AOSpine RECODE-DCM Study

Participant Registration Form

Principal Investigators: Mark R. Kotter and Benjamin M. Davies.

You are registering to participate in RECODE-DCM, a consensus project to define the key research questions and measurements in degenerative cervical myelopathy (DCM).

Degenerative cervical myelopathy (DCM) is an umbrella term for cervical spinal cord compression and dysfunction from spinal stenosis due to degeneration of the cervical spine (bone, joints, discs or ligaments). This includes cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament.


You are participating as an expert in DCM because you treat those affected. This consensus process will start with a DELPHI survey, to inform an eventual face-to-face consensus meeting. To reduce your time commitment, you will be randomly allocated to a subsection of this project. All those who contribute to any subsection of this process and wish to be acknowledged, will be acknowledged on all published output. Further information can be found in the published protocol and participation information sheet.

Which of these best describes your experience of DCM?

Job title

(including grade)

Hospital and/or university affiliation

First Name


Last Name


Biological sex

Age

Preferred email address

Country of residence

On average, how many people with DCM do you encounter every year as part of your clinical practice?

For how many years have your managed people with DCM?

Do you plan on attending the Cervical Spine Research Society Annual Meeting in New York, 21st 23rd November 2019?

I would like to to be acknowledged as a contributor to RECODE on any published material

After completing ALL rounds of the online survey, I would be interested in being contacted about attending the RECODE-DCM international face-to-face consensus meetings:

I would like to be contacted about other DCM research:

I confirm that I have read the Conflict of Interest Information Sheet and hereby declare any conflicts of interest I may hold (e.g. competing professional or financial interests, or any other factor that may influence my responses):

I confirm that I have read the Participant Information Sheet including details of the management of my personal data and risks/benefits. I have had the opportunity to consider the information and ask any questions I may have. I understand that my participation is voluntary and that I am free to withdraw at any time without giving any reason, without my legal rights being affected. I hereby consent to be a RECODE-DCM study participant:


For more information, please see our study website:
www.recode-dcm.com

If you have any questions or concerns, please contact us via email:
admin@recode-dcm.com

If you are upset or concerned following completion of the survey, support is available from our charity partner:
www.myelopathy.org

 
 
 
 
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