ID

1419

Descrição

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

Link

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

Palavras-chave

  1. 27/08/2012 27/08/2012 -
  2. 14/07/2017 14/07/2017 - Martin Dugas
Transferido a

27 de agosto de 2012

DOI

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Licença

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

No Instruction available.

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

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

Patient Initials
Descrição

PatientInitials

Tipo de dados

text

Patient Hospital No.
Descrição

PatientHospitalNo.

Tipo de dados

text

Institution/Affiliate
Descrição

Institution/Affiliate

Tipo de dados

text

Participating Group
Descrição

ParticipatingGroup

Tipo de dados

text

Participating Group Protocol No.
Descrição

ParticipatingGroupProtocolNo.

Tipo de dados

text

Participating Group Patient ID
Descrição

ParticipatingGroupPatientID

Tipo de dados

text

Interviewer or CRA
Descrição

InterviewerorCRA

Tipo de dados

text

Assessment Number
Descrição

AssessmentNumber

Tipo de dados

text

Has your physical condition gotten
Descrição

Hasyourphysicalconditiongotten

Tipo de dados

text

Has your emotional state gotten
Descrição

Hasyouremotionalstategotten

Tipo de dados

text

Has your ability to enjoy social life gotten
Descrição

Hasyourabilitytoenjoysociallifegotten

Tipo de dados

text

Has your overall quality of life gotten
Descrição

Hasyouroverallqualityoflifegotten

Tipo de dados

text

Similar models

No Instruction available.

  1. StudyEvent: CALGB: 80203 CHANGES IN FUNCTION FORM-Rev
    1. No Instruction available.
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
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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