RTC Registry Form

What Works Clearinghouse – Registry of Randomized Controlled Trials Details

Forms and Commitment Letter:
A user of the Registry of Randomized Controlled Trials who wishes to submit data and not
simply search the registry is required to submit forms about contact information and study
details, along with a signed commitment letter.

Commitment Letter:
In order to complete the submission, a user will be required to complete the following forms.
Additionally, the user is required to send a signed commitment letter via fax to the What Works
Clearinghouse (WWC). Any information supplied by the user through the online forms will be
posted only if a signed commitment letter is received.

Online Forms:
Contact Information
Field Name
First Name
Last Name
Prefix

Title
Type

Organization
Phone Number

Fax Number

No Fax Number
Email
Confirm Email
Address Line 1
Address Line 2
City

Field Type and Validation
Text Box
Text Box
Pre-populated drop-down menu with the following options:
1. Dr.
2. Hon.
3. Mr.
4. Mrs.
5. Ms.
6. Prof.
Text Box
Pre-populated drop-down menu with the following options:
1. Individual
2. Organization
Text Box
Text Box
Numeric data in one of the following three formats:
(XXX) XXX-XXXX
XXX-XXX-XXXX
XXXXXXXXXX
Text Box
Numeric data in one of the following three formats:
(XXX) XXX-XXXX
XXX-XXX-XXXX
XXXXXXXXXX
Check Box
Text Box
Data check for @ and . symbols
Text box
Data check for entry identical to Email
Text Box
Text Box
Text Box

Required to Save
Yes
Yes
Yes

Yes
Yes

Yes
Yes

Not required if “No
Fax Number”
option is selected

No
Yes
Yes
Yes
No
Yes

What Works Clearinghouse – Registry of Randomized Controlled Trials Details

Contact Information (Continued)
Field Name
Foreign State

State

Country
ZIP Code

Save
Reset

Field Type and Validation
Check Box
If checked, this will disable the state drop-down menu and
open a new text box for the foreign state or territory
information. This will void the validation on the ZIP Code
field.
Pre-populated drop-down menu with list of U.S. states

Pre-populated drop-down menu with list of all countries
Text Box
Numeric data in the following format:
XXXXX ( length = 5)
Button
Button

Required to Save
No

Not required if
“Foreign State” is
selected
Yes
Not required if
“Foreign State” is
selected
Yes
No

Randomized Controlled Trial Study Information
Field Name
Field Type and Validation
Study Information – For Studies Funded and In Progress
Study Status
Radio Button options:
1. Funded and In Progress
2. Completed with Available Final Report
RCT Title
Text Box
Principal Investigator
Text Box
First Name
Principal Investigator
Text Box
Last Name
Principal Investigator
Pre-populated drop-down menu with the following options:
Prefix
1. Dr.
2. Hon.
3. Mr.
4. Mrs.
5. Ms.
6. Prof.
Principal Investigator
Text Box
Title
Start Date
Text Box
Numeric data in one of the following two date formats:
mm/dd/yyyy
mm-dd-yyyy
Anticipated End Date
Text Box
Numeric data in one of the following two date formats:
mm/dd/yyyy
mm-dd-yyyy
Sponsor
Text Box

Continued on Next Page

Required to Save
Yes

Yes
Yes
Yes
Yes

No
Yes

Yes

Yes

What Works Clearinghouse – Registry of Randomized Controlled Trials Details

Randomized Controlled Trial Study Information
Field Name
Field Type and Validation
Study Abstract and Details – For Studies Funded and In Progress
1. What is the study setting?
Text Box
2. What is the intervention?
Text Box
3. What is the randomized unit?
Radio Button options:
1. Cluster
2. Individual
4. Study Sample Characteristics
Check Box Options:
Gender
1. Male
2. Female
3. Not Applicable
Student Race/Ethnicity
1. American Indian or Alaska Native
2. Asian
3. Black or African American
4. Caucasian
5. Hispanic or Latino
6. Native Hawaiian or Other Pacific Islander
7. Not Applicable
Student Level(s) of Education
1. Adult/Continuing Education
2. Elementary School
3. High School
4. Kindergarten
5. Middle School
6. Preschool
7. Postsecondary Education
8. Vocational/Career Education
9. Not Applicable
Student Disability
1. Autism
2. Deaf-Blindness
3. Deafness
4. Emotional Disturbance (ED)
5. Hearing Impairment
6. Mental Retardation
7. Multiple Disabilities
8. Orthopedic Impairment
9. Other Health Impairment (OHI)
10. Specific Learning Disability (LD)
11. Speech or Language Impairment
12. Traumatic Brain Injury
13. Visual Impairment
14. Not Applicable
5. Additional Study Sample Information
Text Box
6. What research design and methods
Text Box
will be used?
7. What is the control (counterfactual)
Text Box
condition?
8. What are the intended primary
Text Box
outcomes?
9. What are the intended secondary
Text Box
outcomes?
10. What is the data analytic strategy?
Text Box
11. Summary of the Study/Abstract
Text Box
Save
Button
Reset
Button

Required to Save
Yes
Yes
Yes

Yes (at least 1 of 3)

Yes (at least 1 of 7)

Yes (at least 1 of 9)

Yes (at least 1 of 14)

Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
No

What Works Clearinghouse – Registry of Randomized Controlled Trials Details

Randomized Controlled Trial Study Information
Field Name
Field Type and Validation
Study Information – For Studies Completed with an Available Final Report
Study Status
Radio Button options:
1. Funded and In Progress
2. Completed with Available Final Report
RCT Title
Text Box
Principal Investigator
Text Box
First Name
Principal Investigator
Text Box
Last Name
Principal Investigator
Pre-populated drop-down menu with the following options:
Prefix
1. Dr.
2. Hon.
3. Mr.
4. Mrs.
5. Ms.
6. Prof.
Principal Investigator
Text Box
Title
Start Date
Text Box
Numeric data in one of the following two date formats:
mm/dd/yyyy
mm-dd-yyyy
End Date
Text Box
Numeric data in one of the following two date formats:
mm/dd/yyyy
mm-dd-yyyy
Sponsor
Text Box
Web Address for Report Text Box
Published Report
Text Box
Citation (APA Format)

Continued on Next Page

Required to Save
Yes

Yes
Yes
Yes
Yes

No
Yes

Yes

Yes
No
Yes

What Works Clearinghouse – Registry of Randomized Controlled Trials Details

Randomized Controlled Trial Study Information
Field Name
Field Type and Validation
Study Abstract and Details – For Studies Completed with an Available Final Report
1. What was the study setting?
Text Box
2. What was the intervention?
Text Box
3. What was the randomized unit?
Radio Button options:
1. Cluster
2. Individual
4. Study Sample Characteristics
Check Box Options:
Gender
1. Male
2. Female
3. Not Applicable
Student Race/Ethnicity
1. American Indian or Alaska Native
2. Asian
3. Black or African American
4. Caucasian
5. Hispanic or Latino
6. Native Hawaiian or Other Pacific Islander
7. Not Applicable
Student Level(s) of Education
1. Adult/Continuing Education
2. Elementary School
3. High School
4. Kindergarten
5. Middle School
6. Preschool
7. Postsecondary Education
8. Vocational/Career Education
9. Not Applicable
Student Disability
1. Autism
2. Deaf-Blindness
3. Deafness
4. Emotional Disturbance (ED)
5. Hearing Impairment
6. Mental Retardation
7. Multiple Disabilities
8. Orthopedic Impairment
9. Other Health Impairment (OHI)
10. Specific Learning Disability (LD)
11. Speech or Language Impairment
12. Traumatic Brain Injury
13. Visual Impairment
14. Not Applicable
5. Additional Study Sample Information
Text Box
6. What research design and methods
Text Box
were used?
7. What was the control (counterfactual)
Text Box
condition?
8. What were the primary outcomes?
Text Box
9. What were the secondary outcomes?
Text Box
10. What was the data analytic strategy?
Text Box
11. Summary of the Study/Abstract
Text Box
12. Interpretation of Results/Discussion
Text Box
Save
Button
Reset
Button

Required to Save
Yes
Yes
Yes

Yes (at least 1 of 3)

Yes (at least 1 of 7)

Yes (at least 1 of 9)

Yes (at least 1 of 14)

Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
No