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ID:17858355
大小:30.44 KB
页数:11页
时间:2018-09-07
《consent for participation - university of tennessee college of 田纳西大学学院参与-同意》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、(MUSTBEWRITTENINSECONDPERSONUSING12PITCHFONT)Mustincludea1.5MarginatthetoporBottom,ConsentforParticipationUniversityofTennesseeCollegeofMedicineChattanooga/ErlangerHealthSystem960EastThirdStreetChattanooga,Tennessee37403TitleofProject:PrincipalInvestigator:Co-Investigator(s):PrintedNameofPati
2、ent_______________________________________GENERALINFORMATION:YouarebeingaskedtoparticipateintheabovetitledclinicalresearchstudyconductedatErlangerHealthSystem.Youhavetheoptionnottoparticipateinthisstudy.Thestudywilllastfor()months/yearsandtherewillbeapproximately_____patientsinvolvedinthisstu
3、dy.PURPOSEOFSTUDY:Thepurposeofthisresearchisasfollows:EXAMPLES;Testthesafetyofdrug/interventionandseewhateffects(goodandbad)ithasonmeandmytypeofconditionorFindthehighestdoseofadrugthatcanbegivenwithoutcausingseveresideeffects.Findoutwhateffects(goodandbad)drug/interventionhasonmeandmytypeofco
4、ndition.Comparetheeffects(goodandbad)ofthenewdrug/interventionwithcommonly-useddrug/interventiononmeandmytypeofconditiontoseewhichisbetter.Thisresearchisbeingdonebecause_________________________________________________________.[Explaininoneortwosentences.Examplesare:“Currently,thereisnoeffect
5、ivetreatmentforthistypeofcancer,”or“Wedonotknowwhichofthesetwocommonlyusedtreatmentsisbetter.”]DESCRIPTIONOFSTUDY:[Providesimplifiedschemaand/orcalendar.]VersionDate:_________Pt.Initials:_______________[Forrandomizedstudies:]Youwillbe“randomized”intooneofthestudygroupsdescribedbelow.Randomiza
6、tionmeansthatyouwillbeputintoagroupbychance.Itislikeflippingacoin.Neitheryounortheresearcherwillchoosewhatgroupyouwillbein.Youwillhaveanequal/oneinthree/etc.chanceofbeingplacedinanygroup.[Fornonrandomizedandrandomizedstudies]Byparticipatinginthisstudy,youwillhavethefollowingtestsandprocedures
7、performed:[Listproceduresandtheirfrequencyunderthecategoriesbelow.Forrandomizedstudies,listthestudygroupsandundereachdescribecategoriesofprocedures.Includewhetherapatientwillbeathome,inthehospital,orinanoutpatientsetting.Ifobjectivesincludeac
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