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  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
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19 Search results.

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USMCI 8214/Z6091: Tissue Sample Submission Form NCT01167725

- 9/20/21 - 1 form, 3 itemgroups, 19 items, 1 language
Itemgroups: Header Module,Biopsy specimen,Footer Module
USMCI 8214/Z6091: Tissue Sample Submission Form NCT01167725 Standard Therapy With or Without Surgery and Mitomycin C in Treating Patients With Advanced Limited Peritoneal Dissemination of Colon Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=62328DCB-01DD-B01D-E040-BB89AD435CDE

HPV Antibody Collection and Shipping Form (NCT00513526)

- 9/20/21 - 1 form, 1 itemgroup, 9 items, 2 languages
Itemgroup: Specimen
AMC-052 Serum HPV Antibody Collection and Shipping Form Human Papillomavirus Vaccine Therapy in Treating Men With HIV-1 Infection NCT00513526 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=546E2EAC-07C0-32E8-E044-0003BA3F9857

FHIR v4.0.1 - Resource Specimen Definition (0)

- 3/18/20 - 1 form, 1 itemgroup, 14 items, 1 language
Itemgroup: SpecimenDefinition (0)
https://www.hl7.org/fhir/resourcelist.html (accessed at 14.02.2020) This form contains an incomplete implementation of the FHIR Resource Specimen Definition (0). After preliminary review, it contains the data elements that request clinical information.

FHIR v4.0.1 - Biologically Derived Product (0)

- 3/10/20 - 1 form, 1 itemgroup, 8 items, 1 language
Itemgroup: BiologicallyDerivedProduct
The form corresponds to an incomplete version of FHIR Resource Biologically Derived Product, v4.0.1. It contains all data elements that query a medical issue. The file was created for analysis purposes. https://www.hl7.org/fhir/resourcelist.html 02.01.2020

FHIR v4.0.1 - Resource Specimen (2)

- 3/9/20 - 1 form, 1 itemgroup, 15 items, 1 language
Itemgroup: Specimen
The form corresponds to an incomplete version of FHIR Resource Specimen, v4.0.1. It contains all data elements that query a medical issue. The file was created for analysis purposes. https://www.hl7.org/fhir/resourcelist.html 02.01.2020

Cisplatin and Topotecan Recurrent or Persistent Carcinoma of the Cervix - 103369 - Pathology Report

- 12/31/19 - 1 form, 6 itemgroups, 20 items, 1 language
Itemgroups: Administrative data,Primary,Histology Type,Histologic Grade,Specimens,Secondary
Study ID: 103369 Clinical Study ID: 103369 Study Title: A Randomized Phase III Study of Cisplatin Versus Cisplatin plus Topotecan Versus MVAC in Stage IVB, Recurrent or Persistent Squamous Cell Carcinoma of the Cervix Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: N/A Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: Topotecan Trade Name: Topotecan Study Indication: Cancer 

OMOP Common Data Model (CDM) Specimen

- 2/26/19 - 1 form, 1 itemgroup, 15 items, 1 language
Itemgroup: Specimen
OMOP Common Data Model (CDM) Specimen The specimen domain contains the records identifying biological samples from a person. OMOP Common Data Model Version 6.0 Specifications 11October2018. The Observational Medical Outcomes Partnership (OMOP) was a public-private partnership established to inform the appropriate use of observational healthcare databases for studying the effects of medical products. © 2014 Observational Health Data Sciences and Informatics This work is based on work by the Observational Medical Outcomes Partnership (OMOP) and used under license from the FNIH at http://omop.fnih.org/publiclicense. Version updated on 26.02.2019, from https://github.com/OHDSI/CommonDataModel/wiki/SPECIMEN

Biopsie ENDO SubSub University Hospital Muenster (UKM) Subform

- 11/13/16 - 1 form, 1 itemgroup, 5 items, 1 language
Itemgroup: Endoscopic biopsy
Hospital Routine Documentation Subform at the University Hospital Muenster. Original Form name: Biopsie ENDO SubSub

Eligibility Renal Cell Carcinoma NCT00026663

- 2/10/16 - 1 form, 2 itemgroups, 10 items, 1 language
Itemgroups: Criteria,Exclusion Criteria
Collection of Blood, Bone Marrow, Tumor, or Tissue Samples From Patients With Cancer to Study Drug Resistance; ODM derived from: https://clinicaltrials.gov/show/NCT00026663

ANBL0321: PK Specimen Shipping Form NCT00053326

- 7/3/15 - 1 form, 5 itemgroups, 33 items, 1 language
Itemgroups: Header,Patient Information,Biopsy and Cytology Specimens,Biopsy and Cytology Specimens shipment,CCRR MODULE
ANBL0321: PK Specimen Shipping Form NCT00053326 Fenretinide in Treating Children With Recurrent or Resistant Neuroblastoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C42AE414-4572-73E3-E034-0003BA12F5E7

Breast Cancer SWOG NCT00070564 - SPECIMEN SUBMISSION FORM Breast Cancer SWOG NCT00070564

- 3/22/15 - 1 form, 2 itemgroups, 29 items, 1 language
Itemgroups: Header,SPECIMEN
SOUTHWEST ONCOLOGY GROUP SPECIMEN SUBMISSION FORM Adjuvant Doxorubicin, Cyclophosphamide, and Paclitaxel in Treating Patients With Breast Cancer Breast Cancer NCT00070564 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A678B75B-66D7-50A2-E034-0003BA0B1A09

Neuroblastoma NCT00053326 Transmittal - Immunocytology Specimen Shipping Form [ANBL0321] - 2174356v3.0 - Immunocytology Specimen Shipping Form [ANBL0321]

- 1/9/15 - 1 form, 3 itemgroups, 33 items, 1 language
Itemgroups: Header,Patient Information,CCRR MODULE
Immunocytology Specimen Shipping Form [ANBL0321] Fenretinide in Treating Children With Recurrent or Resistant Neuroblastoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C427B2DA-BD65-633A-E034-0003BA12F5E7

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