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ID
1419
Description
CALGB: 80203 CHANGES IN FUNCTION FORM-Rev Fluorouracil and Leucovorin Plus Either Irinotecan or Oxaliplatin With or Without Cetuximab in Treating Patients With Previously Untreated Metastatic Adenocarcinoma of the Colon or Rectum Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BFC578AC-199D-0418-E034-0003BA12F5E7
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Versions (2)
- 8/27/12 8/27/12 -
- 7/14/17 7/14/17 - Martin Dugas
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August 27, 2012
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Creative Commons BY-NC 3.0
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Colorectal Cancer NCT00077233 Quality of Life - CALGB: 80203 CHANGES IN FUNCTION FORM-Rev - 2088973v3.0
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- StudyEvent: CALGB: 80203 CHANGES IN FUNCTION FORM-Rev
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- StudyEvent: CALGB: 80203 CHANGES IN FUNCTION FORM-Rev
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
CL Item
Last (Last)
CL Item
First (First)
CL Item
Middle (Middle)
PatientHospitalNo.
Item
Patient Hospital No.
text
Institution/Affiliate
Item
Institution/Affiliate
text
ParticipatingGroup
Item
Participating Group
text
ParticipatingGroupProtocolNo.
Item
Participating Group Protocol No.
text
ParticipatingGroupPatientID
Item
Participating Group Patient ID
text
InterviewerorCRA
Item
Interviewer or CRA
text
CL Item
7 Day (7 Day)
CL Item
30 Day (30 Day)
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Moderatly worse (Moderatly worse)
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Moderatly worse (Moderatly worse)
CL Item
A little worse (A little worse)
CL Item
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CL Item
Moderatly better (Moderatly better)
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Very much worse (Very much worse)
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Moderatly worse (Moderatly worse)
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A little worse (A little worse)
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Moderatly better (Moderatly better)
CL Item
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