Information Collection Request

Clostridium difficile Infection (CDI) Surveillance

ICR 201106-0920-012 · OMB 0920-0892 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form New form Telephone Interview Form and Instruction New Repair queued
Form New form Screening Form Form and Instruction New Available
Supporting Statement B .doc Supporting Statement B Uploaded 2011-06-16 Repair queued
Attachment H - IRB approval for portocol 5558_Cont.doc Supplementary Document Uploaded 2011-06-16 Repair queued
Attachment G - CDI Case Report Form.pdf Supplementary Document Uploaded 2011-06-16 Available
Attachment C _ADULT VERBAL CONSENTrevised.doc Supplementary Document Uploaded 2011-06-16 Repair queued
Attachment D _ CDI ASSENT for 13-15 .doc Supplementary Document Uploaded 2011-06-16 Repair queued
Supporting Statement A .doc Supporting Statement A Uploaded 2011-06-16 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
198154 Telephone Interview Form and Instruction New
198153 Screening Form Form and Instruction New
ICR Details
0920-0892 201106-0920-012
Historical Active
HHS/CDC
Clostridium difficile Infection (CDI) Surveillance
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/25/2011
Retrieve Notice of Action (NOA) 06/16/2011
  Inventory as of this Action Requested Previously Approved
07/31/2014 36 Months From Approved
1,100 0 0
383 0 0
0 0 0

CDC is requesting OMB approval for a new data collection. Steady increases in the rate and severity of Clostridium difficile infection (CDI) indicate a clear need to conduct longitudinal assessment of the impact of CDI in the United States. The proposed surveillance for CDI through the EIP will expand CDC capacity to monitor incidence of C. difficile in community and healthcare settings as well as to monitor and detect antimicrobial resistance.

None
None

Not associated with rulemaking

  75 FR 53310 08/31/2010
76 FR 14021 03/09/2011
No

2
IC Title Form No. Form Name
Screening Form New form Attachment E Screening Questions for CDI
Telephone Interview New form Attachment F CDI Health Interview

  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 1,100 0 0 1,100 0 0
Annual Time Burden (Hours) 383 0 0 383 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new ICR request, there are no changes to report.

$214,588
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Daniel Holcomb 770 488-4472 [email protected]

  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.
06/16/2011