PrCa Bone Lesions - Pre-specified Locations

This example shows a CRF used to collect information on the total number of bone lesions identified by pre-specified locations.

"Bone Lesions (Pre-specified Locations) [PrCa_Bone Lesions Pre-specified]" Form Preview
Bone Lesions (Pre-specified Locations)
Pre-specified locations
Response Criteria
Tumor Type According to Criteria
Were any bone lesions identified? Yes  No  
Date of Procedure
 01 Jan 2000
Method of Evaluation Scintigraphy  CT Scan  Other  
If Other, Specify Method of Evaluation
Evaluator Investigator  Independent Assessor  
Evaluator Identifier Radiologist 1  Radiologist 2  Oncologist  
Number of Skull Bone Lesions
Skull Bone Lesion ID
Number of Thorax Bone Lesions
Thorax Bone Lesion ID
Number of Pelvic Bone Lesions
Pelvic Bone Lesion ID
Number of Limb Bone Lesions
Limb Bone Lesion ID
* Mandatory field