ID

11363

Description

NCT00057928 SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE (S0227) S0227 Comparison of Cisplatin Combined With Either Paclitaxel or Gemcitabine in Treating Patients With Recurrent, Persistent, or Metastatic Cervical Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C44FD3-7B1D-3AAB-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C44FD3-7B1D-3AAB-E034-0003BA12F5E7

Keywords

  1. 8/27/12 8/27/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 7/3/15 7/3/15 -
Uploaded on

July 3, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy

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NCT00057928 SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE (S0227)

No Instruction available.

  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE (S0227)
    1. No Instruction available.
Header
Description

Header

SWOG Patient ID
Description

SWOGPatientID

Data type

text

SWOG Study No.
Description

SWOGStudyNo.

Data type

text

Registration Step
Description

RegistrationStep

Data type

text

Patient Initials (L, F M)
Description

Patient Initials

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Institution / Affiliate
Description

InstitutionName

Data type

text

Physician (Groups other than SWOG)
Description

RegisteredInvestigator

Data type

text

Group Name
Description

ParticipatingGroupName

Data type

text

Study No.
Description

Particip.GroupProtocolNumber

Data type

float

Pt. ID
Description

PatientStudyID,ParticipatingGroup

Data type

text

Treatment period
Description

Treatment period

Treatment Start Date
Description

TreatmentStartDate

Data type

date

Treatment End Date
Description

TreatmentEndDate

Data type

date

Regimen or Procedure or Site(s)
Description

RegimenorProcedureorSite(s)

Data type

text

Off-protocol treatment
Description

Off-protocol treatment

Off Treatment Reason
Description

OffTreatmentReason

Data type

text

Patient refused, other than toxicity, specify
Description

Patientrefused,otherthantoxicity,specify

Data type

text

Progression or relapse, specify site
Description

Progressionorrelapse,specifysite

Data type

text

Other, specify (Off Treatment Date)
Description

OffTreatmentReason,Other

Data type

text

Date of completion, progression, death or decision to discontinue therapy
Description

Dateofcompletion,progression,deathordecisiontodiscontinuetherapy

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Further treatment
Description

Further treatment

Will patient receive further treatment?
Description

FurtherTreatmentInd

Data type

text

Yes, specify
Description

Yes,specify

Data type

text

Vital status
Description

Vital status

Date of Last Contact (or death)
Description

DeathDate/LastContactDate

Data type

date

Vital Status
Description

Patient'sVitalStatus

Data type

text

Comments
Description

Comments

Comments
Description

Comments

Data type

text

Ccrr Module For Southwest Oncology Group Off Treatment Notice (s0227)
Description

Ccrr Module For Southwest Oncology Group Off Treatment Notice (s0227)

Similar models

No Instruction available.

  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE (S0227)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
Patient Initials
Item
Patient Initials (L, F M)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
InstitutionName
Item
Institution / Affiliate
text
RegisteredInvestigator
Item
Physician (Groups other than SWOG)
text
ParticipatingGroupName
Item
Group Name
text
Particip.GroupProtocolNumber
Item
Study No.
float
PatientStudyID,ParticipatingGroup
Item
Pt. ID
text
Item Group
Treatment period
TreatmentStartDate
Item
Treatment Start Date
date
TreatmentEndDate
Item
Treatment End Date
date
RegimenorProcedureorSite(s)
Item
Regimen or Procedure or Site(s)
text
Item Group
Off-protocol treatment
Item
Off Treatment Reason
text
Code List
Off Treatment Reason
CL Item
Patient Withdrawal, Medically Required Due To Toxicity (Medically required, due to toxicity)
CL Item
Patient Withdrawal Or Refusal Subsequent To Toxicity (Patient refused, due to toxicity)
CL Item
Patient Withdrawal Or Refusal For Reason Other Than Toxicity (Patient refused, other than toxicity, specify)
CL Item
Progression or relapse, specify site (Progression or relapse, specify site)
CL Item
Death (Death)
CL Item
Specify Other Reason (Other, specify)
Patientrefused,otherthantoxicity,specify
Item
Patient refused, other than toxicity, specify
text
Progressionorrelapse,specifysite
Item
Progression or relapse, specify site
text
OffTreatmentReason,Other
Item
Other, specify (Off Treatment Date)
text
Dateofcompletion,progression,deathordecisiontodiscontinuetherapy
Item
Date of completion, progression, death or decision to discontinue therapy
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item Group
Further treatment
Item
Will patient receive further treatment?
text
Code List
Will patient receive further treatment?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes, specify)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Yes,specify
Item
Yes, specify
text
Item Group
Vital status
DeathDate/LastContactDate
Item
Date of Last Contact (or death)
date
Item
Vital Status
text
Code List
Vital Status
CL Item
Alive (Alive)
CL Item
Dead (Dead)
Item Group
Comments
Comments
Item
Comments
text
Item Group
Ccrr Module For Southwest Oncology Group Off Treatment Notice (s0227)

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