Email Invitation

AppndxB Email Invitation V4 20150604.docx

Data Supplement for Ebola Virus Disease Patients Treated Outside of West Africa

Email Invitation

OMB: 0920-1069

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Appendix B. Email Invitation



Dear Dr X:


As you know, the United States Centers for Disease Control and Prevention (US CDC) is coordinating the collection of clinical information on patients with Ebola virus disease (EVD) that have received care in higher-resource settings in Europe and the US. This important project, titled “Data Collection for Ebola Virus Disease Patients Treated Outside of West Africa,” is needed to help inform both the public health response as well as the clinical management of these patients.


Since you and your clinical colleagues participating in the US/World Health Organization (WHO) Clinical Network have cared for one or more of these EVD patients we would like to ask you to participate in this important data collection by completing the attached form, one for each of patient. It is estimated that each form will require access to the medical record and will take approximately 45 minutes to complete the twelve sections denoted by the tabs.


The completion of this data collection is completely voluntary and there are no penalties for choosing not to complete it. The project has undergone ethical review at the US CDC and has been determined to be public health practice – public health response, and to be non-research. Information disclosure should be only be done consistent with the laws and regulations that control access to patient information in the jurisdiction in which the hospital is located.


Data from all participating centers will be aggregated; aggregated data will be available to all participating centers and may be shared with public health organizations including US CDC and the WHO. Individual patient level data will not be shared or presented, and steps will be taken to protect patients’ privacy to the extent allowable by US federal law.


In order to protect patient privacy, we request that you return the completed form(s) to the secure encrypted file transfer protocol (FTP) site provided by CDC.


Address: XXXXXXXXXX

Password: XXXXXXXXXX


We hope you will consider participating in this urgent and important project. Please do not hesitate to contact me if you have any questions or need any help completing the form. We request that your return the completed form(s) as soon as possible.


Best Regards,

Tim


Tim Uyeki MD, MPH, MPP

CDC Ebola Response

Clinical Team Lead

Email: [email protected]


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