Population Data Management - Support Request Form (RC-PDM)

Population Data Management Support Request Form

Mount Sinai Claude D. Pepper Older Americans Independence Center
The Population Data Use and Management Resource Core (RC-PDM) of Mount Sinai's Claude Dr. Pepper Older Americans Independence Center (OAIC) provides data management and operational support to investigators interested in population-based research of older adults. RC-PDM is co-led by Dr. Claire Ankuda & Dr. Carolyn Zhu.

This form is intended to gather information for projects of varying scope and stage. While a few fields are required, it's okay if you don't (yet) have all information that this form includes.

This request is distinct from the Biostatistician Consulation Request form, which can be found here.

Please email katelyn.ferreira@mssm.edu with any questions regarding this form.
Name

First NameLast Name
Email
example@example.com
Role/training level

Other
Completed degree(s), including area of study if applicable.
(e.g., MD, PhD in Epidemiology, MPH, MA in Economics)
Department (if Mount Sinai) / Institution (if non-Mount Sinai)
If you are a Mount Sinai employee, do you work remotely or on campus?
What type(s) of support are you requesting at this stage? (Note that some of these may not be possible at this time, depending on data use restrictions and capacity.)

Other
Is this project part of a career development plan or Career Development Award (CDA)?

Other
If this project is (or may be) part of a career development plan or CDA, please provide details.
Is this project part of a pilot funded by Mount Sinai's Pepper OAIC?

Other
If this project is (or may be) part of a pilot funded by Mount Sinai's Pepper OAIC, please provide details.
Do you have a mentor on this project?

Other
Please include the name(s) of mentor(s) below.
Please add team members here (including yourself, any mentor[s], and others).
Please provide a brief summary of your project, in 250 words or less.

0/250
Do you know what dataset(s) you are interested in?
Does your project/idea involve CMS claims data?

Other
Does your project/idea involve geographic data?

Other
If your project involves geographic data, please include notes about survey and non-survey sources, geographic resolution, etc.
Please feel free to include URLs to publicly available datasets here.
What is the planned/ideal timeline for your project?
Please note intended/ideal start date & length of time (e.g., starting in December 2021, for a period of one year).
Do you have funding for this project?
Please share any applicable details regarding funding here.
This can include funder, timing, or decision-making regarding funding.
If you have (current or planned) funding, have you budgeted for analytic support?
If you have (current or planned) funding with analytic support, what amount have you budgeted?
Please include an amount in USD (e.g., $10,000), a % FTE with salary (e.g., 10% at $80,000), and/or a # of calendar months with salary (e.g., 1.2 calendar months at $80,000).
What is the status of your IRB submission, if applicable?

Other
If you have an IRB approval letter, please upload it here.

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Do you know any programming languages/software?
Please describe your level of familiarity with the above, if applicable.
If you have a project proposal or research strategy section for this project, please upload it here.

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If you'd like to share your CV or biosketch, please upload it here.

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Have you had a previous conversation regarding this request with a member of our team?

Other
Should be Empty:

Population Data Management Support Request Form