Attachment 3 Data Collection Crosswalk OMB 0920-0848

Title: Laboratory Medicine Best Practices Project (LMBP)

OMB Control Number: 0920-0848

Expiration Date: 5/31/2013

Final Web Reformatting for Non Material Change

March 6, 2012

Original Section 1 About Your Organization	New Q#	Description of Modification
Type of Facility ( page 2 of 9)	Q#4a.	Number of response categories for this close-ended question has been decreased by 4
Size (page 2 of 9)	Q#4b.	Reordered, no other change
Total annual test volume ( page 2 of 9)	Q#4c.	Question has been reordered to 4c. and minor wording change to: Total laboratory test volume per year
Topic review submission (page 2 of 9)	Q#1.	Question is now an open text field
Original Section II. What at you did?	New Q#	Description of Modification
Problem or quality issue (page 3 of 9)	Q#2a.	Question has been reordered but not changed
No question	Q#2b.	New question asked to know if respondent has obtained IRB approval for their project
Summary of the candidate practice	Qs#8-9	Question has been reworded instead of “candidate” practice” “new intervention” is used. For analysis, information on both the usual and new practice is needed.
Impacts/Outcome	Q#12	Question is reordered, the same description from original form is used in the new instruction form
Setting of the project/study	Q#6	Question is now closed ended using examples provided in the text guidance of original form
Original Section III. How you did it?	New Q#	Description of Modification
Study Population	Q#7a-c	Question reordered and reworded and 7a. made closed ended
Funding Source	Q#3	Question reordered, now close ended using choices in text guidance of original form
Study/Project Design	Q#5a-b	Question reordered and made close ended using text guidance provided in original form. Subpart b added for description to verify response to subpart a
Start and End Date of Practice	Q#10a-b	Question reordered and reworded to gain information on how long both new and usual practices have been in place
Measurement Time Period	Q#13a-b	Question reordered and reworded to be clearer to respondents to provide information on both usual and new practice
Recording Method	Q#14a.	New question now subparts a and b. Part a. I closed ended using examples provided in the text guidance of original form
Recording Method	Q#14b.	Respondents asked to provide a brief description of what they did for their response to Q14a.
Resources Used	Q#11a-c	Items listed in text guidance of original question are now a subpart question; staff resource is closed ended, training and supplies items are open ended
Original Section IV. Did it work?	New Q#	Description of Modification
Results/Findings	Q#16	Reordered, no other change
None	Q#17	New, closed ended
Study Bias	None	Question deleted
Original Section V. Implementation Consideration	New Q#	Description of Modification
Sustaining This Practice	Q#19	Reordered, no other change
Barriers to Implementation	Q#18	Reordered, no other change
Technology Issues	None	Deleted
Other Considerations and Lessons	Q#20	Minor rewording to Lessons Learned