ID

11921

Descrizione

SOUTHWEST ONCOLOGY GROUP S0227 TREATMENT FORM (S0227) S0227 Comparison of Cisplatin Combined With Either Paclitaxel or Gemcitabine in Treating Patients With Recurrent, Persistent, or Metastatic Cervical Cancer NCT00057928 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AA4D01C2-8134-3CDA-E034-0003BA12F5E7

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AA4D01C2-8134-3CDA-E034-0003BA12F5E7

Keywords

  1. 18/12/14 18/12/14 - Martin Dugas
  2. 02/06/15 02/06/15 -
  3. 03/06/15 03/06/15 -
  4. 22/08/15 22/08/15 - Martin Dugas
Caricato su

22 agosto 2015

DOI

Per favore, per richiedere un accesso.

Licenza

Creative Commons BY-NC 3.0 Legacy

Commenti del modello :

Puoi commentare il modello dati qui. Tramite i fumetti nei gruppi di articoli e articoli è possibile aggiungere commenti a quelli in modo specifico.

Commenti del gruppo di articoli per :

Commenti dell'articolo per :

Per scaricare i modelli di dati devi essere registrato. Per favore accesso o registrati GRATIS.

Treatment form Cervical Cancer SWOG S0227 NCT00057928

No Instruction available.

  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP S0227 TREATMENT FORM (S0227)
    1. No Instruction available.
SWOG clinical trial administrative data
Descrizione

SWOG clinical trial administrative data

SWOG Patient ID
Descrizione

SWOGPatientID

Tipo di dati

text

SWOG Study No.
Descrizione

SWOGStudyNo.

Tipo di dati

text

Registration Step
Descrizione

RegistrationStep

Tipo di dati

text

Patient Initials (L, F M)
Descrizione

PatientInitials

Tipo di dati

text

Cycle #
Descrizione

CourseIdentification

Tipo di dati

float

Institution / Affiliate
Descrizione

InstitutionName

Tipo di dati

text

Physician (Groups other than SWOG)
Descrizione

RegisteredInvestigator

Tipo di dati

text

Group Name
Descrizione

ParticipatingGroupName

Tipo di dati

text

Study No.
Descrizione

Particip.GroupProtocolNumber

Tipo di dati

float

Pt. ID
Descrizione

PatientStudyID,ParticipatingGroup

Tipo di dati

text

Status
Descrizione

Status

Date of Last Contact or Death
Descrizione

DeathDate/LastContactDate

Tipo di dati

date

Vital Status
Descrizione

Patient'sVitalStatus

Tipo di dati

text

First Cycle Of Treatment
Descrizione

First Cycle Of Treatment

Cycle start date (same as treatment start date)
Descrizione

CourseBeginDate

Tipo di dati

date

Cycle end date (Date immediately prior to the date next cycle begins, or date decision made to discontinue patient from protocol treatment if last cycle)
Descrizione

Cycleenddate

Tipo di dati

text

Weight (First day of this cycle)
Descrizione

PatientWeight

Tipo di dati

float

Body surface area
Descrizione

BSA: First day of this cycle

Tipo di dati

float

Unità di misura
Alias
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25157
UMLS CUI [1]
C0005902
Were there any dose modifications or additions/omissions to protocol treatment
Descrizione

DoseModification(Change)

Tipo di dati

text

Total dose for this cycle: gemcitabine (Arm 2 only)
Descrizione

AgentTotalDose(percourse)

Tipo di dati

float

CONCOMITANT MEDICATIONS / MEDICAL INTERVENTIONS
Descrizione

CONCOMITANTMEDICATIONS/MEDICALINTERVENTIONS

Tipo di dati

text

Alias
UMLS CUI [1]
C2347852
Others, specify
Descrizione

AgentName

Tipo di dati

text

Start Date
Descrizione

AgentBeginDate

Tipo di dati

date

Stop Date
Descrizione

AgentEndDate

Tipo di dati

date

Comments
Descrizione

Comments

Tipo di dati

text

Similar models

No Instruction available.

  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP S0227 TREATMENT FORM (S0227)
    1. No Instruction available.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
SWOG clinical trial administrative data
SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
PatientInitials
Item
Patient Initials (L, F M)
text
CourseIdentification
Item
Cycle #
float
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
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
First Cycle Of Treatment
CourseBeginDate
Item
Cycle start date (same as treatment start date)
date
Cycleenddate
Item
Cycle end date (Date immediately prior to the date next cycle begins, or date decision made to discontinue patient from protocol treatment if last cycle)
text
PatientWeight
Item
Weight (First day of this cycle)
float
BSA
Item
Body surface area
float
C16960 (NCI Thesaurus ObjectClass)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS CUI [1])
Item
Were there any dose modifications or additions/omissions to protocol treatment
text
Code List
Were there any dose modifications or additions/omissions to protocol treatment
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
(i.e., The Treatment Was Changed According To Protocol Guidelines) (Yes, planned, specify in comments)
CL Item
(i.e., The Treatment Change Was Not Part Of Protocol Guidelines) (Yes, unplanned, specify in comments)
AgentTotalDose(percourse)
Item
Total dose for this cycle: gemcitabine (Arm 2 only)
float
Concomitant medication
Item
CONCOMITANT MEDICATIONS / MEDICAL INTERVENTIONS
text
C2347852 (UMLS CUI [1])
AgentName
Item
Others, specify
text
AgentBeginDate
Item
Start Date
date
AgentEndDate
Item
Stop Date
date
Comments
Item
Comments
text

Si prega di utilizzare questo modulo per feedback, domande e suggerimenti per miglioramenti.

I campi contrassegnati da * sono obbligatori.

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