Unauthorized Access to Data: There is a possibility of an unauthorized party gaining access to secure PHI contained in the database. This is also a low risk, and several precautions have been implemented to minimize unauthorized access. First, reports from participants’ records concerning research observations will not be made available to outside medical facilities without the written consent of the participant. All data obtained from research interviews and the laboratory will be coded. The data will be secured and accessible only to authorized research personnel. Only study numbers will appear on specimens, data and documents used for evaluation or statistical analysis. In addition, any publications resulting from this research will not identify individual participants.
Risk of Chest X-ray: This involves a small amount of radiation. The chest x-ray will be carried out on one occasion. The above radiation exposure is not necessary for medical care and is for research purposes only. This use involves minimal risk and is necessary to obtain the research information desired.
To put your estimated effective dose in perspective, the radiation that you will get for this research study will be less than the average person in the United States receives each year from natural sources (sun, outer space, air, food, and soil) and medical procedures. Based on these calculations, the risk from the radiation exposure in this research study is very small
Risk of Blood Draw: Risks associated with drawing blood include momentary discomfort and/or bruising. Infection, excess bleeding, clotting, dizziness or fainting are also possible, although unlikely.
Risks/discomforts to questionnaires: While there are no apparent risks from the questionnaires some questions may be uncomfortable for some individuals. Any questions that are uncomfortable to answer may be skipped. However, if the questions being skipped are used to determine eligibility, then the individual will not be allowed to participate in the study due to safety concerns.
Risk of Intravenous Catheter: Insertion of the intravenous catheter (IV needle) into the arm involves the same risks as drawing blood, but the participant may also experience discomfort from having the catheter taped to their arm. In about 10% of cases, a small amount of bleeding under the skin will produce a bruise (hematoma). The risk of temporary clotting of the vein (from the IV) is about 1%, while the risk of infection of a hematoma or significant blood loss is less than 1 in 1000. Rarely there can be a severe infection of the blood stream or the heart valves or the formation of a blood clot that could go to the lungs. Complications are unlikely but treatment could require hospitalization. The IV catheter will be in place for approximately 4 hours.
Risk of Spirometry: The participant may become short of breath or experience dizziness due to requiring some exertion. To limit discomfort, the participant will be instructed to wear loose clothing and avoid eating for 12hrs before their scheduled visit.
Risks of Nasal Brushing: Risks associated with nasal brushing procedure include feeling a local burning with eye tearing, rarely local bleeding.
Risk of bronchoscopy: The participant may experience temporary coughing, vocal cord and bronchial spasms (airway narrowing), gagging, vomiting, fever, soreness of the throat or the procedure may involve a risk that is currently unforeseeable as a result of the bronchoscopy. More serious complications resulting in hospitalization or death can occur, but are extremely rare. There is also a risk of aspiration if the participant eats or drinks before the effects of the lidocaine have worn off. With the review of bronchoscopies performed, the overall rate of complications is 15% for any type of complication (including minor complications such as coughing or sore throat) with a 5% risk for serious complications that may require further evaluation and medication. Appropriate treatment will be given if adverse events occur.
Risk of endobronchial biopsy: There is a risk of minor bleeding from the biopsy site. This may occur in up to 10% of the cases. The participant may expectorate blood-tinged sputum for 24 hours after the procedure as a result of minor trauma to the airway lining.
Risk of bronchoalveolar lavage: Pulmonary lavage may result in complications such as a fever, lung infection (pneumonia), a collapse of a small segment of the lungs at the lavage site (atelectasis), sharp chest pain and/or fever, vocal cord and bronchial spasms, and difficulty breathing. The study team follow up with the participant for several days after the procedure to monitor any complications that may arise. Should complications occur, the participant will be instructed visit the hospital and/or their primary care physician.
Risk of endobronchial brushing: There is a risk of minor bleeding from the brushing site. This may occur in up to 10% of the cases. The participant may cough up some blood for 24 hours after the procedure as a result of minor trauma to the airway lining which may occur. For the small airway brushings, the research team uses X-ray guidance which will expose the participant with a small amount of radiation. This risk is minimal and is necessary to obtain the research information desired.
Risk of sedation: The administration of a sedative medication may pose risks, such as problems with breathing, low blood pressure, heart rate, allergic reactions or, rarely, hospitalization or death. Also, sedation may cause temporary side effects including drowsiness, shaking, chills, dizziness, unsteadiness or forgetfulness. Appropriate monitoring equipment and medications will be used to promptly identify and manage complications if they occur. The participant will be instructed to not drive or make important decisions for 24 hours following the sedative medications. The participant will need to have someone escort them home. This will be explained to them prior to scheduling visit 2, the bronchoscopy procedure.
Risk of loss of private information: this risk always exists, but the study will implement strict study procedures to minimize this risk.
Group Risks: Although identifiable information is not shared to other investigators or entity, basic information such as race, ethnic group, and sex may be shared. This information helps investigators determine factors (if any) that lead to health problems between different groups of people. It is possible that such findings could be beneficial to certain groups of people. However, this could also be used to support harmful stereotypes or discrimination.
Risk of genetics: Because genetic information is unique to an individual, there is a small chance that it can be traced back to a specific person. The risk of this happening is very small but may grow in the future. Since the database will contain this genetic information, a break in security may also pose a potential risk to the participant’s blood relatives. For example, it could be used to make it harder for you (or a relative) to get or keep a job or medical insurance. If this information is breached or misused, it is possible you would experience other harms, such as stress, anxiety, stigmatization, or embarrassment from revealing information about family relationships, ethnic heritage, or health conditions.
Subjects will not be identified on any study reports. Mount Sinai firewalls, multiple passwords, and encryption programs protect the security of the electronic data entry system, which will be housed on a highly secure university server. All computers are located in lockable offices and are accessible only by frequently changed passwords. Identifiable information that could directly identify a participant (based on any single 18 HIPAA identifier/ or any combination of information that could lead back to an individual) will only be accessed by the study team. All study members requiring access to identifiable information will undergo study onboarding training which will involve an overview of the entire protocol, and the standard operating procedures applicable to their role.
The study team will closely safeguard participant privacy regarding protected health and personal information. A study ID number will be generated at the time of consent and will be maintained in a secure file (e.g., linker file) which will contain the participant’s name and date of birth. Further telephone numbers, addresses, and other study related data will be stored securely and only accessible by delegated study team members.
Participant Death While in Study
While it is not anticipated that a participant will pass away given that this study is targeting healthy individuals, death may occur. If a participant passes away, information regarding their death will be collected by the study team to the best of their ability and immediately reported to the IRB as a serious adverse event. Information collected may include:
Date of Death
Cause of Death
Location of Death
If an individual states that they wish to drop out, the study team will respect that as well. A follow-up question may be asked to ascertain the reason for withdrawing; however, this is for documentation purposes only and will serve to make any improvements, if necessary, to the study procedures. Additionally, the study and/or site PI retain the right to withdraw the participant from the study if they feel that participation is no longer in the participant’s best interest and/or the participant is non-compliant despite numerous attempts to contact by the study team.
This project will not enroll individuals from vulnerable populations (e.g., imprisoned, pregnant, mental disabilities); however, it will recruit Mount Sinai Employees and students (except for employees and students under the direct supervision of the study team)