ID

2241

Beschrijving

OFF TREATMENT NOTICE S0023: Combination Chemo Plus RT With or Without Gefitinib in Treating Patients With Unresectable Stage III NSCLC Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9CA62D43-4EE1-361C-E034-080020C9C0E0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9CA62D43-4EE1-361C-E034-080020C9C0E0

Trefwoorden

  1. 19-09-12 19-09-12 -
  2. 30-04-15 30-04-15 - Martin Dugas
Geüploaded op

19 september 2012

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy

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Lung Cancer NCT00020709 Off Treatment - OFF TREATMENT NOTICE - 2030406v3.0

No Instruction available.

  1. StudyEvent: OFF TREATMENT NOTICE
    1. No Instruction available.
Unnamed1
Beschrijving

Unnamed1

SWOG Patient ID
Beschrijving

SWOGPatientID

Datatype

text

SWOG Study No.
Beschrijving

SWOGStudyNo.

Datatype

text

Registration Step
Beschrijving

RegistrationStep

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain
C16154
UMLS 2011AA ValueDomain
C1704379
Patient Initials (L, F,M)
Beschrijving

PatientInitials

Datatype

text

Institution / Affiliate
Beschrijving

Institution/Affiliate

Datatype

text

Physician
Beschrijving

Physician

Datatype

text

Group Name (Groups other than SWOG )
Beschrijving

GroupName

Datatype

text

Study No. (Groups other than SWOG )
Beschrijving

StudyNo.

Datatype

double

Pt. ID (Groups other than SWOG )
Beschrijving

Pt.ID

Datatype

text

Unnamed2
Beschrijving

Unnamed2

Treatment Start Date
Beschrijving

TreatmentStartDate

Datatype

date

Treatment End Date
Beschrijving

TreatmentEndDate

Datatype

date

Regimen or Procedure or Site(s)
Beschrijving

RegimenorProcedureorSite(s)

Datatype

text

Unnamed3
Beschrijving

Unnamed3

Off Treatment Reason (select one:)
Beschrijving

OffTreatmentReason

Datatype

text

Medically required, due to toxicity, specify
Beschrijving

Medicallyrequired,duetotoxicity,specify:

Datatype

text

Patient refused, due to toxicity, specify
Beschrijving

Patientrefused,duetotoxicity,specify:

Datatype

text

Progression or relapse. Sites
Beschrijving

Progressionorrelapse.Sites:

Datatype

text

Other, specify
Beschrijving

Other,specify:

Datatype

text

Date of completion, progression, death or decision to discontinue therapy (Off Treatment Date)
Beschrijving

Dateofcompletion,progression,deathordecisiontodiscontinuetherapy:

Datatype

text

Unnamed4
Beschrijving

Unnamed4

Will patient receive further treatment?
Beschrijving

Willpatientreceivefurthertreatment?

Datatype

text

Unnamed5
Beschrijving

Unnamed5

Date of Last Contact (or death)
Beschrijving

DateofLastContact(ordeath):

Datatype

text

Vital Status
Beschrijving

VitalStatus:

Datatype

text

Notes
Beschrijving

Notes

Notes
Beschrijving

Notes

Datatype

text

Similar models

No Instruction available.

  1. StudyEvent: OFF TREATMENT NOTICE
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Unnamed1
SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16154 (NCI Thesaurus ValueDomain)
C1704379 (UMLS 2011AA ValueDomain)
PatientInitials
Item
Patient Initials (L, F,M)
text
Institution/Affiliate
Item
Institution / Affiliate
text
Physician
Item
Physician
text
GroupName
Item
Group Name (Groups other than SWOG )
text
StudyNo.
Item
Study No. (Groups other than SWOG )
double
Pt.ID
Item
Pt. ID (Groups other than SWOG )
text
Item Group
Unnamed2
TreatmentStartDate
Item
Treatment Start Date
date
TreatmentEndDate
Item
Treatment End Date
date
RegimenorProcedureorSite(s)
Item
Regimen or Procedure or Site(s)
text
Item Group
Unnamed3
Item
Off Treatment Reason (select one:)
text
Code List
Off Treatment Reason (select one:)
CL Item
Treatment completed per protocol criteria (Treatment completed per protocol criteria)
CL Item
Medically required, due to toxicity, specify (Medically required, due to toxicity, specify)
Item
Medically required, due to toxicity, specify
text
Code List
Medically required, due to toxicity, specify
CL Item
Pt_refused_due_to_toxic2006857 (Patient refused, due to toxicity, specify)
Item
Patient refused, due to toxicity, specify
text
Code List
Patient refused, due to toxicity, specify
CL Item
Pt_refused_oth_than_tox2006859 (Patient refused, other than toxicity, specify)
CL Item
Prog_or_relapse_sites_2006860 (Progression or relapse. Sites)
Item
Progression or relapse. Sites
text
Code List
Progression or relapse. Sites
CL Item
Death_attach_notice_of_2006862 (Death (attach Notice of Death form))
CL Item
Other_specify_2006863 (Other, specify)
Other,specify:
Item
Other, specify
text
Dateofcompletion,progression,deathordecisiontodiscontinuetherapy:
Item
Date of completion, progression, death or decision to discontinue therapy (Off Treatment Date)
text
Item Group
Unnamed4
Item
Will patient receive further treatment?
text
Code List
Will patient receive further treatment?
CL Item
No (No)
CL Item
Yes, specify (Yes, specify)
CL Item
Unknown (Unknown)
Item Group
Unnamed5
DateofLastContact(ordeath):
Item
Date of Last Contact (or death)
text
Item
Vital Status
text
Code List
Vital Status
CL Item
Alive (Alive)
CL Item
Dead (Dead)
Item Group
Notes
Notes
Item
Notes
text

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