STInG Membership Application STInG membership application The primary aim of the ACTA STInG is to improve the statistical quality of investigator initiated clinical trials within Australia through enhanced collaboration among trial statisticians/ data analysts. It is a networking group between statisticians/ data analysts, it provides opportunity for collaboration and support, and provides a resource for contacting statisticians working in a particular research field. The group is open to trained biostatisticians with experience working in clinical trials/ registries across Australia, as well as clinicians with an interest in statistical methods and increasing recognition of the critical role of statistics in clinical trials/ registries. In order to become a member of this interest group, we ask you to complete the brief questionnaire below. Note: There are no fees for membership. Being a member of ACTA STInG does not require (affiliate) membership of ACTA but we encourage you to consider supporting ACTA in this way. Please visit https://clinicaltrialsalliance.org.au/membership/ Application to be a member of ACTA Statistics in Trials Interest Group (STInG) Title Name Name First Name First Name Last Name Last Name Work address City State Post Code Country Work Phone Work Mobile Work Email Please list the organisations you are employed by or affiliated with Current position title Which one of the following professional categories do yourepresent? (Please select ONE only) Statistician Clinical Research Health Professional Trial Coordinator/ Project Manager Health Professional In which field do you work? Clinical trials Clinical registries Both Neither If you currently work with a clinical registry, please name the registry/ registries and briefly describe your role. Do you have experience contributing to: (Select ALL thatapply) Registry-based trial designs Statistical analysis plans for registries, Registry reporting (e.g. annual/ site/ industry reports) Data linkage or integration across registries Quality assurance or data governance for registries None of the above Please tell us a little bit about your experience in statistics relating to clinical trials or clinical registries Areas of interest: (Select ALL that apply) Learning from peers in registry reporting, registry-based trial methodology Contributing to STInG’s working groups or resources, Participating in the registry statistician mentoringprogram Presenting at webinars or meetings Networking with other registry data analysts/statisticians What other benefits are you hoping to get out of STInG membership, and how are you intending to contribute to thegroup? Would you like to be included on our Find A Statistician(FAS) database- a directory where statisticians can searchfor other statisticians with experience in a particular area inorder to be able to reach out to them for support andcollaboration? It is only accessible to statisticians who aremembers of ACTA STInG. Yes, please add my details to the directory No, view-only access Are you or your organisation a member of ACTA? Yes- Individual Member No Unsure Would you like to receive our monthly ACTA newsletter(via email)? Yes No Add my details to the ACTA Find A Statistician (FAS) Directory Trial Phase (Select ALL that apply) Phase 1 Phase 2 (including dose ranging) Phase 3 (regulatory confirmation), Phase 4 (post marketing) Trial Sponsorship (Select ALL that apply) Investigator-initiated trials Option 2 Trial Design (Select ALL that apply) Parallel-group randomised Cluster-randomised Randomisation Method (Select ALL that apply) Stratified Simple or blocked Other areas of expertise (Select ALL that apply) Cluster-randomised Trials in public health Survival analysis Multi-level analysis Meta-analysis, Please note the 3 main areas of your statistical/ clinicaltrial expertise that you would like displayed on your profilecard. Please list the therapeutic areas (or diseases) in whichyou have designed a clinical trial. What year did you start working on clinical trials? Would you be willing to be on a list of potential DSMBstatisticians available to other STInG statisticians? Yes No Maybe, I need more information Do you have previous experience being on a DSMB? Yes No Have you prepared a report for a DSMB? Yes Neo Have you served on a DSMB as an independentstatistician? Yes No Please provide the number of DSMB’s for which you haveserved as a DSMB statistician (including current). Submit If you are human, leave this field blank. Δ
