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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03945110
Registration number
NCT03945110
Ethics application status
Date submitted
3/05/2019
Date registered
10/05/2019
Titles & IDs
Public title
Intravesical Glycosaminoglycan Instillation and Urinary Tract Infection in Acute Spinal Cord Injury
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Scientific title
Intravesical Glycosaminoglycan Instillation Following Spinal Cord Injury and Early Urinary Tract Infections; Safety and Feasibility Study
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Secondary ID [1]
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RA/4/20/5351
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Spinal Cord Injuries
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Condition category
Condition code
Infection
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Other infectious diseases
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Injuries and Accidents
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Fractures
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Injuries and Accidents
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Other injuries and accidents
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Neurological
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Other neurological disorders
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Skin
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Other skin conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Devices - iAluRil® intravesical instillations
Experimental: Arm A - Patients in this Arm will receive a series of seven iAluRil® intravesical instillations over a 12-week period as follows: Once per week for 4 weeks; then once every two weeks for 4 weeks; then once 4 weeks later.
No intervention: Arm B - Patients in this Arm will receive usual bladder care only.
Experimental: Arm C - Patients in this Arm will be Spinal Urology Outpatients or Inpatients who are eligible for inclusion and experiencing significant urinary tract infection recurrence and/or complications. Patients will receive a series of seven iAluRil® intravesical instillations over a 12-week period as follows: Once per week for 4 weeks; then once every two weeks for 4 weeks; then once 4 weeks later. Patients will be encouraged and supervised to self-administer iAluRil® intravesical instillations.
Treatment: Devices: iAluRil® intravesical instillations
50ml of a sterile solution of sodium hyaluronate (1.6% 800mg/50ml) and sodium chondroitin sulphate (2% - 1 g/50ml) is administered intravesically (directly into the bladder) via a pre-filled syringe connected to a catheter and held in the bladder for at least 30 minutes.
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Intervention code [1]
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Treatment: Devices
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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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Proportion of eligible traumatic SCI patients who start iAluRil within 10 days post injury
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Assessment method [1]
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The proportion of eligible traumatic SCI patients who were urinary tract infection (UTI) free, able to provide informed consent and receive the first iAluRil instillation within 10 days of SCI
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Timepoint [1]
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10 days pos-SCI for each participant
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Secondary outcome [1]
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Proportion of eligible traumatic SCI patients administered iAluRil within 10 days of SCI who completed seven iAluRil instillations as per protocol over 12 weeks
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Assessment method [1]
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The proportion of eligible traumatic SCI patients administered iAluRil within 10 days who then completed seven iAluRil instillations as per protocol over 12 weeks
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Timepoint [1]
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12 weeks (+/- 1 week) following recruitment for each participant
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Secondary outcome [2]
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Median time to first symptomatic UTI
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Assessment method [2]
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Median time (days) between SCI and first medically diagnosed symptomatic UTI
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Timepoint [2]
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Date of SCI to date of hospital discharge, an average of three months
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Secondary outcome [3]
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Incidence of symptomatic UTI/100 patient days
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Assessment method [3]
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Number of medically diagnosed symptomatic UTIs per 100 days of hospitalisation
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Timepoint [3]
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Date of SCI to date of hospital discharge, an average of three months
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Secondary outcome [4]
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Incidence of other urological complications/100 patient days
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Assessment method [4]
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Number of other (non-UTI) urological complications per 100 days of hospitalisation
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Timepoint [4]
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Date of SCI to date of hospital discharge, an average of three months
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Secondary outcome [5]
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Length of hospital stay
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Assessment method [5]
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Number of days of initial hospitalisation (acute and subacute/rehabilitation)
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Timepoint [5]
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Date of SCI to date of hospital discharge, an average of three months
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Secondary outcome [6]
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Bladder-related quality of life - bladder management difficulties
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Assessment method [6]
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Validated SCI-QOL Questionnaire: 'Bladder Management Difficulties SF8a'
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Timepoint [6]
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Conducted at 12 weeks post recruitment and at 24 weeks post recruitment for each participant
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Secondary outcome [7]
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Bladder-related quality of life - bladder complications
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Assessment method [7]
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Validated SCI-QOL Questionnaire: 'Bladder Complications'
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Timepoint [7]
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Conducted at 12 weeks post recruitment and at 24 weeks post recruitment for each participant
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Secondary outcome [8]
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Incidence of Adverse Events
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Assessment method [8]
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Incidence of significant adverse events requiring medical intervention and/or impacting on hospital length of stay in Arm A will be described
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Timepoint [8]
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During 12-week intervention period for each participant
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Eligibility
Key inclusion criteria
Arm A & B
- Patients hospitalised at Royal Perth Hospital (RPH) in Western Australia following first acute traumatic SCI (with any degree of neurological impairment)
Arm A & B
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Minimum age
18
Years
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Maximum age
70
Years
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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
* Admitted to a hospital outside of Western Australia following SCI (prior to RPH)
* Unable to commence intervention within 10 days post-SCI
* Bladder or urethral trauma on admission
* Known history of bladder cancer or other bladder pathology
* Known hypersensitivity to hyaluronic acid, sodium salt or sodium chondroitin sulphate
* Diagnosis of a symptomatic urinary tract infection prior to commencing treatment
* Pregnancy
* Previous neurological disorder
* Inability to provide own consent due to intellectual, mental or cognitive impairment
Arm C Inclusion Criteria:
* Previous traumatic or non-traumatic (sudden onset) SCI
* Experience significant, recurrent UTIs (in the opinion of the treating Spinal / Urology Consultant
* Willing and able to partake in all study requirements
* Emptying bladder via intermittent catheterisation (self or carer administered)
Arm C
* Bladder or urethral trauma
* Known history of bladder cancer or other bladder pathology
* Known hypersensitivity to hyaluronic acid sodium salt or sodium chondroitin sulphate
* Pregnancy
* Previous neurological disorder
* Inability to provide own consent due to intellectual, mental or cognitive impairment
* Significant known history of Autonomic Dysreflexia associated with urological procedures
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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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
18/09/2019
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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
18/03/2021
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Sample size
Target
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Accrual to date
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Final
10
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Royal Perth Hospital - Perth
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Recruitment postcode(s) [1]
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6000 - Perth
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Funding & Sponsors
Primary sponsor type
Other
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Name
The University of Western Australia
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Royal Perth Hospital
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Fiona Stanley Hospital
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Address [2]
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Country [2]
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Other collaborator category [3]
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Other
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Name [3]
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Perth Urology Clinic
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Address [3]
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Country [3]
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to assess the safety and feasibility of administering glycosaminoglycan (GAG) therapy, iAluRil®, intravesically in individuals with acute spinal cord injury (SCI), commencing within the first ten days of injury, to prevent early urinary tract infections.
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Trial website
https://clinicaltrials.gov/study/NCT03945110
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Trial related presentations / publications
Damiano R, Cicione A. The role of sodium hyaluronate and sodium chondroitin sulphate in the management of bladder disease. Ther Adv Urol. 2011 Oct;3(5):223-32. doi: 10.1177/1756287211418723. Manas A, Glaria L, Pena C, Sotoca A, Lanzos E, Fernandez C, Riviere M. Prevention of urinary tract infections in palliative radiation for vertebral metastasis and spinal compression: a pilot study in 71 patients. Int J Radiat Oncol Biol Phys. 2006 Mar 1;64(3):935-40. doi: 10.1016/j.ijrobp.2005.09.016. Epub 2006 Jan 10. Damiano R, Quarto G, Bava I, Ucciero G, De Domenico R, Palumbo MI, Autorino R. Prevention of recurrent urinary tract infections by intravesical administration of hyaluronic acid and chondroitin sulphate: a placebo-controlled randomised trial. Eur Urol. 2011 Apr;59(4):645-51. doi: 10.1016/j.eururo.2010.12.039. Epub 2011 Jan 18. Erratum In: Eur Urol. 2011 Jul;60(1):193. King GK, Goodes LM, Hartshorn C, Thavaseelan J, Jonescu S, Watts A, Rawlins M, Woodland P, Synnott EL, Barrett T, Hayne D, Boan P, Dunlop SA. Intravesical hyaluronic acid with chondroitin sulphate to prevent urinary tract infection after spinal cord injury. J Spinal Cord Med. 2023 Sep;46(5):830-836. doi: 10.1080/10790268.2022.2089816. Epub 2022 Jul 6.
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Public notes
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Contacts
Principal investigator
Name
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Sarah A Dunlop, PhD
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Address
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The University of Western Australia
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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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?
De-identified individual participant data for primary and secondary outcomes that form the basis of the final scientific paper will be made available.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP), Informed consent form (ICF)
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When will data be available (start and end dates)?
Data will be made available upon request immediately following publication and indefinitely thereafter via a link to the relevant section of The University of Western Australia's research repository.
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Available to whom?
Data will be available upon request to Researchers providing a methodologically sound research proposal, for the purpose of achieving the aims in this proposal. Proposals should be directed to
[email protected]
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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
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03945110