CDWR/CTMS User Survey - Final

Section 1: Participant Information

1. First Name

Last Name

2. Title:

Other Title:

3. Highest Degree:

Other Degree:

4. Email address:

Section 1 continued: Participant Information

5. Campus where you spend the majority of your time:

Other Campus:

6. School:

Dentistry - Division:

Engineering - Department:

Medicine - Department:

Pharmacy - Department:

Other School/Affiliation:

7. Are you affiliated with the USC Norris Comprehensive Cancer Center?

Yes No

Section 2 continued: CDWR

10. Listed below are types of data that could be included in a CDWR.

Please rate each in terms of its importance to your research.

9. Listed below are TYPES OF DATA that could be included in a CDWR.
	Would not use	Minimally important	Important	Critically important
Demographics	9. Listed below are TYPES OF DATA that could be included in a CDWR. : Demographics (Would not use)	Demographics (Minimally important)	Demographics (Important)	Demographics (Critically important)
Diagnoses (ICD 9/10)	Diagnoses (ICD 9/10) (Would not use)	Diagnoses (ICD 9/10) (Minimally important)	Diagnoses (ICD 9/10) (Important)	Diagnoses (ICD 9/10) (Critically important)
Procedures (CPT)	Procedures (CPT) (Would not use)	Procedures (CPT) (Minimally important)	Procedures (CPT) (Important)	Procedures (CPT) (Critically important)
Medications	Medications (Would not use)	Medications (Minimally important)	Medications (Important)	Medications (Critically important)
Laboratory test results	Laboratory test results (Would not use)	Laboratory test results (Minimally important)	Laboratory test results (Important)	Laboratory test results (Critically important)
Radiology reports	Radiology reports (Would not use)	Radiology reports (Minimally important)	Radiology reports (Important)	Radiology reports (Critically important)
Stage (for cancer diagnoses)	Stage (for cancer diagnoses) (Would not use)	Stage (for cancer diagnoses) (Minimally important)	Stage (for cancer diagnoses) (Important)	Stage (for cancer diagnoses) (Critically important)
Pathology reports	Pathology reports (Would not use)	Pathology reports (Minimally important)	Pathology reports (Important)	Pathology reports (Critically important)
Outcomes	Outcomes (Would not use)	Outcomes (Minimally important)	Outcomes (Important)	Outcomes (Critically important)
Financial/cost data	Financial/cost data (Would not use)	Financial/cost data (Minimally important)	Financial/cost data (Important)	Financial/cost data (Critically important)
Insurance coverage	Insurance coverage (Would not use)	Insurance coverage (Minimally important)	Insurance coverage (Important)	Insurance coverage (Critically important)
Bio-repository data	Bio-repository data (Would not use)	Bio-repository data (Minimally important)	Bio-repository data (Important)	Bio-repository data (Critically important)
Genetic/genomic data	Genetic/genomic data (Would not use)	Genetic/genomic data (Minimally important)	Genetic/genomic data (Important)	Genetic/genomic data (Critically important)
Elements of physical exam - vital signs	Elements of physical exam - vital signs (Would not use)	Elements of physical exam - vital signs (Minimally important)	Elements of physical exam - vital signs (Important)	Elements of physical exam - vital signs (Critically important)
Elements of physical exam - other than vital signs	Elements of physical exam - other than vital signs (Would not use)	Elements of physical exam - other than vital signs (Minimally important)	Elements of physical exam - other than vital signs (Important)	Elements of physical exam - other than vital signs (Critically important)
Review of Systems (i.e., checklist covering organ systems)	Review of Systems (i.e., checklist covering organ systems) (Would not use)	Review of Systems (i.e., checklist covering organ systems) (Minimally important)	Review of Systems (i.e., checklist covering organ systems) (Important)	Review of Systems (i.e., checklist covering organ systems) (Critically important)
Allergies	Allergies (Would not use)	Allergies (Minimally important)	Allergies (Important)	Allergies (Critically important)
Smoking status	Smoking status (Would not use)	Smoking status (Minimally important)	Smoking status (Important)	Smoking status (Critically important)
Drug/Alcohol use	Drug/Alcohol use (Would not use)	Drug/Alcohol use (Minimally important)	Drug/Alcohol use (Important)	Drug/Alcohol use (Critically important)
Family history	Family history (Would not use)	Family history (Minimally important)	Family history (Important)	Family history (Critically important)
Images	Images (Would not use)	Images (Minimally important)	Images (Important)	Images (Critically important)
Physician notes	Physician notes (Would not use)	Physician notes (Minimally important)	Physician notes (Important)	Physician notes (Critically important)
Other text in medical records	Other text in medical records (Would not use)	Other text in medical records (Minimally important)	Other text in medical records (Important)	Other text in medical records (Critically important)
Other (specify below)	Other (specify below) (Would not use)	Other (specify below) (Minimally important)	Other (specify below) (Important)	Other (specify below) (Critically important)

Other type(s) of data:

Section 4: Participation in planning process

17. We will soon begin selecting individuals to guide the development of the CDWR. We want broad representation of perspectives and research areas (faculty and staff).

Would you be interested in participating in: (check all that apply)

Quarterly meetings to update and gather input from users of the CDWR? Working group that met more frequently (e.g., monthly) to develop key functionality, policies or operational strategies?

18. We will soon begin selecting individuals to guide the development of the CTMS. We want broad representation of perspectives and research areas (faculty and staff).

Would you be interested in: (check all that apply)

Attending two CTMS vendor demonstrations on the afternoons of May 13th and May 29th on the HSC campus? Participating on an advisory committee for a CTMS (meeting every 6 to 8 weeks or via email questions)? Serving on a working group that meets more frequently (e.g., monthly) to develop operational strategies for the CTMS?

Section 5 continued: Clinical Research Challenges

22. What is your biggest challenge(s) in conducting clinical research?

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