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Orthodontists’ perception of CBCT prescription
INFORMED CONSENT FORM
Study Title: Survey of orthodontists’ perception of the CBCT prescription
Principal Investigator: Dr. Carlos Flores-Mir Co-investigators: Camila Pacheco-Pereira Study coordinator: Fabiana Marques Study coordinator Phone: (780) 492 0576 ETHICS ID: Pro00092421
Why am I being asked to consider this research study? We invite you to be part of this study because you are an orthodontist who is licensed to practice in Canada. This questionnaire was developed to get a better understanding of CBCT prescription in orthodontic practice.
What is the reason for doing this study? CBCT has found particular applications in Orthodontic practice. Although growing evidence supporting the CBCT use, there is no consensus regarding to which clinical situation the image should be indicated. Our study aim to ask orthodontists in which situation CBCT is requested.
What will I be asked to do? You will be asked to answer an online survey of 19 questions. In this survey, demographic information as gender and age and information about CBCT prescription will be collected.
Duration: The survey will take no longer than 4 minutes to be answered.
Will there be any risks? We do not see any risks from participating in this research. If you don’t feel comfortable with a specifically question you can choose not to answer it.
Will there be any benefits? There is no direct benefit to the participants. The indirect benefit is to collaborate to the improvement of health care practice.
Do I have to take part in the study? Being in this study is your choice. If you prefer not to be in the study, you can simply decide not to complete the questionnaire.
Data information and Confidentiality: No personal data that may be used to identify you will be released. All the collected information will be analyzed together. No individual responses will be showcased. The information declared in the questionnaire will be stored anonymously. As per University of Alberta policies, after the study is done we will still need to securely store the collected data for 5 years.
Reimbursement of expenses: There are no financial incentives provided for participating in this study.
Questions If you have any questions about the research now or later, please contact Dr. Carlos Flores-Mir by email the cf1@ualberta.ca or at 780-492-7409
If you have questions about your rights as a study participant you can contact the Research Ethics Office, at 780-492-2615. This office has no affiliation with the study investigators.
By answering the survey questions and submitting it you are giving your consent. Also, you are saying that you understand what is involved in this study and voluntarily agree to participate. Your signature will not be collected.
Welcome to this scientific survey!
The purpose of this survey is to get to know your perceptions of CBCT prescription in orthodontic practice. Your opinion is invaluable to our profession. This survey consists of 19 questions. It will take no longer than 4 minutes!
