IASLC International Staging Project Data Query Application

IASLC International Staging Project Data Query Application
Submitter Name*

TitleFirst NameLast Name
Submitter Institution*
Submitter Phone Number*

Country CodeArea CodePhone Number
Submitter Email Address*
Are you a contributor of data to the IASLC International Staging Project?*

YesNo
Are you an IASLC member?*

YesNo
If yes, please provide the member ID
Is this working being done as part of a student project?*

YesNo
IASLC Contact (if applicable)
Name

TitleFirst NameLast Name
Email Address
Proposal Details
Project Title*
Proposed Project Start Date*

MonthDayYear
Date
Proposed Project End Date*

MonthDayYear
Date
Please upload your proposal which highlights the following areas:
- Relevant background and previous studies
- State of the science
- Justification for the analysis
- Project goals and specific aims
- Project benefits and public interest value
- Summary of research desgin, proposed analytic methods and tools
This document should not exceed 3 pages single spaced
Proposal Upload*
Research Team
Principal Investigator*

TitleFirst NameLast Name
Institution/Organization*
Email Address*
Is the Principal Investigator an IASLC member?*

YesNo
If yes, please provide the member ID
Please upload the Principal Investigator's Biosketch*
Do you have a Co-Principal Investigator?

YesNo
Co-Principal Investigator Name

TitleFirst NameLast Name
Co-Principal Investigator Institution/Organization
Co-Principal Investigator Email Address
Is the Co-Principal Investigator an IASLC member?

YesNo
If yes, please provide the member ID
Please upload the Co-Principal Investigator's Biosketch
Do you have senior or key personnel to include?

YesNo
Name

TitleFirst NameLast Name
Email
example@example.com
Is the individual an IASLC member?

YesNo
If yes, please provide the member ID
Do you have other personnel to include (not including a statistician)?

YesNo
Name

TitleFirst NameLast Name
Email Address
Is the individual an IASLC member?

YesNo
If yes, please provide the member ID
Data Query Request
The following questions will be used to aid CRAB in determining data suffciency. Additional clarifying questions may be asked of the applicant following the initial submission of the application.
What is the primary research question? (Please include: primary descriptors, classifiers or groupings of interest)*
Subject population of interest? (E.g. histology, stage categories, specific mutations, treatment)*
What are the outcomes of interest?*
What are the factors that might affect the desired completion date?*
Additional Proposal Details
Dissemination Plan - How will this data be shared with the scientific community? (e.g. a manuscript submission, scholarly presentation, etc.)*
Do you accept that any publication must be reviewed by the committee prior to submission?*

YesNo
Do you accept that all publications must first be submitted to the Journal of Thoracic Oncology?*

YesNo
Do you accept that the primary authors of the study include at least one medical member of the SPFC and one member of CRAB?*

YesNo
Do you accept that the IASLC, CRAB and any identified sponsors must be acknowledged in the presentation of data (e.g. manuscript, scholarly presentation, etc)?*

YesNo
Do you accept that any manuscript must contain an appendix that lists all contributing institutions?*

YesNo
Should be Empty:

IASLC International Staging Project Data Query Application

IASLC Contact (if applicable)

Proposal Details

Research Team

Data Query Request

Additional Proposal Details