Research Project Proposal Form

Reynolds Cardiovascular Research Center Dallas Heart Study

Research Project Proposal Form

Reynolds Cardiovascular Research Center – Dallas Heart Study

Date:

Investigator (your name):

Project Title (max 300 characters) *:

Project Summary (max 4200 characters). State the project’s broad objectives and aims, and describe concisely the research design and methods for achieving these goals. This is meant to be a stand-alone description of the project when separated from this proposal form. If the project is approved, as is, will be made available to the entire Reynolds Center investigator community:

Project Description:

Hypothesis (Max 1200 characters) *:

Aims of Proposal (Max 3000 characters) *:

Significance & Relevance *:

Method & Analysis Plan *:

Writing Group Members (List proposal senior author last) *:

Planned date for submission of completed manuscripts to Reynolds Center for pre-publication review *:

Keywords (Check all that applies) *:

Research Fields:

Coronary Artery Disease / Women’s Health / Arrhythmias
Diet & Nutrition / Minority Health: Hispanics / LVH
Alcohol Use / Hyperlipidemia / Health Beliefs
CHF/ Cardiomyopathy / Obesity / Acculturation
Other: Congenital Heart Disease / Minority Health: African Americans / Diabetes
Smoking, Tobacco Use / Exercise, Physical Activity / Hypertension
Polycystic Ovary Syndrome / Other

Data Types:

Survey / DNA Sequence Variants / Aortic MRI
Blood Pressure Readings / ECG / Pelvic MRI
Lab: Blood Chemistries / Abdominal Fat MRI / Coronary
Lab: Urine Chemistries / Liver MR Spectroscopy / Lab: Lipids
Lab: Glucose/Chemistries / Cardiac MRI / Lab: Biomarkers/ Proteins
Other

Reynolds Resource Access Requested (Check all that applies) *:

Original Reynolds Data / Request Lab Specimen/DNA
Request New Image Analysis / Request Cohort Study

NDA & Technology Transfer Disclosures:

Identify all funding sources to be used in the study (external and internal sources) *:

Identify all sources of materials to be used in conjunction with the study (external sources and internal) *:

Identify any known relationships between the proposed project and patents, patents pending, or any intellectual property which may be on file with UT Southwestern *:

Identify all contracts or relationships you have with other third parties that might gain access to the results of the study *:

Other comments or information:

* Required Information

Form Version: 03/09/2006