Menstrual Disorders, Endometriosis and Gynaecological Endoscopy Clinical Studies Group

Proposal Form

PLEASE SUBMIT THIS FORM AT LEAST 12 WEEKS IN ADVANCE

OF ANYFUNDING APPLICATION DEADLINE

Please complete this form and return to the CSG by:

  • Email:
  • Post:Jane Daniels, Nottingham Clinical Trials Unit,Nottingham Health Partners, Queens Medical Centre,Nottingham NG7 2UH

Investigator Contact Details

Principal Investigator / Other Investigator / Other Investigator(s)
Name
Role
Hospital/ University
Department
Telephone
Email

Please add any other investigators in the ‘Other Comments’ section in the table below.

Proposed Study

Level of CSG support sought:Mark appropriate boxwith an X / Support from BSGE for grant application to be led by PI / Proposal to go to RCOG/ NIHR Prioritisation Panel (PICO submission) / Advice only

Please provide a brief description of your study. It would be extremely useful to also supply a draft protocol, however rough and incomplete, to allow the CSG to gain an idea of the proposed study.

Study Title (acronym):
Study Type
Mark appropriate box or boxes with an X / RCT (please indicate trial phase) / Diagnostic study / Monitoring/ surveillance study
Survey or practice audit / Risk factors cohort / Other (please describe below)
Disease Area:
Background:
Please provide information for why the study is needed (max 250 words)
Study Design:
Please provide information on the following:-
  • Proposed study design
  • Treatment/ surgery arms
  • Treatment schedule/ surgical technique
  • Blinding
  • Follow-up schedule
  • Duration of follow-up
  • Outcome measures
  • Duration of study

Sample Size: (if estimated)
Proposed Number of Centres:
Location:
Mark appropriate boxwith an X / Local / National
International – Europe only / International – excluding USA / International – including USA
Stage of Study:
Mark appropriate box or boxes with an X / Idea / Funding Application / Submitted for Funding
Draft Protocol / Submitted Regulatory Approvals / Recruiting
Funding & Sponsorship (if grant application to be led by PI)
Proposed Funder:
Timelines:
We ask for this form to be submitted 12 weeks in advance of any deadline / Funding application deadline
Proposed start date for study
Proposed Sponsor:
Have you contacted a Clinical Trials Unit? / Yes
(name) / No, not yet / No, study design does not warrant CTU involvement
The UKCRC Clinical Trials Unit Network offers a resource for clinical researchers wishing to identify CTUs that have expertise in trial design, data management, and analysis. Involvement of a CTU is essential for those considering a randomised controlled trial.
Have you contacted a Research Design Service? / Yes
(name) / No, not yet / No, not applying for peer-reviewed funding
The NIHR Research Design Service (RDS) Network provides help for researchers to prepare proposals for submission to NIHR and other national, peer-reviewed funding competitions for applied health or social care research by providing expert advice on research design and methodology
CSG Support (only if support requested)
Type of Support & Advice sought - more than one can be selected:
Mark appropriate boxwith an X (This will help direct you to the CSG member most suitable to provide advice) / Developing research question / Peer review of idea / Identification of collaborators (grant applicants)
Study design and methodology / Involvment of manufacturers / Identification of recruiting clinicians
Public and patients involvement / Training of recruiting clinicians / Access to Endometriosis Centre database
Other Comments:

By requesting support and/or advice from the MDEGE- CSG, you are agreeing for the following data to be held on the CSG databases:

  • Title of study and brief description of study objective and design
  • Name and contact details of investigator and any co-investigators

We would like to send you details about research funding calls in related to gynaecology, which you could pass on to colleagues if not of interest to yourself.Please markthe box with a X if you do notwish to be put on our mailing list

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