ID

12736

Descripción

EUropean survey on the assessment of deep molecular REsponse in chronic phase CML patients after at least two years of therapy with tyrosine KinAse inhibitors - major component of the Path to Cure Pillar of EUTOS III. ODM derived from: http://www.eutos.org/content/path_to_cure/eureka/index_eng.html

Link

http://www.eutos.org/content/path_to_cure/eureka/index_eng.html

Palabras clave

  1. 16/12/15 16/12/15 -
  2. 19/12/15 19/12/15 -
  3. 19/12/15 19/12/15 -
  4. 20/12/15 20/12/15 -
  5. 3/1/16 3/1/16 -
Subido en

16 de diciembre de 2015

DOI

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Licencia

Creative Commons BY-NC 3.0

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Molecular Monitoring Survey EUREKA

Informed Consent Form

  1. StudyEvent: ODM
    1. Informed Consent Form
Patient Information
Descripción

Patient Information

Patient information
Descripción

Dear patients, As your health care provider we ask you to consent to participate at the European survey on the assessment of deep molecular Response in chronic phase CML patients after at least two years of therapy with tyrosine kinase inhibitors (EUREKA-Survey). This informed consent form shall provide you the necessary information on deciding to participate at the EUREKA survey. Your treating physician has thoroughly informed you that you have been afflicted with CML. You have also been taught about the importance of the molecular response in the context of CML management and prognosis, accurate and reproducible molecular analyses of the peripheral blood are essential for monitoring the therapy effectiveness. Measurement of minimal residual disease has been improved considerably over the last couple of years. Assessing the significance of the findings according an international standardized method is very important.

Tipo de datos

integer

Alias
UMLS CUI [1]
C1955348
Aim of the EUREKA-survey
Descripción

Aim of the EUREKA-survey

Study aim
Descripción

In an effort to constantly improving the treatment of CML, the EUREKA-survey is collecting and assessing medical data and molecular results of the measurement of the residual disease independent of a patients participation in a therapy study. The laboratories providing that particular data have special experience and fulfill certain quality assurance procedures. The data assessment shall give new insights into a European-wide availability of the standardized measurement of deep molecular response of CML. The results will be available for all CML patients that have been treated with tyrosine kinase inhibitor for at least two years. Biospecimen for the measurement of the residual disease (deoxyribonucleic acid, DNA; Ribonucleic acid, RNA) will be stored for a potential future reassessment with further developed methods.

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1947946
UMLS CUI [1,2]
C0008972
Process of data collection
Descripción

Process of data collection

Process of data collection
Descripción

The survey consist of a data acquisition alongside biomaterial collection. You will be fully informed about the therapy of your disease through your treating physician. Your treating physician will send survey documentation sheets comprising information about your disease, course of therapy and the result of the latest examination of the residual disease and your blood for the most recent analysis to the examination laboratory. There the data plus the results of the measurement will be entered into an electronic data acquisition system

Tipo de datos

integer

Alias
UMLS CUI [1]
C0262727
Process of biomaterial collection
Descripción

Process of biomaterial collection

Process of biospecimen collection
Descripción

The measurement of the residual disease during a CML therapy is a routine procedure. Therefore the EUREKA-survey does not require additional taking of blood samples. 20 ml. of peripheral blood will be sent to a national reference laboratory for the measurement of deep molecular response of CML. The biospecimen will be stored at the reference laboratory for an undefined period and if necessary used for scientific research purposes for further research into CML or for applying new methods of measurement of residual disease. All research projects where biospecimen from the EUREKA-biobank is used are examined and approved by the scientific panel of the EUREKA-survey. Furthermore all research projects have to be approved previously by an ethic commission.

Tipo de datos

integer

Alias
UMLS CUI [1]
C2347027
Potential risks and benefits
Descripción

Potential risks and benefits

Potential risks and benefits
Descripción

By providing your informed consent to data collection and biospecimen collection you can contribute to the development and distribution of new standardized detection methods. By doing so you also contribute to further improving the medical care of CML: By participating at the biobank you will receive the result of the measurement of residual disease from a laboratory that is participating at international studies on standardization and quality control. Your participation does not contain a direct personal benefit for your treatment. As the EUREKA-survey is a mere data collection survey and concomitantly biospecimen collection your participation does not involve any additional risk.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0687742
Information of data security
Descripción

Information of data security

Information of data security
Descripción

Information of data security

Tipo de datos

integer

Alias
UMLS CUI [1]
C0086100

Similar models

Informed Consent Form

  1. StudyEvent: ODM
    1. Informed Consent Form
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Patient Information
Patient information
Item
Patient information
integer
C1955348 (UMLS CUI [1])
Item Group
Aim of the EUREKA-survey
Study aim
Item
Study aim
integer
C1947946 (UMLS CUI [1,1])
C0008972 (UMLS CUI [1,2])
Item Group
Process of data collection
Process of data collection
Item
Process of data collection
integer
C0262727 (UMLS CUI [1])
Item Group
Process of biomaterial collection
Process of biospecimen collection
Item
Process of biospecimen collection
integer
C2347027 (UMLS CUI [1])
Item Group
Potential risks and benefits
Potential risks and benefits
Item
Potential risks and benefits
integer
C0687742 (UMLS CUI [1])
Item Group
Information of data security
Information of data security
Item
Information of data security
integer
C0086100 (UMLS CUI [1])

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