Proposed Data Collections Submitted for Public Comment and Recommendations

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[INFO-98-06]

Proposed Data Collections Submitted for Public Comment and

Recommendations

In compliance with the requirement of Section 3506(c)(2)(A) of the

Paperwork Reduction Act of 1995 for opportunity for public comment on

proposed data collection projects, the Centers for Disease Control and

Prevention (CDC) will publish periodic summaries of proposed projects.

To request more information on the proposed projects or to obtain a

copy of the data collection plans and instruments, call the CDC Reports

Clearance Officer on (404) 639-7090.

Comments are invited on: (a) Whether the proposed collection of

information is necessary for the proper performance of the functions of

the agency, including whether the information shall have practical

utility; (b) the accuracy of the agency's estimate of the burden of the

proposed collection of information; (c) ways to enhance the quality,

utility, and clarity of the information to be collected; and (d) ways

to minimize the burden of the collection of information on respondents,

including through the use of automated collection techniques for other

forms of information technology. Send comments to Wilma Johnson, CDC

Reports Clearance Officer, 1600 Clifton Road, MS-D24, Atlanta, GA

30333. Written comments should be received within 60 days of this

notice.

Proposed Projects

1. National Hospital Ambulatory Medical Care Survey--(0920-0278)--

Extension--The National Hospital Ambulatory Medical Care Survey

(NHAMCS) has been conducted annually since 1992 by the Division of

Health Care Statistics, National Center for Health Statistics, CDC. The

NHAMCS is the principal source of data on the approximately 158 million

visits to hospital emergency and outpatient departments and is the only

source of nationally representative estimates on the demographic

characteristics of outpatients, diagnoses, diagnostic services,

medication therapy, and the patterns of use of care in hospitals which

differ in size, location, and ownership. Additionally, the NHAMCS is

the only source of national estimates on non-fatal causes of injury in

the emergency department.

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These data complement the data on visits to non-Federal physicians

in office-based practices collected through the NHAMCS (0920-0234),

together providing data on approximately 90 percent of the ambulatory

care provided in the U.S. Data collected through the NHAMCS are

essential for the planning of health services, for improving medical

education, determining health care work force needs and assessing the

health status of the population. Users of NHAMCS data include, but are

not limited to, congressional offices, Federal agencies such as NIH.,

various private associations such as the American Heart Association, as

well as universities and state health departments. The total cost to

respondents is estimated to be $292,223.

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Number of Number of Avg. burden/ Total

Noninstitutional general and short-stay hospital respondents responses/ response burden (in

outpatient and emergency departments (departments) respondent (in hrs.) hrs.)

----------------------------------------------------------------------------------------------------------------

Induction forms.......................................... 440 6 1 2,640

Patient record forms:

Emergency departments................................ 425 50 0.06666 1,417

Outpatient departments............................... 275 200 0.066666 3,667

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Total.............................................. ............. ........... ............ 7,724

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2. Children's Longitudinal Development Study--New--Since 1991,

surveillance of children aged three to ten years who have one or more

select developmental disabilities (cerebral palsy, mental retardation,

hearing impairment, and vision impairment) has been conducted in the

five-county Atlanta metropolitan area through the Metropolitan Atlanta

Developmental Disabilities Surveillance Program (MADDSP). Children have

been identified primarily through the special education programs of the

public schools in those five counties. Recently, surveillance has been

expanded to identify children with cerebral palsy at younger ages

through a broader array of medical facilities where diagnostic

evaluations are performed, and to include autism as one of the

developmental disabilities routinely under surveillance. An ongoing

case-control study is proposed to yearly (1) contact parents of all

children with any of the five developmental disabilities who are newly

identified in the surveillance data base and who were born in the metro

Atlanta area (approximately 675 children per year) and contact parents

of 250 children used as controls in order to request access to both

maternal prenatal and labor and delivery hospital records and infant

hospital records prior to newborn discharge (all accessed medical

records will be reviewed to obtain detailed information on pre- and

perinatal risk factors for developmental disabilities; this type of

information typically is lacking or incomplete in school records or

childhood medical records) and (2) conduct telephone interviews with

mothers of approximately 250 children with cerebral palsy or severe

mental retardation selected from the larger pool of approximately 675

children, plus interview mothers of the 250 control children. The

interviews will supply additional risk factor information relating to

the mothers' medical and reproductive histories, prenatal behaviors and

exposures, and family histories of developmental problems. Initially,

to be cases, children in the interview sample would be under seven

years of age at the time they were diagnosed as having cerebral palsy

or severe mental retardation. A sample of Atlanta-born children of

similar age and birth weight to the interview case children would be

randomly identified from vital records and used as controls.

Additionally, photographs and head circumference measurements of case

and control mothers and children included in the interview sample will

be taken either in the home or at a centralized location. The total

cost to respondents is $0.

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Average

Number of Number of burden/ Total

Respondents respondents responses/ response burden (in

respondents (in hrs.) hrs.)

----------------------------------------------------------------------------------------------------------------

Mothers:

Contact calls........................................... 1,000 1 .33 330

Scheduling call......................................... 500 1 .33 165

Telephone interview..................................... 500 1 1.50 750

Photography/anthropometry............................... 500 1 .75 375

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Total................................................. ........... ........... ........... 1,620

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3. Cognitive Function and Symptom Patterns in Gulf War Veterans--

New--This study will use functional magnetic resonance imaging (fMRI)

on previously studied cohorts of Gulf War veterans and Germany-deployed

Gulf War-era controls to determine if there are differences in patterns

of brain activation between both Gulf War veterans reporting a high

level of physical symptoms and Gulf War veterans with fewer symptoms

and between those veterans deployed to the Persian Gulf and those

deployed to Germany. In addition, an assessment of the relationship

between brain activation patterns and levels of cognitive functioning

will be completed. Patterns of activation on fMRI will be measured

while the subject is presented with a number of challenge paradigms

including a finger tapping task and a test of visual working memory.

Conventional magnetic resonance imaging scans will also be acquired on

all subjects prior to the fMRI in order to rule out subjects with brain

pathology

[[Page 65270]]

(e.g., stroke, cancer) and also to examine whether there are volumetric

differences between the groups within specific neuroanatomical areas.

The total cost to respondents is $0.00.

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Number of Avg. burden/ Total

Respondents Number of responses/ response burden (in

respondents respondent (in hrs.) hrs.)

----------------------------------------------------------------------------------------------------------------

High-symptom Gulf-deployed veterans......................... 40 1 1.5 60

Low symptom Gulf-deployed veterans.......................... 40 1 1.5 60

Normal controls (non-Gulf-deployed veterans)................ 40 1 1.5 60

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Total................................................. ........... ........... ........... 180

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4. X-ray Examination Program--(0920-0020)--Extension--The X-ray

Examination Program is a federally mandated program under the Federal

Mine Safety and Health Act of 1977, PL-95-164. The Act provides the

regulatory guidance for the administration of the National Coal

Workers' X-ray Surveillance Program, a surveillance program to protect

the health and safety of underground coal miners. This program requires

the gathering of information from coal mine operators, participating

miners, participating x-ray facilities and participating physicians.

The Appalachian Laboratory for Occupational Safety and Health (ALOSH),

National Institute for Occupational Safety and Health (NIOSH) is

charged with administration of this program. The total cost to

respondents is $47,910.00.

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Number of Avg. burden/ Total

Respondents Number of responses/ response burden (in

respondents respondent (in hrs.) hrs.)

----------------------------------------------------------------------------------------------------------------

Physicians/interpretation.................................. 20,000 1 0.05 1,000

Physician/certification.................................... 350 1 0.166 58

Miners..................................................... 10,000 1 0.3333 3,333

Mine operators............................................. 500 1 0.5 250

Facilities................................................. 300 1 0.5 150

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Total................................................ ........... ........... ............ 4,791

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5. National Ambulatory Medical Care Survey--(0920-0234)--

Extension--The National Ambulatory Medical Care Survey (NAMCS) was

conducted annually from 1973 to 1981, again in 1985, and resumed as an

annual survey in 1989. It is directed by the Division of Health Care

Statistics, National Center for Health Statistics, CDC. The purpose of

NAMCS is to meet the needs and demands for statistical information

about the provision of ambulatory medical care services in the United

States. Ambulatory services are rendered in a wide variety of settings,

including physicians' offices and hospital outpatient and emergency

departments. The NAMCS target population consists of all office visits

within the United States made by ambulatory patients to non-Federal

office-based physicians (excluding those in the specialties of

anesthesiology, radiology, and pathology) who are engaged in direct

patient care. The complement portion of data collection consists of the

remaining physicians in the AMA and AOA files; that is, physicians who

AMA and AOA classify as being federally employed, or in the three

specialties excluded from the traditional NAMCS, or as not spending the

majority of their professional time in office based practice. Since

more than 80 percent of all direct ambulatory medical care visits occur

in physicians' offices, the NAMCS provides data on the majority of

ambulatory medical care services. To complement these data, in 1992

NCHS initiated the National Hospital Ambulatory Medical Care Survey

(NHAMCS, OMB No. 0920-0278) to provide data concerning patient visits

to hospital outpatient and emergency departments. The NAMCS, together

with the NHAMCS constitute the ambulatory component of the National

Health Care Survey (NHCS), and will provide coverage of more than 90

percent of ambulatory medical care.

The NAMCS provides a range of baseline data on the characteristics

of the users and providers of ambulatory medical care. Data collected

include the patients' demographic characteristics and medical problems,

and the physicians' diagnostic services, therapeutic prescriptions and

disposition decisions. These data, together with trend data, may be

used to monitor the effects of change in the health care system,

provide new insights into ambulatory medical care, and stimulate

further research on the use, organization, and delivery of ambulatory

care.

Users of NAMCS data include congressional and other federal

government agencies (e.g. NIMH, NIAAA, NCI, HRSA), state and local

governments, medical schools, schools of public health, colleges and

universities, private businesses, nonprofit foundations and

corporations, professional associations, as well as individual

practitioners, researchers, administrators and health planners. Users

vary from the inclusion of a few selected statistics in a large

research effort, to an in-depth analysis of the entire NAMCS data set

covering several years. The total cost to respondents is estimated to

be $153,250.

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Number of Number of Avg. burden/ Total

Respondents respondents responses/ response burden (in

(physicians) respondent (in hrs.) hrs.)

----------------------------------------------------------------------------------------------------------------

Office-based physicians................................... 2,500 1 0.25 625

Induction form............................................ 2,500 30 0.03333 2,500

Patient record form....................................... ............ ........... ............ ...........

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Complement physicians..................................... 500 1 0.25 125

Induction form............................................ 100 30 0.0333 100

Patient record form....................................... ............ ........... ............ ...........

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Total............................................... ............ ........... ............ 3,350

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6. Information Collection to Establish Community Assistance Panels

(CAPs)--(0923-0007)--Extension--The Agency for Toxic Substances and

Disease Registry (ATSDR) is mandated pursuant to the 1980 Comprehensive

Environmental Response Compensation and Liability Act (CERCLA), and its

1986 Amendments, The Superfund Amendments and Reauthorization Act

(SARA), to prevent or mitigate adverse human health effects and

diminished quality of life resulting from the exposure of hazardous

substances into the environment. To facilitate this effort, ATSDR seeks

the cooperation of the community being evaluated through direct

communication and interaction. Direct community involvement is required

to conduct a comprehensive scientific study and to effectively

disseminate specific health information in a timely manner. Also, this

direct interaction fosters a clear understanding of health issues that

the community considers to be of importance and establishes credibility

for the agency. The Community Assistance Panel nomination forms are

completed by individuals in the community to nominate themselves or

others for participation on these panels. Other than the possible cost

of a postage stamp, there is no cost to respondents. This request is

for a 3-year extension of the current OMB approval of the Community

Assistance Panel nominations form.

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Number of Avg. burden/ Total

Respondents Number of responses/ response burden (in

respondents respondents (in hrs.) hrs.)

----------------------------------------------------------------------------------------------------------------

General Public.............................................. 300 1 .1666 50

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Total................................................. ........... ........... ........... 50

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Dated: December 5, 1997.

Wilma G. Johnson,

Acting Associate Director for Policy Planning and Evaluation, Centers

for Disease Control and Prevention (CDC).

[FR Doc. 97-32399 Filed 12-10-97; 8:45 am]

BILLING CODE 4163-18-M