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Table of contents
  1. 1. Clinical Trial
  2. 2. Routine Documentation
  3. 3. Registry/Cohort Study
  4. 4. Quality Assurance
  5. 5. Data Standard
  6. 6. Patient-Reported Outcome
  7. 7. Medical Specialty
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Lung Cancer NCT01041781 Response - CALGB: 30801 Follow-Up and Response Form - 2891478v1.0 - CALGB: 30801 Follow-Up and Response Form

- 9/20/21 - 1 form, 6 itemgroups, 33 items, 1 language
Itemgroups: 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

CALGB 140503 PRE-REGISTRATION WORKSHEET

- 9/20/21 - 1 form, 3 itemgroups, 20 items, 1 language
Itemgroups: Protocol Administration, Patient Demographics/Pre-Treatment Characteristics, Notes:
CALGB 140503 PRE-REGISTRATION WORKSHEET Comparison of Different Types of Surgery in Treating Patients With Stage IA Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6E4AB7DA-A34F-776C-E040-BB89AD430B3B

E1505 Disease and Vital Status Form NCT00324805

- 9/20/21 - 1 form, 12 itemgroups, 45 items, 1 language
Itemgroups: Header, Patient demographics, Data amendment, ON TREATMENT, VITAL STATUS, Section II - Reporting Period, Section III - Notice of New Primary, Disease Follow-Up Status, Biopsy, Section VI - Non-Protocol Therapy Prior To Recurrence, Section VII - Treatment for First Recurrence, Footer Module
E1505 Disease and Vital Status Form NCT00324805 Chemotherapy With or Without Bevacizumab in Treating Patients With Stage IB, Stage II, or Stage IIIA Non-Small Lung Cancer That Was Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=07D0C4EF-5573-55B4-E044-0003BA3F9857

Registration Worksheet NSCLC Z4032 NCT00107172

- 9/20/21 - 1 form, 8 itemgroups, 55 items, 1 language
Itemgroups: Header Module, Patient demographics, Pre-Operative Criteria, CT Scan of Chest/Upper Abdomen, Pregnancy Test, Clinical Stage, Pre-operative PFT's, Footer Module
Z4032 Registration Worksheet NCT00107172 Surgery With or Without Internal Radiation Therapy in Treating Patients With Stage I Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F20F53D3-C88B-6847-E034-0003BA3F9857

Intra-operative Registration/Randomization Lung Cancer CALGB 140503 NCT00499330

- 9/20/21 - 1 form, 8 itemgroups, 26 items, 1 language
Itemgroups: Protocol Administration, Patient Demographics/Pre-Treatment Characteristics1, Patient Demographics/Pre-Treatment Characteristics2, Patient Demographics/Pre-Treatment Characteristics3, Certification Of Eligibility, Protocol Design, Companion Studies, Notes:
Lung Cancer NCT00499330 Registration - CALGB 140503 INTRA-OPERATIVE REGISTRATION/RANDOMIZATION WORKSHEET - 2916823v1.0 CALGB 140503 INTRA-OPERATIVE REGISTRATION/RANDOMIZATION WORKSHEET Comparison of Different Types of Surgery in Treating Patients With Stage IA Non-Small Cell Lung Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6E4AB7DA-A794-776C-E040-BB89AD430B3B

Prestudy form NSCLC Stage III NCT00020709

- 9/20/21 - 1 form, 4 itemgroups, 25 items, 1 language
Itemgroups: SWOG clinical trial administrative data, PATIENT AND DISEASE DESCRIPTION, CURRENT LABORATORY VALUES (SI UNITS), Notes
NCT00020709 S0023: Combination Chemo Plus RT With or Without Gefitinib in Treating Patients With Unresectable Stage III NSCLC Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9CA62D43-4AA8-361C-E034-080020C9C0E0

CALGB: 30607 Follow-Up and Response Form NCT00693992

- 9/20/21 - 1 form, 6 itemgroups, 27 items, 1 language
Itemgroups: Header, Patient demographics, Patient status assessment, Response Data, Non-Protocol Treatment, New Primary Data
CALGB: 30607 Follow-Up and Response Form NCT00693992 Sunitinib as Maintenance Therapy in Treating Patients With Stage III or Stage IV Non-Small Cell Lung Cancer Previously Treated With Combination Chemotherapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=35A0F1D4-FCF7-1AF2-E044-0003BA3F9857

Treatment and Response Form Lung Cancer (CALGB 30607)

- 9/20/21 - 1 form, 4 itemgroups, 32 items, 1 language
Itemgroups: Header Section, Survival Status, Treatment, Response
CALGB: 30607 Treatment and Response Form Sunitinib as Maintenance Therapy in Treating Patients With Stage III or Stage IV Non-Small Cell Lung Cancer Previously Treated With Combination Chemotherapy NCT00693992 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=35681A7B-54DB-54F0-E044-0003BA3F9857

ECOG-E1505 Long-Term Follow-up Form NCT00324805

- 9/20/21 - 1 form, 12 itemgroups, 46 items, 1 language
Itemgroups: Header, Patient demographics, Data amendment, Off protocol treatment period, Section I - Vital Status, Section II - Reporting Period, Section III - Notice of New Primary, Section IV - Disease Follow-up Status, Section V - Adverse Events, Section VI - Non-Protocol Therapy Prior To Recurrence, Treatment for First Recurrence, Footer module
ECOG-E1505 Long-Term Follow-up Form NCT00324805 Chemotherapy With or Without Bevacizumab in Treating Patients With Stage IB, Stage II, or Stage IIIA Non-Small Lung Cancer That Was Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=076D113B-20F5-4CB7-E044-0003BA3F9857

Radiation Therapy Oncology Group Initial Follow-up Form Phase III Lung Prophylactic Cranial RT NCT00048997

- 9/20/21 - 1 form, 3 itemgroups, 46 items, 1 language
Itemgroups: Header Module, Medical history, Comments
Radiation Therapy Oncology Group Initial Follow-up Form Phase III Lung Prophylactic Cranial RT Radiation Therapy in Preventing CNS Metastases in Patients With Non-Small Cell Lung Cancer NCT00048997 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9EC372A6-7094-05D5-E034-080020C9C0E0

Radiation Therapy Oncology Group Follow-up Form Phase III Lung Prophylactic Cranial RT 10363 NCT00048997

- 9/20/21 - 1 form, 3 itemgroups, 44 items, 1 language
Itemgroups: Header Module, Patient medical history, Comments
Radiation Therapy Oncology Group Follow-up Form Phase III Lung Prophylactic Cranial RT 10363 Radiation Therapy in Preventing CNS Metastases in Patients With Non-Small Cell Lung Cancer NCT00048997 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9EC372A6-6F06-05D5-E034-080020C9C0E0

On-Study Form Lung Cancer - SCLC

- 9/20/21 - 1 form, 8 itemgroups, 68 items, 1 language
Itemgroups: CRF Header, Pre-Treatment Characteristics , Disease Description SCLC, Prior Treatment SCLC, Prior Systemic Therapy, Prior Surgery, Prior Radiation Therapy, Comments
Phase II Consortium - Phase II Lung Cancer - SCLC On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=005B53D3-2C60-14E5-E044-0003BA3F9857

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