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Trial registered on ANZCTR
Registration number
ACTRN12609000566235
Ethics application status
Approved
Date submitted
9/07/2009
Date registered
10/07/2009
Date last updated
3/02/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
A double blind, randomised placebo controlled trial of topical 2% viscous lignocaine in improving oral intake in children with painful infectious mouth conditions.
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Scientific title
For children with painful infectious mouth conditions and poor oral intake, does topical 2% viscous lignocaine improve oral intake?
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Secondary ID [1]
260062
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the Painful Oral Ulcer Treatment trial
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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:
gingivostomatitis
237199
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ulcerative pharyngitis
237200
0
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hand, foot and mouth disease
237201
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herpangina
237202
0
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Condition category
Condition code
Oral and Gastrointestinal
237521
237521
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
administration of 0.15 ml/kg of 2% viscous lignocaine, topically to the oral cavity
once only
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Intervention code [1]
236902
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Treatment: Drugs
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Comparator / control treatment
the placebo is water mixed with methylcellulose, gelatin and cherry flavoring
0.15 ml/kg of this mixture is administered topically to the oral cavity
once only
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The primary outcome is the amount of fluid ingested by each child, expressed in ml/kg, as recorded by the treating nurses on a standard fluid balance chart
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Assessment method [1]
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Timepoint [1]
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60 minutes after administration of the treatment
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Secondary outcome [1]
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the proportion of subjects in each arm to have ingested more than 10 ml/kg of fluid
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Assessment method [1]
244735
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Timepoint [1]
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30 minutes after administration of the study solution
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Secondary outcome [2]
244736
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Incidence of adverse effects (seizures, cardiac arrhythmia, aspiration as defined by presence of cough and increased respiratory rate or decreased saturation or onset of new adventitial breath sounds)
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Assessment method [2]
244736
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Timepoint [2]
244736
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90 minutes after administration of the treatment
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Secondary outcome [3]
244737
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the proportion of patients who undergo involuntary fluid administration via intravenous or nasogastic routes
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Assessment method [3]
244737
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Timepoint [3]
244737
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90 minutes after administration of the treatment
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Secondary outcome [4]
262176
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the proportion of subjects in each arm to have ingested more than 10ml/kg of fluid
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Assessment method [4]
262176
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Timepoint [4]
262176
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60 minutes from the time of administration of the study mixture
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Secondary outcome [5]
262178
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The proportion of subjects in each arm to have ingested more than 20 ml/kg of fluid
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Assessment method [5]
262178
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Timepoint [5]
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30 minutes from the time of administration of the study mixture
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Secondary outcome [6]
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The proportion of subjects in each arm to have ingested more than 20 ml/kg of fluid
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Assessment method [6]
262179
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Timepoint [6]
262179
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60 minutes after administration of the study solution
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Secondary outcome [7]
262180
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the proportion of subjects who experience vomiting
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Assessment method [7]
262180
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Timepoint [7]
262180
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90 minutes after administration of the study solution
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Secondary outcome [8]
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The proportion of subjects who are admitted to hospital (both to the hospital and to the Emergency department short stay unit)
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Assessment method [8]
262181
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Timepoint [8]
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discharge or admission to hospital
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Secondary outcome [9]
262182
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Length of stay in the Emergency department (ED)
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Assessment method [9]
262182
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Timepoint [9]
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discharge or transfer to the ward
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Secondary outcome [10]
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The proportion of subjects in each arm to have ingested more than 5 ml/kg of fluid
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Assessment method [10]
276122
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Timepoint [10]
276122
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30 minutes from the time of administration of the study mixture
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Secondary outcome [11]
276123
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The proportion of subjects in each arm to have ingested more than 5 ml/kg of fluid
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Assessment method [11]
276123
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Timepoint [11]
276123
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60 minutes from the time of administration of the study mixture
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Eligibility
Key inclusion criteria
gingivostomatitis (herpetic or non herpetic), ulcerative pharyngitis, herpangina and hand foot and mouth disease as assessed by the treating clinician, in association with a history of poor oral fluid intake (as assessed by parent and defined as oral fluid intake of less than 10ml/kg of fluid in the preceding 2 hours).
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Minimum age
6
Months
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Maximum age
8
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
Presence of more than 2 vomits in the preceding 24 hours
Presence of active painful dental disease (caries, dental abscess) or painful recent mouth trauma, mouth burn, or post-operative state (minimum of 5 days)
Systemic toxicity related to infection
Severe dehydration requiring immediate therapy
Pre-existing significant upper airway obstruction and swallowing difficulties
Known allergy to local anaesthetic, gelatine, methylcellulose, cherry flavouring, paracetamol or ibuprofen
Chronic renal or liver impairment History of epilepsy or cardiac disease Presence of acute porphyria
Presence of malignancy
Current use of anti-arrhythmic drugs, xylocaine, phenytoin, cimetidine or beta-blockers, warfarin, lithium, angiotensin converting enzyme (ACE) inhibitors, thiazide diuretics, frusemide, aspirin, salicylates, probenecid, anti-diabetic medications, zidovudine, cardiac glycosides or methotrexate.
Analgesia taken 1 hour preceding enrolment to study.
More than 1 dose of Xylocaine viscous and/or other medications containing lignocaine as an active ingredient given in this episode of illness
Non- English speaking parents/guardians
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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)
Patients that fulfil the eligibility criteria will be randomised to either 2% viscous lignocaine or the placebo mixture in labelled Bottle A and a study number will be allocated. All study drugs will be packaged in blinded containers stored in the locked ED cupboard labelled only with the study details and the study number.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The randomisation schedule will be computer generated using block randomisation by the Clinical Biostatistics and Epidemiology Unit (CEBU). The randomisation will not be stratified. Sequentially numbered bottles of either study drug or placebo will be arranged according to this schedule by a pharmacist at the RCH. Once a patient has been randomised they will be given the next available study number which will equate to the next bottle (labelled Bottle A) in sequence.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
9/11/2009
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Actual
9/11/2009
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Date of last participant enrolment
Anticipated
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Actual
10/11/2012
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Date of last data collection
Anticipated
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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
101
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
237300
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Other Collaborative groups
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Name [1]
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Murdoch Children's Research Institute
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Address [1]
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Royal Children's Hospital
Flemington Rd
Parkville, 3052
VIC
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Country [1]
237300
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Australia
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Primary sponsor type
Individual
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Name
Sandy (Alexander) M Hopper
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Address
Emergency Department
Royal Children's Hospital
Flemington Rd
Parkville, 3052
VIC
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Country
Australia
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Secondary sponsor category [1]
236784
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Individual
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Name [1]
236784
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Franz E Babl
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Address [1]
236784
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Emergency Department
Royal Children's Hospital
Flemington Rd
Parkville, 3052
VIC
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Country [1]
236784
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Australia
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Other collaborator category [1]
755
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Individual
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Name [1]
755
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Michelle McCarthy
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Address [1]
755
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Emergency Department
Royal Children's Hospital
Flemington Rd
Parkville, 3052
VIC
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Country [1]
755
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
239397
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Royal Children's Hospital Human Research Ethics Committee (HREC)
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Ethics committee address [1]
239397
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Royal Children's Hospital Flemington Rd Parkville, 3052 VIC
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Ethics committee country [1]
239397
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Australia
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Date submitted for ethics approval [1]
239397
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29/11/2010
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Approval date [1]
239397
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13/12/2010
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Ethics approval number [1]
239397
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29070 C
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Summary
Brief summary
This study looks at children with viral infections which create painful ulcers in the mouth. These ulcers can cause children to become dehydrated because the ulcers make drinking painful. This study aims to find out whether 2%viscous lignocaine, a numbing drug, helps children drink. 50 children will be given the drug and 50 children will be given a mixture which looks and tastes like the drug, but has no active medicine in it. The study will record how much fluid the children drink, and also look at whether or not any complications develop. This way, we hope to work out if 2% viscous lignocaine is a helpful medication for children with painful ulcers in the mouth.
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Trial website
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Trial related presentations / publications
Publications: 1. Hopper S, Babl F, McCarthy M, Tancharoen C, Lee K, Oakley E. A double blind, randomised placebo controlled trial of topical 2% viscous lidocaine in improving oral intake in children with painful infectious mouth conditions. BMC Pediatr. 2011;11:106. 2. Hopper SM, McCarthy M, Tancharoen C, Lee KJ, Davidson A, Babl FE. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med. 2013;63(3):292-9. 3. Hopper S, McCarthy M, Tancharoen C, Lee KJ, Orsini F, Babl FE. What do clinicians perceive as a successful "trial of fluids"? A secondary assessment of a randomised controlled trial. Pediatric Emergency care. Publish Ahead of Print, POST AUTHOR CORRECTIONS, 14 July 2015. Presentations Topical lignocaine to improve oral intake in children with painful infectious mouth ulcers: A blinded, randomized placebo–controlled trial. Oral Presentation, Annual Scientific Meeting, Australasian College for Emergency Medicine, Nov 2013 What do clinicians perceive as a successful "trial of fluids"? A secondary assessment of a randomised controlled trial PosterPresentation, Annual Scientific Meeting, Australasian College for Emergency Medicine, Nov 2013
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Public notes
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Contacts
Principal investigator
Name
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Dr Sandy M Hopper
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Address
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Royal Children's Hospital
Flemington Rd
Parkville, 3052
VIC
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Country
29873
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Australia
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Phone
29873
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+61393456592
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Fax
29873
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Email
29873
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[email protected]
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Contact person for public queries
Name
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Sandy (Alexander) M Hopper
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Address
13120
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Emergency Department
Royal Children's Hospital
Flemington RD
Parkville, 3052
VIC
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Country
13120
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Australia
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Phone
13120
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+61393456592
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Fax
13120
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Email
13120
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[email protected]
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Contact person for scientific queries
Name
4048
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Sandy (Alexander) M Hopper
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Address
4048
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Emergency Department
Royal Children's Hospital
Flemington RD
Parkville, 3052
VIC
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Country
4048
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Australia
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Phone
4048
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+61393456592
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Fax
4048
0
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Email
4048
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
What do clinicians perceive as a successful "trial of fluids"?: A secondary assessment of a randomized controlled trial.
2017
https://dx.doi.org/10.1097/PEC.0000000000000464
N.B. These documents automatically identified may not have been verified by the study sponsor.
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