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Information:
Fel:
ID
6235
Beskrivning
SOUTHWEST ONCOLOGY GROUP S0227 TREATMENT FORM (S0227) S0227 Comparison of Cisplatin Combined With Either Paclitaxel or Gemcitabine in Treating Patients With Recurrent, Persistent, or Metastatic Cervical Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AA4D01C2-8134-3CDA-E034-0003BA12F5E7
Länk
Nyckelord
Versioner (4)
- 2014-12-18 2014-12-18 - Martin Dugas
- 2015-06-02 2015-06-02 -
- 2015-06-03 2015-06-03 -
- 2015-08-22 2015-08-22 - Martin Dugas
Uppladdad den
18 december 2014
DOI
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Licens
Creative Commons BY-NC 3.0 Legacy
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Cervical Cancer NCT00057928 Treatment - SOUTHWEST ONCOLOGY GROUP S0227 TREATMENT FORM (S0227) - 2057770v3.0
No Instruction available.
- StudyEvent: SOUTHWEST ONCOLOGY GROUP S0227 TREATMENT FORM (S0227)
Similar models
No Instruction available.
- StudyEvent: SOUTHWEST ONCOLOGY GROUP S0227 TREATMENT FORM (S0227)
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
PatientInitials
Item
Patient Initials (L, F M)
text
CourseIdentification
Item
Cycle #
double
InstitutionName
Item
Institution / Affiliate
text
RegisteredInvestigator
Item
Physician (Groups other than SWOG)
text
ParticipatingGroupName
Item
Group Name
text
Particip.GroupProtocolNumber
Item
Study No.
double
PatientStudyID,ParticipatingGroup
Item
Pt. ID
text
DeathDate/LastContactDate
Item
Date of Last Contact or Death
date
CL Item
Alive (Alive)
CL Item
Dead (Dead)
CourseBeginDate
Item
Cycle start date (same as treatment start date)
date
Cycleenddate
Item
Cycle end date (Date immediately prior to the date next cycle begins, or date decision made to discontinue patient from protocol treatment if last cycle)
text
PatientWeight
Item
Weight (First day of this cycle)
double
BodySurfaceArea
Item
BSA (First day of this cycle)
double
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS 2011AA Property)
C0030705 (UMLS 2011AA ObjectClass)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS 2011AA Property)
Item
Were there any dose modifications or additions/omissions to protocol treatment
text
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
CL Item
(i.e., The Treatment Was Changed According To Protocol Guidelines) (Yes, planned, specify in comments)
CL Item
(i.e., The Treatment Change Was Not Part Of Protocol Guidelines) (Yes, unplanned, specify in comments)
AgentTotalDose(percourse)
Item
Total dose for this cycle: gemcitabine (Arm 2 only)
double
AgentTotalDose(percourse)
Item
Total dose for this cycle: gemcitabine (Arm 2 only)
double
AgentTotalDose(percourse)
Item
Total dose for this cycle: gemcitabine (Arm 2 only)
double
AgentBeginDate
Item
Start Date
date
AgentEndDate
Item
Stop Date
date
AgentName
Item
Others, specify
text
AgentName
Item
Others, specify
text
CONCOMITANTMEDICATIONS/MEDICALINTERVENTIONS
Item
CONCOMITANT MEDICATIONS / MEDICAL INTERVENTIONS
text
Comments
Item
Comments
text