Protocol Administration
ProtocolIRBApprovedDate
date
InformedConsentFormSignedDate
date
TreatmentProjectedBeginDate
date
PatientSignedDischargeMedicalRecordDate
date
InstitutionContactPersonName
text
ContactPersonTelephoneNumber
text
ContactPersonFaxNumber
text
Patient Demographics/pre-treatment Characteristics
PatientInitialsName
text
PatientBirthDate
date
PatientPersonSocialSecurityNumber
text
PatientMedicalRecordNumber
text
PatientGenderCategory
text
PatientRaceCategory
text
PatientEthnicGroupCategory
text
Patient Demographics/pre-treatment Characteristics2
PerformanceStatusAssessmentEasternCooperativeOncologyGroupScale
text
PatientHeightMeasurement
double
PatientWeightMeasurement
double
PersonBodySurfaceAreaValue
double
PatientPaymentType
text
Patient Demographics/pre-treatment Characteristics3
DiseaseDescriptionText
text
PersonAddressPostalCode
text
PersonAddressCountryName
text
Certification Of Eligibility And Protocol Design
PatientAncillaryStudyOneEligibilityDeterminationInd-3
text
PatientAncillaryStudyTwoEligibilityDeterminationInd-3
text
PatientAncillaryStudyThreeEligibilityDeterminationInd-3
text
Protocol Design
StudyStratificationText
text
ProtocolTreatmentArmAssignmentText
text
Initial Patient Consent For Specimen Use
PatientQualityofLifeConsentInd-2
text
TissueSpecimenMalignantNeoplasmRelatedResearchConsentInd-3
text
BloodSpecimenRelatedGeneticResearchConsentInd-2
text
PersonSpecimenMalignantNeoplasmResearchConsentInd-2
text
BloodTissueSpecimenOtherDiseasesandDisordersResearchConsentInd-3
text
PatientContactConsentInd-3
text
Notes
ClinicalResearchAssociateResponsiblePersonName
text
ClinicalResearchAssociatePersonEmailAddressText
text
ClinicalResearchAssociatePersonFullAddressText
text
ClinicalResearchAssociatePersonTelephoneNumber
text
Registration Information
PatientRegistrationDate
date
PatientParticipatingIdentifierNumber
text
PatientCALGBIdentifierNumber
text
RegisteringPersonIdentifierSignatureName
text