Please include the following information on your new IRB application. If you are filing an amendment to an existing IRB application, please use this as a guide for the information you need to include. However, the iStar fields possibly will not match.
2) 1. In section 9. Methods and Procedures, please check one of the secondary analysis options, that most apply to your research. Checking one of these boxes triggers the activation of section 13, also needed for your application.
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2). In section 13.2, upload a Data Collection Form which includes all of the variables you will need for the research.
Please differentiate between data elements you plan to abstract from the chart and data that will be obtained using the Informatics Core team and or tools such as i2b2. If applicable, please also include a PDF of your i2b2 print query report. Please review the how-to "Print Query" article for further instruction
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53. In section 13.2.1, please check "Yes" for use of the Clinical Data Warehouse (CDW).
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64. Please Indicate if you intend to contact patients using the information provided by the Informatics and Analytics core for study recruitment purposes.In section 13.3, in your own words, generally state you will be working with the Clinical Research Informatics core to extract the data variables listed in sections 13.2 & 13.3 which will be sourced from the Keck Data Warehouse or Keck i2b2.
Indicate which variables you plan to obtain by working with the Informatics Team and or i2b2.
Indicate which variables you plan to abstract by conducting further chart review.
75. In section 13.4 Methods and Procedures, please indicate if any identifying patient information is requested.
ADDRESS1
ADDRESS2
Admit Date
City
Discharge Date
Encounter Number
MRN
Name
Phone
State
Zip
86. In section 24.3, indicate if you will or will not require a HIPAA Waiver of Consent.
97. In section 42 indicate which Clinical Data Warehouse you will be requesting data from.
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108. In your methods and procedures section, please include a plan for data storage, transfer, and management. Please indicate that all data files will be encrypted, password-protected, and will only be accessed/reside behind DHS firewalls (check section 24.5.1 B). Data will only be released to individuals named and approved for viewing identifiable data as named in your IRB. All provisioned datasets will be destroyed upon completion of the research study. Please indicate that the Informatics and Analytics Core will receive any incoming data and deliver the requested data via one of the two following methods
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9. In section 42.2, please indicate which variables from the CDW you will require.
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10. In section 42.3 please indicate if you plan to contact people whose data will be obtained from the CDW.
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