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Pre-Study - NCI Standard Participant Identification Template - 2729615v1.0 - NCI Standard Participant Identification Template

- 20/09/2021 - 1 Formulaire, 2 Groupes Item, 11 Eléments de données, 1 Langue
Groupes Item: Conditional Participant ID Questions, Optional Participant ID Questions
The collection of CDEs used in the Participant ID module. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=46716FCE-3AD1-70D5-E044-0003BA3F9857

Pre-Study - PRIOR THERAPY SUPPLEMENT - 2394210v1.0 - PRIOR THERAPY SUPPLEMENT

- 09/01/2015 - 1 Formulaire, 2 Groupes Item, 11 Eléments de données, 1 Langue
Groupes Item: PRIOR THERAPY SUPPLEMENT, COMMENTS
Prior Therapy form for C3D 3.12 Adopters Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF07B012-CA3F-1CA3-E034-0003BA3F9857

Pre-Study - NCI Standard Registration Template - 2745056v1.0 - NCI Standard Registration Template

- 20/09/2012 - 1 Formulaire, 3 Groupes Item, 18 Eléments de données, 1 Langue
Groupes Item: Mandatory Registration Questions, Conditional Registration Questions, Optional Registration Questions
The collection of CDEs used in the registration module. Registration consists of the registering institution applying for entry of a consented participant into a specific research study by conveying designated registration information to a central facility that is in charge of accepting participants into the study. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C056DEC-99CB-35E0-E044-0003BA3F9857

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

Cervical Cancer Baseline assessment NCT00057928 - Baseline assessment Cervical Cancer NCT00057928 SWOG

- 28/03/2015 - 1 Formulaire, 2 Groupes Item, 15 Eléments de données, 1 Langue
Groupes Item: Header, TARGET LESIONS
SOUTHWEST ONCOLOGY GROUP BASELINE TUMOR ASSESSMENT FORM S0227 Comparison of Cisplatin Combined With Either Paclitaxel or Gemcitabine in Treating Patients With Recurrent, Persistent, or Metastatic Cervical Cancer NCT00057928 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C374FF-72CD-367D-E034-0003BA12F5E7

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

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

Enrollment Cervical Cancer ANZGOG-0902 NCT01414608

- 04/08/2015 - 1 Formulaire, 7 Groupes Item, 39 Eléments de données, 1 Langue
Groupes Item: Header, Inclusion Criteria, Laboratory Eligibility Data, Consent, Exclusion Criteria, Stratification Factors, Footer Module
ANZGOG-0902 Enrollment Cisplatin and Radiation Therapy With or Without Carboplatin and Paclitaxel in Patients With Locally Advanced Cervical Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=90675395-7527-57AA-E040-BB89AD43454D

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

Anal Cancer Screen Failure AMC-076 NCT01164722 - Screen Failure Form (SFF) Anals Cancer NCT01164722

- 20/05/2015 - 1 Formulaire, 1 Groupe Item, 8 Eléments de données, 1 Langue
Groupe Item: Screen Failure
AMC-076 Screen Failure Form (SFF) Infrared Coagulator Ablation or Observation in Preventing Anal Cancer in HIV-Positive Patients With Anal Neoplasia NCT01164722 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A80D02C4-02DA-DA36-E040-BB89AD436D9D

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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