eCRF FORMS

REMINDER: You can save forms and come back later to complete the entries (if you ‘Submit’ the form, then data cannot be changed).

  1. Demography forms: questions concerning antifungal prophylaxis (first line and subsequent lines) have been separated out from the Demography forms, and will now be available to you only at 12 weeks after the start of chemotherapy.
  2. Names of forms and when they will become available to you are listed below:
Form name Content Available COMMENT
Screening Criteria New patient information Enrolment
Demography StemCellTransplant Demography information After ‘Screening’ form is submitted Only available if patient is eligible based on screening criteria
Demography AML & MDS Demography information After ‘Screening’ form is submitted
Prophylaxis Initial and ongoing antifungal prophylaxis 12 weeks after date of starting chemotherapy. The prophylaxis questions were originally contained within the Demography form, but have now been split out.
Initial Diagnostic Workup Diagnosis of IMDTreatment of IMD

Initial diagnostic work up

7 days after ‘Screening‘ form is submitted You can start to add data when the patient develops IMD, or you can wait until 12 weeks after starting chemo and then add all data at the same time. If the patient does not develop IMD in the 12 weeks after starting chemo, only the first 3 questions will be available to you.

If the patient develops IMD later than 12 weeks after enrolment, data should NOT be entered as it is outside the timescale of this study.

Additional diagnostics obtained Ongoing treatment of IMDAdditional diagnostic work ups After ‘Initial Diagnostic Workup’ form is submitted This form will only be available if your patient developed IMD in the first 12 weeks after starting chemotherapy.
Week 12 after inclusion Information on neutropenia 12 weeks after starting chemotherapy
EORTC classification Comment on EORTC classification 12 weeks after starting chemotherapy
Final outcome
(6 months)
Patient status at 26 weeks 26 weeks after starting chemotherapy