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Barwon Health Research Reference Number Generator

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Please complete the below questions to generate a Barwon Health reference number for your research project.

An email confirming your reference number will be sent to the email address provided below upon completion of this form. This may take 1 - 2 minutes to deliver.

Please email RDU@barwonhealth.org.au if you do not receive an email containing your reference number.

Reference Number
______/______

Year

Project Title

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Project Short Title

Principal Investigator

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Contact Email Address
(An automated email containing your Barwon Health Reference Number will be sent to this address)

* must provide value

Department performing the project

Directorate	Department

Not sure which Department to select? Select the department where the majority of the research will be conducted OR if it is equally spread across departments, select the department that reflects the Principal Investigator's profession.

Department

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If other, please state your department

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What is your profession?

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Other

Please select the research type that best describes your project.

Research Type	Definition
Laboratory/Basic Science	National Statement 3.2 describes biospecimens as, "any biological material obtained from a person including tissue, blood, urine, sputum; it also includes any derivative of these such as cell lines. It does not include non-human biological material such as micro-organisms that live on or in a person." Biospecimen analysis includes potential genetic or genomic investigations.
Epidemiological	The World Health Organization describes epidemiology as "the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems. Various methods can be used to carry out epidemiological investigations: surveillance and descriptive studies can be used to study distribution; analytical studies are used to study determinants."
Clinical Trials	Interventional research is the use of one or more substances, devices, treatments, therapies, techniques or processes in a defined cohort of participants to determine its impact or effect on individuals. Interventions can be physical, behavioural, psychological or informational and can be used in clinical, educational or other contexts. Interventional research may or may not: Be comparative, Randomise the participants, Include an experimental arm, and/or Include a placebo arm. The World Health Organization defines a clinical trial as "any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes".
Observational	Observational research involves the researcher observing participant/s in their own environment, or in the environment being studied. Data collection through observation can be structured or unstructured, with the observer as a collaborative participant (participant observation) or external to the environment
Survey/Interview/Focus Group	Interviews involve researchers talking to one or more participants, where the categories of response are focused but not necessarily pre-determined. Interviews are usually recorded by audio- or video-tape, or notes. These records are research data in themselves, but also may be transcribed. Interviews are usually conducted in locations mutually acceptable to participants and interviewers. Focus groups of participants discuss a set of research questions or topics. This may entail the researcher acting as a moderator for the discussion.
Quality Assurance/Clinical Audit	A project that involves the potential for no more than negligible risk. Typically these projects involve an audit or evaluation

* must provide value

Laboratory/Basic Science

Epidemiological

Clinical Trial

Observational

Survey/Interview/Focus Group Research

Quality Assurance/Clinical Audit

Other

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Research Type

* must provide value

Clinical Trial Device

Clinical Trial Under CTN/CTA

Clinical Trial - Interventional

Clinical Research

Laboratory/Basic Science

Psychological Research

Public Health Research

Cohort

Qualitative Research

Registry/Database

Quality Assurance/Audit

Social Science

Case Study

Authorised Prescriber

Nursing

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Phase

* must provide value

III

Pilot

Other

What is your ANZ Clinical Trial Registration number?

* must provide value

Are Barwon Health acting as the lead site for this trial?

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Yes

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Are Barwon Health Leading this Research? (DU/BH Joint or Honorary CPIs included)

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Yes

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Please provide a brief description/summary of your research

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Expand

Sites

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Single Site

Multi Site

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Project Review Type

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Barwon Health HREC

National Mutual Acceptance - External HREC

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Level of Ethical Risk

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Minimal Risk/Audit/Quality Assurance

Low Risk

High Risk

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If you're unsure about the level of risk your project involves, please use the Ethical Risk Checklist below.

Attachment:Ethical Risk Checklist.pdf

Name of Reviewing HREC

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Sponsor Type

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Commercially Sponsored

Collaborative

Investigator Initiated - Institution Sponsored

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Name of Commercial Sponsor

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Name of Australian CRO (Contract Research Organisation)

Name of Acting Sponsor (Australian Entity)

Every research project requires ONE Institution or Collaborative Group to take overall responsibility for the conduct of the research. If unclear, please provide the name of the Instiution where the Chief Principle Investigator is employed.

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