Contents |
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Record details of prior surgery related to the disease being studies by the protocol or when the details would be clinically significant for the evaluation of this study.
Field Name | Description / Instructions | Format | |
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Visit Date(m) | Enter the date the form was completed.
| DD-MMM-YYYY | |
Date of Surgery(m) | Enter the date of the surgical procedure. Partial dates are acceptable when the day is not known. | DD-MMM-YYYY or MMM-YYYY | |
Procedure(m) | Enter the type of procedure performed to diagnose / to treat the patient's disease. | 50 characters | |
Site(m) | Select the anatomical site of the procedure. | Use pick list. | |
Findings | Briefly describe the findings of the procedure. | 24 characters | |
Residual Disease | Briefly describe the extent of the residual disease, if any, at the conclusion of the operation. (i.e.: microscopic, macroscopic). | 24 characters | |
Therapeutic? | Select if the surgical procedure was performed with curative intent: | Use pick list. |
Legend: (d) derived field, (m) RDC mandatory, (c) for CTEP reporting only. |
Code | Description | Resolutions |
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PSG01 | Date of Surgery is in the future. | Enter a date that is equal to or earlier than the current date. |