Comparative Effectiveness and Clinical Outcomes Research Center (CECORC)

New Research Proposal Form

Principal Investigator:                                                                Email:   

Institution/Department:    

Co-investigator(s):                                 

Date:   

 

Title of Proposal:  

Hypothesis:  

Type of Study: 

 

Background-

Define the Knowledge Gap that Study Addresses:  

 

Study Aim(s)-

Primary Aim:  

Secondary Aim:   

 

Proposed Study Population-

Inclusion Criteria:   

Exclusion Criteria:   

 

Outcome Measures-

Primary Outcome:   

Secondary Outcome(s):   

Data Collection Variables:  

 

Planned Duration of Study: 

 

Center Participation Goal:   

Patient Recruitment Goal:  

Power Analysis Performed: Yes     ☐         No       ☐

Plan for Statistical Analysis:           

 

Expected/Anticipated Results:  

 

Define How Findings from this Study Will Serve as the Foundation for Future Studies or Future Funded Research:  

 

Does Study Require Informed Consent, Describe Rationale:  

 

 

Key References -

 

 

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Signature                                                                                             Date

Principal Investigator (Attending) 

______________________________________________                 ______________________

Signature                                                                                             Date

Co-investigator (Resident/Student)

                                                                                                                                              

v.1-2018