Clinical Trial Evaluation Rubric Form
Assess a clinical trial proposal or protocol using the rubric and share your recommendation.
Evaluator Name
*
First Name
Last Name
Evaluator Role or Affiliation
*
Trial Title or Identifier
*
Trial Phase
*
Please Select
Phase I
Phase II
Phase III
Phase IV
Other or not specified
Evaluation Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Proposal or Protocol Rubric
*
Rows
Rating
Scientific rationale
1 — Poor
2 — Needs improvement
3 — Adequate
4 — Strong
5 — Excellent
Not applicable
Study design and methodology
1 — Poor
2 — Needs improvement
3 — Adequate
4 — Strong
5 — Excellent
Not applicable
Feasibility
1 — Poor
2 — Needs improvement
3 — Adequate
4 — Strong
5 — Excellent
Not applicable
Participant safety and ethical safeguards
1 — Poor
2 — Needs improvement
3 — Adequate
4 — Strong
5 — Excellent
Not applicable
Data quality and statistical plan
1 — Poor
2 — Needs improvement
3 — Adequate
4 — Strong
5 — Excellent
Not applicable
Strengths and Rationale
*
Concerns or Areas Needing Clarification
*
Overall Rating
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Recommendation
*
Recommend approval
Recommend approval with revisions
Request major revision and reevaluation
Do not recommend
Submit Evaluation
Should be Empty: