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