New research proposal form
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This document appears to be a research proposal application form for the King Abdullah International Medical Research Center and King Saud Bin Abdulaziz University for Health Sciences. It requests information about the proposed research study including the title, investigators, objectives, methodology, timeline, and budget. The proposal form provides instructions for completing each section and requests details on the background, study design, sampling, data collection/analysis, references, workplan, and appendices. It emphasizes that the proposal should justify the public health importance and provide a literature review to support the study.
New research proposal form
- 1. KING ABDULLAH INTERNATIONAL MEDICAL RESEARCH CENTER KING SAUD BIN ABDULAZIZ UNIVERSITY FOR HEALTH SCIENCES National Guard Health Affairs FOR OFFICIAL USE ONLY Date of Receipt Research Area ID Number 1. Title of Proposal: (Instructions: fill all appropriate boxes applicable to your project) 2. Type of project (please check all applicable options) Chart Review Diagnostic PhD Project Qualitative Research Human Laboratory MSC Project Quantitative Research Therapeutic Basic Science Other: _____________________ 3. Starting Date: 4. Duration: 5. Total Fund Requested (SR): 6. Principal Investigator (PI): Name: Tel. No. (W): Mobile No.: Affiliation & Address: Title/Position: Email: 7. Name of co-investigator (PI) (instructions: There is no limit to the number of co-investigators and their expertise should cover the different areas) Co-Investigators Title/Position Department Signature 8. Principal Investigator's Assurance: The undersigned agrees to accept responsibility for the scientific and technical conduct of the proposed research and submission of progress reports if this application is approved Signature of the Principal Investigator Date APPROVED Name and Signature of the Chairman Department
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- 3. 9. Background: (Instructions: Literature review of previous studies on the subject; and justification of the study by stating the problem and its public health importance) 3
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- 5. 10. Objectives of the study: 10.1 Aim of the study: (Instructions: state the goal you need to achieve) 10.2 Specific objectives: (Instructions: state the details of each objective that will finally lead to achievement of the goal) 1. 2. 3. 4. 5. 10.3 Secondary objectives: (Instructions: these are subsidiary objectives that could be studied during the course of the project but are not the main objectives of the study, they are optional and vary according to the type of the study) 5
- 6. 11. Materials and Methods: (Instructions: Describe the research methods that could best achieve the study objectives, recommend to attached flow charts) 11.1 Study Area/Setting: (Instructions: describe the area or setting where the study will be conducted. This description should cover the details relevant to the study topic) 11.2 Study Subjects: (Instructions: Inclusion and exclusion criteria of the study subjects) 6
- 7. 11.3 Study Design: (Instructions: mention the type of study design eg cross-sectional, case-control, intervention study, etc..) 11.4 Sample Size:: (Instructions: mentioned the input criteria for smple size estimation.) 7
- 8. 11.5 Sampling Technique: (Instructions: mention the sampling technique, (e.g. randomization) that will be used on order to obtain a representative sample for your target population.) 8
- 9. 11.6 Data Collection methods, instruments used, measurements (Instructions: Describe the instruments used for data collection (questionaire, observation recording from, ect..), ans studied variables included in these instruments, as well as the methods used to test for the validity and reliability of the instrument. Techniques used should be briefly described and referenced. Study definitions (eg case definition) should be mentioned) 9
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- 11. 11.7 Data mangement and analysis plan: (Instruction: Describe the analysis plan, tests used for data analysis ans statistical package(s) used) 12 Bibliographic References: (Instructions: mention recent articles relevant to the study subject and enumerated accroding to their order of appearance in the text) 11
- 12. 15 workplan: (Instructions: Please use this form as a template for the timeline of your project) Task MONTH 1 2 3 4 5 6 7 8 9 10 11 12 Progress report 12
- 13. • Funds allocated to all personnel should not exceed 30% of the budget, otherwise justification letter should be included • Unit cost of each task should be accurately given to allow propoer budget evaluation. 16. Budget (Please use the attached documents for the price list of equipments used in the project if applicable) Budget Breakdown Unit cost (SR) Total (SR) Remarks Personnel * Total Supplies and Equipment Patients Cost Total Training Total Others (please, specify and justify briefly) Total GRAND TOTAL 13
- 14. 17. Appendices: (Instructions: Data collection instruments, elaboration on methods and procedures to be used, etc..) (Please attach the related documents) 14
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