Micro Lab Registration Template

Mico Lab Registration Template.docx

Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)

Micro Lab Registration Template

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Shape1 TITLE OF INFORMATION COLLECTION: Registration Questions for AI-Ethics Micro Lab Participation


PURPOSE:


The purpose of this information collection is to collect general information (e.g., name, contact information, professional organization), area of expertise, and interest areas from people applying to attend the AI-Ethics Micro Lab. During the online Micro Lab, discussion groups of 10-30 individuals, with various backgrounds and expertise, will be formed into teams to identify important areas of consideration and future directions for AI/ML and ethics in biomedicine relevant to the NIH mission. The information that is collected will be used by activity organizers to invite participants, ensuring that a diversity of perspectives is represented, and attendance is balanced across disciplines.



DESCRIPTION OF RESPONDENTS:


Respondents are individuals interested in participating in the AI-Ethics Micro Lab. The registration link will be made available on a public-facing website, with targeted outreach to communities comprised of data scientists, biomedical scientists, social scientists, ethicists, patient advocates, legal scholars, science communicators, and artists. During this two-hour event, participants will come together to discuss the opportunities and challenges of ethics in biomedical AI/ML.




TYPE OF COLLECTION: (Check one)


[ ] Abstract [ ] Application

[X ] Registration [ ] 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.

  4. The results are not intended to be disseminated to the public.

  5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

  6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.


Name: Laura Biven, Ph.D., Branch Chief, Data Science Ecosystem, Office of Data Science Strategy, NIH/OD


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

  3. If Applicable, has a System or Records Notice been published? [ ] Yes [ X ] No


Gifts or Payments:

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



ESTIMATED BURDEN HOURS and COSTS


Category of Respondent

No. of Respondents

No. of Responses per Respondent

Time per

Response

(in hours)

Total Burden

Hours

Individual

1000

1

5/60

83

Totals


1000

5/60

83


COST TO RESPONDENT


Category of Respondent


Total Burden

Hours

Hourly Wage Rate*

Total Burden Cost

Individual (computer scientists)

30

$62.93

$ 1,887.90

Individual (social scientists and ethicists)

30

$44.91

$1,347.30

Individual (industry)

23

$43.27

$995.21

Totals

83


$4,230,41


*Sourced from https://www.bls.gov/oes/current/oes151221.htm; https://www.bls.gov/oes/current/oes193041.htm; https://www.bls.gov/oes/current/oes191029.htm



FEDERAL COST: The estimated annual cost to the Federal government is $3,755.06


Staff


Grade/Step

Salary*

% of Effort

Fringe (if applicable)

Total Cost to Gov’t

Federal Oversight






Branch-Chief

15-10

$170,800

0.5%


$854

Health Scientist (AAAS Fellow)

12-2

$90,106

1%


$901.06







Contractor Cost






Know Innovation





$2000

Travel






Other Cost












Total





$3,755.06

*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2020/DCB.pdf



If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:


The selection of your targeted respondents

  1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ ] Yes [X ] 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?


There is not a pre-existing customer list. Several communication channels will be used to announce the event including announcements to relevant networks, professional societies, experts, and through social media. Participants will be selected based on the experience and motivation they describe in their application. For additional questions, please send a request to Laura Biven ([email protected]).


Administration of the Instrument

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

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

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

  1. Will interviewers or facilitators be used? [ ] Yes [X ] No

4

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
File Modified0000-00-00
File Created2022-02-01

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