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ID
10603
Beschrijving
ECOG 3200 Non-Protocol Therapy 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=A170529B-26A1-6913-E034-080020C9C0E0
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- 27-08-12 27-08-12 -
- 23-05-15 23-05-15 -
- 03-06-15 03-06-15 -
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3 juni 2015
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Creative Commons BY-NC 3.0 Legacy
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ECOG 3200 Non-Protocol Therapy Form NCT00025337
No Instruction available.
- StudyEvent: ECOG 3200 Non-Protocol Therapy Form
Similar models
No Instruction available.
- StudyEvent: ECOG 3200 Non-Protocol Therapy Form
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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)
Non-ProtocolTherapyDate,First
Item
Non-Protocol Therapy Date, First
date
Non-ProtocolChemotherapyInd
Item
Non-Protocol Chemotherapy Ind
text
Non-ProtocolHormonalTherapyInd
Item
Non-Protocol Hormonal Therapy Ind
text
Non-ProtocolImmunotherapyInd
Item
Non-Protocol Immunotherapy Ind
text
Non-ProtocolHDC/ASCTInd
Item
Non-Protocol HDC/ASCT Ind
text
Non-protocolSurgeryPerformedInd-3
Item
Non-Protocol Surgery Ind
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C25590 (NCI Thesaurus ObjectClass)
C1518384 (UMLS 2011AA ObjectClass)
C1512699 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C25590 (NCI Thesaurus ObjectClass)
C1518384 (UMLS 2011AA ObjectClass)
Non-ProtocolRTInd
Item
Non-Protocol RT Ind
text
OtherNon-ProtocolTherapyInd
Item
Other Non-Protocol Therapy Ind
text
OtherNon-ProtocolTherapyName
Item
Other Non-Protocol Therapy Name
text
Non-ProtocolTherapygivenfordisease
Item
Non-Protocol Therapy given for disease
text
Comments
Item
Comments
text
Comments2
Item
Comments2
text
Non-ProtocolTherapynotpreviouslyrpt
Item
Non-Protocol Therapy not previously rpt
text