CONSENT TO PARTICIPATE IN A CLINICAL RESEARCH STUDY 

 STUDY TITLE: Current Approaches to Screening for, Diagnosing, and Managing Primary Sclerosing Cholangitis in Pediatric Patients with Inflammatory Bowel Disease Among Pediatric Gastroenterologists

PRINCIPAL INVESTIGATOR: Alaa Abdelghani, MD

CO-INVESTIGATOR: Sabina Ali, MD and Malika Goel, MBBS

NOTE:  The words "you" and "your" in this consent form refer to the study volunteer

Introduction

This survey aims to assess current practices in caring for pediatric patients with Inflammatory bowel disease and Primary sclerosing cholangitis (IBD-PSC).  Eligible participants include all practicing healthcare providers involved in the care of pediatric patients with IBD. 

Your responses will contribute valuable insight into the diversity of approaches used in real-world settings and help advance care for children with IBD and associated hepatobiliary conditions. The survey will take approximately 5 minutes to complete. Participation is voluntary, and all responses will be kept confidential and de-identified. The survey is anonymous, and no one will be able to link your answers back to you. Please do not include your name or other information that could be used to identify you in the survey responses. Please contact Alaa Abdelghani and Malika Goel at alaa.abdelghani@ucsf.edu and malika.goel@ucsf.edu respectively with questions about this study. If you have questions or concerns about your rights as a research participant, you can call the University of California, San Francisco (UCSF) Institutional Review Board at 415-476-1814.

Common questions:

1)   WHAT ARE THE RISKS OF BEING IN THIS STUDY?

The risks for this study are no more than what happens in everyday life. There may be other risks of being in this research study that are not known at this time.

2)   ARE THERE BENEFITS TO TAKING PART IN THIS STUDY? 

Although there may be no benefit to you from being in this study, we hope to learn something that could help others.

3)   WHAT ARE THE COSTS AND REIMBURSEMENTS?

You will not be paid to participate in this study.

4)   WHAT HAPPENS IF YOU DO NOT FINISH THIS STUDY?

It is your choice to be in this study. You may decide to stop taking the survey at any time. If you stop taking the survey, there will be no penalty or loss of benefits to which you are otherwise entitled.

5) HOW WILL MY STUDY INFORMATION BE KEPT PRIVATE? 

Efforts will be made to keep your study-related information confidential. The results from this study may be published or presented but your identity will not be revealed.

By completing the survey below, you are agreeing to participate in this study.

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