CRIS Project Application Form

1. Details: First Name
Last name
Job Title
Department
2. Preferred email address (please use KCL, SLaM or an NHS email addresses for any communications regarding CRIS)
3. Do you have a substantive or honorary contract with SLaM? View Guidance Notes
4. Project Title
5. Lay Summary: Please provide just one sentence summarising the reasoning behind the project, and just one sentence describing what the project will do View Guidance Notes
6. Objectives of the analysis View Guidance Notes
7. Rationale for the analysis (i.e. anticipated benefits / useful knowledge will arise from the results) View Guidance Notes
8. Types of variables you envisage using to define groups View Guidance Notes
9. Types of variables you envisage needing as outputs View Guidance Notes
10. Are there any variables / combinations of variables which might identify individuals on the database? (If yes: what steps will be taken to avoid de-anonymisation?)
11. Will your project use CRIS as part of the C4C process? (recruitment) If Yes please complete Q11a-f. If No please continue to Q12 View Guidance Notes
11a. Research Ethics Committee approval number (REC approval number).
11b. Date of REC approval
11c. REC Expiry Date
11d. SLaM Research and Development (R&D) reference number
11e. Date of SLaM R&D approval
11f. Quote statement which explicitly states that your project is covered to approach clients who have given consent to be approached for recruitment purposes
12a. Will your project require linking CRIS data to one of the external datasets held by the SLAM secure clinical data linkage service (CDLS), e.g. HES (acute hospital admissions, outpatient and A&E attendance), cause of death data etc.? If Yes, please complete Q12b. If No, please continue to Q13 View Guidance Notes
12b. Please select which dataset you envisage your project will require linkage to (i.e. HES, Mortality)
13. Names of anyone else who will be involved in CRIS use for this project (or state ‘None’). Please provide the roles, affiliation and email addresses (They must have SLaM honorary contracts or be a SLaM member of staff)
14. Please provide details of your supervisor (Name, Profession, Department, Work address, Telephone number). Please note we would like the details of the supervisor for the project you’ve detailed in this application (This may not necessarily be your line manager)If you are applying as the supervisor for this project, please indicate your level of clinical and/or academic seniority.
15. How long do you envisage requiring use of CRIS for this project? View Guidance Notes
16. Is this project a BRC project? If so, which theme does it fall under?
17. Would you class your project as research, audit, service development or service evaluation?
18a. If audit, please confirm the project has received appropriate SLAM Clinical Governance approval and email the approval to the CRIS administrator along with this filled out application View Guidance Notes
18b. State the Directorate responsible for this approval
18c. Give the title of the approved project if different from above
19a. If research is intended to be published, please, State what is the output envisaged to directly arise from this analysis (publication/pilot study)? View Guidance Notes
19b. Is it likely that texts from CRIS will be quoted in the publications?
19c. Please give an indication of where you are intending to publish
20. Please list the CAG(s) for which your study may have relevance / utility
21. Use of CRIS requires adherence to the security model Please note here that you have read and understood these requirements . View Guidance Notes
22. Does this application relate to a study forming all or part of an MSc dissertation?

 

By submitting this project application, you agree to treat CRIS data confidentially and in adherence to the guidelines stated above. You confirm to have the necessary honorary or substantive contract with SLAM to be authorised to access CRIS. Your searches will be audited to ensure that all searches are within the remit of the project you specify in this application form. Any searches performed outside the remit of the application form will be queried with the user and where found in breach of CRIS terms and conditions, CRIS access may be withdrawn subject to discussions with the CRIS Oversight Committee. You agree and confirm that this project has the relevant audit approvals or if a research project has an official research supervisor.

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