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

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Evaluation of the clinical effectiveness and safety of the CHORDS 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

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

Since when have you been using the CHORDS medical device ?

Select one answer

How often do you use CHORDS in your practice?

Select one answer

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

Select one answer

Which CHORDS variants do you use in your practice?

Select one or more answers

Do you think that the above-mentioned width and length variants of CHORDS are:

Select one answer

Please indicate which variants are missing*

How do you use the CHORDS product?

Select one answer

How do you use the CHORDS?*

For what clinical indications do you use the CHORDS medical device?

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

For which other clinical indications do you use the CHORDS?*

Have you ever used the CHORDS medical device on:

Choose one answer in each line

How would you assess the clinical effectiveness of the CHORDS product in terms of the clinical indications listed in the Instructions for Use of the medical device?

1 – very low, 5– very high

What other indications?*

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

For what period do you estimate the durability of the CHORDS – how long does the work remain in the patient’s oral cavity?

Select one answer

How do you assess the duration of work made with CHORDS in the patient’s oral cavity compared to other dental fibers?

Select one answer

How do you assess the ease of use of CHORDS compared to glass fibers?

Select one answer

How do you assess the durability of works made with CHORDS compared to glass fibers?

Select one answer

How do you assess the safety of using CHORDS for the patient and the dentist compared to glass fibers?

Select one answer

How do you assess CHORDS compared to COMCORD?

You can select any number of options

What are the main factors that most affect the durability of fiber splints in the patient’s oral cavity?

Select up to 3 answer

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

(1 – very low 5 – very high)

What product features make do you use CHORDS in your practice?

You can select up to 3 answers

How would you assess the information contained on the CHORDS 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 justified by explaining what information is missing or unclear.

What information is missing or unclear?*

Has it ever happened during your professional practice that the CHORDS medical device:

Select one answer in each line

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

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

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

What adverse reaction have been observed?*

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

The answer NO should not 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 CHORDS in your case require prior practical training?

Select one answer

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

Select one answer

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

Select one answer

Do you have any comments, suggestions, ideas or concerns regarding the CHORDS 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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