Federal Register / Vol. 79, No. 170 / Wednesday, September 3, 2014 / Notices 52337 

The Supplemental Draft EIS is being 

prepared to address substantial changes 

to the proposed action that are relevant 

to environmental concerns, as required 

under NEPA (40 CFR 1502.9), and will 

assess any new circumstances or 

information relevant to potential 

environmental impacts. The 

Supplemental Draft EIS will incorporate 

by reference and build upon the 

analyses presented in the 2012 Draft 

EIS, and will document the Section 106 

process under the National Historic 

Preservation Act of 1966, as amended 

(36 CFR Part 800). 

GSA will prepare the Supplemental 

Draft EIS in cooperation with DOS, 

United States Army Corps of Engineers, 

United States Environmental Protection 

Agency, and National Guard Bureau. 

Dates and Addresses: A public 

scoping period and public scoping 

meeting for the proposed action were 

held in October 2011. However, the 

public may submit comments 

concerning the proposal for 30 days 

from the date of this notice. Written 

comments may be mailed to Abigail 

Low, GSA Project Manager 20 N 8th 

Street, Philadelphia, PA 19107, or may 

be sent via email to FASTC.info@

gsa.gov. More information on the 

proposed FASTC program is available at 

www.state.gov/recovery/fastc. 

Future notices will be published to 

announce the availability of the 

Supplemental Draft EIS and additional 

opportunities for public input. 

FOR FURTHER INFORMATION CONTACT: 

Abigail Low, GSA Project Manager; 20 

N 8th Street, Philadelphia, PA 19107 

(215) 446–4815, FASTC.info@gsa.gov. 

SUPPLEMENTARY INFORMATION: 

Background: The purpose of the 

proposed FASTC at Fort Pickett is to 

consolidate existing dispersed hardskills training functions into a single 

suitable location to improve training 

efficiency and enhance training 

operations. The proposed FASTC is 

needed to establish a facility from 

which DOS Bureau of Diplomatic 

Security may conduct a wide array of 

hard-skills security training to meet the 

increased demand for well trained 

personnel serving at embassies overseas 

and select foreign partners. 

Fort Pickett and Nottoway County’s 

LRA area in Nottoway County near 

Blackstone, Virginia was selected as a 

potential site in July 2011, and a Draft 

EIS was released in October 2012. In 

early 2013, the Administration 

indicated all efforts and work at the 

proposed site in Fort Pickett Army 

National Guard Maneuver Training 

Center and Nottoway County’s LRA area 

should be put on hold pending 

additional due diligence and reviews at 

an existing training site in Georgia. As 

part of the due diligence effort requested 

by the Administration, DOS conducted 

site visits to the Federal Law 

Enforcement Training Center (FLETC) in 

Glynco, Georgia. During this time 

period, DOS assessed the scope and size 

of the FASTC project and determined a 

smaller platform at Fort Pickett was 

more fiscally prudent. 

In April 2014, the Administration reaffirmed the earlier DOS selection of the 

FASTC proposed sites in Fort Picket 

Army National Guard Maneuver 

Training Center and the Nottoway 

County LRA area at a reduced scope of 

requirements. The project will proceed 

as a hard-skills only facility. 

Based on adjustments made to the 

proposed FASTC Program, DOS has 

undertaken the preparation of a Master 

Plan Update that modifies the previous 

alternatives evaluated in the 2012 Draft 

EIS. The Master Plan Update concept 

will be evaluated as Build Alternative 3 

in the Supplemental Draft EIS. The 

alternatives to be fully evaluated in the 

Supplemental Draft EIS include the No 

Action Alternative and Build 

Alternative 3. 

The proposed location of Build 

Alternative 3 includes three adjacent 

land parcels: Fort Pickett Parcels 21/20 

and Grid Parcel, and Nottoway County 

LRA Parcel 9. 

The Supplemental Draft EIS will 

assess potential impacts that may result 

from the modified alternative, 

including, air quality, noise, land use, 

socioeconomics, traffic, infrastructure 

and community services, natural 

resources, biological resources, cultural 

resources, and safety and environmental 

hazards. The analysis will evaluate 

direct, indirect, and cumulative 

impacts. Relevant and reasonable 

measures that could avoid or mitigate 

environmental effects will also be 

analyzed. Additionally, GSA will 

undertake any consultations required by 

applicable laws or regulations, 

including the National Historic 

Preservation Act. 

No decision will be made to 

implement any alternative until the 

NEPA process is completed and a 

Record of Decision is signed. 

Dated: August 19, 2014. 

Myles Vaughan, 

NEPA Program Manager, Facilities 

Management & Services Programs Division, 

U.S. GSA, Mid-Atlantic Region. 

[FR Doc. 2014–20902 Filed 9–2–14; 8:45 am] 

BILLING CODE 6820–89–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Scientific Information Request on 

Diagnosis of Gout 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ), HHS. 

ACTION: Request for Scientific 

Information Submissions. 

SUMMARY: The Agency for Healthcare 

Research and Quality (AHRQ) is seeking 

scientific information submissions from 

the public. Scientific information is 

being solicited to inform our review of 

Diagnosis of Gout, which is currently 

being conducted by the Evidence-based 

Practice Centers for the AHRQ Effective 

Health Care Program. Access to 

published and unpublished pertinent 

scientific information will improve the 

quality of this review. AHRQ is 

conducting this systematic review 

pursuant to Section 1013 of the 

Medicare Prescription Drug, 

Improvement, and Modernization Act of 

2003, Public Law 108–173, and Section 

902(a) of the Public Health Service Act, 

42 U.S.C. 299a(a). 

DATES: Submission Deadline on or 

before October 3, 2014. 

ADDRESSES: Online submissions: http:// 

effectiveheathcare.AHRQ.gov/index.

cfm/submit-scientific-informationpackets/. Please select the study for 

which you are submitting information 

from the list to upload your documents. 

Email submissions: SIPS@epc-src.org. 

Print submissions: 

Mailing Address: Portland VA 

Research Foundation, Scientific 

Resource Center, ATTN: Scientific 

Information Packet Coordinator, PO Box 

69539, Portland, OR 97239. 

Shipping Address (FedEx, UPS, etc.): 

Portland VA Research Foundation, 

Scientific Resource Center, ATTN: 

Scientific Information Packet 

Coordinator, 3710 SW U.S. Veterans 

Hospital Road, Mail Code: R&D 71, 

Portland, OR 97239. 

FOR FURTHER INFORMATION CONTACT: 

Ryan McKenna,Telephone: 503–220– 

8262 ext. 58653 or Email: SIPS@epcsrc.org. 

SUPPLEMENTARY INFORMATION: The 

Agency for Healthcare Research and 

Quality has commissioned the Effective 

Health Care (EHC) Program Evidencebased Practice Centers to complete a 

review of the evidence for Diagnosis of 

Gout. 

The EHC Program is dedicated to 

identifying as many studies as possible 

mstockstill on DSK4VPTVN1PROD with NOTICES

52338 Federal Register / Vol. 79, No. 170 / Wednesday, September 3, 2014 / Notices 

that are relevant to the questions for 

each of its reviews. In order to do so, we 

are supplementing the usual manual 

and electronic database searches of the 

literature by requesting information 

from the public (e.g., details of studies 

conducted). We are looking for studies 

that report on Diagnosis of Gout, 

including those that describe adverse 

events. The entire research protocol, 

including the key questions, is also 

available online at: http://effective

healthcare.ahrq.gov/search-for-guidesreviews-and-reports/?pageaction=

displayproduct&productID=1937. 

This notice is to notify the public that 

the EHC Program would find the 

following information on Diagnosis of 

Gout helpful: 

• A list of completed studies that 

your organization has sponsored for this 

indication. In the list, please indicate 

whether results are available on 

ClinicalTrials.gov along with the 

ClinicalTrials.gov trial number. 

• For completed studies that do not 

have results on ClinicalTrials.gov, 

please provide a summary, including 

the following elements: study number, 

study period, design, methodology, 

indication and diagnosis, proper use 

instructions, inclusion and exclusion 

criteria, primary and secondary 

outcomes, baseline characteristics, 

number of patients screened/eligible/ 

enrolled/lost to followup/withdrawn/ 

analyzed, effectiveness/efficacy, and 

safety results. 

• A list of ongoing studies that your 

organization has sponsored for this 

indication. In the list, please provide the 

ClinicalTrials.gov trial number or, if the 

trial is not registered, the protocol for 

the study including a study number, the 

study period, design, methodology, 

indication and diagnosis, proper use 

instructions, inclusion and exclusion 

criteria, and primary and secondary 

outcomes. 

• Description of whether the above 

studies constitute ALL Phase II and 

above clinical trials sponsored by your 

organization for this indication and an 

index outlining the relevant information 

in each submitted file. 

Your contribution will be very 

beneficial to the EHC Program. The 

contents of all submissions will be made 

available to the public upon request. 

Materials submitted must be publicly 

available or can be made public. 

Materials that are considered 

confidential; marketing materials; study 

types not included in the review; or 

information on indications not included 

in the review cannot be used by the EHC 

Program. This is a voluntary request for 

information, and all costs for complying 

with this request must be borne by the 

submitter. 

The draft of this review will be posted 

on AHRQ’s EHC Program Web site and 

available for public comment for a 

period of 4 weeks. If you would like to 

be notified when the draft is posted, 

please sign up for the email list at: 

http://effectivehealthcare.AHRQ.gov/ 

index.cfm/join-the-email-list1/. 

The systematic review will answer the 

following questions. This information is 

provided as background. AHRQ is not 

requesting that the public provide 

answers to these questions. The entire 

research protocol is also available 

online at: http://effectivehealthcare.

ahrq.gov/search-for-guide-reviews-andreports/?pageaction=displayproduct&

productID=1937. 

Key Questions 

Key Question 1 

• What is the accuracy of clinical 

signs and symptoms and other 

diagnostic tests (such as serum uric 

acid, ultrasound, CT scan, DECT, and 

plain x-ray), alone or in combination, 

compared to synovial fluid analysis in 

the diagnosis of acute gouty arthritis, 

and how does the accuracy affect 

clinical decision making, clinical 

outcomes and complications, and 

patient centered outcomes? 

• How does the diagnostic accuracy 

of clinical signs and symptoms and 

other tests vary by affected joint site and 

number of joints? 

• Does the accuracy of diagnostic 

tests for gout vary by duration of 

symptoms (i.e., time from the beginning 

of a flare) 

• Does the accuracy of synovial fluid 

aspiration and crystal analysis differ by 

i) the type of practitioner who is 

performing the aspiration and ii) the 

type of practitioner who is performing 

the crystal analysis? 

Key Question 2 

What are the adverse effects 

associated with each diagnostic test 

(including pain, infection at the 

aspiration site, radiation exposure) or 

harms (related to false positives, false 

negatives, indeterminate results) 

associated with tests used to diagnose 

gout? 

PICOTS (Population, Intervention(s), 

Comparator, Outcome, Timing, Setting) 

Population(s) (KQ1 and 2) 

• Adults (18 years and over) presenting 

with symptoms (e.g., an acute 

episode of joint inflammation) 

suggestive of gout, including the 

following subgroups: 

Æ Male and female patients 

Æ Older (65 and over) and younger 

patients 

Æ Patients with comorbidities 

including hypertension, type 2 

diabetes, kidney disease (renal 

insufficiency) 

Æ Patients with osteoarthritis, septic 

arthritis, or previous joint trauma 

Æ Individuals with a family history of 

gout 

Interventions (KQ1, 2) 

• Clinical history and physical exam 

• Serum uric acid assessment 

• US 

• DECT 

• Plain x-ray 

• Joint aspiration by physicians and 

synovial fluid analysis using 

polarizing microscopy (by 

physicians or laboratory personnel) 

• Combinations of these tests as 

identified in the literature 

Comparators 

• Joint synovial fluid aspiration and 

microscopic assessment for 

monosodium urate crystals (KQ1a– 

c, 2) 

• Joint synovial fluid aspiration and 

microscopic assessment for 

monosodium urate crystals as 

performed by a practitioner with a 

different level of expertise or 

experience, e.g. rheumatologist, 

laboratory personnel (KQ1d) 

Outcomes 

• Diagnostic accuracy of clinical signs 

and symptoms, US, DECT, plain 

radiographs compared with joint 

aspiration and synovial fluid 

analysis (KQ1) 

Æ Sensitivity/specificity, true 

positives/true negatives, area under 

the curve 

Æ Positive, negative predictive value, 

positive/negative likelihood ratios 

(if prevalence known) 

• Clinical decisionmaking 

Æ Additional testing 

Æ Pharmacologic/dietary management 

• Intermediate outcomes 

Æ sUA 

Æ Synovial fluid crystals 

Æ Radiographic or US changes 

• Clinical outcomes 

Æ Pain, joint swelling and tenderness 

Æ Patient global assessment, and 

activity limitations (KQ1,2) 

• Adverse effects of the tests, including 

Æ Pain, infection, radiation exposure 

Æ Effects of false positive or false 

negative (KQ2) 

Timing 

• For clinical outcomes of symptom 

relief: 1–2 days minimum (KQ1) 

• Early in a flare vs. later or post-flare 

(KQ1c) 

mstockstill on DSK4VPTVN1PROD with NOTICES

Federal Register / Vol. 79, No. 170 / Wednesday, September 3, 2014 / Notices 52339 

• For adverse events: immediate 

Settings 

• Primary care (outpatient) or acute care 

setting, preferentially 

• Outpatient rheumatology practices/

academic medical centers 

Dated: August 26, 2014. 

Richard Kronick, 

AHRQ Director. 

[FR Doc. 2014–20689 Filed 9–2–14; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Scientific Information Request on 

Emerging Approaches To Diagnosis 

and Treatment of Non-Muscle-Invasive 

Bladder Cancer 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ), HHS. 

ACTION: Request for Scientific 

Information Submissions. 

SUMMARY: The Agency for Healthcare 

Research and Quality (AHRQ) is seeking 

scientific information submissions from 

the public. Scientific information is 

being solicited to inform our review of 

Emerging Approaches to Diagnosis and 

Treatment of Non-Muscle-Invasive 

Bladder Cancer, which is currently 

being conducted by the Evidence-based 

Practice Centers for the AHRQ Effective 

Health Care Program. Access to 

published and unpublished pertinent 

scientific information will improve the 

quality of this review. AHRQ is 

conducting this systematic review 

pursuant to Section 1013 of the 

Medicare Prescription Drug, 

Improvement, and Modernization Act of 

2003, Public Law 108–173, and Section 

902(a) of the Public Health Service Act, 

42 U.S.C. 299a(a). 

DATES: Submission Deadline on or 

before October 3, 2014. 

ADDRESSES: Online submissions: http:// 

effectivehealthcare.AHRQ.gov/

index.cfm/submitscientific-informationpackets/. Please select the study for 

which you are submitting information 

from the list to upload your documents. 

Email submissions: SIPS@epc-src.org. 

Print submissions: 

Mailing Address: Portland VA 

Research Foundation, Scientific 

Resource Center, ATTN: Scientific 

Information Packet Coordinator, PO Box 

69539, Portland, OR 97239. 

Shipping Address (FedEx, UPS, etc.): 

Portland VA Research Foundation, 

Scientific Resource Center, ATTN: 

Scientific Information Packet 

Coordinator, 3710 SW U.S. Veterans 

Hospital Road, Mail Code: R&D 71, 

Portland, OR 97239. 

FOR FURTHER INFORMATION CONTACT: 

Ryan McKenna, Telephone: 503–220– 

8262 ext. 58653 or Email: SIPS@epcsrc.org. 

SUPPLEMENTARY INFORMATION: The 

Agency for Healthcare Research and 

Quality has commissioned the Effective 

Health Care (EHC) Program Evidencebased Practice Centers to complete a 

review of the evidence for Emerging 

Approaches to Diagnosis and Treatment 

of Non-Muscle-Invasive Bladder Cancer. 

The EHC Program is dedicated to 

identifying as many studies as possible 

that are relevant to the questions for 

each of its reviews. In order to do so, we 

are supplementing the usual manual 

and electronic database searches of the 

literature by requesting information 

from the public (e.g., details of studies 

conducted). We are looking for studies 

that report on Emerging Approaches to 

Diagnosis and Treatment of NonMuscle-Invasive Bladder Cancer, 

including those that describe adverse 

events. The entire research protocol, 

including the key questions, is also 

available online at: http://

effectivehealthcare.AHRQ.gov/searchfor-guides-reviews-and-reports/

?pageaction=displayproduct&product

ID=1941. 

This notice is to notify the public that 

the EHC Program would find the 

following information on Emerging 

Approaches to Diagnosis and Treatment 

of Non-Muscle-Invasive Bladder Cancer 

helpful: 

• A list of completed studies that 

your organization has sponsored for this 

indication. In the list, please indicate 

whether results are available on 

ClinicafTrials.gov along with the 

ClinicalTrials.gov trial number. 

• For completed studies that do not 

have results on ClinicalTrials.gov, 

please provide a summary, including 

the following elements: Study number, 

study period, design, methodology, 

indication and diagnosis, proper use 

instructions, inclusion and exclusion 

criteria, primary and secondary 

outcomes, baseline characteristics, 

number of patients screened/eligible/

enrolled/lost to follow-up/withdrawn/

analyzed, effectiveness/efficacy, and 

safety results. 

• A list of ongoing studies that your 

organization has sponsored for this 

indication. In the list, please provide the 

ClinicalTrials.gov trial number or, if the 

trial is not registered, the protocol for 

the study including a study number, the 

study period, design, methodology, 

indication and diagnosis, proper use 

instructions, inclusion and exclusion 

criteria, and primary and secondary 

outcomes. 

• Description of whether the above 

studies constitute ALL Phase II and 

above clinical trials sponsored by your 

organization for this indication and an 

index outlining the relevant information 

in each submitted file. 

Your contribution will be very 

beneficial to the EHC Program. The 

contents of all submissions will be made 

available to the public upon request. 

Materials submitted must be publicly 

available or can be made public. 

Materials that are considered 

confidential; marketing materials; study 

types not included in the review; or 

information on indications not included 

in the review cannot be used by the EHC 

Program. This is a voluntary request for 

information, and all costs for complying 

with this request must be borne by the 

submitter. 

The draft of this review will be posted 

on AHRQ’s EHC Program Web site and 

available for public comment for a 

period of 4 weeks. If you would like to 

be notified when the draft is posted, 

please sign up for the email list at: 

http://effectivehealthcare.AHRO.gov/

index.cfm/join-the-email-list1/. 

The systematic review will answer the 

following questions. This information is 

provided as background. AHRQ is not 

requesting that the public provide 

answers to these questions. The entire 

research protocol, is also available 

online at: http://effectivehealth

care.AHRO.gov/search-for-guidesreviews-and-reports/

?pageaction=displayproduct&productID

=1941. 

The Key Questions 

Key Question 1 

What is the diagnostic accuracy of 

various urinary biomarkers compared 

with other urinary biomarkers or 

standard diagnostic methods 

(cystoscopy, cytology, and imaging) in 

(1) persons with signs or symptoms 

warranting evaluation for possible 

bladder cancer or (2) persons 

undergoing surveillance for previously 

treated bladder cancer? 

• Does the diagnostic accuracy differ 

according to patient characteristics (e.g., 

age, sex, ethnicity), or according to the 

nature of the presenting signs or 

symptoms? 

Key Question 2 

For patients with non-muscleinvasive bladder cancer, does the use of 

a formal risk-adapted assessment 

approach to treatment decisions (e.g., 

mstockstill on DSK4VPTVN1PROD with NOTICES