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TEMPLATE INFORMED CONSENT FORM FOR RESEARCH WITH HUMAN SUBJECTS Protocol Title: Genetic Epidemiology of Chronic Obstructive Pulmonary Disease: The COPDGene® Study: Phase 2 Study Sponsor: US National Heart, Lung, and Blo
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Document Date: 2014-03-12 12:04:43


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City

Denver / /

Country

United States / /

Currency

USD / /

Facility

University of Iowa / Hospital Pulmonary Function Testing / Northeastern University / University of Utah / Data Coordinating Center / Hospital Imaging / Medical Center / University of Utah Biorepository / Women’s Hospital / Johns Hopkins University / University of Colorado / /

IndustryTerm

internet searches / privacy law / insurance / healthcare / federal law / internet sources / test gas / gas mixture / therapeutic products / arterial blood gas / Internet Search / /

MedicalCondition

COPD / experience chest tightness / cancerous tumors / nausea / injury / lung disease / illness / cancers / cancer / disease / fainting / shortness of breath / Chronic Obstructive Pulmonary Disease / pain / lung cancer / heart attack / diseases / infection / depression / lightheadedness / disorders / heart/vascular disease / /

MedicalTreatment

emergency treatment / radiation / first aid / /

Organization

US National Heart / Lung / and Blood Institute / Channing Division of Network Medicine / University of Utah Biorepository / Institutional Review Board / Food and Drug Administration / Northeastern University / Harvard School of Public Health Genetic / University of Colorado / Executive Committee / Food and Drug Administration Department of Health / Women’s Hospital / Johns Hopkins University / Channing Division of Network Medicine Genetic Analysis / Harvard School of Public Health / Medicare / National Institutes of Health Data Access Committee for dbGaP / Data Coordinating Center / University of Utah / Medical Center / State office of Vital Statistics / University of Iowa / United States Department of Health and Human Services / /

Person

Brigham Women / Interview / /

Position

personal representative / central study coordinator / Principal Investigator / study coordinator / physician / study physician / friend and personal representative / study center coordinator / personal representative and your treating physician / general internet searches / personal physician / investigator for this study / personal representative and your personal physician / clinical center coordinator / treating physician / chair / /

Product

albuterol / /

ProvinceOrState

Utah / Iowa / Colorado / /

Technology

radiation / Bioinformatics / x-ray / cellular telephone / genetic code / TEMPLATE INFORMED CONSENT FORM FOR RESEARCH WITH HUMAN SUBJECTS Protocol / /

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