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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03573089
Registration number
NCT03573089
Ethics application status
Date submitted
20/05/2018
Date registered
29/06/2018
Titles & IDs
Public title
Pragmatic Randomised Trial of High Or Standard PHosphAte Targets in End-stage Kidney Disease (PHOSPHATE)
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Scientific title
An Investigator-initiated, International, Multi-centre, Prospective, Randomized, Open-label, Parallel-group, Superiority, and Pragmatic Large Simple Trial (LST) to Determine Whether the Currently Recommended Strategy of Intensive Reduction of Serum Phosphate Concentration Towards the Normal Level Results in Significant Patient-centred Benefits in End-stage Kidney Disease (ESKD) Patients Receiving Dialysis.
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Secondary ID [1]
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17.02
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Universal Trial Number (UTN)
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Trial acronym
PHOSPHATE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Kidney Failure, Chronic
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Hyperphosphatemia
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Condition category
Condition code
Renal and Urogenital
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Kidney disease
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Metabolic and Endocrine
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Other metabolic disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Liberal phosphate target
Treatment: Drugs - Intensive phosphate target
Active comparator: Liberal phosphate target - Liberal serum phosphate target of 2.0 to 2.5 mmol/L.
Experimental: Intensive phosphate target - Intensive serum phosphate target of =1.50 mmol/L.
Treatment: Drugs: Liberal phosphate target
All phosphate-lowering medications in use at baseline will be discontinued. Phosphate-lowering medications will be prescribed only if serum phosphate concentration exceeds 2.50 mmol/L. The choice and dosages of phosphate-lowering medications will be at the discretion of treating physicians and/or participants.
Treatment: Drugs: Intensive phosphate target
This will be achieved by prescribing phosphate-lowering medications aimed to intensively lower serum phosphate concentration towards normal level (=1.50 mmol/L). The choice and dosages of phosphate-lowering medications will be at the discretion of treating physicians and/or participants.
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Intervention code [1]
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Treatment: Drugs
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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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Time to a composite endpoint of cardiovascular death or non-fatal major cardiovascular event
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Assessment method [1]
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Time to a composite endpoint of cardiovascular death, non-fatal myocardial infarction or coronary revascularization, stroke, or peripheral arterial event.
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Timepoint [1]
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5 years
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Secondary outcome [1]
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Time to individual components of the primary composite endpoint,
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Assessment method [1]
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Timepoint [1]
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5 years
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Secondary outcome [2]
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Time to all-cause death
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Assessment method [2]
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Timepoint [2]
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5 years
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Secondary outcome [3]
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Utility-based quality of life EQ5D-5L
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Assessment method [3]
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EQ5D-5L will be used to assess patient self-reported quality of life measures.
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Timepoint [3]
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5 years
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Eligibility
Key inclusion criteria
1. Age =45 years, or Age =18 years with diabetes,
2. ESKD on haemodialysis or peritoneal dialysis, for at least 3 months,
3. Currently prescribed at least one phosphate-lowering medication at any dose
4. Able to provide informed consent
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Minimum age
18
Years
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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
1. Elective kidney transplantation scheduled,
2. Concomitant major illness / comorbidity that may result in death in the next 6 months in the view of the treating physician,
3. Participation in an interventional study that is likely to affect serum phosphate concentration.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled 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
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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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
10/12/2019
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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
31/12/2028
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Actual
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Sample size
Target
3600
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC,WA
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Recruitment hospital [1]
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Royal Prince Alfred Hosptial - Camperdown
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Recruitment hospital [2]
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Nepean Hospital - Kingswood
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Recruitment hospital [3]
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St George Hospital - Kogarah
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Royal North Shore Hospital - Saint Leonards
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Recruitment hospital [5]
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Western Sydney Renal Service - Westmead
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Recruitment hospital [6]
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Wollongong Hospital - Wollongong
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Recruitment hospital [7]
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Sunshine Coast University Hospital - Birtinya
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Royal Brisbane and Women's Hospital - Brisbane
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Princess Alexandra Hospital - Brisbane
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Bundaberg Hospital - Bundaberg
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Cairns Hospital - Cairns
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Fraser Coast Renal Service - Hervey Bay
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Mackay Hospital - Mackay
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Logan Hospital - Meadowbrook
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Recruitment hospital [15]
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Gold Coast University Hospital - Southport
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Recruitment hospital [16]
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Central and Northern Adelaide Renal and Transplant Service - Adelaide
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Flinders Medical Centre - Bedford Park
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Austin Health - Heidelberg
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Royal Melbourne Hospital - Melbourne
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St Vincent's Hospital Melbourne - Melbourne
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Latrobe Regional Hospital - Traralgon
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Recruitment hospital [22]
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Armadale Hospital - Armadale
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Recruitment postcode(s) [1]
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2050 - Camperdown
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2750 - Kingswood
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2217 - Kogarah
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2065 - Saint Leonards
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2145 - Westmead
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2500 - Wollongong
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4575 - Birtinya
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4006 - Brisbane
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4110 - Brisbane
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Recruitment postcode(s) [10]
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4670 - Bundaberg
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4870 - Cairns
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Recruitment postcode(s) [12]
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4655 - Hervey Bay
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4740 - Mackay
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Recruitment postcode(s) [14]
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4131 - Meadowbrook
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4215 - Southport
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5000 - Adelaide
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5042 - Bedford Park
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3084 - Heidelberg
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3050 - Melbourne
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3065 - Melbourne
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Recruitment postcode(s) [21]
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3844 - Traralgon
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Recruitment postcode(s) [22]
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6112 - Armadale
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Recruitment outside Australia
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Brazil
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Paraíba
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Brazil
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Rio Grande Do Sul
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Dunedin
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Hamilton
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New Zealand
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Hastings
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Otahuhu
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Takapuna
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Whangarei
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Cheltenham
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Exeter
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Newcastle Upon Tyne
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Reading
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Southend-on-Sea
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Funding & Sponsors
Primary sponsor type
Other
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Name
The University of Queensland
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Address
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Other collaborator category [1]
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Other
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Name [1]
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National Health and Medical Research Council, Australia
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Address [1]
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Other collaborator category [2]
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Other
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Name [2]
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Applied Health Research Centre
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Other
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Name [3]
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Cambridge University Hospitals NHS Foundation Trust
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University of Otago
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Ethics approval
Ethics application status
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Summary
Brief summary
During end-stage kidney disease, clinical guidelines suggest reducing elevated phosphate levels in the blood. However, the effect of lowering blood phosphate levels on important patient-centred outcomes has never been tested. This trial will evaluate whether compared to high levels, lowering blood phosphate levels would reduce death or major events due to heart disease, improve physical health, and be cost-effective.
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Trial website
https://clinicaltrials.gov/study/NCT03573089
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Sunil Badve
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Address
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The University of Queensland
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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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Ron Wald
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Address
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Phone
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+1 416-867-3703
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Fax
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Email
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[email protected]
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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?
Individual participant data that underlie the results reported in the primary publication, after deidentification (text, tables, figures and appendices) will be available for individual participant data meta-analysis.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP)
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When will data be available (start and end dates)?
Beginning 2 years and ending 5 years following main publication. Proposals may be submitted up to 5 years following article publication. After 5 years, the data will be available in our University's data warehouse but without investigator support other than deposited metadata.
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Available to whom?
An independent review board will assess proposals based on the following criteria: sound science, benefit-risk balancing and research team expertise.
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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/NCT03573089