Quantitative Survey of Physician Practices in Laboratory Test Ordering and Interpretation

Forms and Documents

Document Name	Status
Survey of Physician Practices in Laboratory Test Ordering and Interpretation Form	Modified
Web_Modifications_Crosswalk_17OCT11.docx Supplementary Document	2011-10-17
Justification of Changes to Survey Instrument submitted OMB 10-4-2011.docx Justification for No Material/Nonsubstantive Change	2011-10-17
Attachment E Email invite.docx Supplementary Document	2011-05-09
Attachment D Advance letter.doc Supplementary Document	2011-05-09

IC Document Collections

IC ID	Document Title	Status
197773	Survey of Physician Practices in Laboratory Test Ordering and Interpretation Form	Modified

ICR Details

OMB Control No: 0920-0893	ICR Reference No: 201110-0920-009
Status: Historical Active	Previous ICR Reference No: 201105-0920-011
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Quantitative Survey of Physician Practices in Laboratory Test Ordering and Interpretation
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/19/2011
	Date Received in OIRA: 10/19/2011
Terms of Clearance: Previous terms continue: This collection is approved for 12 months, with the understanding that the first screen of the electronic survey instrument will include the full PRA statement with an estimate of the time burden.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2012	07/31/2012	07/31/2012
Responses	1,600	0	1,600
Time Burden (Hours)	373	0	373
Cost Burden (Dollars)	0	0	0

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Abstract: This request is to make minor modifications to some questions on the survey based on feedback from the pilot testing.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Survey of Physician Practices in Laboratory Test Ordering and Interpretation	none	Survey of Physician Practices

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ICR Summary of Burden

	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	1,600	1,600	0	0	0	0
Annual Time Burden (Hours)	373	373	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $4,650

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 10/19/2011

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