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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05003609
Registration number
NCT05003609
Ethics application status
Date submitted
14/07/2021
Date registered
12/08/2021
Titles & IDs
Public title
Early Rehabilitation in Patients on Extracorporeal Membrane Oxygenation
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Scientific title
A Randomised Controlled Trial of Early Rehabilitation in Patients on Extracorporeal Membrane Oxygenation (ECMO-Rehab)
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Secondary ID [1]
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ANZIC-RC/ECMO-REHAB/001
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Universal Trial Number (UTN)
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Trial acronym
ECMO-Rehab
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Extracorporeal Membrane Oxygenation Complication
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Other interventions - Early Rehabilitation
Active comparator: Intervention Group - ECMO early rehabilitation is led by a senior physiotherapist who has specialised training in ECMO care and coordinates individualised early physical training from randomisation to day 28 in ICU and liaises with the patient through to hospital discharge. The early rehabilitation intervention involves physical activity, functional retraining, strengthening exercises and mobilisation based on a reproducible, physiological approach.
No intervention: Control Group - The control group will receive standard care from nursing and physiotherapy staff not involved in the early, co-ordinated rehabilitation.
Other interventions: Early Rehabilitation
The intervention involves a progression of rehabilitation exercises with the objective of rehabilitating the patient at the highest level of exercise possible for the patient for the longest period of time that can be tolerated (up to 60 mins) at each session. The intervention will be administered 5 days per week (weekdays) while the patient remains in ICU, censored at 28 days after randomisation.
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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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Modified Rankin Scale
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Assessment method [1]
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The Modified Rankin Scale (mRS) is a 7-level ordered categorical scale capturing levels of patient disability and dependence, with scores ranging from 0 (no disability) to 6 (dead).
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Timepoint [1]
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180 days post randomisation
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Secondary outcome [1]
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Muscle strength at day 14 (Medical Research Council Sum-Score)
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Assessment method [1]
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Grade 0 to Grade 5 where Grade 5 is the best outcome
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Timepoint [1]
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14 days post randomisation
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Secondary outcome [2]
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ECMO-free days to day 28
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Assessment method [2]
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Timepoint [2]
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28 days post randomisation
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Secondary outcome [3]
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Organ failure free days to day 28
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Assessment method [3]
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Timepoint [3]
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28 days post randomisation
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Secondary outcome [4]
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Delirium-free days to day 28
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Assessment method [4]
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Timepoint [4]
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28 days post randomisation
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Secondary outcome [5]
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Activities of Daily Living (ADL) at hospital discharge
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Assessment method [5]
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Timepoint [5]
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up to day of hospital discharge, an average of 3 months
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Secondary outcome [6]
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Length of stay on ECMO, in ICU and in hospital
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Assessment method [6]
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Timepoint [6]
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up to day of stay on ECMO, ICU and hospital, an average of 3 months
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Secondary outcome [7]
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Mortality rate at ICU and hospital discharge, day 90 and day 180
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Assessment method [7]
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Timepoint [7]
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up to 180 days post randomisation
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Secondary outcome [8]
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Instrumental activities of daily living at 180 days
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Assessment method [8]
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Physical function measured with instrumental activities of daily living
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Timepoint [8]
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180 days post randomisation
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Secondary outcome [9]
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Montreal Cognitive Assessment (MoCA-Blind)
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Assessment method [9]
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Rapid screening instrument for mild cognitive dysfunction. Normal is equal or more than 18 points.
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Timepoint [9]
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180 days post randomisation
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Secondary outcome [10]
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WHO Disability Assessment Schedule 2.0 at day 180
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Assessment method [10]
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Scoring 10-48 are likely to have clinically significant disability.
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Timepoint [10]
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180 days post randomisation
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Secondary outcome [11]
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Health related quality of life (EQ5D-5L) at day 180
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Assessment method [11]
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Level of severity 1 to 5 where 5 is the most severe
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Timepoint [11]
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180 days post randomisation
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Eligibility
Key inclusion criteria
1. Patient is on ECMO and expected to remain on ECMO for at least 24 hours
2. Patient is aged 18 years or older.
3. Patient was functionally independent prior to the current admission.
4. Patient is eligible for Medicare (Australian sites only).
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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. Patient has been receiving ECMO for more than 72 hours.
2. Patient has been in ICU for more than 5 days.
3. Patient has suspected or proven primary myopathic or neurological process associated with prolonged weakness or acute brain injury.
4. Death is deemed imminent by the treating clinician.
5. Patient has a documented medical diagnosis of cognitive impairment e.g. dementia.
6. Patient was unable to mobilise prior to this admission.
7. Patient is unable to communicate in local language.
8. Patient is known to be pregnant.
9. Patient is unlikely to be contactable for 6 months follow-up, e.g. overseas resident, incarcerated
10. The treating clinician does not believe it is in the best interests of the patient to participate in the study
11. Patient who has a bidirectional cannula in situ
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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
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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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
27/04/2022
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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
30/05/2025
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC,WA
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Recruitment hospital [1]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment hospital [2]
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St Vincent's Hospital Sydney - Darlinghurst
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Recruitment hospital [3]
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The Prince Charles Hospital - Chermside
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Recruitment hospital [4]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [5]
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Alfred Health - Melbourne
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Recruitment hospital [6]
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Fiona Stanley Hospital - Murdoch
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Recruitment postcode(s) [1]
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- Camperdown
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Recruitment postcode(s) [2]
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2010 - Darlinghurst
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Recruitment postcode(s) [3]
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4032 - Chermside
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Recruitment postcode(s) [4]
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- Woolloongabba
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Recruitment postcode(s) [5]
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3004 - Melbourne
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Recruitment postcode(s) [6]
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- Murdoch
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Recruitment outside Australia
Country [1]
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Canada
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State/province [1]
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Toronto
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Funding & Sponsors
Primary sponsor type
Other
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Name
Australian and New Zealand Intensive Care Research Centre
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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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Monash University
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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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National Health and Medical Research Council, Australia
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Address [2]
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Country [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
Critically ill patients who require extracorporeal membrane oxygenation (ECMO) are the sickest in the hospital. More patients are surviving but survivors have compromised functional recovery for months or years. This registry-embedded randomised trial aims to determine if early rehabilitation commenced within 72 hours of ECMO is feasible and improves muscle strength and functional status in patients compared to standard practice in a randomised controlled trial of 100 ICU patients. The effect of the intervention on mortality, health status, and function at 180 days will be evaluated, as well as cost-effectiveness. ECMO-Rehab trial is a registry embedded trial and will be utilising EXCEL data.
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Trial website
https://clinicaltrials.gov/study/NCT05003609
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Trial related presentations / publications
ECMO-PT Study Investigators; International ECMO Network. Early mobilisation during extracorporeal membrane oxygenation was safe and feasible: a pilot randomised controlled trial. Intensive Care Med. 2020 May;46(5):1057-1059. doi: 10.1007/s00134-020-05994-8. Epub 2020 Mar 16. No abstract available.
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Public notes
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Contacts
Principal investigator
Name
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Carol Hodgson
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Address
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ANZIC-RC, Monash University
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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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Carol Hodgson
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Address
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Country
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Phone
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+61 448 674 532
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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)?
No
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No/undecided IPD sharing reason/comment
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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/NCT05003609