Application form for MDSi based research

1. Title of your research paper *

2. Involved persons *

3. Problem and Research Question *

4. Hypothesis *

5. Current Knowledge *

6. A.) Timeline to publication in months *

6. B.) Which data elements of the central MDSi-database (cf. MDSi Concept V.26, Ahg. 5) are required/analysed (by KDS) *

7. Results: Your thoughts on evaluation and statistics *

8. Who writes the paper (explanation of results obtained, with respect to the current knowledge, new aspects ..)

9. What happens to the Publication (In which journal is it published? When?) *

10. Date of submission to KDS (DD.MM.YYYY) *

11. Responsible member of the SGI-SSMI *

Somma 3 a 2.

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Società Svizzera di Medicina Intensiva
Schweizerische Gesellschaft für Intensivmedizin
Société Suisse de Médecine Intensive
c/o IMK Institut für Medizin und Kommunikation AG
Münsterberg 1
4001 Basel

+41 61 561 53 64
sgi@imk.ch

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