Form 6 Data Use Annual Progress Report

0925-0744-NEW_DASH_ATTACHMENT A.2-6_DATA USE ANNUAL PROGRESS REPORT (APPROVED OMB NUMBER: 0925-0744)

NICHD DATA AND SPECIMEN HUB (DASH)

Annual Data Use Progress Report

1. Guidelines for Reporting DASH Data Use

The Eunice Kennedy Shriver National Institute of Child and Human Development (NICHD) established the NICHD Data and Specimen Hub (DASH) as a data sharing mechanism that enables investigators to organize, store, and mine de-identified data from NICHD funded research studies for the purpose of secondary research use.

As part of the agreement for using DASH data, the Recipient of the data is required to submit annual reports during the validity of the Data Use Agreement (DUA), which is a period of three years (Refer to clause 17 in the DUA). The purpose of the Report is to:

1. Verify that the Recipient is conducting research according to the Research Plan as indicated in the DASH Data Request Form

2. Confirm or amend Affiliates (individuals within the same institution as the Recipient, for whom access to data is required to carry out the Research Plan)

3. Document any collaborations (individuals requiring access to the Data and who are employed by a different institution than the Recipient)

4. Provide information to DASH on any outcomes or outputs that have resulted from the use of DASH data

The Annual Data Use Progress Reports will help NICHD to determine how best to use its resources to foster data sharing.

OMB Control Number: 0925-0744

Expiration Date: 01/31/2022

2. 

   1. Public reporting burden for this collection of information is estimated to average ten 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- 0744). Do not return the completed form to this address.

   Annual Data Use Progress Report

NICHD DASH – Annual Data Use Progress Report
Report Year
Report Year
Data Use Agreement (DUA) Information
Request ID
Project/Study Title
DASH Requested Study
DUA Effective Date
DUA Expiration Date
Data Recipient Information
Name
Job Position/Job Title
Institution
Division/Center/Branch
Email Address
Phone Number
Project/Study Information*1
4A. Were there any changes to your Research Plan from what you provided in the DASH Data Request Form (shown below)? Yes ­­­____ No__
Project/Study Title
Research Plan
Design and Analysis Plan
4B. If Yes to 4A, have you submitted a separate data request, including new Data Request Form and signed a new Data Use Agreement for the new Research Plan? Yes ___ No ___
4C. If No to 4B, please provide an explanation as to why a new Data Request was not submitted. Please note: As per clause 4 of the Data Use Agreement you signed, “Data obtained from the NICHD DASH listed in Appendix B will be used by the Recipient for studies and analysis specifically indicated and described in the Research Plan. The Recipient agrees that Data will not be used in any research that is not approved by the NICHD DASH Data Access Committee as part of the Research Plan. The Recipient will submit a separate and completed DUA for each Research Plan for which Data are requested.”
Requester
Name
Affiliates2*
6A. Were there any new Affiliates added to your study this past year? Yes ____ No ____
6B. If Yes to 6A, have all the new Affiliates registered in DASH, as required by the Data Use Agreement (Clause 12.a.i)? Yes ____ No _____
6C. If No to 6B, please list the affiliates who have not registered and ensure that they are registered in DASH before submitting this Annual Report to DASH.
Name	Role on Project				Registered in DASH (Yes/No)?
Collaborators3*
7A. Were there any collaborators added to your study this past year? Yes ____ No _X___
7B. If Yes to 7A, have all the Collaborators submitted a separate data request in DASH, including a Data Request Form and signed a Data Use Agreement with NICHD before receiving access to the data, as required by the Data Use Agreement (Clause 1)? Yes ____ No _____
7C. If No to 7B, please list below the Collaborators and ensure that they have submitted a separate data request in DASH including a Data Request Form and signed a Data Use Agreement with NICHD before submitting this Annual Report.
Name	Institution/Branch			Role on Project		Comment
Outputs and Outcomes
8A. Peer Review Publication(s)*
Publication Title
Date of Publication
Journal
Link (e.g. PubMed)
Impact Factor4
Publication Title
Date of Publication
Journal
Link (e.g. PubMed)
Impact Factor4
More Publications?		Please add an Appendix with additional publications
8B. Patent(s)
Patent Number
Provisional/ Actual Patent Application Number
Description of newly discovered/ developed tool or technology
Patent Number
Provisional/ Actual Patent Application Number
Description of newly discovered/ developed tool or technology
More Patents?		Please add an Appendix with additional patents
8C. Significant Impact/Findings from Secondary Use
8D. Other Outputs or Outcomes generated from the use of Data received from DASH
Data Recipient Signature*5
Signature of the Data Recipient
						Date

1* Indicates a mandatory field.

2* Indicates a mandatory field.

“Affiliates" are individuals within the same institution as the Recipient, for whom access to data is required to carry out the Research Plan.

3 "Collaborators" are individuals collaborating with the Recipient, requiring access to the Data, and who are employed by a different institution than the Recipient. Collaborators who need access to DASH are required to submit a separate Data Request Form and Data Use Agreement.

4*Indicates a mandatory field.

The impact factor is a measure of the frequency with which the average article in a journal has been cited over the past 2 years.

5*Indicates a mandatory field.

NICHD DASH – Annual Data Use Progress Report 6

Version: 01/06/21