Create eConsent document
An HTML document containing at least one coded consent statement needs to be uploaded in the “Consents” tab of a collection protocol. These consents are to be set up per CP.
Prerequisite
Coded consent statement should be defined in the “Consents” of the OpenSpecimen instance.
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title | Steps to add a coded consent statement: |
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From the navigation menu/home page, click on “Consents”
In the “Consents” tab, check whether the consent you want to use is already present
If not, click on “Create”
Input the consent code in the “Code” field and the consent statement in the “Statement” field. The statement needs to be a one-line crux of the consent. Then click on “Create”.
The consent statement will be visible in the “Consents” tab
A document describing the consent process and the detailed explanation of the consents is designed via HTML. Before that, identify the fields that the participant will be entering after he is done with reading the consent, for example, the e-signature, the full name as provided in identity proof, the date of signature etc.
Designing the document
We can break this into 3 steps:
Descriptive text
Consent statements
Participant information and other details
Descriptive text:
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Here’s a demo HTML file for reference. This is an example of an assent form for a minor.
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Descriptive part can be designed using any online HTML editor.
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Consent statement(s) are to be added after the descriptive text. You can add them in the form of dropdown, radio-button, checkbox. All these can be defined in the HTML.
Here’s how it would look in the document:
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Below is the code for defining the above consent statements in the consent document:
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<div style="padding: 8px 8px 8px 0px; border-top: 5px solid #ddd;">
<div class="clearfix" consent-question="C0001" style="padding: 8px 8px 8px 0px; border-bottom: 1px solid #ddd;">
<label class="control-label">
<span>Do you consent to participate in biobank activities?</span>
</label>
<div>
<label class="radio-inline">
<input type="radio" name="C0001" value="Y" ng-model="ectx.statements.C0001" required>
<span>Yes</span>
</label>
<label class="radio-inline">
<input type="radio" name="C0001" value="N" ng-model="ectx.statements.C0001" required>
<span>No</span>
</label>
</div>
<div os-field-error field="econsentForm.C0001"></div>
</div>
<div class="clearfix" consent-question="C0002" style="padding: 8px 8px 8px 0px; border-bottom: 1px solid #ddd;">
<label class="control-label">
<input name="C0002" type="checkbox" ng-model="ectx.statements.C0002" ng-true-value="'Y'" ng-false-value="'N'">
<span>I consent to store my specimens in long term storage for future research.</span>
</label>
</div>
<div class="clearfix" consent-question="C104" style="padding: 8px 8px 8px 0px; border-bottom: 1px solid #ddd;">
<label class="control-label">
<span>I consent to distribute my specimens to external institutes for future research.</span>
</label>
<div style="width: 10%">
<select name="C104" class="form-control" ng-model="ectx.statements.C104" required>
<option value="Y">Yes</option>
<option value="N">No</option>
</select>
</div>
<div os-field-error field="econsentForm.C104"></div>
</div> |
Participant infromation and other details
Once the description is done, consents are defined, the other participant related fields to be filled up can be added in the form. In order to add fields of different control types (like full name of the participant, e-signature of parent/guardian, date etc.), they first need to be added to a “Consent Custom Fields” form, which is attached at “Consent Document Custom Fields” level.
In order to add different control types to the custom form, refer this wiki page.
Here are a few pointers to keep in mind:
Refrain from adding repetitive controls to the form. For example, ‘participant name’ is the same as the ‘patient name’ is the same as the ‘full name of the participant’. One control can be used by changing the captions as needed in the HTML.
A single “Consent Custom Fields” form is maintained across the system and the fields from this form can be used across all CPs in the system. The relevant fields that are to be used in the consent document are to be defined in the consent HTML.
Once the fields have been added to the form, they have to be defined in the HTML to add it to the consent document.
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Info |
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You need to be well-versed with HTML to configure consent forms. The HTML files can be created manually or using online editors like this. In future versions, we plan to give a UI-based editor within OpenSpecimen to create the consent forms. |
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Introduction
eConsent Forms are configured at System level and it contains the following:
HTML text (Text formatting/Image source etc.)
Consent Statements
Custom fields (Text/Dropdowns/Signatures etc.)
Prerequisites
'Allowed File Types' setting
The system setting “Allowed File Types” should have ‘HTML’ as an allowed file type.
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Consent Statements
The consent statements are defined at a global level so that they can be reused across CPs. Go to Menu->Consents to define new consent statements. Refer to Coded Consents for more details.
Consent Response Code
A unique concept code for each consent response is mandatory. These codes are used in the consent HTML document for invoking the specific consent response. For example, “Y” for “Yes” response, “W” for “Withdrawn,” etc.
Make sure the concept code is unique for every response.
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Custom Fields
The consent form could have fields like consent witness, consent date, e-signatures, etc. These fields are to be added in a custom form attached to the “Consent Document Custom Fields” level. A single form is maintained for consent custom fields across the system to avoid duplicating fields across CPs and making it easy for reporting.
Refer to Create and Edit Formfor details on how to create a new form.
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Refrain from adding duplicate fields. For example, ‘participant name’ is the same as the ‘patient name’. |
Designing the Consent Form
The consent form is designed in HTML, since it gives us the flexibility of easy formatting. E.g. use of bullet points, use of text formatting like bold, underline, embed videos/photos, etc.
There are three sections in the consent form:
Formatted text
Header/Footer
Consent statements
Custom fields
Formatted HTML text
This section contains the consent text. For example:
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Consent Statements
Consent statement(s) can be added anywhere in the consent form. They can be displayed as a dropdown, radio-button, or checkbox.
For example:
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Custom Fields
Details such as signature, date of signature, etc. that were defined in the custom form (step 2 in the “Prerequisites”) can be displayed as below in the consent form.
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Headers and Footers
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Configure headers and footer for the consent document print file: To configure this, you need to set the print template in OpenSpecimen settings as below. You can set the logo, stamp on headers, and footer, including page numbers.
Example: PDF Example HTML code for the above document:
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Examples of Consent Form
Here’s the HTML for the above consent document: The HTML document has a below example of a consent statement, custom fields, signature, and date.
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Other Example
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In the consent HTML, the code for the ‘Consent Date’ field needs to be updated as below:
The ‘os-date-picker’ sets the value to the current date and the time picker allows the display of the current timestamp. 2. Add consent statement with the default value set and hidden on the overview page
3. Add custom field radio button "I Agree/I do not agree"
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Once this HTML is created, this is ready to be uploaded to the system.
Adding the consent document to the CP
Here is how you can upload the above-created consent document to the collection protocol:
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From the navigation menu, go to Collection Protocols list page > CP Overview > Consents tab This would lead you to the list page of the Cp level consents. Click on “Add” from the screen A pop-up appears for user to enter the name of the consent document in “Title” field, the version in “Revision” field and upload the HTML file in the “Document File” field. Click on “Add”.
4. Add custom field text-box
5. Add signature field
6. Add date as a custom field with default current date and non-editable
7. Add number custom field
8. Add OpenSpecimen PV-dropdown as a custom field site dropdown
9. Add custom field dropdown value with options
Complete Code Snippet:
10. Add print break in the consent document PDF: In the below example, the 'We may contact you….' line will be printed on the next page.
11. Show/hide field/section based on the other field selection Syntax: Needs to add the 'ng-show' tag to implement the show/hide logic
Example: When a user clicks on the “I agree to participate" option, the below section highlighted in red is enabled. Example HTML for the above example:
12. Mark consent statement non-editable with default selected.
13. Mark consent statement editable with default selected.
14. Default custom value with non-editable
15. Make field mandatory based on other field value Eg:1 - Make Guardian name custom field mandatory for Male patients.
Eg:2 - Make Guardian name custom field mandatory when site='
Eg:3 - Make Participant Signature(
16. Add File Type Control
17. Conditional field mandatory (File Type Field) Eg, The consent form has the participant’s signature, parent’s signature, and paper consent file (File type). Out of three fields, one of them needs to fill.
18. Change the caption for the Next and Previous button
19. Add Participant’s Information in the Consent document: Below is an example to display/print First Name and Last Name
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Upload Consent Document in OpenSpecimen
Users can upload consent documents in the Consents tab and can access those in the collection protocol. From v9.0, OpenSpecimen will allow using the same consent form in different CPs. The user who has. the access to the Consent can be uploaded or updated consent document in OpenSpecimen.
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Adding the Consent Document Form to a CP
Once the HTML is ready, you can upload it for a CP using the below steps.
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Updating a Consent Form
The title, version, and HTML content can be updated. It can be done by clicking the “Edit” icon from the consents list page.
From v9.1, OpenSpecimen will not allow updating the consent document if that is used with any patient.
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Consent Revision (Versioning)
A consent document can have multiple versions. When a new version is added, the new version is available for old and new participants. The data collected for older version remains in the database and is available for querying.
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Archiving Consent Form
If a version of a consent form is not needed, it can be archived. Once archived, the consent document is not available any more for consent response collection. However, if consent is already collected for that version, then it is available for viewing, editing, and reporting.
From v9.0, OpenSpecimen allows archiving the document at the system level and CP level. If the document is archived at the system level, the user won't be able to add that in new collection protocols, but if that document is already used in other CP will work without affecting anything.
Users also allow archiving the document in the collection protocol, and users won't be able to collect any responses for new patients.
System-Level Archive Option:
Navigates to Home → Consent → View Documents
Click on the Archive option
CP Level Archive Option:
Go to the Collection Protocol Overview Page → Consents tab
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Download Consent
The consent form’s HTML file can be downloaded and used to edit the form or upload it to another instance or another CP. This saves the re-work of designing the document from scratch.
Navigate to Home → Consent Card → View Documents → Click on the Download button below
Sort Consents
The order of consent documents can be changed using the “Sort” option. If no order is specified, the consent documents will appear in the order that they were added.
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Audit Trails for consent document
You can check the audit trails for the consent document. The audit trails show who updated the consent document and when.
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Navigate to Home Page → Consent Card → View Documents –> Click on the Audit Trail button |
Consents Validation
One or more validation rules can be added to ensure that specimens cannot be collected before the participant has consented. These validation rules are defined at a CP level.
To define validation rules:
Go to the CP Overview > Consents > Validations
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Click on “Add”.
Field | Description | Options |
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Statement | Coded consent statements | All the consent statements defined for the CP |
Match | Condition for the consent response |
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Response | Response of the consent statement | Any valid consent response. |
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The above rule is to allow collection when the response for C0001 is “Yes”. Click on “Add”.
Follow the above steps to add more than one consent.
In the validations list page, there is another match for multiple consents.
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ALL: It allows the collection of visits/specimens when ALL rules are true. Works like “AND” in the query.
ANY: It allows the collection of visit/specimens when ANY one of the rules is true. Works like “OR” in the query.
ADVANCED: This is used for creating a combination of rules using ‘and’ and ‘or’.
For example,
The below will be true if either (consent 1 is yes AND consent 2 is yes) OR consent 3 is yes.
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The expression in the box defines the rule which allows collection. It can be edited by clicking on “Edit”.
Consents Digests
OpenSpecimen provides two options to receive the consent digest, which described below. User will get receive the participants and consent document information who consented on that day(within 24hrs).
Site based Recipients? → No, The user has to specify a list of users and those users will get the consent digest email.
Site based Recipients? → Yes, The user has to specify a sites and user groups and those users from groups will receive the digest emails
What information is present in Digest Email?
The digest email has the information on the patient who consented on that day(24hrs) or who updated the consent document on that day for that patient along with the date. Furthermore, you can configure when to send the digest email, like Hourly, Monthly, Daily, On Demand etc.
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Digests Settings: Site based Recipients? → Yes Digests Settings: Site based Recipients? → No Digests Email Example: Digest email configuration: The user should have the super admin privilege to change the digest job settings as below.
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Reuse Participant Consents
At many centers, participant consents are registered or collected only once as per the IRB guidelines and reused in multiple studies.
From v10.3, A new setting has been added to the CP consents tab, this allows consent responses to be shared between multiple collection protocols, streamlining the consent management process.
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How to copy consents from another CP.
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Points to remember :
No new consent tiers or documents can be added in the receiver CP.
Consent responses cannot be added/updated via receiver CP registrations.
The participants' consent responses can be seen in the read-only mode in the receiver CPs with the option to print the consent document.
Since the consents for participants is copied to receiver CP, openspecimen users can distribute specimens collected for the receiver CP.