I/We would like to ask your permission to use medical information held at Halimatu Musa Hospital for a case study. A case study is where we use medical information to tell other healthcare workers about a rare or interesting case.
I/We believe that other healthcare workers can learn a lot from this particular case study. We would like to use this information for an article in a medical journal. We will never use the name of the patient or any other personal details.
If you agree to allow us to use these medical records for this study, we would need to access the following types of information: age, medical conditions, medical history, laboratory/radiological investigations as well as pharmaceutical information.
Your decision to allow your health information to be used for a case study is entirely voluntary. Although the hospital will not benefit directly from allowing the case to be presented, this information will help to advance our understanding of these particular issues.
Privacy and Confidentiality:
The privacy of the patient will be respected and all reasonable efforts will be made to protect their information. Only the hospital will have access to information identifying the patient. All of the data used for this study will be de-identified, which means that information such as patient name and medical record number, will not be used.
Ethics approval:
This case study is therefore submitted to the HMH Ethical Review Board (Research Ethics Committee), Halimatu Musa Hospital, telephone number 08114163781 for written approval by the committee.
Please note that the study has been structured in accordance with the Declaration of Helsinki (last update: October 2013), which deals with the recommendations guiding doctors in biomedical research involving human/subjects.