UNC Anesthesiology Research

Anesthesiology Request for Statistician Time

Please fill in all requested information and direct any questions to Clinical Trial Manager Karen Van Manen (karen_vanmanen@med.unc.edu) or Research Program Manager April Soward (april_soward@med.unc.edu).

Faculty Principal Investigator (P.I.)(Required)

Date(Required)

Project Title(Required)

Fundamental Scientific Question(Required)

Brief Description of Study (2-3 sentences)(Required)

Hypothesis(Required)

Description of Patient Sample(Required)

Primary Outcome (Dependent Variable):(Required)

Independent Variable:(Required)

Potential Confounding Variables:(Required)

Estimate of Project Time(Required)

Potential Analysis Strategy(Required)

Publication Plan & Target Submission Date(Required)

Briefly describe your timeline for drafting, finalizing and submitting your manuscript. Please note target publication(s) for submission.

Principal Investigator (Signature & Date)(Required)

Director for Clinical Research (Signature & Date Received)

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Anesthesiology Request for Statistician Time