Consent to Participate in Research

Financial Interest Disclosure:

The following disclosure is made to give you an opportunity to decide if this relationship will affect your willingness to participate in this research study: This research is being funded by Lapetus Solutions, Inc. Dr. Karl Ricanek Jr. is co-founder of Lapetus Solutions, Inc. Though he will not receive a personal gain, Lapetus Solutions, Inc could, thus he stands to gain indirectly from this study. This conflict is being managed by the research team.

 

Key Information about this research study:

The following is a short summary of this study to help you decide whether to be a part of this study.
Information that is more detailed is listed later on in this form.

This data collection effort is to study the effects of behavior and health and whether signals can be derived from the face. Data collected from the participants, both face image, i.e. medical selfie, and data from a questionnaire, will be used to develop algorithms to derive signals from the face that could be used as health indicators or likelihood of developing specific disease states, i.e. diabetes, heart disease, cancer (melanoma) etc. In addition, we will examine the possibility of deriving a biological aging surrogate from the face coined the Physiological Face Age. You may be asked to take a short questionnaire with a set of major questions. As part of the survey, you will be asked to provide your current height and weight. You will take a photograph with a neutral expression and fully facing the camera at eye level.

 

Why am I being asked to take part in this research study?

We are asking you to take part in this research study because you are between the ages of 18-120 years, are able to communicate either verbally or written, are able to sit upright for more than 5 minutes, and are mentally aware.

 

How many people will be in this study?

We expect about 10,000 people will be enrolled in this research study world wide.

  • Whether or not you take part is up to you.
  • You can choose not to take part.
  • You can agree to take part and later change your mind.
  • Your decision will not be held against you.
  • You can ask all the questions you want before you decide.

 

What happens if I say, "Yes, I want to be in this research"?

You will be asked to do the following if you choose to participate in this research:

  • Complete a survey questionnaire: you will be asked to complete a background survey to include information on demographic data, height, weight, and smoking.
  • Photograph/Scan: you will be asked to take a photograph of the face using a digital camera. The photograph is of the face without obstructions, i.e. glasses, scarves, hair covering the face or forehead, etc.

 

Will being in this study help me in any way?

We cannot promise any benefits to you or others from your taking part in this research. However, possible benefits include potentially developing systems to help in the prediction of future disease states.

 

Is there any way being in this study could be bad for me?

To the best of our knowledge, there will be no more risk of harm than you would experience in everyday life.

 

What happens if I do not want to be in this research?

Participation in this research is voluntary. You can decide to participate or not to participate.

 

What happens if I say "Yes", but I change my mind later?

You can leave the research within 24 hours of submitting your photograph and/or data. If you want to leave, you must send a request to support@lapetussolutions.com.

 

What happens to the information collected for the research?

Efforts will be made to limit the use and disclosure of your personal information, including research study and medical records, to people who have a need to review this information. We cannot promise complete secrecy. Organizations that may inspect and copy your information include the collaborating university (UNCW), the IRB and other representatives of this institution.

Data Sharing: De-identified data from this study may be shared with the research community at large to advance science and health. We will remove or code any personal information that could identify you before files are shared with other researchers to ensure that, by current scientific standards and known methods, no one will be able to identify you from the information we share. Despite these measures, we cannot guarantee anonymity of your personal data.

 

Who can I talk to?

If you have questions, concerns, or complaints, or think the research has affected you in some way, talk to Dr. Karl Ricanek at 910-962-4261 during normal business hours.

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