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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03646227
Registration number
NCT03646227
Ethics application status
Date submitted
15/08/2018
Date registered
24/08/2018
Titles & IDs
Public title
Multi-Drug Resistant Organism Network
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Scientific title
Multi-Drug Resistant Organism Network - MDRO Network
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Secondary ID [1]
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UM1AI104681
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Secondary ID [2]
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Pro00071149
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Universal Trial Number (UTN)
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Trial acronym
MDRO Network
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Infections Resistant to Multiple Drugs
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Bacterial Infections
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Condition category
Condition code
Infection
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Studies of infection and infectious agents
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Infection
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Other infectious diseases
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Infection
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Sexually transmitted infections
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Other interventions - Standard of Care
Other interventions: Standard of Care
There is no prescribed intervention for this study. Standard of care will be captured in the eCRF.
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Intervention code [1]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Disposition at Discharge
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Assessment method [1]
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The disposition at discharge is a composite of different locations, to which the subject is discharged (skilled nursing facility, home, long term acute care facility, transfer to another hospital, death, or hospice) and it is used to compare patient outcomes based on MDRO collected form the subject.
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Timepoint [1]
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Up to 1 year from index culture date
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Primary outcome [2]
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Charlson Score
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Assessment method [2]
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Components of the Charlson Score are collected from the medical record and the Charlson comorbidity index is calculated to determine chronically ill subjects.
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Timepoint [2]
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At 90 days after discharge from the index hospitalization
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Primary outcome [3]
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Pitt Bacteremia Score
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Assessment method [3]
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Components of the Pitt Bacteremia Score are collected from the medical record and the Pitt bacteremia score is calculated to determine acutely ill subjects.
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Timepoint [3]
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On the day of index culture
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Primary outcome [4]
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Source of positive culture
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Assessment method [4]
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The differences in outcomes based on the anatomic source of the positive culture are determined. The anatomic sources collected are blood, respiratory, urine, wound, abdominal, and other, which is collected from the medical record.
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Timepoint [4]
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At collection of the MDRO isolates
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Primary outcome [5]
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Length of Stay
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Assessment method [5]
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The length of stay is determined by the hospital admission and discharge dates, which is collected from the medical record.
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Timepoint [5]
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Up to 1 year from index culture date
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Primary outcome [6]
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ICU Admissions
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Assessment method [6]
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The total number ICU days during the index hospitalization will be collected from the medical record to determine high risk populations and exposure.
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Timepoint [6]
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Up to 1 year from index culture date
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Primary outcome [7]
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Antibiotic Summary
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Assessment method [7]
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All antibiotics administered during the hospital stay will be collected from the medical record. The antibiotic name, duration of therapy, frequency of dosing, dosage, and reason for discontinuation will be collected for the antibiotics of interest.
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Timepoint [7]
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Only during hospitalization and up to one year from index culture date
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Primary outcome [8]
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Survival Status
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Assessment method [8]
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Survival status will be collected through 90 days after discharge from index hospitalization, up to one year, to determine mortality.
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Timepoint [8]
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90 days from discharge or up to one year from index hospitalization.
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Primary outcome [9]
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Readmission Status
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Assessment method [9]
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Readmission data will be collected through 90 days after discharge from index hospitalization to determine readmission.
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Timepoint [9]
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90 days after discharge from index hospitalization.
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Eligibility
Key inclusion criteria
* Hospitalized patients.
* Must have at least one multi-drug resistant organism isolated from a clinical culture while hospitalized.
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Patients who do not have a positive culture during hospitalization.
* Patients who's only positive culture was obtained outside of hospital admission.
* Patients who have cystic fibrosis and a CRPa infection.
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Study design
Purpose
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Duration
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Selection
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/06/2016
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
30/05/2020
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Sample size
Target
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Accrual to date
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Final
6496
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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The University of Queensland Centre for Clinical Research - Herston
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Recruitment postcode(s) [1]
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4029 - Herston
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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North Carolina
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Country [2]
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China
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State/province [2]
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Shanghai
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Country [3]
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Colombia
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State/province [3]
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Bogota
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Funding & Sponsors
Primary sponsor type
Other
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Name
Duke University
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Address
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Country
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Other collaborator category [1]
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Government body
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Name [1]
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National Institute of Allergy and Infectious Diseases (NIAID)
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
This study is specifically designed to provide observational data which can be used to help in the design of future randomized clinical trials on both therapeutics and diagnostics for MDRO infections. To this end, clinical and epidemiological data will be collected on patients who have MDRO isolated from clinical cultures during hospitalization, as well as descriptions of the outcomes of patients treated with various antimicrobial regimens. Molecular and microbiological characterization will also be performed on MDRO isolates. These data will include a detailed clinical and epidemiological description of patients including identifying potential barriers to enrollment in future trials. In addition, data will be collected on species, strain type, and mechanism of drug resistance of the causative organism. Knowing the molecular characteristics will further inform future trial design as not all diagnostics detect and not all therapeutics are active against the same mechanisms of resistance.
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Trial website
https://clinicaltrials.gov/study/NCT03646227
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Trial related presentations / publications
Clatworthy AE, Pierson E, Hung DT. Targeting virulence: a new paradigm for antimicrobial therapy. Nat Chem Biol. 2007 Sep;3(9):541-8. doi: 10.1038/nchembio.2007.24. Infectious Diseases Society of America (IDSA); Spellberg B, Blaser M, Guidos RJ, Boucher HW, Bradley JS, Eisenstein BI, Gerding D, Lynfield R, Reller LB, Rex J, Schwartz D, Septimus E, Tenover FC, Gilbert DN. Combating antimicrobial resistance: policy recommendations to save lives. Clin Infect Dis. 2011 May;52 Suppl 5(Suppl 5):S397-428. doi: 10.1093/cid/cir153. No abstract available. Vardakas KZ, Rafailidis PI, Konstantelias AA, Falagas ME. Predictors of mortality in patients with infections due to multi-drug resistant Gram negative bacteria: the study, the patient, the bug or the drug? J Infect. 2013 May;66(5):401-14. doi: 10.1016/j.jinf.2012.10.028. Epub 2012 Nov 6. Zasowski EJ, Rybak JM, Rybak MJ. The beta-Lactams Strike Back: Ceftazidime-Avibactam. Pharmacotherapy. 2015 Aug;35(8):755-70. doi: 10.1002/phar.1622. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM Jr, Musher DM, Niederman MS, Torres A, Whitney CG; Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2(Suppl 2):S27-72. doi: 10.1086/511159. No abstract available. American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416. doi: 10.1164/rccm.200405-644ST. No abstract available. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008 Jun;36(5):309-32. doi: 10.1016/j.ajic.2008.03.002. No abstract available. Erratum In: Am J Infect Control. 2008 Nov;36(9):655. van Duin D, Perez F, Rudin SD, Cober E, Hanrahan J, Ziegler J, Webber R, Fox J, Mason P, Richter SS, Cline M, Hall GS, Kaye KS, Jacobs MR, Kalayjian RC, Salata RA, Segre JA, Conlan S, Evans S, Fowler VG Jr, Bonomo RA. Surveillance of carbapenem-resistant Klebsiella pneumoniae: tracking molecular epidemiology and outcomes through a regional network. Antimicrob Agents Chemother. 2014 Jul;58(7):4035-41. doi: 10.1128/AAC.02636-14. Epub 2014 May 5. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P; Acute Dialysis Quality Initiative workgroup. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004 Aug;8(4):R204-12. doi: 10.1186/cc2872. Epub 2004 May 24. Chow JW, Yu VL. Combination antibiotic therapy versus monotherapy for gram-negative bacteraemia: a commentary. Int J Antimicrob Agents. 1999 Jan;11(1):7-12. doi: 10.1016/s0924-8579(98)00060-0. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. doi: 10.1016/0021-9681(87)90171-8. Wang M, Earley M, Chen L, Hanson BM, Yu Y, Liu Z, Salcedo S, Cober E, Li L, Kanj SS, Gao H, Munita JM, Ordonez K, Weston G, Satlin MJ, Valderrama-Beltran SL, Marimuthu K, Stryjewski ME, Komarow L, Luterbach C, Marshall SH, Rudin SD, Manca C, Paterson DL, Reyes J, Villegas MV, Evans S, Hill C, Arias R, Baum K, Fries BC, Doi Y, Patel R, Kreiswirth BN, Bonomo RA, Chambers HF, Fowler VG Jr, Arias CA, van Duin D; Multi-Drug Resistant Organism Network Investigators. Clinical outcomes and bacterial characteristics of carbapenem-resistant Klebsiella pneumoniae complex among patients from different global regions (CRACKLE-2): a prospective, multicentre, cohort study. Lancet Infect Dis. 2022 Mar;22(3):401-412. doi: 10.1016/S1473-3099(21)00399-6. Epub 2021 Nov 9. van Duin D, Arias CA, Komarow L, Chen L, Hanson BM, Weston G, Cober E, Garner OB, Jacob JT, Satlin MJ, Fries BC, Garcia-Diaz J, Doi Y, Dhar S, Kaye KS, Earley M, Hujer AM, Hujer KM, Domitrovic TN, Shropshire WC, Dinh A, Manca C, Luterbach CL, Wang M, Paterson DL, Banerjee R, Patel R, Evans S, Hill C, Arias R, Chambers HF, Fowler VG Jr, Kreiswirth BN, Bonomo RA; Multi-Drug Resistant Organism Network Investigators. Molecular and clinical epidemiology of carbapenem-resistant Enterobacterales in the USA (CRACKLE-2): a prospective cohort study. Lancet Infect Dis. 2020 Jun;20(6):731-741. doi: 10.1016/S1473-3099(19)30755-8. Epub 2020 Mar 6. Erratum In: Lancet Infect Dis. 2020 Jun;20(6):e116. doi: 10.1016/S1473-3099(20)30354-6.
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Public notes
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Contacts
Principal investigator
Name
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David van Duin, MD. PhD
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Address
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University of North Carolina
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Phone
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Fax
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Email
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
The resulting SAP and results will be shared and discussed within the MDRO Publications Committee for the purpose of manuscript developing, and to inform the design of future clinical trials.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP)
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When will data be available (start and end dates)?
Starting January 2017 through November 2019
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Available to whom?
Must have an executed CDA and sub-award with ARLG/Duke for this specific purpose.
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
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Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/27/NCT03646227/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/27/NCT03646227/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03646227