| Screened NB any patient identifiable data recorded on screening log is not shared with CTU | Eligible | Approached | Randomised? |
---|---|---|---|---|
T1 | Patient initials, NHS number, age, gender, screening ID, date of qualifying intervention. Screening criteria: Yes. Complete for all patients referred for Treatment X | Ineligible recorded as final screening outcome Reason for ineligibility (open response) Histology, pathology | Date two written information sheets provided Non-approach recorded as final screening outcome Reason for non-approach (open response) | Randomisation ID and allocation If not randomised, reason for non-participation (open response) |
T2 | Patient initials, gender, date of potential recruitment. Screening criteria: No | Reason for exclusion or ineligibility (using coded inclusion and exclusion criteria printed on back of the log) | Not recorded | Reason for eligible patients declining the trial (6 codes) Final treatment recorded for all screened participants Treatment preferences for eligible decliners |
T3 | Patient initials, age, screening ID, date screening initiated. Screening criteria: Yes. Complete for all patients with whom the trial is discussed. | Clinical data – nodal status (+/), tumour size Was the patient eligible? (Y/N) Reason for ineligibility (open response) | Not recorded | Consent (Y/N) for main and two substudies and participant ID Reason to decline main study and two substudies (open response) Final treatment received for all screened participants |
T4 | Patient initials, screening ID, age range, gender, MDT date. Screening criteria: Yes. Complete for all patients referred for Treatment X | MDT decision – potentially eligible (Y/N) and reason (open response); eligibility checked against each inclusion/exclusion criteria; Final MDT decision eligible (Y/N). If not, reason recorded (coded and/or open response). | ‘Reason not eligible’ includes 3 coded responses why patient not approached | Randomisation ID Reason eligible patients decline trial (open response) Treatment received by non-randomised patients |
T5 | Patient initial, gender, age, hospital ID, referral from (5 codes). Screening criteria: No. | Eligible (Y/N) | Written information given (Y/N) Date trial discussed | Randomisation ID Patient consent (Y/N). If no, record reason Final treatment decision (non-randomised patients) |
T6 | Patient name, study ID, hospital number. Screening criteria: Complete for all patients referred for intervention X. Kept on site form – not entered into database if patient does not join the trial. | Eligibility (Y/N) against all trial inclusion/ exclusion criteria | Written information given (Y/N), date provided, reason not given (open response) Date of trial discussed Approached to participate in trial (Y/N) and reason not approached (open response) Coded when added to the study database | Reason eligible patient declined consent Final treatment decision (non-randomised patients) Coded when added to the study database |
T7 | Patient initials, date of birth, study number, gender, date of MDT decision, pathology. Screening criteria: Yes. 3 ‘initial’ trial eligibility criteria | Eligibility against all trial inclusion/exclusion criteria (Y/N). Reason for ineligibility (open response) | Patient invite to join study (Y/N). Reason (2 codes/open response) | Reason eligible patient declined trial (open response) Final treatment received (non-randomised patients) |
T8 | Patient initials, NHS no., date first screened. Screening criteria: Please enter all patients recommended by MDT as potentially eligible for Trial X | Inclusion/exclusion criteria met (Y/N) Reason for ineligibility | Provision of written information (Y/N) Approach consent for trial (Y/N) | Consent given (Y/N) Randomised (Y/N) Reason eligible patients declined (open response) |