Bladder
Cancer
406024002 SNOMED CT
2014015 TS 1 NARMS Planned 3
Considerations in Creating SDTM Trial Design Datasets, Continued
8
Number of
Arms
2014015 TS 1 PLANSUB Planned
Number of
Subjects
138
2014015 TS 1 RANDQT Randomization
Quotient
0.67
2014015 TS 1 TBLIND Trial Blinding
Schema
OPEN
LABEL
C49659 CDISC
2014015 TS 1 TPHASE Trial Phase
Classification
Phase II
Trial
C15601 CDISC
2014015 TS 1 DRUGA TRT Investigational
Therapy or
Treatment
Drug A
2014015 TS 1 DRUGB TRT Investigational
Therapy or
Treatment
Drug B
Just a few points regarding the above table and TS in general:
 Even if it’s a SDTM IG 3.1.2 TS dataset (and thus no “Required” parameters), as many parameters as possible
should be used to adequately describe the study.
 When employing both ACTSUB and PLANSUB parameters, the numbers for both should refer to the same
degree of subject participation (i.e., both indicating number of “randomized” subjects (planned and actual)
 TSSEQ – is a sequence number within a parameter allowing multiple records with the same TSPARMCD,
such as DOSE in the table above
 TSGRPID – can be used to tie together any block of records in the dataset. In this case, the DOSE and DOSU
records were tied to the treatments administered.
 TSPARMCD and TSPARM come from CDISC Controlled Terminology (CT) as do many of the responses in
the TSVAL column. For those responses, the case shown in TSVAL matches the case in CT.
 In this three Arm study, the drug Docetaxel acts as a CURTRT (Current Therapy or Treatment) for both
investigational products, Drug A and Drug B.
 The parameter INDIC (Trial Indication) is linked to the NCI Term Browser located at
http://ncit.nci.nih.gov/ncitbrowser. This parameter represents the overall disease indication for the study
medication. For Phase I studies that primarily collect PK data on a “healthy subject” population, this parameter
should be omitted.
 The value shown for RANDQT represents the percentage (the decimal-based fraction of 1) of subjects that are
planned to be exposed to investigational treatment. If all subjects are exposed at one time or another during
the course of the trial, this would be 1.
 For Docetaxel, the value in TSVALCD comes from the FDA Substance Registration System’s “Unique
Ingredient Identifier” (UNII) available at http://fdasis.nlm.nih.gov/srs.
 For those values that come from CDISC CT, NCI EVS “Concept Code” appears in the TSVALCD. This comes
from Column A of the controlled terminology spreadsheet available via the NCI website at
http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/cdisc.
CONCLUSIONS
Creating SDTM trial design datasets can often be challenging, depending on the complexity of the study. Even after
gaining experience across different therapeutic areas, two people still may not model a study in exactly the same
way, but both may be defensible and, for the most, correct. Our general philosophy is to try to keep the datasets as
simple as possible, but still within the framework of the model and the intent of the study protocol. It takes a lot of
practice and experience with trials of many types of designs before one can become adept at creating Trial Design
datasets. We expect the relative importance of these datasets in an SDTM-based submission to be increasing as
more and more sponsors submit them, and reviewers get more experience in seeing how valuable they are.
RESOURCES
 Wood, F. and Lenzen, M. (2011) Trials and Tribulations of Trial Design. PharmaSUG Proceedings, May
2011.
 Study Data Tabulation Model. Clinical Data Interchange Standards Consortium (CDISC) Submission Data
Standards (SDS) Team, Version 1.4, December 2013.
 Study Data Tabulation Model Implementation Guide: Human Clinical Trials. Clinical Data Interchange
Standards Consortium (CDISC) Submission Data Standards (SDS) Team, Version 3.2, December 2013
 There are also several case studies and Trial Design examples posted in the “Member’s Only” area on the
CDISC website (http://www.cdisc.org).
Considerations in Creating SDTM Trial Design Datasets, Continued
9
ACKNOWLEDGMENTS
The authors would like to acknowledge the management at Accenture Life Sciences who understand the importance
of data standards in pharmaceutical research, and who have supported our participation in numerous CDISC teams.
SAS and all other SAS Institute Inc. product or service names are registered trademarks or trademarks of SAS
Institute Inc. in the USA and other countries. ® indicates USA registration. Other brand and product names are
registered trademarks or trademarks of their respective companies.
CONTACT INFORMATION
Your comments and questions are valued and encouraged. Contact the authors at:
Jerry Salyers
Senior Consultant, Data Standards Consulting
Accenture Life Sciences
1160 W. Swedesford Road Bldg One
Berwyn, PA 19312
513.668.8126
jerry.j.salyers@accenture.com
Richard Lewis
Senior Consultant, Data Standards Consulting
Accenture Life Sciences
1160 W. Swedesford Road Bldg One
Berwyn, PA 19312
262.716.4167
richard.m.lewis@accenture.com
Fred Wood
Senior Manager, Data Standards Consulting
Accenture Life Sciences
1160 W. Swedesford Road Bldg One
Berwyn, PA 19312
484.881.2297
f.wood@accenture.com
Kim Minkalis
Consultant, Data Standards Consulting
Accenture Life Sciences
1160 W. Swedesford Road Bldg One
Berwyn, PA 19312
484.467.4988
kimberly.a.minkalis@accenture.com

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  • 1. 1 PharmaSUG2014 - Paper DS03 Considerations in Creating SDTM Trial Design Datasets Jerry Salyers, Accenture Life Sciences, Berwyn, PA Richard Lewis, Accenture Life Sciences, Berwyn, PA Kim Minkalis, Accenture Life Sciences, Berwyn, PA Fred Wood, Accenture Life Sciences, Berwyn, PA ABSTRACT Many sponsors are now submitting clinical trials data to the FDA in the format of the CDISC SDTM. The Trial Design Model (TDM) datasets can be especially challenging because, in most cases, they are being created retrospectively from the protocol, and cannot be created from electronic data. From the most recent Common Data Standards Issues document, it is clear that FDA is placing a greater emphasis on incorporating the trial design datasets into any SDTM based submission. This paper will discuss some of the considerations and challenges in creating the TDM datasets, using case studies of both relatively simple and more complex trials. We will highlight a number of the pitfalls and misconceptions that are commonly seen when sponsors and their vendors attempt to create the TDM datasets for the first time. Included will be practical advice on which datasets should be created first, which datasets drive the creation of others, and how the trial-level and subject-level datasets relate to each other. The presentation will conclude with a list of resources for TDM dataset creation. INTRODUCTION Since the time of one of the author’s first paper on the creation of the trial design datasets in 2011 (Wood and Lenzen), these datasets have increasingly become a part of most SDTM-based submissions. As a general rule, most of the creation of the standard “T” tables continues to be “retrospective”, performed after the supporting data is already collected. This retrospective creation can lead to difficult, or even incorrect, presentations of the planned conduct of the study. We are, however, starting to see more occasions where sponsors and their vendors are developing the “T” tables earlier in the data specification process and thus are seeing the benefit of this prospective approach. Although this is definitely a step in the right direction, there continues to be a lack of basic understanding of many facets of trial design. This paper will provide an overview of the Trial Design datasets, and present a number of case studies that illustrate some of the challenges we have seen. TRIAL DESIGN OVERVIEW The Trial Design Model, described in the SDTM and the SDTM Implementation Guide (SDTMIG), provides a standardized way to represent the basic aspects of the “planned” conduct of a clinical trial. The purpose of standardizing the plan from the protocol is to allow reviewers (and others) to do the following:  Clearly and quickly grasp the design of a clinical trial  Understand the rules for how subjects transition through various periods or phases of a trial  Compare the designs of different trials  As Trial Design creates a machine-readable version of the protocol, it allows reviewers to search a data warehouse for clinical trials with similar features  Compare planned and actual treatments for subjects in a clinical trial. The Trial Design Model (TDM) is built on the concepts and identification of Elements, Arms, Epochs, and Visits. These are illustrated in Figure 1 below. Figure 1. Trial Design Basic Concepts
  • 2. Considerations in Creating SDTM Trial Design Datasets, Continued 2 Trial Elements represent the “building blocks” of the clinical trial. In the Trial Elements (TE) dataset, each Element is represented by an Element Code (ETCD) and an Element description (ELEMENT). The TE dataset also contains variables providing “rules” for each Element that describe how a subject transitions into (TESTRL) and out of the Element (TEENRL). There is never a time within the trial that a subject is not in one of the trial Elements, so the rules have to be created in such a way that a “gap” (or an “overlap”) is not created. Put another way, while the Element “End Rule” may indicate when an element should end, the Start Rule of any Element drives the transition from the previous Element. TE also contains a “duration” variable (TEDUR) that can be used either in lieu of, or in addition to, the Element End Rule, to indicate a protocol-defined duration for the Element. For the simple trial design shown in the diagram above, the TE dataset might look like this: STUDYID DOMAIN ETCD ELEMENT TESTRL TEENRL TEDUR 1999001 TE SCREEN Screen Date of Informed Consent First dose of run- in medication 1999001 TE RUNIN Run-in Frist dose of run-in medication First dose of blinded trial medication P1W 1999001 TE PLAC Placebo First dose of blinded trial medication when randomized to placebo Last dose of trial medication P2W 1999001 TE DRUGA Drug A First dose of blinded trial medication when randomized to Drug A Last dose of trial medication P2W 1999001 TE DRUGB Drug B First dose of blinded trial medication when randomized to Drug B Last dose of trial medication P2W The TA dataset shows the planned order of Elements (TAETORD) within each of the Arms along with identifying “decision points” where subjects may “branch” (TABRANCH) into an Element that is unique for their assigned Arm, or “rules” by which a subject may “skip” (TATRANS, not shown) the next Element(s) in their assigned sequence. Epoch is defined in TA as a vertical slice of time that is independent of Arm and provides a way to describe what is happening across Elements while a trial is blinded. “Decision points” or “branches” always occur between Epochs. The Arm (and ARMCD) values defined in TA must be the same as those used in the Demographics (DM) dataset. For one of the Arms in the trial above, the dataset may look like: STUDYID DOMAIN ARMCD ARM TAETORD ETCD TABRANCH EPOCH 1999001 TA DRUGA Drug A 1 SCREEN Randomized to Drug A SCREENING 1999001 TA DRUGA Drug A 2 RUNIN RUN-IN 1999001 TA DRUGA Drug A 3 DRUGA TREATMENT The TV table represents the planned visits, or “clinical encounters” that are defined with the protocol’s time and event schedule. To facilitate data collection and to satisfy constraints inherent in some data management systems, data such as AEs or concomitant medications may be collected in a type of “Log” visit. However, these “visits” should not be accounted for in TV. Just as with TE, TV contains a “start rule” (TVSTRL) that is used to indicate when, according to the protocol, a visit is scheduled to occur. Most visits are assumed to last only a single day and thus a visit’s “end rule” (TVENRL) is often not populated. While ARMCD is an “Expected” variable, ARM and ARMCD are only populated if the visit schedule varies by Arm. As the SDTM IG explains, “If the timing of Visits…does not depend on which Arm a subject is in, ARMCD should be null. The TV table for our example study might look something like this: STUDYID DOMAIN VISITNUM VISIT ARMCD TVSTRL TVENRL 1999001 TV 1 Visit 1 Informed Consent date; Start of Visit 1 assessments End of Visit 1 assessments 1999001 TV 2 Visit 2 Subject dispensed one week supply of run-in medication and takes first dose 1999001 TV 3 Visit 3 Subject dispensed 2 week supply of study medication and takes first dose 1999001 TV 4 Visit 4 Visit 4 assessments, 1 week after starting study medication +/- 1 day 1999001 TV 5 Visit 5 Visit 5 assessments, 2 weeks after starting study medication +/- 1 day At Trial Exit Additionally, there are the Trial Inclusion (TI) and Trial Summary (TS) datasets. TI represents the inclusion/exclusion criteria as detailed either in the protocol or in the CRF and is trial level data. If the study data only collects an over- arching question regarding a subject’s eligibility, then TI will come from the protocol and/or any amendments that impact subject inclusion/exclusion. It is imperative that the text in IETEST within the TI domain match the IETEST in
  • 3. Considerations in Creating SDTM Trial Design Datasets, Continued 3 the subject-level IE domain which records any criteria that a subject may have failed. If the protocol has amendments that impact study inclusion/exclusion, complete sets of the inclusion/exclusion criteria must be included for each version of the protocol. The Trial Summary (TS) dataset represents key information about the trial as a whole. This dataset, if constructed first, will often help to establish the treatment specific trial elements as well as define the number of Arms for the study. The TS domain has been substantially changed with the release of the SDTM IG v3.1.3. Prior to this release, there was no real concept of “Required” trial summary parameters. If a parameter such as AGEMAX (Maximum Age of Subjects) had no protocol-defined value, the parameter was simply omitted. With the advent of the “null-flavor” variable in TS, the AGEMAX parameter has become “Required” whether or not the maximum age is defined in the protocol. In cases where the maximum age is not defined, the parameter is retained, but with the Null Flavor value of ‘PINF’ (positive infinity). Later in this paper, we will look more closely at the TS dataset along with several specific parameters. It should be noted that there is an extensible CDISC Controlled Terminology (CT) codelist for Trial Summary parameters as well as CT for a number of parameter values or choices. TRIAL DESIGN CASE STUDIES The design of different types of clinical trials that may not be as routine or as simple as the trial in our illustration above. As the design of clinical trials can change dramatically depending on the “Phase” of the study or the indication, how the trial is modeled within the trial design datasets also changes dramatically. In the following examples, we will examine some challenges sponsors may face in the creation of Trial Design datasets for more- complicated studies. Example Trial 1 This is a study involving “Drug A” which has a placebo-controlled 12-week double-blind period followed by a 4-week open-label extension where all subjects take active medication. A diagram of this trial is shown in Figure 2. Figure 2. Double Blind into Open Label – Design Based on Protocol The sponsor’s initial attempt at developing the TA dataset is shown in the table below (for ease of display, we’ve left out the STUDYID column), which would have resulted in the design shown in Figure 3: DOMAIN ARMCD ARM TAETORD ETCD ELEMENT TABRANCH EPOCH TA A Drug A 50 mg 1 SCRN Screen Randomized to Drug A SCREENING TA A Drug A 50 mg 2 DRGA50 Drug A 50 mg TREATMENT TA A Drug A 50 mg 3 FU Follow Up FOLLOW-UP TA B Placebo 1 SCRN Screen Randomized to Placebo SCREENING TA B Placebo 2 PLAC Placebo TREATMENT TA B Placebo 3 DRGA50OL Drug A 50 mg OL OPEN LABEL TREATMENT TA B Placebo 4 FU Follow Up FOLLOW-UP Figure 3. Double Blind into Open Label – Design Based on Sponsor TA Dataset With this (mis)representation, subjects who were initially randomized to active treatment have only a single TREATMENT Epoch while subjects who were initially randomized to placebo have a TREATMENT Epoch and an
  • 4. Considerations in Creating SDTM Trial Design Datasets, Continued 4 OPEN LABEL TREATMENT Epoch. However, based on the protocol, as well as the collected data, both treatment groups should have the same study Epochs, even though, for the subjects initially randomized to 12 weeks of active drug, their medication doesn’t change over the course of the 16-week dosing period. Our modified TA dataset (which reflects the design in Figure 2, shows the following rows: DOMAIN ARMCD ARM TAETORD ETCD ELEMENT TABRANCH EPOCH TA A Drug A 50 mg 1 SCRN Screen Randomized to Drug A SCREENING TA A Drug A 50 mg 2 DRGA50 Drug A 50 mg TREATMENT TA A Drug A 50 mg 3 DRGA50OL Drug A 50 mg OL OPEN LABEL TREATMENT TA A Drug A 50 mg 4 FU Follow Up FOLLOW-UP TA B Placebo 1 SCRN Screen Randomized to Placebo SCREENING TA B Placebo 2 PLAC Placebo TREATMENT TA B Placebo 3 DRGA50OL Drug A 50 mg OL OPEN LABEL TREATMENT TA B Placebo 4 FU Follow Up FOLLOW-UP Example Trial 2 This study is a three-period crossover trial where subjects receive a single dose of Drug B at 2 mg, 6 mg, or placebo in a crossover fashion. The following is an excerpt (STUDYID, ARM, and TABRANCH left out) of the initial TA dataset, highlighting two of the sequences where P = Placebo, A = 2 mg, and B = 6 mg: DOMAIN ARMCD TAETORD ETCD ELEMENT EPOCH TA P-A-B 1 SCREEN Screen SCREENING TA P-A-B 2 S1P1 Seq 1, Period 1, Placebo TREATMENT 1 TA P-A-B 3 WASHOUT Washout WASHOUT TA P-A-B 4 S1P2 Seq 1, Period 2, 2 mg TREATMENT 2 TA P-A-B 5 WASHOUT Washout WASHOUT TA P-A-B 6 S1P3 Seq 1, Period 3, 6 mg TREATMENT 3 TA A-P-B 1 SCREEN Screen SCREENING TA A-P-B 2 S2P1 Seq 2, Period 1, 2 mg TREATMENT 1 TA A-P-B 3 WASHOUT Washout WASHOUT TA A-P-B 4 S2P2 Seq 2, Period 2, Placebo TREATMENT 2 TA A-P-B 5 WASHOUT Washout WASHOUT TA A-P-B 6 S2P3 Seq 2, Period 3, 6 mg TREATMENT 3 In this table, individual Elements have been assigned based on where they occur in the dosing sequence, instead of there simply being one placebo Element, one 2 mg Element, and one 6 mg Element. The remaining Arms or sequences were similarly modeled. Thus the TE dataset contains many more rows than are necessary. Our feedback to the sponsor was to create a single Element for each possible dose, regardless of when it occurs in the subject’s assigned sequence: DOMAIN ARMCD TAETORD ETCD ELEMENT EPOCH TA P-A-B 1 SCREEN Screen SCREENING TA P-A-B 2 PLACEBO Placebo TREATMENT 1 TA P-A-B 3 WASHOUT Washout WASHOUT TA P-A-B 4 DRUGB2MG Drug B 2 mg TREATMENT 2 TA P-A-B 5 WASHOUT Washout WASHOUT TA P-A-B 6 DRUGB6MG Drug B 6 mg TREATMENT 3 TA A-P-B 1 SCREEN Screen SCREENING TA A-P-B 2 DRUGB2MG Drug B 2 mg TREATMENT 1 TA A-P-B 3 WASHOUT Washout WASHOUT TA A-P-B 4 PLACEBO Placebo TREATMENT 2 TA A-P-B 5 WASHOUT Washout WASHOUT TA A-P-B 6 DRUGB6MG Drug B 6 mg TREATMENT 3 Example Trial 3 Consider this more complicated “single-sequence” crossover study (See Figure 4 below for a graphic representation of the study design). In this trial, subjects receive the following:
  • 5. Considerations in Creating SDTM Trial Design Datasets, Continued 5  On Day 1, a single dose of “Drug S, followed by PK sample collections for 48 hours  On Day 3, a single dose of “Drug R” followed by PK evaluations for 72 hours  On Day 6, BID dosing of “Drug X’ for a total of 9 days  On Day 10, a single dose of Drug S in conjunction with the continued BID dosing of Drug X, followed by PK evaluations for 48 hours (analogous to the single dose of Drug S given at Day 1)  On Day 12, a single dose of Drug R in conjunction with their continued BID dosing of Drug X, followed by PK evaluations for 72 hours (analogous to the single dose of Drug R given at Day 3) Figure 4. “Single sequence” crossover design The following represents two possible TA tables: DOMAIN ARMCD TAETORD ETCD ELEMENT EPOCH TA A 1 SCREEN Screen SCREENING TA A 2 DRUGS Drug S, Single 10 mg Dose TREATMENT TA A 3 DRUGR Drug R, single 10 mg Dose TREATMENT TA A 4 DRUGX1 Drug X, 400 mg BID, Days 6-9 TREATMENT TA A 5 DRUGXS Drug S 10 mg in combination with Drug X TREATMENT TA A 6 DRUGX2 Drug X, 400 mg BID, Day 11 TREATMENT TA A 7 DRUGXR Drug R 10 mg in combination with Drug X TREATMENT TA A 8 DRUGX3 Drug X, 400 mg BID, Days 13-14 TREATMENT TA A 9 FOLLOWUP Follow-Up FOLLOW-UP OR DOMAIN ARMCD TAETORD ETCD ELEMENT EPOCH TA A 1 SCREEN Screen SCREENING TA A 2 DRUGS Drug S, Single 10 mg Dose TREATMENT TA A 3 DRUGR Drug R, single 10 mg Dose TREATMENT TA A 4 DRUGX Drug X, 400 mg BID, Days 6-9 TREATMENT TA A 5 DRUGXS Drug S 10 mg in combination with Drug X TREATMENT TA A 6 DRUGXR Drug R 10 mg in combination with Drug X TREATMENT TA A 7 FOLLOWUP Follow-Up FOLLOW-UP Note the two extra Elements in the first version of the table where the continued BID dosing on Day 11 and Days 13 and 14 are broken out into separate Elements. We consider the second version of TA to be the more correct version for the above study. The former table was the design originally favored by the sponsor. We provided the latter TA table back to them along with the TE table below. DOMAIN ETCD ELEMENT TESTRL TEENRL TE SCRN Screen Date/time of Informed Consent Date/time of first single dose of Drug S TE DRUGS Drug S, Single 10 mg Dose Date/time of first single dose of Drug S Date/time of first single dose of Drug R TE DRUGR Drug R, single 10 mg Dose Date/time of first single dose of Drug R Date/time of first BID dose of Drug X
  • 6. Considerations in Creating SDTM Trial Design Datasets, Continued 6 TE DRUGX Drug X, 400 mg BID, Days 6-9 Date/time of first BID dose of Drug X Date/time of second single dose of Drug S while subject is receiving Drug X TE DRUGXS Drug S 10 mg in combination with Drug X Date/time of second single dose of Drug S while subject is receiving Drug X Date/time of second single dose of Drug R while subject is receiving Drug X TE DRUGX R Drug R 10 mg in combination with Drug X Date/time of second single dose of Drug R while subject is receiving Drug X Final PK sample collected at Day 15 TE FOLLOW UP Follow-Up Discharge from unit after final PK sample collection At Trial Exit As we see, the sponsor had originally wanted to split out into separate Elements the continued BID dosing of Drug X following the second single dose of Drug S and Drug R, respectively. Our explanation was basically that trial design is less concerned with these specific “protocol-defined” days than it is with defining a “treatment strategy”. We also advised them that we felt it was very important that the Element “start rules” (and by default, the “end rules”) be consistent between the initial single dose of either Drug R or Drug S and the second single dose of the two drugs. The evaluation period for each should remain the same. When subjects continue to receive study drug on Study Day 11 and on Study Day 13-14, these should not represent additional Elements in the study. Subjects are continuing to take the study drug during this time simply to remain at steady state while the pharmacokinetic profiles of Drug S and Drug R are being evaluated in the presence of Drug X. COMMON ISSUES As our previous trial design paper (Wood and Lenzen, 2011) pointed out, often constructing the T tables is more a matter of art than it is pure science. To be sure, as shown in the above examples, there are instances where some representations are “more correct”. There are also occasions, however where there may be more than one “correct” design. Consider information in Figure 4: does the Element reflecting the dose of Drug A last all the way to the dose of Drug B? Or is there an Element in between? The decision will be based upon how one wants to analyze the in- between period. Is this a continuation of the Drug A dosing period that will contain evaluations related to Drug A, or is it considered to be a washout period with no assessments related to Drug A? Often there is no single correct answer that’s appropriate for all trials. Again, it comes down to the strategy and the analysis. Figure 5. Determining the Best Representation of Trial Elements Let’s take a moment and look at each trial design domain and highlight just a few of the more important issues and problems that we often see when reviewing some sponsors attempts at trial design. TA:  Branching statements should be included on the line of the Element where, at its conclusion, it leads into the Element that makes the Arm unique.  Transition “rules” should be present when the protocol indicates that subjects may qualify for a “shortened path” within their assigned Arm. As with branching, statements should be included on the line of the Element where, at its conclusion, leads to the transition.  All values for ETCD and ELEMENT should be present in TE.  The values of ARMCD and ARM should be those used in DM.
  • 7. Considerations in Creating SDTM Trial Design Datasets, Continued 7 TE  The Element Start Rules and End Rules should point to events for which there is collected data. An example of an issue is when the protocol states that an Element ends when the subject leaves the clinic, but the CRF did not collect the date this occurred. As a result, one may have to define a surrogate Element End Rule that’s different from what the sponsor intended in the protocol. The earlier trial design is created, the more likely that the required data points will be part of the data collection.  A Start Rule should be specific enough to ensure there is no confusion as in: o If a subject participates in two Elements of the same drug with different dose levels, the dose level needs to be included in the Start Rule. o When there are actually multiple Arms with one or more unique treatments, an Element of “Treatment” alone is not sufficient.  TEDUR should not be populated for Elements of variable lengths. An example of such a misuse would be for a Screening Element with TEDUR = ‘P28D’ where the Screening period is defined in the protocol as simply “within 28 days of randomization”. TV  An End Rule should be present for visits that are likely to last more than one day. An example would be for an oncology trial where a visit equates to a cycle of treatment.  Unscheduled visits should not be included in TV, since TV is only for planned visits. Unscheduled visits would only be present in Subject Visits.  When study visits vary, even slightly, between Arms of the study, a full set of the Visit structure should be supplied for each Arm with ARMCD populated in each instance. TI  Versions of TI should be included when an amendment has affected any of the inclusion/exclusion criteria.  There should be a 1:1 relationship between IETESTCD and IETEST. Sometimes sponsors fail to update the IETEST after updating IETESTCD as the result of an amendment. TS The TS domain underwent some significant changes in SDTM-IG v3.1.3 compared to previous versions. To illustrate these changes as well as provide an example of a TS dataset, we’ll use the following study description: This open label Phase II study will randomize approximately 138 subjects (18 years of age and older) with metastatic bladder or urethra cancer into 3 treatment ARMs: Docetaxel (75 mg/m2), Docetaxel + Drug A (10 mg/kg), and Docetaxel + Drug B (12 mg/kg). Obviously, there’s much more to the study than this, such as specifying the primary and secondary study objectives, where the study is to be conducted, etc., but just this short description is enough to start with. STUDYID DOMAIN TSSEQ TSGRPID TSPARMCD TSPARM TSVAL TSVALNF TSVALCD TSVCDREF 2014015 TS 1 ACTSUB Actual Number of Subjects 130 2014015 TS 1 ADAPT Adaptive Design N C49487 CDISC 2014015 TS 1 ADDON Added onto Existing Treatments Y C49488 CDISC 2014015 TS 1 AGEMIN Planned Minimum Age P18Y ISO 8601 2014015 TS 1 AGEMAX Planned Maximum Age PINF ISO 21090 2014015 TS 1 DOC CURTRT Current Therapy or Treatment Docetaxel 15H5577C QD UNII 2014015 TS 1 DOC DOSE Dose per Administration 75 2014015 TS 2 DRUGA DOSE Dose per Administration 10 2014015 TS 3 DRUGB DOSE Dose per Administration 12 2014015 TS 1 DOC DOSU Dose Units mg/m2 C67402 CDISC 2014015 TS 2 DRUGA DOSU Dose Units mg/kg C67401 CDISC 2014015 TS 3 DRUGB DOSU Dose Units mg/kg C67401 CDISC 2014015 TS 1 INDIC Trial Indication Bladder Cancer 406024002 SNOMED CT 2014015 TS 1 NARMS Planned 3
  • 8. Considerations in Creating SDTM Trial Design Datasets, Continued 8 Number of Arms 2014015 TS 1 PLANSUB Planned Number of Subjects 138 2014015 TS 1 RANDQT Randomization Quotient 0.67 2014015 TS 1 TBLIND Trial Blinding Schema OPEN LABEL C49659 CDISC 2014015 TS 1 TPHASE Trial Phase Classification Phase II Trial C15601 CDISC 2014015 TS 1 DRUGA TRT Investigational Therapy or Treatment Drug A 2014015 TS 1 DRUGB TRT Investigational Therapy or Treatment Drug B Just a few points regarding the above table and TS in general:  Even if it’s a SDTM IG 3.1.2 TS dataset (and thus no “Required” parameters), as many parameters as possible should be used to adequately describe the study.  When employing both ACTSUB and PLANSUB parameters, the numbers for both should refer to the same degree of subject participation (i.e., both indicating number of “randomized” subjects (planned and actual)  TSSEQ – is a sequence number within a parameter allowing multiple records with the same TSPARMCD, such as DOSE in the table above  TSGRPID – can be used to tie together any block of records in the dataset. In this case, the DOSE and DOSU records were tied to the treatments administered.  TSPARMCD and TSPARM come from CDISC Controlled Terminology (CT) as do many of the responses in the TSVAL column. For those responses, the case shown in TSVAL matches the case in CT.  In this three Arm study, the drug Docetaxel acts as a CURTRT (Current Therapy or Treatment) for both investigational products, Drug A and Drug B.  The parameter INDIC (Trial Indication) is linked to the NCI Term Browser located at http://ncit.nci.nih.gov/ncitbrowser. This parameter represents the overall disease indication for the study medication. For Phase I studies that primarily collect PK data on a “healthy subject” population, this parameter should be omitted.  The value shown for RANDQT represents the percentage (the decimal-based fraction of 1) of subjects that are planned to be exposed to investigational treatment. If all subjects are exposed at one time or another during the course of the trial, this would be 1.  For Docetaxel, the value in TSVALCD comes from the FDA Substance Registration System’s “Unique Ingredient Identifier” (UNII) available at http://fdasis.nlm.nih.gov/srs.  For those values that come from CDISC CT, NCI EVS “Concept Code” appears in the TSVALCD. This comes from Column A of the controlled terminology spreadsheet available via the NCI website at http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/cdisc. CONCLUSIONS Creating SDTM trial design datasets can often be challenging, depending on the complexity of the study. Even after gaining experience across different therapeutic areas, two people still may not model a study in exactly the same way, but both may be defensible and, for the most, correct. Our general philosophy is to try to keep the datasets as simple as possible, but still within the framework of the model and the intent of the study protocol. It takes a lot of practice and experience with trials of many types of designs before one can become adept at creating Trial Design datasets. We expect the relative importance of these datasets in an SDTM-based submission to be increasing as more and more sponsors submit them, and reviewers get more experience in seeing how valuable they are. RESOURCES  Wood, F. and Lenzen, M. (2011) Trials and Tribulations of Trial Design. PharmaSUG Proceedings, May 2011.  Study Data Tabulation Model. Clinical Data Interchange Standards Consortium (CDISC) Submission Data Standards (SDS) Team, Version 1.4, December 2013.  Study Data Tabulation Model Implementation Guide: Human Clinical Trials. Clinical Data Interchange Standards Consortium (CDISC) Submission Data Standards (SDS) Team, Version 3.2, December 2013  There are also several case studies and Trial Design examples posted in the “Member’s Only” area on the CDISC website (http://www.cdisc.org).
  • 9. Considerations in Creating SDTM Trial Design Datasets, Continued 9 ACKNOWLEDGMENTS The authors would like to acknowledge the management at Accenture Life Sciences who understand the importance of data standards in pharmaceutical research, and who have supported our participation in numerous CDISC teams. SAS and all other SAS Institute Inc. product or service names are registered trademarks or trademarks of SAS Institute Inc. in the USA and other countries. ® indicates USA registration. Other brand and product names are registered trademarks or trademarks of their respective companies. CONTACT INFORMATION Your comments and questions are valued and encouraged. Contact the authors at: Jerry Salyers Senior Consultant, Data Standards Consulting Accenture Life Sciences 1160 W. Swedesford Road Bldg One Berwyn, PA 19312 513.668.8126 jerry.j.salyers@accenture.com Richard Lewis Senior Consultant, Data Standards Consulting Accenture Life Sciences 1160 W. Swedesford Road Bldg One Berwyn, PA 19312 262.716.4167 richard.m.lewis@accenture.com Fred Wood Senior Manager, Data Standards Consulting Accenture Life Sciences 1160 W. Swedesford Road Bldg One Berwyn, PA 19312 484.881.2297 f.wood@accenture.com Kim Minkalis Consultant, Data Standards Consulting Accenture Life Sciences 1160 W. Swedesford Road Bldg One Berwyn, PA 19312 484.467.4988 kimberly.a.minkalis@accenture.com