Proforma for adoption of research projects into the HOME Initiative
Title of project:
Which research groups does this project relate to (tick all that apply) ?
Symptoms domain

Signs domain

Long term control domain 
Quality of Life domain

Other (please specify)
 _____________________________________________
What is the research question to be answered? (1-2 sentences only)
Give a brief explanation of why this research is needed
Give a brief summary of methods to be used, including which outcome measures will be included
Primary outcome
Secondary Outcome (s)
Version 3 JC Jun 2012
Proforma for adoption of research projects into the HOME Initiative
Is external funding needed for the project?
Yes / No
If yes, is the funding already secured?
Yes / No
If yes, name of funder _________________________________________________
If no, where do you propose to obtain funding from? ________________________
___________________________________________________________________
Please provide details below of everyone planning to work on this project. Please also indicate
who is the lead for this research project.
Name and Role in project
Institution
Email address
Telephone number
Name and Role in project
Institution
Email address
Telephone number
Name and Role in project
Institution
Email address
Telephone number
Name and Role in project
Institution
Email address
Telephone number
Name and Role in project
Institution
Email address
Telephone number
Name and Role in project
Institution
Email address
Telephone number
Do you need any further expertise / collaborators to complete the research group?
Version 3 JC Jun 2012
Proforma for adoption of research projects into the HOME Initiative
For official use only
Name of reviewer from Scientific oversight committee______________________________
Recommendation
Proceed as a “core” priority HOME research project
Proceed as a “related” HOME research project
Not directly relevant to HOME but will support through website presence etc.
Not relevant to HOME




Action required
No further support required
Require help in identifying collaborators
Require methodology support e.g. statistician



Version 3 JC Jun 2012