Prof. Hans Christoph Diener, (VISTA-Prevention Chair)Department of Neurology University of Duisburg-Essen Dr. Myzoon Ali (VISTA Coordinator)University of Glasgowwww.firstname.lastname@example.org
Data Contribution FormClinical datasets will be lodged with the Robertson Centre for Biostatistics, University of Glasgow on behalf of VISTA.
Section 1.0 Clinical Dataset InformationSection 1.1Using the checklist below, please ensure that your clinical datasets meet the eligibility criteria for VISTA-Prevention.
Minimum dataset of 100 Patients
Documented entry criteria
Documented consent following local IRB-approved procedure
Baseline assessment includes recording of persisting disability by at least one of NIHSS, SSS, Rankin, Barthel or GOS and of basic risk factors including diabetes, atrial fibrillation
Outcome assessment includes non-fatal stroke, non-fatal MI and mortality
Monitoring procedures existed to validate data
Please check the boxes corresponding to the format of your data.
SAS data sets
Microsoft Excel spreadsheets
Microsoft Access Database
Other (please state)
Section 2.0 Contribution Procedure Please provide contact details for the Principal Investigator(s) who will represent the trial on the VISTA-ICH Steering Committee:
Section 2.2Please detail the inclusion of relevant documents for your clinical dataset in the check-box below and attach these documents using the file transfer link that will be emailed separately
All fields marked with * are essential
Please tick all files that are attached electronically
Raw Data* 1
Data Dictionary 2
Annotated CRF* 3
Ethics Approval* 5
Consent to hold/ collect original data 5
Section 3.0 Memorandum of Understanding Summary
I hereby acknowledge that I have read and understood the terms and conditions and consent to the contribution of the proposed trial/ registry to VISTA-Prevention.
The raw datasets can be transferred using the University of Glasgow’s file transfer system. A separate link will be emailed to you following submission of this form.
Agree to Terms and Conditions
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