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ID
10486
Description
E3200 Treatment Summary Form NCT00025337 Combination Chemotherapy With or Without Bevacizumab Compared With Bevacizumab Alone in Treating Patients With Advanced or Metastatic Colorectal Cancer That Has Been Previously Treated Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A16FACD4-477B-6CEF-E034-080020C9C0E0
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Keywords
Versions (3)
- 12/18/14 12/18/14 - Martin Dugas
- 6/2/15 6/2/15 -
- 6/3/15 6/3/15 -
Uploaded on
June 3, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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E3200 Treatment Summary Form NCT00025337
No Instruction available.
- StudyEvent: E3200 Treatment Summary Form
Similar models
No Instruction available.
- StudyEvent: E3200 Treatment Summary Form
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Dateofdatatransfer
Item
Date of data transfer
text
TransferMethod
Item
Transfer Method
text
Specifyothertransfermethod
Item
Specify other transfer method
text
StepNo.
Item
Step No.
text
PatientName
Item
Patient Name
text
Particip.GroupProtocolNumber
Item
Particip. Group Protocol Number
double
PatientStudyID,ParticipatingGroup
Item
Patient Study ID, Participating Group
text
InstitutionName
Item
Institution Name
text
AffiliateName
Item
Affiliate Name
text
AmendedDataInd
Item
Amended Data Ind
text
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
AmendedDataInd
Item
Amended Data Ind
text
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
TreatmentArmNumber
Item
Treatment Arm Number
text
TreatmentBeginDate
Item
Treatment Begin Date
date
TreatmentEndDate
Item
Treatment End Date
date
OffTreatmentReason
Item
Off Treatment Reason
text
OffTreatmentReason,ComplicatingDisease
Item
Off Treatment Reason, Complicating Disease
text
OffTreatmentReason,Other
Item
Off Treatment Reason, Other
text
TotalCourseNumber
Item
Total Course Number
double
DoseModification(Change)
Item
Dose Modification (Change)
text
DoseModification(Change)
Item
Dose Modification (Change)
text
TherapyModificationName
Item
Therapy Modification Name
text
TherapyModificationType
Item
Therapy Modification Type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
C0332307 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
TherapyModificationReason
Item
Therapy Modification Reason
text
Comments
Item
Comments
text
Comments2
Item
Comments2
text