Form 1 NCA Survey

OMB No.: 0925-0648

Expiration Date: 03/01/2018

Collection of this information is authorized by The Public Health Service Act, Section 411 (42 USC 285a). Rights of study participants are protected by The Privacy Act of 1974. Participation is voluntary, and there are no penalties for not participating or withdrawing from the study at any time. Refusal to participate will not affect your benefits in any way. The information collected in this study will be kept private to the extent provided by law. Names and other identifiers will not appear in any report of the study. Information provided will be combined for all study participants and reported as summaries. This survey is available to CTSU members’ website users upon login to the members’ website funding page so that we can improve the National Coverage Analysis process.

Public reporting burden for this collection of information is estimated to average 10 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 (0925-0648). Do not return the completed form to this address.

Demographic Questions

1. Which NCTN network groups is your site affiliated with? (select as many as apply)

• Alliance

• COG

• ECOG-ACRIN

• NRG

• SWOG

• CCTG

2. What membership type best describes your site? (select one)

   • Rostered group site

   • LAPS site

   • NCORP site
     
     
     

3. What site type best describes your site? (select one)

   • Academic site

   • Community site

National Coverage Analysis Questions

4. Overall, how aware are you of the National Coverage Analyses (NCA) posted by the CTSU for select NCTN and NCORP trials?

 Extremely aware

Very aware

Somewhat aware

 Not aware

5. Have you downloaded a NCA for an NCTN or NCORP trial from the CTSU website?

   • Yes – I use the NCA document

   • Yes – I download the NCA document for other staff at my institution.

     

   • No – I do not use the NCA document, if no, provide reason:

6. To what degree, if any, have the NCAs helped decrease the time required to activate NCI trials at your site?

NCAs have been extremely helpful

NCAs have been very helpful

NCAs have been somewhat helpful

 NCAs have not been helpful

 NCAs have made things worse

 N/A

7. To what degree, if any, have the NCAs helped improve your understanding of the financial resources required to activate NCI trials?

NCAs have been extremely helpful

NCAs have been very helpful

NCAs have been somewhat helpful

 NCAs have been slightly helpful

 NCAs have not been helpful

 N/A

8. To what degree, if any, have the NCAs helped with NCI clinical trial billing compliance at your site?

NCAs have been extremely helpful

NCAs have been very helpful

NCAs have been somewhat helpful

 NCAs have been slightly helpful

 NCAs have not been helpful

 N/A

9. To what degree, if any, have the NCAs helped provide clarity of the NCI trial funding available for your site?

NCAs have been extremely helpful

NCAs have been very helpful

NCAs have been somewhat helpful

 NCAs have been slightly helpful

 NCAs have not been helpful

 N/A

10. To what degree, if any, have the NCAs helped with activation of the NCI-MATCH trial (EAY131) subprotocols at your site?

NCAs have been extremely helpful

NCAs have been very helpful

NCAs have been somewhat helpful

 NCAs have been slightly helpful

 NCAs have not been helpful

 N/A

11. Overall, how satisfied are you with the NCA documents?

Very satisfied

Somewhat Satisfied

Neither satisfied nor dissatisfied

 Somewhat dissatisfied

 Very dissatisfied

 N/A

12. What, if any, improvements or changes would you like to see in the National Coverage Analyses program?

NOTE: For more information about the National Coverage Analyses provided by NCI and the CTSU, log in to the CTSU website and read the National Coverage Analysis FAQs or the National Coverage Analysis – CTSU Initiative Slides

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Mishkin, Grace (NIH/NCI) [E]
File Modified	0000-00-00
File Created	2021-01-22