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Table of contents
  1. 1. Clinical Trial
  2. 2. Routine Documentation
  3. 3. Registry/Cohort Study
  4. 4. Quality Assurance
  5. 5. Data Standard
  6. 6. Patient-Reported Outcome
  7. 7. Medical Specialty
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Blutdosimetrie PSMA-Studie Prostatakarzinom NCT0000001

- 7/9/16 - 1 form, 9 itemgroups, 43 items, 2 languages
Itemgroups: Patient Data, Cycle 1, Cycle 2, Cycle 3, Cycle 4, Cycle 5, Cycle 6, Cycle 7, Cycle 8
Quelle: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Teil: Blutdosimetrie

Lu PSMA-Studie Prostatakarzinom NCT0000001

- 7/8/16 - 1 form, 9 itemgroups, 21 items, 2 languages
Itemgroups: Identificaton, Session 1, Session 2, Session 3, Session 4, Session 5, Session 6, Session 7, Session 8
Quelle: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Teil: Lu PSMA

CTC PSMA-Studie Prostatakarzinom NCT0000001

- 7/8/16 - 1 form, 9 itemgroups, 101 items, 2 languages
Itemgroups: Baseline, 1st Cycle, 2nd Cycle, 3rd Cycle, 4th Cycle, 5th Cycle, 6th Cycle, 7th Cycle, 8th Cycle
Quelle: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Teil: CTC

Laboratory Values PSMA-Studie Prostatakarzinom NCT0000001 - Laborwerte PSMA-Studie Prostatakarzinom NCT0000001

- 7/14/16 - 1 form, 9 itemgroups, 82 items, 2 languages
Itemgroups: Patient Data, Cycle 1, Cycle 2, Cycle 3, Cycle 4, Cycle 5, Cycle 6, Cycle 7, Cycle 8
Quelle: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Teil: Laborwerte

TER-MAG PSMA-Studie Prostatakarzinom NCT0000001

- 7/14/16 - 1 form, 9 itemgroups, 20 items, 2 languages
Itemgroups: Patient Data, Cycle 1, Cycle 2, Cycle 3, Cycle 4, Cycle 5, Cycle 6, Cycle 7, Cycle 8
Quelle: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Teil: TER-MAG

GK Dosimetrie PSMA-Studie Prostatakarzinom NCT0000001

- 7/9/16 - 1 form, 9 itemgroups, 57 items, 2 languages
Itemgroups: Patient Data, Cycle 1, Cycle 2, Cycle 3, Cycle 4, Cycle 5, Cycle 6, Cycle 7, Cycle 8
Quelle: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Teil: GK Dosimetrie

Standard Activity PSMA-Studie Prostatakarzinom NCT0000001 - Standardaktivität PSMA-Studie Prostatakarzinom NCT0000001

- 7/9/16 - 1 form, 9 itemgroups, 49 items, 2 languages
Itemgroups: Patient Data, Cycle 1, Cycle 2, Cycle 3, Cycle 4, Cycle 5, Cycle 6, Cycle 7, Cycle 8
Quelle: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Teil: Standardaktivität

PET, Kidney, Saliva PSMA-Studie Prostatakarzinom NCT0000001 - PET, Niere, Speichel PSMA-Studie Prostatakarzinom NCT0000001

- 7/14/16 - 1 form, 10 itemgroups, 21 items, 2 languages
Itemgroups: Identification, Cycle 1, Cycle 2, Cycle 3, Cycle 4, Cycle 5, Cycle 6, Cycle 7, Cycle 8, Saliva
Quelle: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Teil: PET, Niere, Speichel

PSA Before Therapy PSMA-Studie Prostatakarzinom NCT0000001 - PSA vor Therapie PSMA-Studie Prostatakarzinom NCT0000001

- 7/14/16 - 1 form, 2 itemgroups, 13 items, 2 languages
Itemgroups: Patient Data, Measurements
Quelle: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Teil: PSA vor Therapie

Basic Data PSMA-Study Prostate Cancer NCT0000001 - Stammdaten 2 PSMA-Studie Prostatakarzinom NCT0000001

- 1/9/18 - 1 form, 9 itemgroups, 48 items, 1 language
Itemgroups: Patient Data, Cycle 1, Cycle 2, Cycle 3, Cycle 4, Cycle 5, Cycle 6, Cycle 7, Cycle 8
Source: PSMA-Studie Prostatakarzinom PD Dr. med. Kambiz Rahbar UKM, Nuklearmedizin Part: Stammdaten 2

Prostate Cancer NCT00499174 Follow-Up - NCIC-PR.11 Form 5AS - Active Surveillance Form - 2457525v1.0 - NCIC-PR.11 Form 5AS - Active Surveillance Form

- 9/20/21 - 1 form, 16 itemgroups, 96 items, 1 language
Itemgroups: Patient Information, Month of Report, Physical Exam, Digital Rectal Exam, PSA Measurements, Histology/Grade, Clinical Progression, Adverse Event Status, Therapy for Lower Urinary Tract Symptoms/Prostate Cancer since the last report, Other Malignancies or Marrow Dysplasia, Continuation of Active Surveillance, Prostate Tissue Samples, Quality of Life Questionnaire, Comments, Supporting Documentation, Form Completion
NCIC-PR.11 Form 5AS - Active Surveillance Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0EF81D84-2928-1CED-E044-0003BA3F9857

Prostate Cancer NCT00499174 Follow-Up - NCIC-PR.11 Form 5 - Follow-Up after Radical Intervention Form - 2457271v1.0 - NCIC-PR.11 Form 5 - Follow-Up after Radical Intervention Form

- 9/20/21 - 1 form, 15 itemgroups, 76 items, 1 language
Itemgroups: Patient Information, Month of Report, Physical Exam, Digital Rectal Exam, PSA Measurements, Notice of Biochemical/Distant Relapse/Progression after Radical Intervention, Adverse Event Status, Therapy for Lower Urinary Tract Symptoms/Prostate Cancer since the last report, Other Malignancies or Marrow Dysplasia, Quality of Life Questionnaire1, Quality of Life Questionnaire2, Quality of Life Questionnaire3, Comments, Supporting Documentation, Form Completion (please print)
NCIC-PR.11 Form 5 - Follow-Up after Radical Intervention Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0EF815F1-49C3-1C6E-E044-0003BA3F9857

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