ID

1419

Descrizione

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

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BFC578AC-199D-0418-E034-0003BA12F5E7

Keywords

  1. 27/08/12 27/08/12 -
  2. 14/07/17 14/07/17 - Martin Dugas
Caricato su

27 agosto 2012

DOI

Per favore, per richiedere un accesso.

Licenza

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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  1. StudyEvent: CALGB: 80203 CHANGES IN FUNCTION FORM-Rev
    1. No Instruction available.
Ccrr Module For Calgb: 80203 Changes In Function Form-rev
Descrizione

Ccrr Module For Calgb: 80203 Changes In Function Form-rev

Patient Initials
Descrizione

PatientInitials

Tipo di dati

text

Patient Hospital No.
Descrizione

PatientHospitalNo.

Tipo di dati

text

Institution/Affiliate
Descrizione

Institution/Affiliate

Tipo di dati

text

Participating Group
Descrizione

ParticipatingGroup

Tipo di dati

text

Participating Group Protocol No.
Descrizione

ParticipatingGroupProtocolNo.

Tipo di dati

text

Participating Group Patient ID
Descrizione

ParticipatingGroupPatientID

Tipo di dati

text

Interviewer or CRA
Descrizione

InterviewerorCRA

Tipo di dati

text

Assessment Number
Descrizione

AssessmentNumber

Tipo di dati

text

Has your physical condition gotten
Descrizione

Hasyourphysicalconditiongotten

Tipo di dati

text

Has your emotional state gotten
Descrizione

Hasyouremotionalstategotten

Tipo di dati

text

Has your ability to enjoy social life gotten
Descrizione

Hasyourabilitytoenjoysociallifegotten

Tipo di dati

text

Has your overall quality of life gotten
Descrizione

Hasyouroverallqualityoflifegotten

Tipo di dati

text

Similar models

No Instruction available.

  1. StudyEvent: CALGB: 80203 CHANGES IN FUNCTION FORM-Rev
    1. No Instruction available.
Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Ccrr Module For Calgb: 80203 Changes In Function Form-rev
Item
Patient Initials
text
Code List
Patient Initials
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
Item
Assessment Number
text
Code List
Assessment Number
CL Item
7 Day (7 Day)
CL Item
30 Day (30 Day)
Item
Has your physical condition gotten
text
Code List
Has your physical condition gotten
CL Item
Very much worse (Very much worse)
CL Item
Moderatly worse (Moderatly worse)
CL Item
A little worse (A little worse)
CL Item
About the same (About the same)
CL Item
A little better (A little better)
CL Item
Moderatly better (Moderatly better)
CL Item
Very much better (Very much better)
Item
Has your emotional state gotten
text
Code List
Has your emotional state gotten
CL Item
Very much worse (Very much worse)
CL Item
Moderatly worse (Moderatly worse)
CL Item
A little worse (A little worse)
CL Item
About the same (About the same)
CL Item
A little better (A little better)
CL Item
Moderatly better (Moderatly better)
CL Item
Very much better (Very much better)
Item
Has your ability to enjoy social life gotten
text
Code List
Has your ability to enjoy social life gotten
CL Item
Very much worse (Very much worse)
CL Item
Moderatly worse (Moderatly worse)
CL Item
A little worse (A little worse)
CL Item
About the same (About the same)
CL Item
A little better (A little better)
CL Item
Moderatly better (Moderatly better)
CL Item
Very much better (Very much better)
Item
Has your overall quality of life gotten
text
Code List
Has your overall quality of life gotten
CL Item
Very much worse (Very much worse)
CL Item
Moderatly worse (Moderatly worse)
CL Item
A little worse (A little worse)
CL Item
About the same (About the same)
CL Item
A little better (A little better)
CL Item
Moderatly better (Moderatly better)
CL Item
Very much better (Very much better)

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