ID

10607

Description

ECOG 3200 Long-Term Follow-up 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=A1703F76-0F9C-684E-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A1703F76-0F9C-684E-E034-080020C9C0E0

Keywords

  1. 8/27/12 8/27/12 -
  2. 5/23/15 5/23/15 -
  3. 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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ECOG 3200 Long-Term Follow-up Form NCT00025337

No Instruction available.

  1. StudyEvent: ECOG 3200 Long-Term Follow-up Form
    1. No Instruction available.
ECOG Long-Term Follow-up
Description

ECOG Long-Term Follow-up

Date of data transfer
Description

Dateofdatatransfer

Data type

text

Transfer Method
Description

TransferMethod

Data type

text

Specify other transfer method
Description

Specifyothertransfermethod

Data type

text

Step No.
Description

StepNo.

Data type

text

Patient Name
Description

PatientName

Data type

text

Particip. Group Protocol Number
Description

Particip.GroupProtocolNumber

Data type

double

Patient Study ID, Participating Group
Description

PatientStudyID,ParticipatingGroup

Data type

text

Institution Name
Description

InstitutionName

Data type

text

Affiliate Name
Description

AffiliateName

Data type

text

Amended Data Ind
Description

AmendedDataInd

Data type

text

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

AmendedDataInd

Data type

text

Alias
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Interval Report From Date
Description

IntervalReportFromDate

Data type

date

Interval Report To Date
Description

IntervalReportToDate

Data type

date

Patient's Vital Status
Description

Patient'sVitalStatus

Data type

text

Death Reason
Description

DeathReason

Data type

text

Death Reason, Specify
Description

DeathReason,Specify

Data type

text

Death Date/Last Contact Date
Description

DeathDate/LastContactDate

Data type

date

Cancer Follow-up Status Ind
Description

CancerFollow-upStatusInd

Data type

text

Cancer Follow-up Status Date
Description

CancerFollow-upStatusDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
Progression Ind
Description

ProgressionInd

Data type

text

Progression Date
Description

ProgressionDate

Data type

date

Formal Progressive Disease Diagnosis
Description

FormalProgressiveDiseaseDiagnosis

Data type

text

Progression Site
Description

ProgressionSite

Data type

text

New Primary Cancer Ind
Description

NewPrimaryCancerInd

Data type

text

New Primary Site
Description

NewPrimarySite

Data type

text

Late Adverse Event Ind
Description

LateAdverseEventInd

Data type

text

Non protocol therapy prior to first progression
Description

Nonprotocoltherapypriortofirstprogression

Data type

text

Comments
Description

Comments

Data type

text

Comments2
Description

Comments2

Data type

text

Non-Protocol Therapy Date, First
Description

Non-ProtocolTherapyDate,First

Data type

date

New Primary Cancer Date
Description

NewPrimaryCancerDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008

Similar models

No Instruction available.

  1. StudyEvent: ECOG 3200 Long-Term Follow-up Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
ECOG Long-Term Follow-up
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)
IntervalReportFromDate
Item
Interval Report From Date
date
IntervalReportToDate
Item
Interval Report To Date
date
Patient'sVitalStatus
Item
Patient's Vital Status
text
DeathReason
Item
Death Reason
text
DeathReason,Specify
Item
Death Reason, Specify
text
DeathDate/LastContactDate
Item
Death Date/Last Contact Date
date
CancerFollow-upStatusInd
Item
Cancer Follow-up Status Ind
text
CancerFollow-upStatusDate
Item
Cancer Follow-up Status Date
date
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
ProgressionInd
Item
Progression Ind
text
ProgressionDate
Item
Progression Date
date
FormalProgressiveDiseaseDiagnosis
Item
Formal Progressive Disease Diagnosis
text
ProgressionSite
Item
Progression Site
text
NewPrimaryCancerInd
Item
New Primary Cancer Ind
text
NewPrimarySite
Item
New Primary Site
text
LateAdverseEventInd
Item
Late Adverse Event Ind
text
Nonprotocoltherapypriortofirstprogression
Item
Non protocol therapy prior to first progression
text
Comments
Item
Comments
text
Comments2
Item
Comments2
text
Non-ProtocolTherapyDate,First
Item
Non-Protocol Therapy Date, First
date
NewPrimaryCancerDate
Item
New Primary Cancer Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)

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