Patient Input Questionnaire

Patient Guide to Input

We want to hear from you

When starting a new report, we have a lot of questions. What treatments should we include? What outcomes should we consider? What are we missing? We need help answering these questions. We look to all kinds of groups- doctors, drug makers, insurance companies, and, importantly, patients—to help us fill in the gaps.

That’s where you come in. By providing us with information about how patients experience their disease and what is most important to them, you help us to make sure we’re thinking about these issues from the very beginning. It’s important to us that we know what matters to you—the patient—to make sure our reports can support policies and guidelines that help make sure patients can access, and afford, the most effective treatments.

Sending your input

The questions below can help give you an idea of what kinds of information are most helpful to our reports.  Anything you can tell us about your experience is very helpful and important in helping us create a useful report.

  • To give us time to consider your input, we’ll need to receive your answers by the draft scope, revised scope, or draft evidence report deadline. You can find the deadlines here.
  • Use the below form to submit your responses directly, or email your responses, and any other information or documents, to publiccomments@icer-review.org. We’ll confirm that we’ve received it.

ICER’s Patient Input Questionnaire is for patients, their families, caregivers, and patient advocacy groups. Please feel free to answer any question that applies to you and to skip the ones that don’t. ICER does not publicly post responses to this survey but will describe the input we receive anonymously in our reports. ICER uses your feedback to guide specific components of our review, including the types of evidence we look for. You may see this referred to as “PICOTS” in our scoping documents. This stands for:

  • Populations (people),
  • Interventions (treatments of interest),
  • Comparators (other available treatments),
  • Outcomes (benefits and harms),
  • Timing (length of study), and
  • Settings (where care is given).

Responses also inform the sections of our report about the patient experience and aspects of the treatment or disease that may not be described in available clinical evidence.

You acknowledge that you are not required to provide information to ICER and that you are doing so voluntarily.  Please see our Terms of Use and Conditions and our Privacy Policy to review how we use and disclose information submitted to us.  While we do not plan to publish information that identifies a particular individual, we intend to use the information submitted as part of our drug reviews.  We recognize that submissions sometimes contain specific medical information that might raise concerns about appropriateness of treatment, physical or mental health, and safety.  The use of this site, and information submitted to ICER, should not take the place of professional medical care.  ICER does not diagnose health problems or provide treatment advice.  The completion of this questionnaire does not trigger any patient-provider relationship.  Any information found on this site, or inferred from this survey, should in no way be considered medical advice or a plan for health management.  Anyone seeking or needing immediate medical treatment is advised to contact their health care provider or visit an emergency room.