ID

10486

Beschrijving

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

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A16FACD4-477B-6CEF-E034-080020C9C0E0

Trefwoorden

Versies (3)
  1. 18-12-14 18-12-14 - Martin Dugas
  2. 02-06-15 02-06-15 -
  3. 03-06-15 03-06-15 -
Geüploaded op

3 juni 2015

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy
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E3200 Treatment Summary Form NCT00025337

Engels

No Instruction available.

1 Formulieren  
  1. StudyEvent: E3200 Treatment Summary Form
    1. No Instruction available.
Treatment Summary
Beschrijving

Treatment Summary

Date of data transfer
Beschrijving

Dateofdatatransfer

Datatype

text

Transfer Method
Beschrijving

TransferMethod

Datatype

text

Specify other transfer method
Beschrijving

Specifyothertransfermethod

Datatype

text

Step No.
Beschrijving

StepNo.

Datatype

text

Patient Name
Beschrijving

PatientName

Datatype

text

Particip. Group Protocol Number
Beschrijving

Particip.GroupProtocolNumber

Datatype

double

Patient Study ID, Participating Group
Beschrijving

PatientStudyID,ParticipatingGroup

Datatype

text

Institution Name
Beschrijving

InstitutionName

Datatype

text

Affiliate Name
Beschrijving

AffiliateName

Datatype

text

Amended Data Ind
Beschrijving

AmendedDataInd

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Amended Data Ind
Beschrijving

AmendedDataInd

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Treatment Arm Number
Beschrijving

TreatmentArmNumber

Datatype

text

Treatment Begin Date
Beschrijving

TreatmentBeginDate

Datatype

date

Treatment End Date
Beschrijving

TreatmentEndDate

Datatype

date

Off Treatment Reason
Beschrijving

OffTreatmentReason

Datatype

text

Off Treatment Reason, Complicating Disease
Beschrijving

OffTreatmentReason,ComplicatingDisease

Datatype

text

Off Treatment Reason, Other
Beschrijving

OffTreatmentReason,Other

Datatype

text

Total Course Number
Beschrijving

TotalCourseNumber

Datatype

double

Dose Modification (Change)
Beschrijving

DoseModification(Change)

Datatype

text

Dose Modification (Change)
Beschrijving

DoseModification(Change)

Datatype

text

Therapy Modification Name
Beschrijving

TherapyModificationName

Datatype

text

Therapy Modification Type
Beschrijving

TherapyModificationType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25572
Therapy Modification Reason
Beschrijving

TherapyModificationReason

Datatype

text

Comments
Beschrijving

Comments

Datatype

text

Comments2
Beschrijving

Comments2

Datatype

text

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Similar models

No Instruction available.

1 Formulieren
  1. StudyEvent: E3200 Treatment Summary Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Treatment Summary
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)
AmendedDataInd
Item
Amended Data Ind
text
C25474 (NCI Thesaurus ObjectClass)
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)
TherapyModificationReason
Item
Therapy Modification Reason
text
Comments
Item
Comments
text
Comments2
Item
Comments2
text
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