ProposalForm for Translational Research Projects
Please fill in the following form as completely as possible. At the SAKK Coordinating Center we are happy to help you.
Title of the translational research project
Related to SAKK trial
Responsible researcher
Name
Institution
Address
Phone
Fax
Principal research facility
Institution
Address
Phone
Fax
Person in charge of the biological material collection and storage
Name
Institution
Address
Phone
Fax
Collaborating researchers
Name
Institution
Name
Institution
- Scientific Background
1.1.Short description of the project
1.2.Current status of research in the field
1.3.Aims/Objectives of the project
1.4.Connections between the project and the applicant’s field of research
1.5.Rationale of the project
1.6.Potential impact of the project
2.Organization of the project at the applicant site
2.1.Start of the analysis and availability of final data
2.2.Is there any need to have access to patients clinical data? No YesIf yes, give details.
2.3.Experimental procedure (precise description)
2.3.1.Material and Methods (biological material collection will be discussed in detail in the next section)
2.3.2.Analyzed parameters
2.3.3.Methods of scoring
2.3.4.Hypothesis (driving the project or generated by this study) and statistical considerations (expected sample size…)
2.4.Experience of the investigators in the planned assays
3.Biological material collection at the site
3.1.Required biological material (e.g. blood, bone marrow, tumor biopsy, tissue…)
3.2.Collection of the biological material
3.2.1.Schedule of sampling
3.2.2.Handling of samples during collection
3.2.3.Number of sample required to perform the experiments
3.3.Sample preparationat the site (e.g. blood or serum preparation, freezing methods, fixation techniques…)
3.4.Sample storage before shipping
3.5.Shipping procedure to collection site (dry ice, over-night service, prospective or retrospective collection…)
3.6.Do you plan to set up a blood or tissue bank?No Yes If yes, give detail.
4.Financial considerations
No funding can be expected from the SAKK.
4.1.Budget for thetranslational research project?
Biological material collection:
Laboratory apparatus:
Consumables:
SalariesScientists, technicians:
Administration:
Diverse:
TOTAL:
OR
Please, provide TarMed position if any:
4.2.Is there any external funding? No Yes If yes, give details (KFS, SNF, others).
4.3.Do you plan to submit a grant application? No Yes If yes, give details (KFS, SNF, others).
5.Additional information
5.1.External reviewer (name and address)Project will be reviewed by specialists out of Switzerland.
Excluded:
Recommended:
5.2.Expected/planned publications
5.3.Critical factorsfor the achievement of the project
5.4.Additional explanation/justification not fitting in the outline format
5.5.Important References
Prepared by (name and address):
Date:
Signature:
SAKK Proposal Form for Translational Research Project21.08.20091/5