Help Us Evaluate a Lung Cancer Screening Tool

We appreciate your interest in helping evaluate a provider decision support tool for lung cancer screening and smoking cessation. Your opinion is very valuable for this research study being conducted by Dr. Shiraz Mishra from the UNM Comprehensive Cancer Center.

Informed Consent

Your participation will involve completing an on-line survey about prototypical decision support tools for lung cancer screening and smoking cessation. The survey should take about 15 to 20 minutes to complete. Your involvement in the study is voluntary, and you may choose not to participate. You may also withdraw at any time. Your decision to participate will have no impact upon your employment. There are no names or identifying information associated with this survey.

The on-line survey contains questions to help evaluate the final prototypes of the on-line decision support tools. The questions inquire about your impressions regarding the internet-based prototype decision support tool in terms of the materials’ content, balance, format, usability, readability, and language. The survey will also collect a limited amount of demographic information and practice setting. You can refuse to answer any of the questions at any time. There are no known risks in this study, but some individuals may experience discomfort when answering questions. All data will be kept for 3 years in a locked file in Dr. Mishra’s office and in password-protected computer files and then destroyed.

The findings from this project will provide information to develop a written and an internet-based decision support tool. If published, we will present results only in summary form. If you have any questions about this research project, please feel free to call Dr. Shiraz Mishra at (505) 925-6085. If you have questions regarding your legal rights as a research subject, you may call the UNMHSC Office of Human Research Protections at (505) 272-1129. By reading this consent and agreeing to be surveyed you will be agreeing to participate in the above described research study. Thank you for your consideration.


Shiraz I. Mishra, MBBS, PhD
Professor, Department of Pediatrics

Review the Lung Cancer Screening Tool (about 20 minutes total).


The survey starts after reviewing the tool.

The hard links if needed:
Tool –
Survey –

Above Informed Consent Cover Letter for On-Line Survey in pdf format/IRB approved.