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Publication Number: FHWA-HRT-04-136
Date: December 2005

Enhanced Night Visibility, Volume V: Phase II—Study 3: Visual Performance During Nighttime Driving in Snow

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APPENDIX B—INFORMED CONSENT FORM


[Contractor Facility]
Informed Consent for Participants of Investigative Projects

Title of Project: Detection and Recognition of Pedestrians, Objects, and Traffic Control Devices under Various Weather Conditions and Different Vision Enhancement Systems

Investigators: __________________________________________

THE PURPOSE OF THIS RESEARCH PROJECT

THE PURPOSE OF THE PROJECT IS TO DETERMINE THE DEGREE OF ENHANCED VISIBILITY OF THE ROADWAY ENVIRONMENT WITH VARIOUS TYPES OF VISION ENHANCEMENT SYSTEMS WHILE DRIVING AT NIGHT.

  1. PROCEDURES

    Show a current valid driver's license.

    Read and sign this Informed Consent Form (if you agree to participate).

    Participate in three vision tests.

    Perform one or more of the following portions of the study (you will be performing the studies that are marked with a checkmark):

    • Study 1: Drive a vehicle on the Smart Road at no more than 25 miles per hour and report when you see the first and the last pavement markings on a given portion of the road.

    • Study 2: Drive a vehicle on the Smart Road at no more than 25 miles per hour and evaluate the level of discomfort caused by glare from headlamps of vehicles coming in the opposite direction.

    • Study 3: Drive a vehicle along the Smart Road at no more than 10 miles per hour and respond when you see objects in and along the roadway.

  2. RISKS

    The primary risks that you may come into contact with are the obstacles on the road for the study or sliding on the roadway during the "Rain" or "Snow" conditions (if this applies to the study that you will be performing). It is for this reason that you are to maintain a speed of not more than 10 miles per hour and to maintain a 50-foot area between the vehicle and the obstacles (only applies to Study 3). For your safety, the following precautions are taken:

    • The Smart Road is equipped with guardrails in the All-Weather Testing section. Therefore, if you do lose control of the vehicle, the guardrails will prevent you from sliding off the road.

    • You are required to wear a seatbelt at all times in the vehicle, and the vehicle is equipped with antilock brakes.

    • You do not have any medical condition that would put you at a greater risk, including but not restricted to heart conditions, head injuries, epilepsy, and balance disorders.

    • In addition, you have not had radial keratotomy, [laser] eye surgery, or any other ophthalmic surgeries.

    • The only other risk that you may be exposed to is fatigue after sitting in the driver's seat for a prolonged period of time. However, if you would like to take a break at any time, please inform the experimenter.

  3. BENEFITS OF THIS PROJECT

    While there are no direct benefits to you from this research (other than payment), you may find the experiment interesting. No promise or guarantee of benefits is made to encourage you to participate. Your participation will help to improve the body of knowledge regarding various vision enhancement systems.

  4. EXTENT OF ANONYMITY AND CONFIDENTIALITY

    The data gathered in this experiment will be treated with confidentiality. Shortly after you have participated, your name will be separated from your data. A coding scheme will be employed to identify the data by participant number only (e.g., Participant No. 3). After the experiment, the data will be kept in a locked safe.

  5. COMPENSATION

    You will be paid 20 dollars per hour for participating in this study. You will be paid in cash at the end of your voluntary participation in this study.

  6. FREEDOM TO WITHDRAW

    As a participant in this research, you are free to withdraw at any time without penalty. If you choose to withdraw, you will be compensated for the portion of time of the study for which you participated. Furthermore, you are free not to answer any question or respond to experimental situations without penalty.

  7. APPROVAL OF RESEARCH

    Before data can be collected, the research must be approved, as required, by the [name of review board]. You should know that this approval has been obtained.

  8. SUBJECT'S RESPONSIBILITIES

    If you voluntarily agree to participate in this study, you will have the following responsibilities:

    1. Follow the experimental procedures as well as you can.

    2. Inform the experimenter if you incur difficulties of any type.

    3. Wear your seatbelt.

    4. Abide by the 10 miles per hour speed limit.

  9. SUBJECT'S RESPONSIBILITIES

    I have read and understand the informed consent and conditions of this project. I have had all my questions answered. I hereby acknowledge the above and give my voluntary consent for participation in this project.

    If I participate, I may withdraw at any time without penalty. I agree to abide by the rules of this project.

    __________________________       _________________________
    Signature                                       Date

    Should I have any questions about this research or its conduct, I may contact:

    (Name of researchers and review board)                                       (Phone number)

 

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