Qualitative Interviews with Patients with Focal Onset Seizures
-- Pre-Consent Screener Form --
Thank you for your interest in this study. The purpose of this interview study is to understand the non-seizure-related experiences of adult and adolescent patients living with focal onset seizures. First, we need to ask you some questions to see if you or your adolescent child are eligible to participate in the interview.
We will be asking you some questions to see if you / your adolescent child are eligible to participate. Individuals who meet the eligibility criteria may be asked to take part in up to two 60-minute one-on-one interviews via online teleconference with a trained healthcare research professional. These interviews would be conducted approximately 4-8 months apart. For the interviews, you / your adolescent child will need to have access to an internet-enabled computer or other device with screen-sharing capabilities. For the interview, you will need to have access to an internet-enabled computer or other device, such as a tablet in order to view and read a slide deck shared on screen.
Any information you provide to us as part of the eligibility questions will be treated as confidential. It will be combined with feedback from others like yourself and will be stored in an access-controlled file. Your / your adolescent child’s information will be kept secure at all times. Personally identifying information, such as names and locations, will be removed from your child’s data and your / your child’s information will not be passed to any other organization without your permission. Any personally identifying information you give to us as part of the eligibility questions will be destroyed after at least 15 years for named and masked data after study completion.
If you / your adolescent child are eligible to take part in the interview study, you will be provided with a consent form (your adolescent child will be provided with an assent form), which explains how the study works and your / your child’s rights as a study participant. You will also be required to provide confirmation of focal onset seizure diagnosis by having your / your child’s physician complete a confirmation of diagnosis form.
This research is being conducted by IQVIA™. You have the right to withdraw at any time. For more information about your / your adolescent child’s rights, please see our privacy notice, which is available at
www.iqvia.com/about-us/privacy.
If you have any questions, please contact the study team at
focalseizurestudy@iqvia.com.
Do you consent to the information above and wish to proceed to see if you / your adolescent child are eligible for this study?