Information:
Fel:
ID
11363
Beskrivning
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
Länk
Nyckelord
Versioner (3)
- 2012-08-27 2012-08-27 -
- 2015-01-09 2015-01-09 - Martin Dugas
- 2015-07-03 2015-07-03 -
Uppladdad den
3 juli 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.
NCT00057928 SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE (S0227)
No Instruction available.
- StudyEvent: SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE (S0227)
Similar models
No Instruction available.
- StudyEvent: SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE (S0227)
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
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)
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
TreatmentStartDate
Item
Treatment Start Date
date
TreatmentEndDate
Item
Treatment End Date
date
RegimenorProcedureorSite(s)
Item
Regimen or Procedure or Site(s)
text
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)
C0011008 (UMLS 2011AA ValueDomain)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes, specify)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
C0439673 (UMLS 2011AA)
Yes,specify
Item
Yes, specify
text
DeathDate/LastContactDate
Item
Date of Last Contact (or death)
date
CL Item
Alive (Alive)
CL Item
Dead (Dead)
Comments
Item
Comments
text