A Cost, Time, and Demographic Analysis of Participant Recruitment and Urine Sample Collection Through Social Media Optimization
2022; Lippincott Williams & Wilkins; Volume: 9; Issue: 6 Linguagem: Inglês
10.1097/upj.0000000000000339
ISSN2352-0787
AutoresPrasun Sharma, Laura E. Lamb, Sarah N. Bartolone, Elijah Ward, Joseph Janicki, Kenneth M. Peters, Nitya Abraham, Melissa Laudano, Christopher P. Smith, Bernadette Zwaans, Michael B. Chancellor,
Tópico(s)Mobile Health and mHealth Applications
ResumoOpen AccessUrology PracticeBusiness1 Nov 2022A Cost, Time, and Demographic Analysis of Participant Recruitment and Urine Sample Collection Through Social Media Optimization Prasun Sharma, Laura E. Lamb, Sarah N. Bartolone, Elijah P. Ward, Joseph J. Janicki, Kenneth M. Peters, Nitya Abraham, Melissa Laudano, Christopher P. Smith, Bernadette Zwaans, and Michael B. Chancellor Prasun SharmaPrasun Sharma Oakland University William Beaumont School of Medicine, Rochester, Michigan , Laura E. LambLaura E. Lamb Oakland University William Beaumont School of Medicine, Rochester, Michigan , Sarah N. BartoloneSarah N. Bartolone Beaumont Health Spectrum Health System, Royal Oak, Michigan , Elijah P. WardElijah P. Ward Beaumont Health Spectrum Health System, Royal Oak, Michigan , Joseph J. JanickiJoseph J. Janicki Beaumont Health Spectrum Health System, Royal Oak, Michigan , Kenneth M. PetersKenneth M. Peters Beaumont Health Spectrum Health System, Royal Oak, Michigan , Nitya AbrahamNitya Abraham Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York , Melissa LaudanoMelissa Laudano Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York , Christopher P. SmithChristopher P. Smith Baylor College of Medicine, Houston, Texas Michael E. DeBakey VA Medical Center, Houston, Texas , Bernadette ZwaansBernadette Zwaans Beaumont Health Spectrum Health System, Royal Oak, Michigan Oakland University William Beaumont School of Medicine, Rochester, Michigan , and Michael B. ChancellorMichael B. Chancellor *Correspondence: Beaumont Health Spectrum Health System, Royal Oak, Michigan, 2811 W. 13 Mile Rd, Suite 505, Royal Oak, Michigan 48073 telephone: 412-721-4392; email address: E-mail Address: [email protected] Beaumont Health Spectrum Health System, Royal Oak, Michigan Oakland University William Beaumont School of Medicine, Rochester, Michigan View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000339AboutAbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Abstract Introduction: Clinical research can be expensive and time consuming due to high associated costs and/or duration of the study. We hypothesized that urine sample collection using online recruitment and engagement of research participants via social medial has the potential to reach a large population in a small timeframe, at a reasonable cost. Methods: We performed a retrospective cost analysis of a cohort study comparing cost per sample and time per sample for both online and clinically recruited participants for urine sample collection. During this time, cost data were collected based on study associated costs from invoices and budget spreadsheets. The data were subsequently analyzed using descriptive statistics. Results: Each sample collection kit contained 3 urine cups, 1 for the disease sample and 2 for control samples. Out of the 3,576 (1,192 disease + 2,384 control) total sample cups mailed, 1,254 (695 control) samples were returned. Comparatively, the 2 clinical sites collected 305 samples. Although the initial startup cost of online recruitment was higher, cost per sample for online recruited was found to be $81.45 compared to $398.14 for clinic sample. Conclusions: We conducted a nationwide, contactless, urine sample collection through online recruitment in the midst of the COVID-19 pandemic. Results were compared with the samples collected in the clinical setting. Online recruitment can be utilized to collect urine samples rapidly, efficiently, and at a cost per sample that was 20% of an in-person clinic, and without risk of COVID-19 exposure. Background Conducting a clinical research study can be expensive and time-consuming. The high cost and/or long duration of a study can delay bringing new diagnostics and therapy to patients and increase the cost of care to patients. Online recruitment of participants using social media (eg, Facebook, TikTok, Twitter, YouTube, etc) for at-home collection of urine samples has the potential to reduce the cost of participant acquisition and retention. A cost- and time-effective online recruitment technique, crowdsourcing, may also help research facilities with smaller budgets to maximize their findings.1 This is an especially appropriate adaptation during the COVID-19 pandemic, with limited hospital and clinic access. To our knowledge, no prior study has performed a detailed cost analysis of the use of online recruitment for urine sample collection. Our study engaged social media to recruit participants and collect urine samples with the goal of creating a noninvasive, rapid, and cost-effective diagnostic test for interstitial cystitis/bladder pain syndrome (IC/BPS) using urine-based biomarkers.2-4 IC/BPS currently has no diagnostic test and diagnosis is mostly based upon patient-reported symptoms and exclusion of other overlapping clinical presentations. We also collected urine samples from clinical sites to compare and evaluate the cost-effectiveness, efficiency, and demographic representation of online recruitment of participants versus in-clinic recruitment. This cost analysis study is a secondary goal to the primary objective of creating a cost-effective diagnostic test for IC/BPS. Materials and Methods Online Recruitment All study materials were approved by the Beaumont Health Institutional Review Board (IRB No. 2019-266) and participant consent was documented both in the clinic and online. We created a research study website that contained a study background, a link to the enrollment survey, shipping information videos, and frequently asked questions.5 A Health Insurance Portability and Accountability Act-compliant survey was created using SurveyMonkey to screen and enroll participants and collect the addresses to which a urine collection kit could be shipped. We partnered with the Interstitial Cystitis Association (ICA), a national IC/BPS patient advocacy group. The ICA sent emails to their members and links to the recruitment website were also circulated through their newsletters. Additionally, the ICA created and circulated social media posts on Instagram, Facebook, and TikTok to reach even more participants (Fig. 1).5 Figure 1. Social media advertisement created and posted by interstitial cystitis (IC)/bladder pain syndrome support group. The study was also directly advertised using Google Ads, with the keywords "IC," "IC/BPS," "interstitial cystitis," and "urology study." Finally, search engine optimization of the study webpage allowed users to easily find and directly signup for the study, as well as share it through email or social media applications.5 Once a potential IC/BPS participant had completed the enrollment survey, met enrollment criteria, and consented to participate, an at-home collection kit was prepared and shipped to them. Participants were instructed to find 2 other sample donors of similar age without a bladder disease health history to serve as control participants. Collection Kit and Mailing Urine sample collection kits were shipped through FedEx and contained a total of 3 boxes, 1 for the IC/BPS participant and 2 for control samples. Each box individually contained study information sheets, disease symptom surveys, a biohazard bag with absorbent material, a urine collection cup containing a room-temperature urine preservative (Norgen Biotek, Thorold, Ontario, Canada), and a pre-paid United States Postal Service return mailing envelope. The urine preservatives allowed the sample to be stored and shipped at ambient temperatures while also stabilizing proteins and nucleic acid and inactivating viruses and bacteria in the sample.6,7 All return boxes contained a nonreversible temperature recording label.7 The same demographic survey filled out by the IC/BPS participant during the initial enrollment was also included in the control boxes, along with disease symptom surveys. Disease symptoms surveys included the Interstitial Cystitis Symptom/Problem Index; the Overactive Bladder questionnaire; the Pelvic Pain, Urgency, and Frequency questionnaire; and the Visual Analogue Scale.5 Sample Collection and Return Shipping Instructions for collecting and returning the urine samples were provided in the kit. Participants were provided paper and online instructions to collect a midstream urine sample and place it in the biohazard bag containing the absorbent material. Next, they were instructed to place the sample and the completed survey in the provided return box and place the envelope in their mailbox. Clinic Sample Collection Participants were physically present at the clinical sites during routine clinical visits to donate urine samples. Recruitment, consent, sample collection, survey completion, and enrollment all happened on the same day. Cost Calculation Cost calculations are based on spending ledgers managed by the online recruitment team and budget invoices sent by the clinic sites. Total cost was calculated only up until the sample collection point. Sample processing cost was not included because both the online recruited and clinic recruited samples were processed together at the same lab using the same methodology and resources. Salaries of all paid staff on both clinic and online teams are calculated based on the percent effort of all the staff combined. Percent efforts for each staff were predetermined during the initial budgeting. Salaries were based on the percent effort reported by the employees during the period of the study. Demographic Analysis Participants self-reported their demographic data on the survey forms provided. Date of birth, age, gender, race, and ethnicity were listed in the survey. Veteran status of the participants was also requested in the survey but is not reported in this paper. The geographical locations of the participants were analyzed based on the returned sample shipping labels. Length of Sample Collection Analysis The online participant recruitment was initiated on September 10, 2020 and closed on December 20, 2020. During the period of just over 3 months, 1,254 IC/BPS and control samples from all 50 states were collected (Fig. 2). Total time spent on online recruitment was 5 months with 4 weeks spent on preparing the kits to ship out and 2 weeks receiving the kits that were mailed back, whereas a 12-month period was spent on clinic recruitment. Figure 2. Geographical distribution of urine samples received from online recruitment. Locations of the 2 clinical sample collection sites are also noted. Results After 3 months and 2 weeks from the first enrollment date, online sample collection was stopped with a total of 1,300 samples collected. Of 1,300, 46 urine samples were excluded due to not meeting the inclusion criteria. With the total accepted online sample of 1,254, we averaged 89.6 samples per week. In-clinic recruitment started at the same time; however, sample collection took longer due to a slower influx of participants. As of December 2021, 319 IC/BPS and control samples were collected at the 2 clinical sites combined. Of the 319 urine samples, 14 were excluded due to not meeting the inclusion criteria. With the total accepted clinic samples of 305, we averaged 5.9 samples per week. The first week of online recruitment had the highest number of enrolled participants with the highest sample return rate in the third week. There was a 2-week average turnaround time from initial online enrollment to sample return.5 The rate of enrollment and return tapered down slowly over time but peaked slightly at weeks 8 and 10 when the ICA sent reminder emails to participants. Enrollment at the clinical sites was at a steady rate with no major spikes or drops. Of the online recruited participants 94% identify as White, while 88% of clinic recruited participants identify as White. All other racial groups made up 6% of the online recruited and 13% of the clinic recruited; 12% of the total online recruited participants identify as Hispanic, whereas 49% of the clinic recruited participants identify as Hispanic (Table 1). Table 1. Demographics Parameters Between Online and Clinic Recruitment Demographics Online recruited Clinic recruited P value Total participants, No. 1,254 305 IC/BPS, No. (%) 559 (45) 251 (82) < .0001 Control, No. (%) 695 (55) 54 (18) < .0001 Age, mean±SD (range), y 48.5±16.71 (19-91) 50.62±12.7 (19-94) n.s. Males, No. (%) 418 (33) 96 (31) n.s. Females, No. (%) 836 (67) 209 (69) n.s. Race, No. (%) White 1,179 (94) 268 (88) n.s. African American 12 (<1) 4 (1.3) n.s. Asian 15 (1.2) 3 (1) n.s. Native American/American Indian/Alaskan Native 7 (<1) 4 (1.3) n.s. Mixed 20 (1.6) 4 (1.3) n.s. No Response Ethnicity, No. (%) 21 (1.7) 22 (7) n.s. Hispanic 152 (12) 151 (49) < .0001 Non-Hispanic 1,102 (88) 154 (51) < .0001 Abbreviations: IC/BPS, interstitial cystitis/bladder pain syndrome; n.s., not significant; SD, standard deviation. Mailing kits were purchased in bulk at $12 per kit. The cost of supplies for the online recruited samples is higher because the cost of mailing kits was mostly incurred by the online recruitment team and distributed to the clinical site. Salaries and benefits for the online recruitment team are calculated for the 5-month period when the collection was completed, whereas the clinic required employees to be present for the sample collection, hence the whole 12 months' salary is reported. Website development and Google Ads were managed in-house, so only website hosting, design, and advertisement costs were incurred. A total of $181.57 was spent on website design and development, and another $2,325 was spent on Google Ads. Social media promotions were designed and distributed by the ICA. All costs for social media promotion were included in the ICA's initial collaboration contract budget. Cost for the social media promotions and collaboration with the ICA was agreed upon with a lump sum of $6,500 (Table 2). Table 2. Cost Comparison Parameters Between Online and Clinic Recruitment Online recruited Clinic recruited Total samples, No. 1,254 305 Total cost, $ 102,081.32 121,432.00 Cost per sample, $ 81.45 398.14 Total supplies, $ Total mailing kit, $ Per mailing kit, $ 28,490.00 14,304.00 12 409.58 N/A N/A Salary and wages, $ 35,944.58 96,025.56 Fringe benefits, $ 10,064.17 24,996.84 Web development, $ 181.57 0 Google Ads, $ 2,325 0 Social media promotion, $ 6,500 0 Shipping, $ 18,576 180 Ship out per kit, $ Ship in per kit, $ 12 10 N/A N/A Abbreviation: N/A, not applicable. The shipping cost for each kit with 3 sample cups averaged $12. The return of individual samples and surveys was $10 each. If all 3 samples (1 IC/BPS and 2 controls) were returned, then the total cost of the shipping was $42. Not every participant was able to recruit control samples, so shipping costs were variable among different participants. Shipping costs incurred by the clinics were to send collected samples to the main processing lab. Bulk samples returned to the processing lab from the clinics were of varying numbers and at different times, so only the total cost of shipping at $180 is reported. The total cost spent on the online recruitment of IC/BPS and control participants was just over $102,081 with the return of 1,254 samples. On the other hand, 305 participants were recruited from a clinic costing $121,432. Thus, the cost per sample for clinic recruitment was $398.14, whereas the cost per sample for online recruitment was $81.45 (Table 2). Discussion The results of this study showed that contactless online recruitment of participants through social media and website search engine optimization is more cost and time effective than a traditional method of recruiting participants in-person at a clinic. Each sample collection kit contained 3 urine cups, 1 for the IC/BPS sample and 2 for control samples. Out of the 3,576 (1,192 IC/BPS + 2,384 control) total sample cups mailed, 1,254+695 control samples were returned within just over a 3-month period. The sample return rate for IC/BPS and controls were 46.9% and 29.1%, respectively. Comparatively, 2 busy health systems combined, managed to get a return of 305 samples in a 12-month time period. Online sample collection with a cost of $81.45 per sample proved to be 80% cheaper with a 70% faster return rate. Recruitment During Pandemic Recruiting and retaining clinical study participants is challenging. One 8-year review found that only a third of clinical trials were able to achieve their original recruitment targets in a time-effective manner.8 Another study of 114 trials in the UK demonstrated that only 31% met the initial goals of enrollment.9 Suboptimal recruitment and retention could lead to an extension of a study for a longer period of time, which in turn increases cost.10 Delayed study and increasing cost could risk biases among investigators and investors towards smaller studies with rapid turnaround time instead of a longer project.11 Additionally, financial constraints, lack of information, competing demands of time, and limited access to transportation make it difficult for some to participate in clinical studies.12,13 The COVID-19 pandemic made matters worse by halting sample collections at many clinical centers, often disrupting the workflow of scientific research studies.14 The risk of COVID-19 exposure, and logistical and staff restrictions made it more difficult to collect samples. Furthermore, the cost of operations for clinical studies was driven higher due to the need for disinfection and safety protocols.14 One survey reported 31% of clinical research study sites feared a complete closure due to participants' concerns over interacting with health care professionals as well as stay-at-home orders.15-17 Cost, Time, and Demographic Analysis The initial cost of online recruitment was higher due to the added cost of website development, advertisement campaigns, and social media promotions. Due to the rapid influx of enrollment and sample returns, the online recruitment campaign ended in 5 months. Salary and wages for the lab members were paid for those 5 months. On the other hand, clinic enrollment and recruitment were carried out for 12 months. Sample collection cups were purchased in bulk by the online recruitment team and distributed to the clinical sites. Thus, the supply cost is disproportionally high in the online recruitment budget. The shipping cost for online recruitment is higher due to the mailing kit being distributed throughout the country. Kits also included United States Postal Service return labels free of cost to the participants. Recruitment at in-person clinical sample collection sites is limited by their physical location. Through online recruitment we were able to recruit participants from all 50 states, virtually eliminating geographical bias in research studies. Utilizing online networks, we were able to reach participants who are historically excluded, at a fraction of the cost. Furthermore, there was no major difference in the quality of the urine samples collected online compared to the sample collected in the clinic. Of the samples collected online 3.5% did not meet the inclusion criteria because of exposure to high temperature, low volume, or lack of a completed survey. Likewise, 4.4% of the sample collected in the clinics did not meet the inclusion criteria for the same reasons. The majority of the discarded samples were either lacking the properly filled surveys or had a low volume due to spillage. Less than 1% were discarded due to temperature failure in the return kit. Study Strengths and Limitations Strengths of this study include our ability to initiate and complete the trial in the midst of COVID-19 pandemic by utilizing a contact-free sample collection method. A return of 29% of the control sample cups is a limitation of the online recruitment process. Of the online recruited participants 94% identified as White while 88% of the clinic recruited participants identified as White, which is consistent with IC/BPS population demographics.11,12 Only 6.5% of the online recruited participants identified as Hispanic. In contrast, 56% of the clinic recruited participants identified as Hispanic. This was because of the locations and demographic makeup of the 2 clinical sites in The Bronx, New York and Houston, Texas (Fig. 2).18-20 One important limitation of the study is that people without Internet access or the elderly, who are not as tech-savvy, could be excluded from online recruitment. This may also limit the underserved minorities disproportionately and remains an area that deserves further unbiased research. Conclusions In conclusion, we conducted a nationwide, contactless, urine sample drive through online participant recruitment in the midst of the COVID-19 pandemic. Results were compared with the samples collected in a traditional clinical setting. Online participant recruitment can be utilized to collect urine samples rapidly, efficiently, and at a cost-per-sample that was 20% of in an in-person clinic and without risk of COVID-19 exposure. Through website and social media optimization, research studies can expedite the recruitment and enrollment of participants. Extensive shipping options allow the cost of transporting biological samples in a safe and efficient manner. Utilizing this method of contact-free sample collection, we successfully recruited 1,254 IC/BPS and control participants in just over 3 months from all 50 United States. It allowed our research facility to maximize our budget and get a more efficient turnaround in our goal of developing a urine-based diagnostic test for IC/BPS. Acknowledgements We thank the interstitial cystitis community that contributed to this study and the Interstitial Cystitis Association (ICA; http://www.ichelp.org/) for assistance with participant recruitment and supporting IC research. References 1. . Crowdsourcing disease biomarker discovery research: the IP4IC study. J Urol. 2018; 199(5):1344-1350. Link, Google Scholar 2. . Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States. J Urol. 2011; 186(2):540-544. Link, Google Scholar 3. . The MAPP research network: a novel study of urologic chronic pelvic pain syndromes. BMC Urol. 2014; 14:57. Google Scholar 4. . The prevalence and overlap of interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome in men: results of the RAND Interstitial Cystitis Epidemiology male study. J Urol. 2013; 189(1):141-145. Link, Google Scholar 5. . Using social media to crowdsource collection of urine samples during a national pandemic. Int Urol Nephrol. 2022; 54(3):493-498. Google Scholar 6. . Emerging utility of urinary cell-free nucleic acid biomarkers for prostate, bladder, and renal cancers. Eur Urol Focus. 2017; 3(2-3):265-272. Google Scholar 7. Norgen Biotek Corp. Urine Collection and Preservation Cup 120 cc (Cat. 18129), 2017. https://norgenbiotek.com/sites/default/files/resources/18118%20-%20Urine%20Pres%20Products%20Info%20Sheet%20-%203.pdf. Google Scholar 8. . What influences recruitment to randomised controlled trials? A review of trials funded by two UK funding agencies. Trials. 2006; 7(9). Google Scholar 9. . Improving recruitment to health research in primary care. Fam Pract. 2009; 26(5):391-397. Google Scholar 10. . Meeting the challenges of recruitment to multicentre, community-based, lifestyle-change trials: a case study of the BeWEL trial. Trials. 2013; 14: 436. Google Scholar 11. . Social media and internet driven study recruitment: evaluating a new model for promoting collaborator engagement and participation. PLoS One. 2015; 10(3):e0118899. Google Scholar 12. . Diversity in clinical and biomedical research: a promise yet to be fulfilled. PLoS Med. 2015; 12(12:e1001918. Google Scholar 13. . The impact of socioeconomic status on access to cancer clinical trials. Br J Cancer. 2014; 111(9):1684-1687. Google Scholar 14. . The impact of the COVID-19 pandemic response on other health research. Bull World Health Organ. 2020; 98(9):625-631. Google Scholar 15. . Survey Shows One Third of Clinical Trial Study Sites Fear Total Closure; 77% Indicate at Least Some Ongoing Research Trials Have Been Impacted Due to COVID-19. April 8, 2020. https://acrpnet.org/2020/04/08/survey-shows-one-third-of-clinical-trial-study-sites-fear-total-closure-77-indicate-at-least-some-ongoing-research-trials-have-been-impacted-due-to-covid-19/. Google Scholar 16. Association of American Medical Colleges. Administration Officials Testify on COVID-19 Research Impact, Operation Warp Speed. [online] AAMC, 2022. Accessed September 5, 2022. https://www.aamc.org/advocacy-policy/washington-highlights/administration-officials-testify-covid-19-research-impact-operation-warp-speed. Google Scholar 17. Clinical trial educator program—a novel approach to accelerate enrollment in a phase III international acute coronary syndrome trial. Clin Trials. 2012; 9(3):358-366. Google Scholar 18. World Population Review. 2021. https://worldpopulationreview.com/us-cities/houston-tx-population. Google Scholar 19. World Population ReviewBronx, New York. https://worldpopulationreview.com/boroughs/bronx-population. Google Scholar 20. United States Census Bureau. Computer and Internet Use in the United States: 2018. April 21, 2021. https://www.census.gov/newsroom/press-releases/2021/computer-internet-use.html. Google Scholar Submitted June 23, 2022; accepted July 7, 2022; published July 21, 2022. Support: This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Technology/Therapeutic Development Research Program under Award No. W81XWH-19-1-0288. The opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense. This work was also supported by Oakland University William Beaumont School of Medicine's EMBARK capstone program. The American Urological Association also supported this work through the 2021 Summer Medical Student Fellowship Award. Conflict of Interest: LEL, JJJ, and MBC have intellectual property associated with methods for diagnosing interstitial cystitis. All other Authors have nothing to disclose. Ethics Statement: Ethics approval and consent to participate: Study was approved by the Beaumont Health Institutional Review Board (IRB No. 2019-266). Samples collected through online crowdsourcing was completed through an information sheet, so no written consent was obtained. Completing the survey and providing the urine sample was taken as full consent to participation. Author Contributions: LEL and MC conceived and designed this study. EPW and SNB curated study data. EPW, SNB, ALC, LEL, and PS analyzed data and prepared figures. LEL and MC provided project administration and supervision. PS wrote the manuscript. SNB, EPW, LEL, and MC reviewed and edited the manuscript. All authors approved the manuscript for submission. Data Availability: All data available from the corresponding Author upon request. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BYNC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.© 2022 The Author(s). Published on behalf of the American Urological Association, Education and Research, Inc.FiguresReferencesRelatedDetails Volume 9Issue 6November 2022Page: 561-566 Advertisement Copyright & Permissions© 2022 The Author(s). Published on behalf of the American Urological Association, Education and Research, Inc.Keywordsefficiencyspecimen handlingonline social networkingpopulation dynamicscost and cost analysisAcknowledgementsWe thank the interstitial cystitis community that contributed to this study and the Interstitial Cystitis Association (ICA; http://www.ichelp.org/) for assistance with participant recruitment and supporting IC research.MetricsAuthor Information Prasun Sharma Oakland University William Beaumont School of Medicine, Rochester, Michigan More articles by this author Laura E. Lamb Oakland University William Beaumont School of Medicine, Rochester, Michigan More articles by this author Sarah N. Bartolone Beaumont Health Spectrum Health System, Royal Oak, Michigan More articles by this author Elijah P. Ward Beaumont Health Spectrum Health System, Royal Oak, Michigan More articles by this author Joseph J. Janicki Beaumont Health Spectrum Health System, Royal Oak, Michigan More articles by this author Kenneth M. Peters Beaumont Health Spectrum Health System, Royal Oak, Michigan More articles by this author Nitya Abraham Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York More articles by this author Melissa Laudano Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York More articles by this author Christopher P. Smith Baylor College of Medicine, Houston, Texas Michael E. DeBakey VA Medical Center, Houston, Texas More articles by this author Bernadette Zwaans Beaumont Health Spectrum Health System, Royal Oak, Michigan Oakland University William Beaumont School of Medicine, Rochester, Michigan More articles by this author Michael B. Chancellor Beaumont Health Spectrum Health System, Royal Oak, Michigan Oakland University William Beaumont School of Medicine, Rochester, Michigan *Correspondence: Beaumont Health Spectrum Health System, Royal Oak, Michigan, 2811 W. 13 Mile Rd, Suite 505, Royal Oak, Michigan 48073 telephone: 412-721-4392; email address: E-mail Address: [email protected] More articles by this author Expand All Submitted June 23, 2022; accepted July 7, 2022; published July 21, 2022. Support: This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Technology/Therapeutic Development Research Program under Award No. W81XWH-19-1-0288. The opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense. This work was also supported by Oakland University William Beaumont School of Medicine's EMBARK capstone program. The American Urological Association also supported this work through the 2021 Summer Medical Student Fellowship Award. Conflict of Interest: LEL, JJJ, and MBC have intellectual property associated with methods for diagnosing interstitial cystitis. All other Authors have nothing to disclose. Ethics Statement: Ethics approval and consent to participate: Study was approved by the Beaumont Health Institutional Review Board (IRB No. 2019-266). Samples collected through online crowdsourcing was completed through an information sheet, so no written consent was obtained. Completing the survey and providing the urine sample was taken as full consent to participation. Author Contributions: LEL and MC conceived and designed this study. EPW and SNB curated study data. EPW, SNB, ALC, LEL, and PS analyzed data and prepared figures. LEL and MC provided project administration and supervision. PS wrote the manuscript. SNB, EPW, LEL, and MC reviewed and edited the manuscript. All authors approved the manuscript for submission. Data Availability: All data available from the corresponding Author upon request. Advertisement Advertisement PDF downloadLoading ...
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