Fee Agreement Report (SPARCRequest v3.12.1)

Study ID/Project ID

System generated from SPARCRequest

protocols.id

Automatically generated by SPARC application.

BIGINT(20)

Short Title

An abbreviated form of the title used to identify your study/project

protocols.short_title

Homepage, Short Title column

VARCHAR(255)

IRB

Institutional Review Board (IRB) System Generated Number(s).

irb_records.pro_number

SPARCRequest Step 2 and SPARCDashboard Protocol Information Page, Human Subject section

VARCHAR(255)

Date

Today’s date

Primary Investigator

Principal Investigator First and Last Name

project_roles.identity_id (role = primary-pi)(identities.first_name identities.last_name)

SPARCRequest Step 2 Authorized Users; One Primary PI is required on each protocol.

SPARCDashboard Authorized Users

VARCHAR (255)

Sponsor Name

Name of the entity funding the project/study

protocols.potential_funding_source

SPARCRequest Step 2: Study Information (Required field when choosing pending funding).

SPARCDashboard Study Information

VARCHAR(255)

Funding Source

System required field which indicates primary source of support for a study, which drives system pricing

protocols.funding_source

SPARCRequest Step 2: Study Information (Required field when choosing funded).

SPARCDashboard Study Information

VARCHAR(255)

Arm Name

The name of the group or subgroup of participants in a clinical trial.

arms.name

Participant Tracker header “Current Arm” column

VARCHAR(255)

Enrollment

Total number of participants per Arm

arms.subject_count

SPARCRequest Step 3: Clinical Services

SPARCDashboard, Admin Edit page, Clinical Services tab

INT(11)

Total Non-Clinical Services Cost

The total cost of the one-time-fee (non-clinical) services

calculated field

N/A

N/A

Total Clinical Services Cost

The total cost of the per-patient (clinical) services

calculated field

N/A

N/A

Total Study Budget

The total cost of the one-time-fee (non-clinical) and per-patient (clinical) services

calculated field

N/A

N/A

Program

The level of organization in which the service belongs

sub_service_requests.organization_id (organizations.name)

Set up in SPARCCatalog as split/notify

VARCHAR(255)

Service Name

The name of the study level activity

line_items.service_id (services.name)

SPARCCatalog

VARCHAR(255)

Your Cost

The amount that your study will be charged

calculated field

N/A

N/A

Quantity

Quantity of service requested

sum (line_items.quantity)

SPARCRequest Step 3: Non-clinical Services

SPARCDashboard, Admin Edit page, Non-clinical Services tab

(calculated)

Total

Total cost of the service based on quantity requested

calculated field

N/A

N/A

Service Notes

Line item notes on services that are entered by study team users and service providers

notes.body

SPARCRequest Step 3 Service Details Line Item Notes;

SPARCDashboard Admin Edit, Non Clinical Services Tab, Line Item Notes.

TEXT

Program

The level of organization in which the service belongs

sub_service_requests.organization_id (organizations.name)

Set up in SPARCCatalog as split/notify

VARCHAR(255)

Service Name

The name of the procedure

line_items.service_id (services.name)

SPARCCatalog Service Form, General Information

VARCHAR(255)

Service Cost

The fee (full rate) associated to the procedure

calculated field

N/A

N/A

Unit

Any unit of measurement (i.e. hours, each, slides, etc)

pricing_maps.unit_type

SPARCCatalog Service Form, Pricing Section

VARCHAR(255)

Enrollment

Total number of participants per Arm

arms.subject_count

SPARCRequest Step 3: Clinical Services

SPARCDashboard, Admin Edit page, Clinical Services tab

INT(11)

(Visit Name)

The visit name and number of times a service will occur for a given subject

visits.research_billing_qty

SPARCRequest Step 3 and SPARCDashboard Admin Edit Clinical Services Tab

BIGINT(20)

Per Service Total

Service cost, per patient

calculated field

N/A

N/A

Service Notes

Line item notes on services that are entered by study team users and service providers

notes.body

SPARCRequest Step 3 Service Details Line Item Notes;

SPARCDashboard Admin Edit, Clinical Services Tab, Line Item Notes.

TEXT

Total Visit Cost (Per Patient)

The sum of all service costs in a given visit for per-patient (clinical) services

calculated field

N/A

N/A

Arm Total

The sum of all service costs across all visits in a given arm for per-patient (clinical) services

calculated field

N/A

N/A