#15_Attach 1_RTR survey Word

The Surveillance, Epidemiology, and End Results (SEER) Residual Tissue Repository Program:

Survey to Assess Service Delivery and Product Quality

OMB No.: 0925-0642-15

Expiration Date: 9/30/2012

STATEMENT OF PUBLIC BURDEN

Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974,Bethesda, MD 20892-7974, ATTN: PRA (0925-0642). Do not return the completed form to this address.

SURVEY OBJECTIVE

Responses are being sought from members of the NIH intramural and extramural community who are experienced with, or who are interested in utilizing, the SEER cancer biospecimen resources. This survey is designed to collect information regarding what improvements can be made to the SEER Residual Tissue Repository (RTR) program in order to improve delivery of quality biospecimens to users and inform emerging technology.

Respondents are encouraged to provide their input on all applicable items. Feedback will be provided during the survey to indicate the amount of progress that has been made. No personal information will be collected and all individual responses will be kept secure to the extent provided by law. Only the processed, anonymous results will be shared internally with Division of Cancer Control and Population Sciences (DCCPS) staff and any scientific working groups convened by the National Cancer Institute, as appropriate.

INQUIRIES

Specific inquiries regarding the SEER Residual Tissue Repository Survey should be directed to the following e-mail address: [email protected]

Your responses will be handled by a team of DCCPS technical staff.

BACKGROUND INFORMATION

1. If you conduct scientific research, please indicate your primary affiliation.

Government

Academic

Private Sector

Non-profit

Other

Not Applicable

PART I: Awareness of and Experience with Using the SEER Residual Tissue Repository

2. Have you worked with biospecimens from the SEER Residual Tissue Repository in the past? If YES, proceed to Question 4.

YES

NO

3. If you are aware of the SEER Residual Tissue Repository, but have not worked with biospecimens from it in the past, please indicate why and continue to Part 2.

• The RTR resource did not meet my research needs.

• I plan to apply for RTR biospecimens once preliminary results are obtained or research funding is secured.

• The RTR biospecimen application process is too difficult.

• Other (Limit 100 words): ___________________________________________________

4. If you answered YES to question 2, what were your research objectives? (Limit 100 words)

5. Please describe how well the SEER Residual Tissue Repository resource enabled you to achieve your research goals? (Limit 100 words)

6. Please comment on any advantages (strengths) or disadvantages (weaknesses) of using the SEER Residual Tissue Repository as a research resource. (Limit 200 words)

7. Please provide suggestions to improve the process of accessing and utilizing SEER Residual Tissue Repository biospecimens and associated data. (Limit 100 words)

PART II: Future Uses of the SEER Residual Tissue Repository

8. Please elaborate on specific research objectives that you would like to see addressed in the future using the SEER Residual Tissue Repository? (Limit 100 words)

9. Please comment on methods or techniques that could be used to assess the tissue quality of SEER Residual Tissue Repository biospecimens to enhance their utility for advanced research applications, such as next generation sequencing. (Limit 100 words)

10. Please indicate the importance of the following standard SEER data items for research using SEER Residual Tissue Repository biospecimens.

	Very Necessary	Necessary	Neutral	Unnecessary	Very Unnecessary
Age of Specimens
Tissue Collection, Processing, and Storage Conditions
Type of Health Insurance Coverage at Diagnosis
Type of Treatment Received
Risk Factors (e.g., obesity, smoking)
Other (please specify: ________)

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