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Table of contents
  1. 1. Clinical Trial
    1. 1.1. Eligibility Determination
    1. 1.2. Medical History
    1. 1.3. Physical Examination
    1. 1.4. Assessment Score
    1. 1.5. Apparative Diagnostics
    1. 1.6. Laboratory
    1. 1.7. Pathology/Histology
    1. 1.8. Consent
    1. 1.9. Therapy
    1. 1.10. Operative Report
    1. 1.11. Adverse Event
    1. 1.12. Follow-Up
  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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Follow-up F1 LeMLAR-Studie Lymphoma NCT01788189 - Follow-up F1

- 9/29/16 - 1 form, 4 itemgroups, 44 items, 1 language
Itemgroups: follow- up, B symptoms, Diagnostic Neoplasm Staging, Laboratory test finding
Study part:Follow-up F1 LeMLAR-Studie. Lenalidomide in conjunction with methotrexate, leucovorin, cytarabine and rituximab for the treatment of relapsed or refractory CD20-positive aggressive lymphomas: an open-label, multicenter phase I/II trial. Publication granted by Prof. Dührsen and provided by Claudia Ose, University clinic Essen, NCT01788189, Version 1.3-28.04.2013.doc.

Follow-up F2 LeMLAR-Studie Lymphoma NCT01788189 - Follow-up F2

- 10/6/16 - 1 form, 2 itemgroups, 131 items, 1 language
Itemgroups: follow­ up, clinical examination Diagnostic Imaging Manifestation of Lymphoma
Study part: Follow-up F2 LeMLAR-Studie. Lenalidomide in conjunction with methotrexate, leucovorin, cytarabine and rituximab for the treatment of relapsed or refractory CD20-positive aggressive lymphomas: an open-label, multicenter phase I/II trial. Publication granted by Prof. Dührsen and provided by Claudia Ose, University clinic Essen, NCT01788189, Version 1.3-28.04.2013.doc.

Bogen 2 Verlaufsbogen Seite 1 von 2 TIGER Studie Version 23052012 Condition DRKS00005243 - Bogen 2 Verlaufsbogen Seite 1 von 2

- 9/20/21 - 1 form, 11 itemgroups, 39 items, 2 languages
Itemgroups: Adiminstrative Daten I, Geburtsdatum, Adiminstrative Daten II, Therapiephase, Bisherige Therapie im Intervall, Nilotinib 2*300 mg, 1. Nilotinib Pause, PEG-IFN, 1. PEG-IFN Pause, weitere Medikation, Unterschrift
NCT01657604

Follow-Up - Melanoma-Follow-up Form - 2020198v2.31 - Melanoma-Follow-up Form

- 1/8/15 - 1 form, 8 itemgroups, 33 items, 1 language
Itemgroups: CRF Header, MELANOMA: VITAL STATUS, MELANOMA: DISEASE FOLLOW-UP STATUS, MELANOMA: NOTICE OF PROGRESSION, MELANOMA: NON-PROTOCOL THERAPY, MELANOMA: NOTICE OF NEW PRIMARY, MELANOMA: LONG-TERM TOXICITY, Comments
Melanoma-Follow-up Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A99C-3FA4-E034-080020C9C0E0

Follow-Up - Primary Amyloidosis - Follow Up Form - 2273817v3.0 - Primary Amyloidosis - Follow Up Form

- 1/9/15 - 1 form, 6 itemgroups, 32 items, 1 language
Itemgroups: CRF Header, Amyloidosis: Vital Status, Amyloidosis: Disease Follow-Up Status, Amyloidosis: Notice of Progression, Amyloidosis: Notice of New Primary, Amyloidosis: Long-Term Toxicity
Primary Amyloidosis - Follow Up Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D6794088-D3E7-0C48-E034-0003BA12F5E7

Follow-Up - Sarcoma - Follow-Up Form - 2290562v3.0 - Sarcoma - Follow-Up Form

- 1/9/15 - 1 form, 7 itemgroups, 32 items, 1 language
Itemgroups: CRF Header, Sarcoma: Follow-up Reporting Period, Sarcoma: Vital Status, Sarcoma: Disease Follow-up Status, Sarcoma: Notice of Progression, Sarcoma: Notice of New Primary, Sarcoma: Long-Term Toxicity
Sarcoma - Follow-Up Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E405767F-8C6A-3312-E034-0003BA3F9857

Follow-Up - Gynecologic Cancer - Follow-Up Form - 2019334v3.0 - Gynecologic Cancer - Follow-Up Form

- 1/9/15 - 1 form, 9 itemgroups, 58 items, 1 language
Itemgroups: CRF Header, GYN: Form Administration, GYN: Vital Status, GYN: Disease Follow-up Status, GYN: Notice of Progression, GYN: Notice of New Primary, GYN: Long-Term Toxicity, GYN: Non-Protocol Therapy, Comments
Gynecologic Cancer - Follow-Up Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=16AA07EB-A6F0-6710-E044-0003BA3F9857

Follow-Up - SOUTHWEST ONCOLOGY GROUP FOLLOW UP FORM - 2217608v1.0 - SOUTHWEST ONCOLOGY GROUP FOLLOW UP FORM

- 1/9/15 - 1 form, 3 itemgroups, 25 items, 1 language
Itemgroups: Header, VITAL STATUS, Comments
SOUTHWEST ONCOLOGY GROUP FOLLOW UP FORM Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F4422C8B-0B8B-49D1-E034-0003BA3F9857

Follow-Up - Colorectal Cancer - Follow-Up Form - 2282337v3.0 - Colorectal Cancer - Follow-Up Form

- 1/9/15 - 1 form, 6 itemgroups, 19 items, 1 language
Itemgroups: CRF Header, Colorectal: Vital Status, Colorectal: Disease Follow-Up Status, Colorectal: Notice of Progression, Colorectal: Notice of New Primary, Comments
Colorectal Cancer - Follow-Up Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DB748B98-21DB-2FC3-E034-0003BA12F5E7

Melanoma (Skin) Follow-Up - Extended Follow-up (EFU) - 2074771v3.0 - Extended Follow-up (EFU)

- 1/9/15 - 1 form, 1 itemgroup, 8 items, 1 language
Itemgroup: CCRR MODULE
Extended Follow-up (EFU) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B122E5B0-F30F-4DE5-E034-0003BA12F5E7

Melanoma (Skin) Follow-Up - Follow-up Assessment (FA) - 2074729v3.0 - Follow-up Assessment (FA)

- 1/9/15 - 1 form, 1 itemgroup, 10 items, 1 language
Itemgroup: CCRR MODULE
Follow-up Assessment (FA) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B122D2BC-9A32-4DD0-E034-0003BA12F5E7

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

- 9/20/21 - 1 form, 6 itemgroups, 25 items, 1 language
Itemgroups: 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

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