Form
Approved OMB
No. 0935-0179 Exp.
Date 10/31/2017
Questions for Patient Key Informants
Number: 1-2 per Topic Refinement or Tech Brief, approximately 30-40/year
Method: electronic survey sent at end of report
Using any number from 0 to 10 where 0 is the worst possible and 10 is the best possible, what number would you use to rate your experience participating in the AHRQ systematic review process?
Do you think the final report will be useful to patients like you? (Yes, definitely; Yes, somewhat; No)
Explain: _______________________
Do you feel like your comments were used in the final report? (Yes, definitely; Yes, somewhat; No)
Explain: __________________________
Would you recommend other patients participate as key informants for future AHRQ systematic reviews? (Yes/No)
Explain:______________________
What could have improved your experience participating as a key informant? _______________________________________________________
Public
reporting burden for this collection of information is estimated to
average 15 minutes per response, the estimated time required to
complete the survey. An agency many not conduct or sponsor, and a
person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this
burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork
Reduction Project (0935-0179) AHRQ, 5600 Fishers Lane, Mail Stop
07W41A, Rockville, MD 20857.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Elisabeth Kato |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |