Information Collection Request

SEARCH for Diabetes in Youth Study

ICR 201405-0920-004 · OMB 0920-0904 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Att 9 all clinical sites Informed Consent_rev. 7.30.2014.pdf Supplementary Document Uploaded 2014-08-06 Available
Att 2B_Summary of Public Comments.doc Supplementary Document Uploaded 2014-05-08 Available
Att 11_Article Describing SEARCH Methods.pdf Supplementary Document Uploaded 2014-05-08 Available
Att 12_Papers and Presentations.docx Supplementary Document Uploaded 2014-05-08 Available
Att 9_Example Consent Forms.pdf Supplementary Document Uploaded 2014-05-08 Available
Att 7_IRB approvals (Nov 2013).pdf Supplementary Document Uploaded 2014-05-08 Available
Att 6_List of Expert Consultants (Feb 2014).docx Supplementary Document Uploaded 2014-05-08 Available
Att 3_SEARCH 3 Sites (Feb 2014).docx Supplementary Document Uploaded 2014-05-08 Available
Att 2A. 60-day FRN 3 07 2014.pdf Supplementary Document Uploaded 2014-05-08 Available
0920 0904 SEARCH Phase 3_SS Part B_Feb 2014.docx Supporting Statement B Uploaded 2014-05-08 Available
Att 10_Data Use Agreements September 2011.pdf Supplementary Document Uploaded 2011-09-23 Available
Att 8_Certificate of Confidentiality September 2011.pdf Supplementary Document Uploaded 2011-09-21 Available
Att 5_References.doc Supplementary Document Uploaded 2011-09-21 Available
Att 1_Authorizing Legislation.doc Supplementary Document Uploaded 2011-09-21 Available
0920 0904 SS Part A_rev 7 31 14.docx Supporting Statement A Uploaded 2014-08-06 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
211580 SEARCH Health Questionnaire (Youth ) Other-WORD New
211579 SEARCH Food Frequency Questionnaire Other-PDF New
197884 SEARCH Specimen Collection Form Other-WORD Modified
197883 SEARCH Physical Examination Form (Cohort Study) Other-WORD Modified
197882 Peds QL Diabetes Module Other-WORD Modified
197881 SEARCH Diabetes Related Family Conflict Survey Other-WORD Modified
197880 SEARCH Pathology Notificaiton (Retinal Photo) Other-WORD Modified
197879 SEARCH Tanner Stage Other-WORD Modified
197878 SEARCH Supplemental Questionnaire Other-WORD Modified
197877 SEARCH Low Blood Surgar Survey Other-WORD Modified
197876 SEARCH Diabetes Eating Problem Survey (DEPS-R) Other-PDF Modified
197875 SEARCH Michigan Neuropathy Screening Instrument (MNSI) Other-PDF Modified
197874 SEARCH PedsQL Other-PDF Modified
197873 SEARCH Quality of Care Survey (Feb 2014) Other-PDF Modified
197871 SEARCH CES-Depression Other-PDF Modified
197869 SEARCH Health Questionnaire (Parent_Feb 2014) Cohort Study Other-PDF Modified
197868 SEARCH Physical Examination Form Other-WORD Removed
197867 SEARCH Specimen Collection Form Other-WORD Removed
197865 SEARCH Medical Inventory (Registry Study) Other-WORD Modified
197864 SEARCH - Initial Participant Survey - Parent/Guardian Registry Study Other-orD Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2017 36 Months From Approved 11/30/2014
13,910 0 15,750
4,248 0 6,135
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 13,910 15,750 0 -1,840 0 0
Annual Time Burden (Hours) 4,248 6,135 0 -1,887 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No