ID

10607

Beskrivning

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

Länk

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

Nyckelord

  1. 2012-08-27 2012-08-27 -
  2. 2015-05-23 2015-05-23 -
  3. 2015-06-03 2015-06-03 -
Uppladdad den

3 juni 2015

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0 Legacy

Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

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
Beskrivning

ECOG Long-Term Follow-up

Date of data transfer
Beskrivning

Dateofdatatransfer

Datatyp

text

Transfer Method
Beskrivning

TransferMethod

Datatyp

text

Specify other transfer method
Beskrivning

Specifyothertransfermethod

Datatyp

text

Step No.
Beskrivning

StepNo.

Datatyp

text

Patient Name
Beskrivning

PatientName

Datatyp

text

Particip. Group Protocol Number
Beskrivning

Particip.GroupProtocolNumber

Datatyp

double

Patient Study ID, Participating Group
Beskrivning

PatientStudyID,ParticipatingGroup

Datatyp

text

Institution Name
Beskrivning

InstitutionName

Datatyp

text

Affiliate Name
Beskrivning

AffiliateName

Datatyp

text

Amended Data Ind
Beskrivning

AmendedDataInd

Datatyp

text

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

AmendedDataInd

Datatyp

text

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

IntervalReportFromDate

Datatyp

date

Interval Report To Date
Beskrivning

IntervalReportToDate

Datatyp

date

Patient's Vital Status
Beskrivning

Patient'sVitalStatus

Datatyp

text

Death Reason
Beskrivning

DeathReason

Datatyp

text

Death Reason, Specify
Beskrivning

DeathReason,Specify

Datatyp

text

Death Date/Last Contact Date
Beskrivning

DeathDate/LastContactDate

Datatyp

date

Cancer Follow-up Status Ind
Beskrivning

CancerFollow-upStatusInd

Datatyp

text

Cancer Follow-up Status Date
Beskrivning

CancerFollow-upStatusDate

Datatyp

date

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

ProgressionInd

Datatyp

text

Progression Date
Beskrivning

ProgressionDate

Datatyp

date

Formal Progressive Disease Diagnosis
Beskrivning

FormalProgressiveDiseaseDiagnosis

Datatyp

text

Progression Site
Beskrivning

ProgressionSite

Datatyp

text

New Primary Cancer Ind
Beskrivning

NewPrimaryCancerInd

Datatyp

text

New Primary Site
Beskrivning

NewPrimarySite

Datatyp

text

Late Adverse Event Ind
Beskrivning

LateAdverseEventInd

Datatyp

text

Non protocol therapy prior to first progression
Beskrivning

Nonprotocoltherapypriortofirstprogression

Datatyp

text

Comments
Beskrivning

Comments

Datatyp

text

Comments2
Beskrivning

Comments2

Datatyp

text

Non-Protocol Therapy Date, First
Beskrivning

Non-ProtocolTherapyDate,First

Datatyp

date

New Primary Cancer Date
Beskrivning

NewPrimaryCancerDate

Datatyp

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
Typ
Description | Question | Decode (Coded Value)
Datatyp
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)

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial