Work on a New Topic Home Work on a New Topic Date Required Primary Contact Information First Name Last Name Title - None -Dr.ProfessorMr.Mrs.Ms.Other If Other Email Telephone Fax Organization Name Organization Type - None -F/P/T Health MinistryHealth AuthorityHospitalNational/Regional Health Care ProgramOther Organization Type: Other Role - None -Decision makerPolicy makerAdvisorAnalystResearcherClinicianSchool staffOther Role: Other City Province Alternative Contact Information (if applicable) First Name Last Name Title - None -Dr.ProfessorMr.Mrs.Ms.Other If Other Email Fax Telephone Organization Name Submitted by Contact type - None -Primary contactAlternative contactOther If Other Request Information Subject Technology Type - Select -DrugMedical DeviceSurgical ProcedureNon-Surgical ProcedureDiagnosticsNon-Drug Mental Health Intervention Purpose of Information - Select -Background Information/Meeting PreparationClinical PracticeCoverage DecisionPolicy DecisionPurchasing DecisionOther Purpose of Information: Other Background Information: What prompted your question? How will this information be used to guide decision-making Information Required: What is the question you are looking to answer? 1.\n2. Patient Population: e.g., age, disease state, comorbidities, clinical setting. Intervention: e.g., name of drug, device, or procedure. Comparator(s): e.g., other similar drugs, devices, or procedures (if applicable). Outcomes of Interest: e.g., effectiveness, clinical benefit or harm, safety, cost, guidelines. Other CADTH reports: Are you aware of previous CADTH reports on this topic?
