ID

11485

Beschreibung

SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE NCT00070564 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=A678BAD9-E0F6-50A4-E034-0003BA0B1A09

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A678BAD9-E0F6-50A4-E034-0003BA0B1A09

Stichworte

  1. 26.08.12 26.08.12 -
  2. 09.01.15 09.01.15 - Martin Dugas
  3. 05.07.15 05.07.15 -
Hochgeladen am

5. Juli 2015

DOI

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Lizenz

Creative Commons BY-NC 3.0 Legacy

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SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE NCT00070564

No Instruction available.

  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE
    1. No Instruction available.
Header
Beschreibung

Header

SWOG Patient ID
Beschreibung

SWOGPatientID

Datentyp

text

SWOG Study No.
Beschreibung

SWOGStudyNo.

Datentyp

text

Registration Step
Beschreibung

RegistrationStep

Datentyp

text

Patient Initials (L, F M)
Beschreibung

Patient Initials

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Institution / Affiliate
Beschreibung

MainMemberInstitution/AffiliateNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Physician (Groups other than SWOG)
Beschreibung

RegisteredInvestigator

Datentyp

text

Group Name (Groups other than SWOG)
Beschreibung

ParticipatingGroupName

Datentyp

text

Study No. (Groups other than SWOG)
Beschreibung

Particip.GroupProtocolNumber

Datentyp

float

Pt. ID (Groups other than SWOG)
Beschreibung

PatientStudyID,ParticipatingGroup

Datentyp

text

Treatment period
Beschreibung

Treatment period

Treatment Start Date
Beschreibung

TreatmentStartDate

Datentyp

date

Treatment End Date
Beschreibung

TreatmentEndDate

Datentyp

date

Regimen or Procedure or Site(s)
Beschreibung

RegimenorProcedureorSite(s)

Datentyp

text

Off-protocol treatment
Beschreibung

Off-protocol treatment

Off Treatment Reason (select one)
Beschreibung

OffTreatmentReason

Datentyp

text

Patient refused, due to toxicity, specify
Beschreibung

OffTreatmentReason,Toxicity

Datentyp

text

Patient refused, due to toxicity, specify
Beschreibung

OffTreatmentReason,Toxicity

Datentyp

text

Progression or relapse. Sites
Beschreibung

ProgressionSite

Datentyp

text

Other, specify (Off Treatment Date)
Beschreibung

OffTreatmentReason,Other

Datentyp

text

Other, specify (Off Treatment Date)
Beschreibung

OffTreatmentReason,Other

Datentyp

text

Date of completion, progression, death or decision to discontinue therapy
Beschreibung

OffTreatmentDate

Datentyp

date

Further treatment
Beschreibung

Further treatment

Will patient receive further treatment?
Beschreibung

FurtherTreatmentInd

Datentyp

text

Yes, specify
Beschreibung

TreatmentType,Specify

Datentyp

text

Vital status
Beschreibung

Vital status

Date of Last Contact (or death)
Beschreibung

DeathDate/LastContactDate

Datentyp

date

Vital Status
Beschreibung

Patient'sVitalStatus

Datentyp

text

COMMENTS
Beschreibung

COMMENTS

Comments
Beschreibung

Comments

Datentyp

text

Ccrr Module For Southwest Oncology Group Off Treatment Notice
Beschreibung

Ccrr Module For Southwest Oncology Group Off Treatment Notice

Ähnliche Modelle

No Instruction available.

  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP OFF TREATMENT NOTICE
    1. No Instruction available.
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Header
SWOGPatientID
Item
SWOG Patient ID
text
SWOGStudyNo.
Item
SWOG Study No.
text
RegistrationStep
Item
Registration Step
text
Patient Initials
Item
Patient Initials (L, F M)
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
MainMemberInstitution/AffiliateNumber
Item
Institution / Affiliate
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
RegisteredInvestigator
Item
Physician (Groups other than SWOG)
text
ParticipatingGroupName
Item
Group Name (Groups other than SWOG)
text
Particip.GroupProtocolNumber
Item
Study No. (Groups other than SWOG)
float
PatientStudyID,ParticipatingGroup
Item
Pt. ID (Groups other than SWOG)
text
Item Group
Treatment period
TreatmentStartDate
Item
Treatment Start Date
date
TreatmentEndDate
Item
Treatment End Date
date
RegimenorProcedureorSite(s)
Item
Regimen or Procedure or Site(s)
text
Item Group
Off-protocol treatment
Item
Off Treatment Reason (select one)
text
Code List
Off Treatment Reason (select one)
CL Item
Treatment Completed Per Protocol Criteria (Treatment completed per protocol criteria)
CL Item
Medically required, due to toxicity, specify (Medically required, due to toxicity, specify)
CL Item
Patient refused, due to toxicity, specify (Patient refused, due to toxicity, specify)
CL Item
Patient refused, other than toxicity, specify (Patient refused, other than toxicity, specify)
CL Item
Progression or relapse. Sites (Progression or relapse. Sites)
CL Item
Death (Death)
CL Item
Other, Specify (Other, specify)
OffTreatmentReason,Toxicity
Item
Patient refused, due to toxicity, specify
text
OffTreatmentReason,Toxicity
Item
Patient refused, due to toxicity, specify
text
ProgressionSite
Item
Progression or relapse. Sites
text
OffTreatmentReason,Other
Item
Other, specify (Off Treatment Date)
text
OffTreatmentReason,Other
Item
Other, specify (Off Treatment Date)
text
OffTreatmentDate
Item
Date of completion, progression, death or decision to discontinue therapy
date
Item Group
Further treatment
Item
Will patient receive further treatment?
text
Code List
Will patient receive further treatment?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes, specify)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
TreatmentType,Specify
Item
Yes, specify
text
Item Group
Vital status
DeathDate/LastContactDate
Item
Date of Last Contact (or death)
date
Item
Vital Status
text
Code List
Vital Status
CL Item
Alive (Alive)
CL Item
Dead (Dead)
Item Group
COMMENTS
Comments
Item
Comments
text
Item Group
Ccrr Module For Southwest Oncology Group Off Treatment Notice

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