Participant Information Sheet

Study Title: Deployable Interstitial Cystitis Urine Diagnostic Technology Development
Principal Investigator: Laura Lamb, PhD
Address: William Beaumont Hospital 3811 West 13 Mile Road, Suite 504 Royal Oak, MI 48073

William Beaumont Hospital- Royal Oak (lead site), Albert Einstein College of Medicine, and Baylor College of Medicine

You are being asked to be in a research study to improve methods to diagnosis interstitial cystitis (IC) because you have been told by a clinician that you have IC. The goal of this study is to develop a simple test for diagnosing IC using a urine sample to look for biomarkers (proteins) specific to IC and answers to symptom questions. This study is being conducted by William Beaumont Hospital, Albert Einstein College of Medicine, and Baylor College of Medicine.
Michael Chancellor, MD, a physician co-investigator on this Beaumont research study has also conducted research on other methods to diagnose interstitial cystitis, for his own private company. Beaumont has a specific plan in place to manage any potential conflict of interest Dr. Chancellor may have between this Beaumont research and his private research.

Study Procedures:
If you take part in the study, you will be asked to provide a urine specimen, complete questionnaires, and recruit both male and female controls to provide a urine sample and complete the surveys. This includes:
·Completing the online Screening Survey, which asks for information to determine eligibility for the study. It should take 5 minutes to complete.
·If eligible, completing the Study Questionnaires, which asks for general medical and demographic information as well as information regarding symptoms and problems related to bladder conditions. This will include questionnaires on symptoms related to IC. It should take about 10-15 minutes total to complete the survey.
·Providing a urine specimen approximately (20-100 cc or about 1-3 ounces) and return to Beaumont by United States Postal Service (pre-paid postage included).
8% of survey complete.