Novartis Digital Biomarker Innovation Challenge Questionnaire




* = required fields


Name of your company*


What kind of group owns this technology?*

Start-up company
Mature company
Academic research group
Other:

Contact person*



Contact Email Address*


Repeat Email Address*



Contact phone number*



Which country are you located?*


Name of your technology*


Website



Which of digital biomarker research themes are you proposing an opportunity for?*

Cognition and attention
Fatigue
Sleep
Depression and mood
Pain
Mobility
Digital imaging of skin
Others:

Briefly explain what the opportunity is (i.e. which aspect of our theme/s is it connected to?)*



What physiological/behavioural parameter/s does the technology measure? Any scientific evidence/validation?


Patent (Link: )
Key scientific publication (Link: )
Other (Link: )

Device classification*

Low-risk (class I) device
Moderate-to-high risk (class II/III) device
Not applicable

Device status*

Discovery and ideation
Invention and prototyping
Clinical trial phase (Trial No.: )
Regulatory reviewing (Name of the authority: )
Product launched (Registration: )

A short presentation (up to 5 slides) supporting your description*



Why are you personally excited about this opportunity?



Apart from our specified research themes, is there anything else you would like to share with NIBR about the technology landscape in your country eg. "cutting-edge" technologies, "left-field" ideas that we should be considering in the digital biomarker/digital endpoint space?



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Confidentiality
Any documents and information submitted and all communication during the application process will be considered as non-confidential. Applicants agree that any documents and information submitted will be accessible to the Novartis and ETBA review committee, as well as the domain experts for the evaluation purpose. Novartis and ETBA assume no responsibility or liability for any confidential information and/or documentation submitted by applicants during the on-line application process as well as for any intellectual property rights and/or know-how contained therein.

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