Cancer Screening Trial Workshop (NCI)

Request for Approval under the Generic Clearance for the “Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)”(OMB#: 0925-0740, Expiration Date: 07/31/2022)

TITLE OF INFORMATION COLLECTION: Cancer Screening Trial Workshop (NCI)

PURPOSE: The purpose of the workshop is in part to obtain information relevant to the potential creation of a new NCI-funded cancer screening clinical trials network focused on small-to-mid range trials. The workshop will focus on three areas as follows:

1. Practical issues in conducting small-to-medium sized cancer screening trials

2. Organ-site specific priorities for NCI-funded screening trials (lung, oral cavity, bladder, renal, prostate, breast, ovarian, endometrial, CRC, upper GI, pancreatic, liver)

3. Prior experience with cancer screening trial networks and necessary infrastructure for success

DESCRIPTION OF RESPONDENTS: The respondents will be individual collaborators from academic universitites and research institutions and NCI staff associated with the network.

TYPE OF COLLECTION: (Check all that apply)

[ ] Abstract [ ] Application

[ x ] Registration Form [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

Name: Paul Pinskey, Ph.D.

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ x ] Yes [ ] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ x ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ x ] No

Amount: _________

Explanation for incentive: (include number of visits, etc)

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individuals	100	1	5/60	8
Totals		100		8

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Individuals	8	$ 38.15	$305.20
Total			$305.20

*Source of the mean Hourly Wage Rate is provided by the Bureau of Labor Statistics, Occupation title “Life, Physical and Social Science” 19-0000 https://www.bls.gov/oes/2020/May/oes190000.htm.

FEDERAL COST: The estimated annual cost to the Federal government is: $1,592.86.

Staff	Grade/Step	Salary**	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Program Director	14/10	$ 159,286	1 %		$ 1,592.86
Contractor Cost					$ 0
Travel					$ 0
Other Cost					$ 0
Total					$1,592.86

**The salary in the table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/21Tables/html/DCB.aspx

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential espondents and do you have a sampling plan for selecting from this universe? [ x ] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

We will invite collaborators from the lead academic institutions and affiliate organizations. We will also invite NCI staff involved with the network to participate. The 2 day event will be held via WebEx

Administration of the Instrument

How will you collect the information? (Check all that apply)

[x] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Survey Form

[ ] Chart Abstraction

[ ] Other, Explain

Will interviewers, facilitators, or research coordinators be used? [ ] Yes [ x ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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