Page History
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| Required (R)/Conditional (C) |
| |
Accrual Data Element | Definition | Subject | Partial Subject | Accepted Values |
Study Subject ID | Enter the unique Patient ID as per the lead organization or the study site where the subject is registered. | R | R | Any numeric or alphanumeric value |
Study Subject Birth Date (MM/YYYY) | Enter the subject's month and year of birth in the format MM/YYYY. Note: The subject's age reported in CTRP cannot be greater than 125 years. | R |
| Accrual |
application format: MM/YYYY |
REST Services format: YYYY-MM-DD |
Study Subject |
Sex | Select the subject’s biological sex. |
If biological sex information is not available, select Unknown. | R |
| Male | |
Study Subject Race | Select one or more values for race. To select multiple races, select one race, and then press and hold the CTRL/CMD key as you select the other(s). | R |
| American Indian or Alaska Native |
Study Subject Ethnicity | Select a value for ethnicity. | R |
| Hispanic or Latino |
Study Subject Country | Select the study subject's country of residence. | R |
| CTRP is using the International Standards Organization country codes: |
Study Subject Zip Code | Enter the study subject’s zip code. | C | C | Required if the Study Subject Country is |
the US, US territories and outlying islands. Must be in a 5 digit or 9 digit (DDDDD-DDDD) format | |
Registration Date | Enter the date that the subject was reg |
istered on the study. | R | R | User Interface format: MM/DD/YYYY |
YYYYMMDD | ||||
Disease | Click Look Up, and follow the instructions in Selecting Diseases for Study Subject Records. Note: For ICD-O-3, CTRP uses a hybrid model with the codes from IACR and the codes in NCI SEER that are not available in IACR. | R |
| Partial Subject: Disease is not required. ICD-O-3: If Disease is reported, Site is also required. Disease Code is required for all trial types. ICD-O-3: |
Disease and |
Site are required. |
Site (for ICD-O-3 Disease Codes) | Click Look Up, and follow the instructions in Selecting Sites for Study Subject Records Using ICD-O-3 Codes. Site Code information is available at: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577 Note: CTRP uses a hybrid model with the codes from IACR and the codes in NCI SEER that are not available in IACR. | C |
| Partial Subject: |
Site is not required. ICD-O-3: If Site is reported, Disease is also required. |
Site is required for all trial types. ICD-O-3: Site and |
Disease are required. | |||
Participating Site | Select the appropriate site from the drop-down list. | R | R |
Medicare
Medicare and Private Insurance
Medicaid
Medicaid and Medicare
Military or Veterans Sponsored, NOS
Military Sponsored (Including CHAMPUS & TRICARE)
Veterans Sponsored
Self-Pay (No Insurance)
No Means of Payment (No Insurance)
Managed Care
State Supplemental Health Insurance
Other
Unknown
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