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  1. 1. Klinische Studie
  2. 2. Routinedokumentation
  3. 3. Register-/Kohortenstudien
  4. 4. Qualitätssicherung
  5. 5. Datenstandard
  6. 6. Patientenfragebogen
  7. 7. Medizinische Fachrichtung
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HSCT recipients - Cause of death

- 20.09.21 - 1 Formular, 9 Itemgruppen, 24 Datenelemente, 1 Sprache
Itemgruppen: Registry Use Only, Identification Data, HSCT Type , Product Type, Death Date, Autopsy report, Primary Cause of Death, Secondary Cause of Death, Author Information
To define the primary and contributing causes of death for HSCT recipients reported as dead on follow up forms 2900 - RECIPIENT DEATH DATA Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6B9DD88E-9E08-08A7-E040-BB89AD430716

Survival

- 20.09.21 - 1 Formular, 1 Itemgruppe, 8 Datenelemente, 1 Sprache
Itemgruppe: Survival
Use this form to record information about the patient's death and autopsy results if applicable. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AD2489D8-8F86-4593-E040-BB89AD436DA5

Z1041: Tumor Measurement Report (TMR) NCT00513292

- 20.09.21 - 1 Formular, 7 Itemgruppen, 36 Datenelemente, 1 Sprache
Itemgruppen: Header Module, Breast Target Lesions, Axilla Target Lesions, TARGET LESIONS, Non-Target Lesions, Follow-up Status of Target Lesions, Footer
Z1041: Tumor Measurement Report (TMR) NCT00513292 Combination Chemotherapy and Paclitaxel Plus Trastuzumab in Treating Women With Palpable Breast Cancer That Can Be Removed by Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=214B3C72-1BE1-3F2B-E044-0003BA3F9857

Breast Cancer FOLLOW-UP NSABP B-36 NCT00087178 - FOLLOW-UP Breast Cancer NCT00087178

- 20.09.21 - 1 Formular, 10 Itemgruppen, 41 Datenelemente, 1 Sprache
Itemgruppen: Header, Vital Status, Cancer Follow-up Status, First Local-Regional Recurrence, First Distant Recurrence, New Primary Cancer or MDS, Patient data, Adverse Events, Late Adverse Events, Therapy
NSABP PROTOCOL B-36: FOLLOW-UP FORM Comparison of Two Combination Chemotherapy Regimens in Treating Women With Breast Cancer NCT00087178 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C89314D7-1DBA-74BA-E034-0003BA12F5E7

Advanced B-Cell Leukemia or Lymphoma (NCT00057811) - Reporting Period (ANHL01P1 NCT00057811)

- 20.09.21 - 1 Formular, 5 Itemgruppen, 70 Datenelemente, 1 Sprache
Itemgruppen: Header, Patient characteristics, CNS involvement, Diagnostics and treatment, Lab values
ANHL01P1: Reporting Period Rituximab, Rasburicase, and Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Advanced B-Cell Leukemia or Lymphoma NCT00057811 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BA568824-31F6-08D7-E034-0003BA12F5E7

Breast Cancer NCT01242800 Follow-Up - E2108 Step 2 Follow-up Form - 3130846v1.0 - E2108 Step 2 Follow-up Form

- 20.09.21 - 1 Formular, 12 Itemgruppen, 67 Datenelemente, 1 Sprache
Itemgruppen: Header Module, Header, Amended Data, Report Period, Section I - Vital Status, Section II - Reporting Period, Status of Local-Regional Disease, CHEST WALL, Breast Involvement, Section IV - Status of Distant Disease, Circulating Tumor Cell (CTC) Enumeration, Comments
E2108 Step 2 Follow-up Form Early Surgery or Standard Palliative Therapy in Treating Patients With Stage IV Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8E30083E-7422-9EAD-E040-BB89AD430E1D

Follow-Up - Myelodysplastic Syndrome (MDS) - Follow-Up Form - 2019374v3.0 - Myelodysplastic Syndrome (MDS) - Follow-Up Form

- 20.09.21 - 1 Formular, 6 Itemgruppen, 25 Datenelemente, 1 Sprache
Itemgruppen: CRF Header, MDS: Form Administration, MDS: Vital Status, MDS: Disease Follow-Up Status, MDS: Notice of Progression, Comments
Myelodysplastic Syndrome (MDS) - Follow-Up Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1AADB4F0-41BA-1ED3-E044-0003BA3F9857

Lung Cancer NCT01041781 Response - CALGB: 30801 Follow-Up and Response Form - 2891478v1.0 - CALGB: 30801 Follow-Up and Response Form

- 20.09.21 - 1 Formular, 6 Itemgruppen, 33 Datenelemente, 1 Sprache
Itemgruppen: Header Module, Header, Vital Status, Response Data, Non-Protocol Treatment, New Primary Data
CALGB: 30801 Follow-Up and Response 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-DEA5-EEE0-E040-BB89AD436D54

E2805 Follow-up Disease Evaluation Form NCT00326898

- 20.09.21 - 1 Formular, 6 Itemgruppen, 30 Datenelemente, 1 Sprache
Itemgruppen: ECOG clinical trial administrative data, Data amendment, Cycle number, Section I - Clinical Assessment, Section II - Notice of Recurrence, Footer module
E2805 Follow-up Disease Evaluation Form NCT00326898 Sunitinib or Sorafenib in Treating Patients With Kidney Cancer That Was Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=054D0EB8-8174-3DEA-E044-0003BA3F9857

Follow-Up 2/2 CML TIGER DRKS00005243 NCT01657604 - Follow-Up 2/2 CML TIGER NCT01657604

- 20.09.21 - 1 Formular, 12 Itemgruppen, 89 Datenelemente, 2 Sprachen
Itemgruppen: Administrative Items, Geburtsdatum, Adiminstrative Daten II, Laborwerte, Quality of Life, klinischer Befund I, Blutdruck, klinischer Befund II, Molekularbiologie, Knochenmarkanalyse, Cytogenetics, Unterschrift
Bogen 2 Verlaufsbogen Seite 2 von 2 NCT01657604 Chronic Myeloid Leukemia Tasigna and Interferon Alpha Evaluation Initiated by the German Chronic Myeloid Leukemia Study Group - the TIGER Study http://clinicaltrials.gov/ct2/show/NCT01657604

TIGER Study CML Disease Course DRKS00005243 NCT01657604 - Disease Course TIGER Study CML NCT01657604

- 20.09.21 - 1 Formular, 12 Itemgruppen, 89 Datenelemente, 2 Sprachen
Itemgruppen: Adiminstrative Daten I, Geburtsdatum, Adiminstrative Daten II, Laborwerte, Quality of Life, klinischer Befund I, Blutdruck, klinischer Befund II, Molekularbiologie, Knochenmarkanalyse, Zytogenetik, Unterschrift
Bogen 2 Verlaufsbogen Seite 2 von 2 NCT01657604

Follow Up Disease Evaluation Form (E2905 NCT00843882)

- 20.09.21 - 1 Formular, 6 Itemgruppen, 37 Datenelemente, 1 Sprache
Itemgruppen: Header, ON TREATMENT, OFF TREATMENT, Section I, Section II, Response
E2905 Follow Up Disease Evaluation Form Lenalidomide With or Without Epoetin Alfa in Treating Patients With Myelodysplastic Syndrome and Anemia NCT00843882 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0F12A9EE-8D74-6165-E044-0003BA3F9857

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