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Cancer Center Research
Population Health and Cancer Outcomes Core (PHCOC) Service Request Form
In This Section
Population Health and Cancer Outcomes Core (PHCOC) Service Request Form
PI Contact Information
Name
If student or fellow, include name of faculty member you will be working under
Department
Phone Number
Email Address
Project Title
Project description (goals and/or hypothesis):
[500 words max]
Analysis Plan (variables and analytic approach):
[1,000 words max]
Goal for this Core service request:
Grant proposal
Cancer Center Report/Presentation
Peer-reviewed paper publication
Other…
Enter other…
Based on your initial literature review for the proposed project, please describe how your project would uniquely contribute to the science and literature. Please summarize the potential impact that your project could have based on the current literature.
Uniqueness:
Potential Impact:
Is this project funded?
Yes
No
Other
Enter other…
How would you pay for this Core service request?
Existing funding/grants
Pending grants
Request for a fee waiver for the initial phase of the project
Cancer Center directly related request which is exempt from fee-for-service
Has this project received IRB approval?
No, approval not required
No, approval will be sought
Approval Pending
Yes
IRB#
Services Area Requested
Large population data analysis including epidemiologic analysis, spatial analysis and visualization, econometric analysis, ecological analysis etc.
Population health measurement and study design including psychometric analysis, survey development, power analysis, complex survey data analysis etc.
Patient reported health outcome measurement and health services research
Economic evaluation including treatment effect analysis, causal inferences, cost-benefit/cost-effectiveness analysis, simulation, economic attribute-based survey design and analysis etc.
Data management for restricted data sets
Population-based cancer research lab/team for grants
Other…
Enter other…
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