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editorial
. 2018 Nov;10(11):6352–6355. doi: 10.21037/jtd.2018.10.58

Table 1. Example of data collection form.

Patient demographics
   Name
   ID code
   Date of birth
   Age
   Gender
   Height (cm)
   Weight (Kg)
   BMI
   ….
Comorbidities
   Current smoker
   Former smoker
   Pack-year
   Diabetes
   Hypertension
   Cardiovascular diseases
   ECOG performance status
   ASA score
   Symptoms (type; duration…)
   ….
   Other syndromes or paraneoplastic syndromes (type; appropriate classification if any…)
   Previous tumors (yes/no; type…)
   Treatment of previous tumor (CT, RT, surgery…)
Oncological data (in case of oncological disease)
   CT (yes/no; date…)
   PET-CT (yes/no; date…)
   MRI (yes/no; date…)
   Other radiological and instrumental examinations (type; date; results…)
   Preoperative biopsies (type and date)
   Preoperative diagnosis
   Clinical stage
Lung functionality (in case of pulmonary surgery)
   FEV1, DLCO, pO2, pCO2
   Pulmonary scintigraphy
   …
Pre-operative cardiological evaluation
   Echocardiography
   Stress test
   ….
Preoperative treatment
   Induction therapy (yes/no; type; number of cycles, in case of neoplastic pathology)
   Antibiotic therapy (type and duration)
   Clinical stage (ycTNM, in case of tumor)
   ….
Surgical info
   Date of operation
   Type of surgery
   Type of surgical access
   Technique (other surgical info…)
   Duration
   Operator
   Assistant
   Use of advanced materials, sealants, energy devices, etc.…
   Number of drainages
   Intraoperative complications (minors, majors, type…)
   ….
Postoperative data
   ICU admission (yes/no; number of days…)
   Postoperative complications
   Re-operation
   Hospital stay
   Drainage length
   Postoperative pain and VAS scale
   Outcomes (level of satisfaction, quality of life, effectiveness, cosmetic results etc.)
   …
Oncological and pathological data (in case of oncological disease)
   Histology
   Stage
   Tumor dimension
   Number of lymph nodes removed (number of positive lymph nodes)
   R-status and site
   Receptor mutations
   ….
Follow-up data
   Date of follow-up
   Recurrence of disease
   Overall survival
   Long term results (level of satisfaction, quality of life, effectiveness, cosmetic results…)
   Any other type of treatment or surgical re-treatment
   Disease-free survival (for oncological diseases)
   Oncological adjuvant treatment (yes/no; type; duration…)
   …

BMI, body mass index; ECOG, Eastern Cooperative Oncology Group; ASA, American Society of Anesthesiologists; CT, computed tomography; RT, radiotherapy; PET, positron emission tomography; MRI, magnetic resonance imaging; VAS, Visual Analogue Scale.