Anesthesiology & Pain Medicine >> Research >> Centers >> Perioperative & Pain initiatives in Quality Safety Outcome (PPiQSO)

PPiQSO Technology Project Request

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Technology title: _________________________________

1. Project PI or Contact:
<Name, email and phone>
Additional Study Team Members:
<Name, email and phone>

2. Clinical/Operational/Administrative problem:
What is the clinical/operational/ administrative problem, why is it significant?
<State the clinical/operational/administrative problem, provide brief description of the project significance and background>

3. Proposed technology goals:
What are the goals of the proposed technology? How will the technology improve the clinical/operational/administrative problem stated above?
<If a research study, list the study hypothesis or hypotheses and the specific aims associated with each>

4. Technology description:
Brief description of the technology. Are there any alternatives? Why is the proposed technology needed?

4.1 Desired technology functionality
<Briefly describe the technology>

4.2 Target population
<Which perioperative patient population or providers will the technology target?>

4.3 Data used and produced by the technology
<Will the technology consume or produce any data, if so explain data sources and frequency of access>

5. Technology evaluation: How will the technology be evaluated?

5.1 Evaluation measures
<What are the primary and secondary measures used to evaluate the technology>

5.2 Sample size (if known) or desired target if known
<Specify the study sample size if known, or minimum target sample size that you need/want to evaluate the technology>

5.3 Statistical analysis plan (for research studies)
<Brief description of statistical methods for each hypothesis>