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Evaluation of the clinical effectiveness and safety of the COMCORD medical device

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Evaluation of the clinical effectiveness and safety of the COMCORD medical device

Please be informed that your data obtained as a result of previous contacts with ARKONA Laboratorium Farmakologii Stomatologicznej Grzegorz Kalbarczyk (hereinafter referred to as ARKONA) is stored in the ARKONA Contractor Database, which is the administrator of your personal data. Details regarding ARKONA's personal data protection policy are available at https://arkonadent.com/wp-content/uploads/2020/10/arkonadent.com-polityka-prywatnosci.pdf. If you would like to obtain detailed information about the rules and purposes of ARKONA's processing of your personal data, please contact us at the following e-mail address: polityka.prywatnosci@arkonadent.com or at the postal address Nasutów 99C, 21-025 Niemce, Poland.

Doctor's personal details, professional licence number

Please provide your first name, surname and professional licence number. Please be aware that your personal data will not be collected, processed or disseminated without your knowledge and consent. It will only be used to confirm that the survey has been completed by an authorised person.

Address of the dental clinic/ practice

Medical Representative's initials

If applicable
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Evaluation of the clinical effectiveness and safety of the COMCORD medical device

Since when have you been using the COMCORD medical device?

Select one answer

How often do you use COMCORD in your practice?

Select one answer

How many (approximately) COMCORDS have you used in your practice so far?

Select one answer

Do you think that COMCORD geometry is:

Select one answer

What should be changed in COMCORD geometry?*

How do you use the COMCORD product?

Select one answer

How do you use COMCORD?*

For which clinical indications do you use the COMCORD medical device?

Please mark the indications for which you have used the product (you can mark any number of indications):

Have you ever used the COMCORD medical device on:

Select one answer in each line

How would you assess the clinical effectiveness of the COMCORD in terms of the clinical indications for which it is used?

1 – very low, 5– very high

What other indications?*

Please provide your indications and evaluation on a scale of 1-5.

How long, according to your estimates, will the COMCORD product last for the patient? How long will it remain in the patient's mouth?

Select one answer

How would you assess the durability of work performed using COMCORD in the patient's mouth compared to other dental fibres?

Select one answer

How would you assess the ease of use COMCORD compared to other fibres?

Select one answer

How would you assess the safety of COMCORD for patients and doctors compared to other fibres?

Select one answer

Which of the following statements about COMCORD compared to other dental fibres would you consider to be true?

You can select minimum 1 and maximum 3 answers.

In your opinion, what are the main factors that most influence the durability of fibres in the patient's mouth?

You can select minimum 1 and maximum 3 answers.

How would you assess the following functional characteristics and features of the COMCORD product?

(1 – very low, 5 – very high)

What features of the product make you use COMCORD in your practice?

You can select minimum 1 and maximum 3 answers.

How would you assess the information on the COMCORD label or in the instructions for use (indications, method of use, contraindications, side effects, warnings, etc.), i.e. is it complete, sufficient and understandable?

The answer NO should be explained by specifying what information is missing or unclear.

What information is misssing or unclear?*

Has it ever happened during your professional practice that COMCORD:

Select one answer in each line:

If COMCORD has caused an allergic reaction, please specify the type*

Have you ever noticed any adverse reactions after using COMCORD products?

The answer YES must be explained. What side effects have been observed?

What side reactions have been observed?*

Do you consider COMCORD to be safe in terms of the clinical indications described in the instructions for use?

The answer NO should be explained

Why not?*

What factors do you usually consider or would consider when deciding to purchase dental fibres?

Select one answer

Did the use of COMCORD in your case require prior practical training?

Select one answer

Would you take part in training on the use of COMCORD?

Select one answer

What type of training do you consider most appropriate for COMCORD?

Select one answer

Do you have any comments, suggestions, ideas or concerns regarding the COMCORD medical device that would help us improve our product?

Please write down your comments/ideas or write ‘NO’.

Where do you usually obtain information about ARKONA products?

Select one or more answers
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