Form 23 Oncology Patient Enrollment Network (OPEN) Survey

Attachment _4_opensurvey

OMB #: 0925-0624
Expiry Date: 12/31/2013

Public reporting
this
collection
of information
is estimated
to varytofrom
10 to15
15 minutes
minutes per response,
Public
reportingburden
burdenforfor
this
collection
of information
is estimated
average
response,
including
thetime
timeforfor
reviewing
instructions,
searching
existing
data sources,
gathering
and maintaining
including the
reviewing
instructions,
searching
existing
data sources,
gathering
and maintaining
the data
the
data and
needed,
and completing
andthe
reviewing
the
of An
information.
An
agency
may
not conduct
needed,
completing
and reviewing
collection
ofcollection
information.
agency may
not
conduct
or sponsor,
and
or
sponsor,
and
a
person
is
not
required
to
respond
to,
a
collection
of
information
unless
it
displays
a
a person is not required to respond to, a collection of information unless it displays a currently valid OMB
currently
valid OMB
control number.
Send
regarding
this
burden
estimate
or any other
control number.
Send comments
regarding
thiscomments
burden estimate
or any
other
aspect
of this collection
of aspect
of this collection of information, including suggestions for reducing this burden, to: NIH, Project
information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge
Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA
Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0624). Do not return the completed form to this
(0925-0624).
Do not return the completed form to this address.
address

Oncology Patient Enrollment Network Survey
1

The navigation and the use of the screen functions were
clear.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree

2

Additional suggestions or comments regarding navigation
and screen functions:

3

The "Create New" screen was clear and easy to use.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I do not have access to this screen
1

Attachment _4_opensurvey

OMB #: 0925-0624
Expiry Date: 12/31/2013

4

Additional suggestions or comments regarding the "Create
New" screen:

5

The "Demography" screen was clear and easy to use.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not available for my protocol
I do not have access to this screen

6

Additional suggestions or comments regarding the
"Demography" screen:

7

The "Checklist" screen was clear and easy to use.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I do not have access to this screen

2

Attachment _4_opensurvey

OMB #: 0925-0624
Expiry Date: 12/31/2013

8

Additional suggestions or comments regarding the checklist
screen:

9

The OPEN system overall was easy to use.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree

10 Was the Training Video helpful in providing the information
you needed to perform an enrollment?
Yes
No
N/A (I did not view it)

11 If no, what information should be added or clarified?

12 Was the User Guide helpful in providing the information you
needed to perform an enrollment?
Yes
No
N/A (I did not use it)

3

Attachment _4_opensurvey

OMB #: 0925-0624
Expiry Date: 12/31/2013

13
If no, what information should be added or clarified?

14

Other comments or suggestions:

4