Form:	URS Follow-up v5.0

CDE ID	CDE Description
* 421	EDRN Participant ID (Go To: 1219)
* 1219	Date of contact (MM/DD/YYYY): (Go To: 423)
* 423	EDRN Protocol ID (Go To: 422)
* 422	EDRN Site ID (Go To: 929)
* 929	EDRN Staff ID of the person who collected the data: (Go To: 1272)
* 1272	Living status: (Go To: 2151)
	Permissible Values (value): Alive (0)
	Dead (3) (Go To: 3408)
	Unknown (99)
* 3408	Date of death (MM/YYYY): (Go To: 2726)
* 2726	Death related to study outcome? (Go To: 2151)
	Permissible Values (value): No (0) (Go To: 1332)
	Yes (1)
	Unknown (99)
* 1332	Cause of death: (Go To: 2151)
* 2151	Have you received any treatment for prostate cancer? (Go To: 3319)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 3214)
	Unknown (99)
* 3214	Number of subform loops to record 2: (Go To: 3201)
	Permissible Values (value): 1 (1)
	2 (2)
	3 (3)
	4 (4)
	5 (5)
	6 (6)
	7 (7)
	8 (8)
	9 (9)
	10 (10)
* 3201	Line number or identifier 2 (system-generated): (Go To: 2193)
* 2193	Treatment(s) received for prostate cancer: (Go To: 2478)
	Permissible Values (value): Chemotherapy (1)
	Radiation therapy (2)
	Surgery (3)
	Hormone therapy (4)
	Other, specify: (97) (Go To: 2192)
* 2192	Treatment received for prostate cancer (Other, specify): (Go To: 2478)
* 2478	Treatment start date (MM/YYYY): (Go To: 2479)
* 2479	Treatment stop date (MM/YYYY): (Go To: 3319)
* 3319	Bone scan? (Go To: 3302)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 3320)
	Unknown (99)
* 3320	Bone scan date (MM/YYYY): (Go To: 3322)
* 3322	Did bone scan detect recurrence? (Go To: 3302)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 3321)
	Unknown (99)
* 3321	Date of bone scan verifying recurrence (MM/YYYY): (Go To: 3302)
* 3302	Imaging procedure performed? (Go To: 3317)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 955)
	Unknown (99)
* 955	Date of imaging test (MM/DD/YYYY): (Go To: 3323)
* 3323	Did imaging procedure detect recurrence? (Go To: 3317)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 3324)
	Unknown (99)
3324	Date of imaging procedure that detected recurrence (MM/YYYY): (Go To: 3317)
* 3317	PSA tests performed? (Go To: 1097)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 2156)
	Unknown (99)
* 2156	Number of PSAs performed: (Go To: 2159)
* 2159	Specimen line number or identifier (system-generated): (Go To: 3996)
* 3996	Date of PSA (MM/YYYY): (Go To: 947)
* 947	PSA (ng/ml) (Go To: 1097)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)