Data Analytic Core (DAC)
Request for Research Support
Analytic Memorandum
__________________________________________________________________________________________________
Instructions:
Fill out and submit research request to the DAC Prioritization Review Committee. Upon
approval, DAC Projects Manager will begin project tracking and an analyst will be
assigned.
Contact Information:
Principal Investigator:
Assigned Analyst:
Other Research Team Members:
Project Management :
Date of Request:
Date of Completion:
Estimated Time to
Complete:
DUA:
Chart String:
Funding Source:
IRB:
IRB Expiration Date:
General Research
Project Description:
Project Name:
Short Description of Research Question:
Identify Research Products (Conference,
Journal Publication, etc.):
Major Task(s) to Accomplish:
Last Modified By:
Date Last Modified:
Page 1
Define Cohort:
A.
Use Pre-existing Cohort:
B.
Define New Cohort:
1) Index Event (inclusions):
2) Exclusions:
3) Sampling Instructions:
Time Frame
Sample and
Definitions:
Max Follow-up
Date
Accrual Window
Time
Look-back window
Observation Period
(look for outcomes)
Index Date
Accrual Start/End Dates:
Max Follow-up Date:
Observation Window:
Look back Window:
Last Modified By:
Date Last Modified:
Page 2
Defining Analytic
Variables:
Main Exposure or Risk
Factor:
Time period -

Covariates:
Outcome Definitions:
Time period -

Outcome Definitions:
Time period -

Outcome Definitions:
Time period -

Outline of
Analysis Plan:
Create Cohort & Summary Report (dataset creation report)
Step 1:
Step 2:
Step 3:
Step 4:
Data Sources:
Last Modified By:
Date Last Modified:
Data Sources
Percent Sample
1
Click Here for Data Sources
Click Here for % Sample
2
Click Here for Data Sources
Click Here for % Sample
3
Click Here for Data Sources
Click Here for % Sample
4
Click Here for Data Sources
Click Here for % Sample
5
Click Here for Data Sources
Click Here for % Sample
6
Click Here for Data Sources
Click Here for % Sample
7
Click Here for Data Sources
Click Here for % Sample
8
Click Here for Data Sources
Click Here for % Sample
9
Click Here for Data Sources
Click Here for % Sample
10
Click Here for Data Sources
Click Here for % Sample
Years
Page 3
Deliverables:
Deliverables From Analyst
To Investigator:
Attachments:
Last Modified By:
Date Last Modified:
Page 4