[Federal Register Volume 62, Number 238 (Thursday, December 11, 1997)]
[Notices]
[Pages 65268-65271]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-32399]


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

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.

[[Page 65269]]

    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.

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

    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.

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

    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.

----------------------------------------------------------------------------------------------------------------
                                                                            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
                                                             ---------------------------------------------------
      Total.................................................  ...........  ...........  ...........          180
----------------------------------------------------------------------------------------------------------------

    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.

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

    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.

----------------------------------------------------------------------------------------------------------------
                                                              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.......................................  ............  ...........  ............  ...........

[[Page 65271]]

                                                                                                                
Complement physicians.....................................           500            1       0.25             125
Induction form............................................           100           30       0.0333           100
Patient record form.......................................  ............  ...........  ............  ...........
                                                           -----------------------------------------------------
      Total...............................................  ............  ...........  ............        3,350
----------------------------------------------------------------------------------------------------------------

    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.

----------------------------------------------------------------------------------------------------------------
                                                                            Number of   Avg. burden/    Total   
                         Respondents                           Number of    responses/    response    burden (in
                                                              respondents  respondents   (in hrs.)      hrs.)   
----------------------------------------------------------------------------------------------------------------
General Public..............................................          300            1        .1666           50
                                                             ---------------------------------------------------
      Total.................................................  ...........  ...........  ...........           50
----------------------------------------------------------------------------------------------------------------

    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