Research Protocol Application Format ( to be completed by applicant )
1. Abbreviated Project Title
i. The content must identical to the Title Page
2. Project Title
i. The content must identical to the Title Page
3. Principal Investigator Name
i. The content must identical to the Title Page
ii. Designation and Department must be included
4. Co Investigator Name / Co Investigators Names
i. The content must identical to the Title Page
ii. Designation and Department must be included in addition
5. Introduction and Background of the proposed project
i. Introduction
ii. Aims and Objectives of the Study
iii.Materials & Methods / Study Description
a. Design Prospective / Retrospective *
b. Place of the study
c. Proposed Duration of the Study
d. Sample size
e. Sampling Method
f. Inclusion Criteria
g. Exclusion Criteria
h. Special subject recruitment procedures along with consent or matter. (E.g. advertisement/letters to doctors/posters if any)
i. Etc.
iv.Parameters to be Studied
a. At the initiation of the Study
b. Duration, Frequency of Follow up and parameters to be observed
v. Organisation of Work elements
| Name of the Milestone | Starting Date | Expected Date of Completion ( Proposed ) |
| Primary end point | | |
| Secondary end point | | |
| Etcetetra | | |
6. Work already done in the Field ( If any )
i. Lacuna in subject knowledge ( if any )
ii. Proposed or expected outcome of the Project
a. Improvement in patient care
b. Attainment of more knowledge
c. Bridging the lacuna in knowledge
d. Any other ( please specify )
7. Bibliography ( for the material in the Research Project Application )
i. The bibliography of the Research Project Application must be In Vancouver style
8. Staff to be appointed on Contractual basis ( if applicable )
i. Number of Staff
ii. Designation of Staff with duration of appointment
iii.Remuneration to Staff ( for complete project )
iv.Work expected / Job Description of appointed Staff as per category
9. Comments by Biostatistician
10. Proposed Expenditure
i. Please submit in Tabular form
ii. Proposed Budgetary cost
iii. Remuneration to Staff to be included
iv. Contribution to DDF of the Concerned Departments
v. Please make provision and add TDS that is proposed be deducted by Sponsor
vi. 10 % of the Total Project cost is to be added as Contribution to SRS*
• * The Contribution to the SRS will be exclusive of TDS; if TDS is to be deducted please specify TDS separately and add to Project cost.
11. Referencesi. Xerox copies of relevant articles for the proposed project to be attached
12. Names and Signatures of all the Investigators
13. Remarks and Signature of Head Concerned Departments
14. Signature of Dean