OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Follow-up Study of Chronic Fatigue Syndrome in Georgia (Survey of Chronic Fatigue Syndrome & Chronic Unwellness in Georgia-Baseline Survey)

ICR 200712-0920-006 · OMB 0920-0638 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Followup CFS in GA - OMB Supporting Statement Rev 05-22-08.doc Supplementary Document Uploaded 2008-06-17 Available
Supporting Statement B.doc Supporting Statement B Uploaded 2007-11-28 Repair queued
Attachment 4 GA protocol 4121.doc Supplementary Document Uploaded 2007-11-28 Available
Attachment 7B Refusal Letter.doc Supplementary Document Uploaded 2007-11-28 Available
Attachment 7A Non-Contact Letter.doc Supplementary Document Uploaded 2007-11-28 Repair queued
Attachment 6 Advance Letter.doc Supplementary Document Uploaded 2007-11-28 Repair queued
Supporting Statment A.doc Supporting Statement A Uploaded 2007-12-06 Available
IC Document Collections
IC IDCollectionTypeStatusForm
7106 Follow-up Study of Chronic Fatigue Syndrome in Georgia (Survey of Chronic Fatigue Syndrome & Chronic Unwellness in Georgia-Base Line Survey) Instruction Modified
ICR Details
0920-0638 200712-0920-006
Historical Active 200402-0920-007
HHS/CDC
Follow-up Study of Chronic Fatigue Syndrome in Georgia (Survey of Chronic Fatigue Syndrome & Chronic Unwellness in Georgia-Baseline Survey)
Reinstatement with change of a previously approved collection   No
Regular
Approved with change 06/30/2008
Retrieve Notice of Action (NOA) 12/18/2007
Approved consistent with CDC revisions outlined in Agency memo. CDC has agreed that the results of the survey are not generalizable and will not be used to generate prevalence/cost estimates associated with CFS at either the state or national level.
  Inventory as of this Action Requested Previously Approved
06/30/2011 36 Months From Approved
2,870 0 0
861 0 0
0 0 0
The Survey of Chronic Fatigue Syndrome and Chronic Unwellness in Georgia (Baseline Survey), conducted between 2004 and 2005, provided baseline information on CFS in metropolitan, urban, and rural regions of Georgia. Our Follow-up Study addresses the need to determine factors that are associated with improvement in clinical course, in order to decrease the morbidity (burden) of this illness. The goal of the Follow-up Study is to build on the Baseline Survey and identify risk factors for and biomarkers of CFS morbidity by evaluating changes in clinical parameters of CFS over the interval since the Baseline Survey.
US Code: 42 USC 241 Name of Law: The Public Health and Welfare
  
None
Not associated with rulemaking
  71 FR 62473 10/25/2006
72 FR 65735 11/23/2007
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,870 0 0 2,870 0 0
Annual Time Burden (Hours) 861 0 0 861 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The goal of the Follow-up Study is to build on the Baseline Survey and identify risk factors for and biomarkers of CFS morbidity by evaluating changes in clinical parameters of CFS over the interval since the Baseline Survey.
$320,000
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Maryam Daneshvar 4046394604
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/17/2007