- 17-04-21 - 1 Formulier, 9 Itemgroepen, 20 Data-elementen, 1 Taal
Itemgroepen: Administrative, Toxicities related to previous Radiotherapy for SCLC, Toxicities related to previous Radiotherapy for SCLC, 12-Lead Electrocardiogram, Diagnostic Studies for Tumor Assessment, Ongoing Medical Conditions Associated with SCLC, Ongoing Medical Conditions Associated with SCLC, Significant Medical/ Surgical History and Physical Examination, Significant Medical/ Surgical History and Physical Examination
- 15-03-21 - 1 Formulier, 18 Itemgroepen, 68 Data-elementen, 1 Taal
Itemgroepen: Identification Numbers, Post Treatment Follow-Up, Health Care Resource Utilization , If Yes to Hospitalization, FACT-An, Stem Cell Transplant (SCT) Follow-Up, If ’Yes’ please indicate chemotherapy regimen/agents below, Total body irradiation, Signature-Name of Person, Patient Assignment Sheet, Patient Assignment Sheet, Patient Log, Patient Log , Month of Report, Outcome, Form D, Laboratory Reference Ranges, Referance Range
- 16-08-19 - 1 Formulier, 12 Itemgroepen, 75 Data-elementen, 1 Taal
Itemgroepen: Administrative documentation, Demography, Vital signs, Rectal Carcinoma, Medical History, Rectal Carcinoma, Operative Surgical Procedures, Previous, 12 lead ECG, Rectal Carcinoma, Evaluation, Diagnostic procedure, Disease, Relationships, Rectal Carcinoma, Medical History; History of surgical procedures; Physical Examination, Pharmaceutical Preparations, Previous; Concomitant Agent, Inclusion, Exclusion Criteria
- 24-04-18 - 1 Formulier, 12 Itemgroepen, 36 Data-elementen, 1 Taal
Itemgroepen: Identification Numbers, Serious Adverse Experiences, 12-Lead Electrocardiogram, Echocardiogram or Multiple Gated Acquisition Scanning (MUGA), If Yes for the obtained Ejection Fraction, Chest X-Ray, Supportive Therapy (Including Erythropoietin), If Yes to Supportive Therapy (Including Erythropoietin), Supportive Anti-Infective Therapy, If Yes to Supportive Anti-Infective Therapy, Concominant Medication, If Yes to Concominant Medication

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