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ID
10599
Description
Southwest Oncology Group Registration Form Step 2 (S0303) Combination Chemotherapy and Bevacizumab in Treating Patients With Locally Advanced, Metastatic, or Recurrent Colorectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=ECDF9D42-18FA-2B72-E034-0003BA3F9857
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Versions (4)
- 8/27/12 8/27/12 -
- 5/23/15 5/23/15 -
- 6/3/15 6/3/15 -
- 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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Southwest Oncology Group Registration Form Step 2 (S0303) NCT00070122
No Instruction available.
- StudyEvent: Southwest Oncology Group Registration Form Step 2 (S0303)
Similar models
No Instruction available.
- StudyEvent: Southwest Oncology Group Registration Form Step 2 (S0303)
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
ActivationDate
Item
Activation Date
text
LastAmendedDate
Item
Last Amended Date
text
Patient'sName
Item
Patient's Name
text
SWOGPatientID
Item
SWOG Patient ID
text
OtherGroupPatientNumber
Item
Other Group Patient Number
text
ParticipatingGroup/ProtocolNumber
Item
Participating Group/Protocol Number
text
Caller'sSWOGRosterID
Item
Caller's SWOG Roster ID
text
SWOGInvestigatorNumber
Item
SWOG Investigator Number
text
OtherGroupInvestigatorName
Item
Other Group Investigator Name
text
OtherGroupInvestigatorNumber
Item
Other Group Investigator Number
text
SWOGTreatingInstitutionNumber
Item
SWOG Treating Institution Number
text
OtherGroupInstitutionName
Item
Other Group Institution Name
text
OtherGroupInstitutionNumber
Item
Other Group Institution Number
text
NCIInvestigatorNumber
Item
NCI Investigator Number
text
ProjectedStartDateofTreatment
Item
Projected Start Date of Treatment
text
Datethatthepatientwasreconsentedtotheopen-labelbevacizumabphaseofthestudy
Item
Date that the patient was reconsented to the open-label bevacizumab phase of the study
text
OriginalTXPREPIDfromStep1
Item
Original TXPREPID from Step 1
text