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

Bladder Cancer NCT01224665 - Pre-Randomization Off-Study Form Bladder Cancer #52060 S1011 NCT01224665

- 24/03/2015 - 1 Formulaire, 5 Groupes Item, 24 Eléments de données, 1 Langue

Groupes Item: Header Module, Treatment Information, Off Treatment Reason, Additional Treatment, Vital Status

S1011 Pre-Randomization Off-Study Form (#52060) Standard or Extended Pelvic Lymphadenectomy in Treating Patients Undergoing Surgery for Invasive Bladder Cancer NCT01224665 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9399F2B7-7E68-06C0-E040-BB89AD436952

Breast Cancer NCT00377156 Pre-Study - North Central Cancer Treatment Group Functional Independence - 2470805v1.0 - North Central Cancer Treatment Group Functional Independence

- 08/01/2015 - 1 Formulaire, 2 Groupes Item, 19 Eléments de données, 1 Langue

Groupes Item: Header, Barthel Function Index

North Central Cancer Treatment Group Functional Independence Stereotactic Radiation Therapy With or Without Whole-Brain Radiation Therapy in Treating Patients With Brain Metastases Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=10DD7D18-F9F9-2FC3-E044-0003BA3F9857

North Central Cancer Treatment Group Pretreatment Measurement Form NCT00377156

- 08/06/2015 - 1 Formulaire, 2 Groupes Item, 11 Eléments de données, 1 Langue

Groupes Item: Header, Target lesion

North Central Cancer Treatment Group Pretreatment Measurement Form NCT00377156 Stereotactic Radiation Therapy With or Without Whole-Brain Radiation Therapy in Treating Patients With Brain Metastases Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=10B2D3B7-59E0-0044-E044-0003BA3F9857

Breast Cancer NCT00659373 Pre-Study - Prior Treatment History Form (Form 24-H) - 2074666v3.0 - Prior Treatment History Form (Form 24-H)

- 09/01/2015 - 1 Formulaire, 3 Groupes Item, 25 Eléments de données, 1 Langue

Groupes Item: BEFORE DIAGNOSIS: CHEMOPREVENTION FOR BREAST CANCER, PRIOR CHEMOTHERAPY REGIMEN FOR BREAST CANCER, CCRR MODULE

Prior Treatment History Form (Form 24-H) Brain Function in Premenopausal Women Receiving Tamoxifen With or Without Ovarian Function Suppression for Early-Stage Breast Cancer on Clinical Trial IBCSG-2402 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B1274765-836E-53AF-E034-0003BA12F5E7

Immunogenicity of Combined Measles Mumps Rubella Varicella Vaccine for healthy 2 y.o children - 104020 - Medical History

- 26/11/2018 - 1 Formulaire, 3 Groupes Item, 22 Eléments de données, 1 Langue

Groupes Item: Administrative data, General Medical History / Physical Examination, Concomitant Medications

Study ID: 104020 Clinical Study ID: 104020 Study Title: Blinded, randomised study to assess the immunogenicity and safety of GlaxoSmithKline (GSK) Biologicals’ live attenuated measles-mumps-rubella-varicella candidate vaccine when given to healthy children in their second year of life Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00126997 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 4 Study Recruitment Status: Completed Generic Name: Combined Measles, Mumps, Rubella, Varicella Vaccine Trade Name: Priorix Tetra Study Indication: Measles; Mumps; Rubella; Varicella CRF Seiten: 268-336; 870-938

Immunogenicity of Combined Measles Mumps Rubella Varicella Vaccine for healthy 2 y.o children - 104020 - Eligibility Criteria

- 26/11/2018 - 1 Formulaire, 4 Groupes Item, 22 Eléments de données, 1 Langue

Groupes Item: Administrative data, Eligibility Question, Inclusion Criteria, Exclusion Criteria

Study ID: 104020 Clinical Study ID: 104020 Study Title: Blinded, randomised study to assess the immunogenicity and safety of GlaxoSmithKline (GSK) Biologicals’ live attenuated measles-mumps-rubella-varicella candidate vaccine when given to healthy children in their second year of life Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00126997 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 4 Study Recruitment Status: Completed Generic Name: Combined Measles, Mumps, Rubella, Varicella Vaccine Trade Name: Priorix Tetra Study Indication: Measles; Mumps; Rubella; Varicella CRF Seiten: 268-336; 870-938

Immunogenicity of Combined Measles Mumps Rubella Varicella Vaccine for healthy 2 y.o children - 104020 - Randomisation Number

- 26/11/2018 - 1 Formulaire, 2 Groupes Item, 4 Eléments de données, 1 Langue

Groupes Item: Administrative data, Randomisation / Treatment Allocation

Study ID: 104020 Clinical Study ID: 104020 Study Title: Blinded, randomised study to assess the immunogenicity and safety of GlaxoSmithKline (GSK) Biologicals’ live attenuated measles-mumps-rubella-varicella candidate vaccine when given to healthy children in their second year of life Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00126997 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 4 Study Recruitment Status: Completed Generic Name: Combined Measles, Mumps, Rubella, Varicella Vaccine Trade Name: Priorix Tetra Study Indication: Measles; Mumps; Rubella; Varicella CRF Seiten: 268-336; 870-938

Immunogenicity of Combined Measles, Mumps, Rubella, Varicella Vaccine for healthy 2 y.o children - 104020 - Contraindications to Subsequent Vaccination

- 22/11/2018 - 1 Formulaire, 3 Groupes Item, 3 Eléments de données, 1 Langue

Groupes Item: Note, Contraindications to Subsequent Vaccination, Precautions for Vaccination

Study ID: 104020 Clinical Study ID: 104020 Study Title: Blinded, randomised study to assess the immunogenicity and safety of GlaxoSmithKline (GSK) Biologicals’ live attenuated measles-mumps-rubella-varicella candidate vaccine when given to healthy children in their second year of life Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00126997 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 4 Study Recruitment Status: Completed Generic Name: Combined Measles, Mumps, Rubella, Varicella Vaccine Trade Name: Priorix Tetra Study Indication: Measles; Mumps; Rubella; Varicella

Breast Cancer NCT00070564 Pre-Study - SOUTHWEST ONCOLOGY GROUP S0221 BREAST CANCER PRESTUDY FORM - 2046547v3.0 - SOUTHWEST ONCOLOGY GROUP S0221 BREAST CANCER PRESTUDY FORM

- 09/01/2015 - 1 Formulaire, 6 Groupes Item, 61 Eléments de données, 1 Langue

Groupes Item: Header, PATIENT CHARACTERISTICS, DISEASE DESCRIPTION, LABORATORY VALUES, PRIOR TREATMENT RELATED TO THIS CANCER, Comments Module

SOUTHWEST ONCOLOGY GROUP S0221 BREAST CANCER PRESTUDY FORM Adjuvant Doxorubicin, Cyclophosphamide, and Paclitaxel in Treating Patients With Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A6788C86-182E-5088-E034-0003BA0B1A09

Pre-Study Breast Cancer SWOG S0307 NCT00127205

- 26/08/2015 - 1 Formulaire, 10 Groupes Item, 46 Eléments de données, 1 Langue

Groupes Item: Administrative documentation, DISEASE DESCRIPTION, LABORATORY VALUES, CONSENT FOR SUBMISSION AND BANKING, PATIENT CHARACTERISTICS, DISEASE DESCRIPTION, TREATMENT WITH STATINS, PATIENT PREFERENCE, PRIOR TREATMENT RELATED TO THIS CANCER, SYSTEMIC TREATMENT FOR THIS CANCER

SOUTHWEST ONCOLOGY GROUP S0307 PRESTUDY FORM Zoledronate, Clodronate, or Ibandronate in Treating Women Who Have Undergone Surgery for Stage I, Stage II, or Stage III Breast SOUTHWEST ONCOLOGY GROUP S0307 PRESTUDY FORM Zoledronate, Clodronate, or Ibandronate in Treating Women Who Have Undergone Surgery for Stage I, Stage II, or Stage III Breast Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DEA0B902-CDD3-54E6-E034-0003BA12F5E7

Breast Cancer SWOG baseline tumor assessment NCT00075764 - BASELINE TUMOR ASSESSMENT Breast cancer SWOG S0226 NCT00075764

- 25/03/2015 - 1 Formulaire, 4 Groupes Item, 20 Eléments de données, 1 Langue

Groupes Item: Header, TARGET LESIONS, NON-TARGET DISEASE, Other tests

SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT 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=C322202A-32BF-25B7-E034-0003BA12F5E7

Breast Cancer Goserelin in Preventing Ovarian Failure NCT00068601 SWOG S0230 - PreStudy

- 24/06/2017 - 1 Formulaire, 3 Groupes Item, 17 Eléments de données, 1 Langue

Groupes Item: Disease Description, Laboratory Tests, CCRR MODULE

Goserelin in Preventing Ovarian Failure in Women Receiving Chemotherapy for Breast Cancer https://clinicaltrials.gov/ct2/show/NCT00068601 Breast Cancer NCT00068601 Pre-Study - Southwest Oncology Group PreStudy (S0230) - 2170510v3.0

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