Résultats de recherche - Portail des modèles médicaux de données (portail MDM)

Leukemia NCT00792948 Registration - Southwest Oncology Group S0805 Registration Worksheet Form (Step 1) - 3135175v1.0 - Southwest Oncology Group S0805 Registration Worksheet Form (Step 1)

- 09/01/2015 - 1 Formulaire, 8 Groupes Item, 20 Eléments de données, 1 Langue

Groupes Item: Protocol Information, SWOG PATIENT ID, DEMOGRAPHY, For SWOG Institutions:, Patient Information, Stratification Question, Indicate how the patient answered the following questions on the consent form, Patient Eligibility

Southwest Oncology Group S0805 Registration Worksheet Form (Step 1) Combination Chemotherapy With or Without Donor Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8FB90D5C-D5F7-9108-E040-BB89AD43238E

Leukemia NCT00945815 Registration - Southwest Oncology Group S0910 Registration Worksheet Form - 3116464v1.0 - Southwest Oncology Group S0910 Registration Worksheet Form

- 09/01/2015 - 1 Formulaire, 7 Groupes Item, 17 Eléments de données, 1 Langue

Groupes Item: Protocol Information, SWOG PATIENT ID, DEMOGRAPHY, For SWOG Institutions:, Patient Information, Indicate how the patient answered the following questions on the consent form, Patient Eligibility

Southwest Oncology Group S0910 Registration Worksheet Form Epratuzumab, Cytarabine, and Clofarabine in Treating Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8A5A6B07-2599-04D8-E040-BB89AD435E5E

Leukemia NCT00558519 Registration - CALGB-10403 OPEN Registration Worksheet - 3057212v1.0 - CALGB-10403 OPEN Registration Worksheet

- 09/01/2015 - 1 Formulaire, 7 Groupes Item, 19 Eléments de données, 1 Langue

Groupes Item: Protocol Administration, Pre-Treatment Characteristics, Certification Of Eligibility, Protocol Design, CALGB Companion Studies, SWOG Companion Studies, Case Notes

CALGB-10403 OPEN Registration Worksheet Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Acute Lymphoblastic Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=83D35A37-D0A0-FE1A-E040-BB89AD435D90

Neuroendocrine Carcinoma NCT00569127 Pre-Study - SOUTHWEST ONCOLOGY GROUP S0518 Prestudy Form - 2459443v1.0 - SOUTHWEST ONCOLOGY GROUP S0518 Prestudy Form

- 09/01/2015 - 1 Formulaire, 6 Groupes Item, 59 Eléments de données, 1 Langue

Groupes Item: Header, Patient and Disease Description, Associated Correlative Science Consent, Laboratory Values, PRIOR TREATMENT RELATED TO THIS CANCER, Comments

SOUTHWEST ONCOLOGY GROUP S0518 Prestudy Form Octreotide and Interferon Alfa-2b or Bevacizumab in Treating Patients With Metastatic or Locally Advanced, High-Risk Neuroendocrine Tumor Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0F1CE67C-C251-11F5-E044-0003BA3F9857

COG AALL08B1 OPEN Registration Worksheet Step 2 - 3371785v1.0 - FP.0000

- 18/12/2014 - 1 Formulaire, 5 Groupes Item, 11 Eléments de données, 1 Langue

Groupes Item: Stratification, INCLUSION CRITERIA, EXCLUSION CRITERIA, REGULATORY INFORMATION, Comments Module

COG AALL08B1 OPEN Registration Worksheet Step 2 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=

Sarcoma NCT01247571 Pre-Study - GOG-0230: Fast Fact Sheet for Protocol 0230-D (Uterus) - 3174263v1.0 - GOG-0230: Fast Fact Sheet for Protocol 0230-D (Uterus)

- 20/09/2021 - 1 Formulaire, 3 Groupes Item, 91 Eléments de données, 1 Langue

Groupes Item: Patient Information, Eligibility 1, Provide comments about this Fast Fact Sheet

GOG-0230: Fast Fact Sheet for Protocol 0230-D (Uterus) Pazopanib Hydrochloride in Treating Patients With Recurrent or Persistent Uterine Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=97F2A353-AB36-7B12-E040-BB89AD432C3D

Lung Cancer NCT01041781 Registration - CALGB-30801 Registration Worksheet Form - 2891095v1.0 - CALGB-30801 Registration Worksheet Form

- 20/09/2021 - 1 Formulaire, 9 Groupes Item, 36 Eléments de données, 1 Langue

Groupes Item: Header Module, Protocol Administration, Patient Demographics/Pre-Treatment Characteristics1, Patient Demographics/Pre-Treatment Characteristics2, Patient Demographics/Pre-Treatment Characteristics3, Certification Of Eligibility, Protocol Design, Companion Study, Registration Information

CALGB-30801 Registration Worksheet Form Gemcitabine Hydrochloride or Pemetrexed Disodium and Carboplatin With or Without Celecoxib in Treating Patients With Advanced Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6AF26CA3-DB68-EEE0-E040-BB89AD436D54

S0201 Southwest Oncology Group Registration Form 2055861v3.0

- 20/09/2021 - 1 Formulaire, 4 Groupes Item, 36 Eléments de données, 1 Langue

Groupes Item: SWOG clinical trial administrative data, Registration data, Patient demographics, CCRR MODULE

S0201 Southwest Oncology Group Registration Form 2055861v3.0 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A8B98C1F-D2E5-127C-E034-0003BA12F5E7 2055861v3.0

Liver Cancer NCT01015833 Registration - CALGB 80802 Registration Worksheet Form - 2940585v1.0 - CALGB 80802 Registration Worksheet Form

- 17/09/2021 - 1 Formulaire, 10 Groupes Item, 45 Eléments de données, 1 Langue

Groupes Item: Header Module, Protocol Administration, Patient Demographics/Pre-Treatment Characteristics1, Patient Demographics/Pre-Treatment Characteristics2, Patient Demographics/Pre-Treatment Characteristics3, Certification Of Eligibility, Protocol Design, Optional Companion Studies, Registration Information, Notes

CALGB 80802 Registration Worksheet Form Sorafenib Tosylate With or Without Doxorubicin Hydrochloride in Treating Patients With Locally Advanced or Metastatic Liver Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=73B6D8AE-48AF-7324-E040-BB89AD43648A

Lung Cancer NCT01107626 Eligibility - E5508 Registration Worksheet (step 2) - 3078042v1.0 - E5508 Registration Worksheet (step 2)

- 17/09/2021 - 1 Formulaire, 3 Groupes Item, 19 Eléments de données, 1 Langue

Groupes Item: Eligibility, Demographic Data Required For Patient Registration, I have reviewed the above data and agree the date are accurate and correct

E5508 Registration Worksheet (step 2) Bevacizumab or Pemetrexed Disodium Alone or In Combination After Induction Therapy in Treating Patients With Advanced Non-Squamous Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8528E45F-A327-F490-E040-BB89AD4356FC

Breast Cancer Registration SWOG NCT00070564 - REGISTRATION Breast Cancer NCT00070564

- 17/11/2021 - 1 Formulaire, 3 Groupes Item, 26 Eléments de données, 1 Langue

Groupes Item: Header, Patient characteristics, Patient Consent For Specimen Use

SOUTHWEST ONCOLOGY GROUP REGISTRATION FORM Adjuvant Doxorubicin, Cyclophosphamide, and Paclitaxel in Treating Patients With Breast Cancer NCT00070564 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A678842F-926F-5086-E034-0003BA0B1A09

Breast Cancer Registration SWOG S0226 NCT00075764 - Registration Breast Cancer NCT00075764

- 27/09/2021 - 1 Formulaire, 3 Groupes Item, 39 Eléments de données, 1 Langue

Groupes Item: Header, Patient data, Consent

Southwest Oncology Group Registration Form (S0226) S0226 Anastrozole With or Without Fulvestrant as First-Line Therapy in Postmenopausal Women With Metastatic Breast Cancer NCT00075764 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C3225DE6-8BA0-26CF-E034-0003BA12F5E7

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