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Trial registered on ANZCTR
Registration number
ACTRN12610000715077
Ethics application status
Approved
Date submitted
27/08/2010
Date registered
27/08/2010
Date last updated
10/07/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Motivational Interviewing Stroke Trial
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Scientific title
Motivational interviews for secondary stroke prevention: A randomised clinical Trial
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Secondary ID [1]
252583
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Health Research Council of New Zealand Ref. number 10/458
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Universal Trial Number (UTN)
U1111-1116-7462
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Trial acronym
MIST
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
stroke
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Condition category
Condition code
Stroke
258247
258247
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0
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Ischaemic
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Stroke
258248
258248
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0
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Haemorrhagic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Motivational interviewing (MI) is a structured, patient-focused, and cost-effective intervention designed to motivate patients to adhere to medication and life-style change recommendations. The MI group will have 4 interviews with trained research nurses. The initial interview will be in-person with patient & family caregivers the day before hospital discharge. Remaining interviews will be done via telephone at 3, 6, and 9 months. Interviews will take up to 1 hr. The intervention will be standardised and sessions will be monitored via standard MI coding, with detailed instructions to guide sessions and ensure consistency across research nurses. Though this study examines the impact of MI on individuals’ post-stroke, recommendations for lifestyle/medication change often fail without support from significant others. Thus, caregivers will be invited to attend the initial session, but this will not be required. Caregiver attendance will be recorded.
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Intervention code [1]
257105
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Behaviour
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Intervention code [2]
257108
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Other interventions
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Comparator / control treatment
Usual care. Participants in the usual care group will receive standard care determined by their treating physicians, which doesn’t typically include MI. In some cases, ad hoc individual therapy may address adherence/non-adherence (e.g., discussing diet with nutritionists). Participation in such therapy will be identified and recorded at follow-up assessments.
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Control group
Active
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Outcomes
Primary outcome [1]
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adherence to medication and lifestyle changes recommended by treating physicians at and after hospital discharge in stroke patients 12 months post-randomisation, indicated by change in systolic blood pressure (BP) and low-density cholesterol (LDL) levels.
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Assessment method [1]
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Timepoint [1]
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baseline and 12 months post-randomisation
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Secondary outcome [1]
265389
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(1) to examine change in systolic BP levels at 3, 6 and 9 months follow-up, and LDL-cholesterol levels at 6 months follow-up
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Assessment method [1]
265389
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Timepoint [1]
265389
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baseline, 3, 6 and 9 months post-randomisation
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Secondary outcome [2]
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(2) self-reported adherence (self-reported use of anti-platelet, statin and BP lowering therapy as prescribed)
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Assessment method [2]
265392
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Timepoint [2]
265392
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baseline, 3, 6 and 9 months post-randomisation
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Secondary outcome [3]
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(3) self-reported barriers to adherence
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Assessment method [3]
265393
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Timepoint [3]
265393
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baseline, 3, 6 and 9 months post-randomisation
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Secondary outcome [4]
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(4) cardiovascular events (new stroke or coronary heart disease, both fatal and non-fatal). This outcome will be assessed by means of questionnaire and extraction of data from medical records.
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Assessment method [4]
265394
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Timepoint [4]
265394
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baseline, 3, 6 and 9 months post-randomisation
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Secondary outcome [5]
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(5) quality of life as measured by the Short Form 36 (SF-36) questionnaire
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Assessment method [5]
265395
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Timepoint [5]
265395
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baseline, 3, 6 and 9 months post-randomisation
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Secondary outcome [6]
265396
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(6) change in other lipid fractions high-density cholesterol, total cholesterol, triglycerides. This outcome will be assessed by means of blood test and extraction of relevant data from medical records.
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Assessment method [6]
265396
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Timepoint [6]
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6 and 12 months post-randomisation
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Secondary outcome [7]
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(7) healthcare resource consumption and cost-effectiveness. The resourse consumption will be estimated from the investigators' point of view. Costs will assessed by means of questionnaires and data from medical records (health service databases) and will include all rehabilitative and medical services, General Medical Service benefit (or other Primary Health Organisation reimbursement), private prescription charges, co-payments, costs for hospitalisations, and resource utilisation costs.
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Assessment method [7]
265397
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Timepoint [7]
265397
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12 months after randomisation. The resource consumption will be estimated by means of questionnaire and extraction of relevant data from medical records and health services databases.
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Eligibility
Key inclusion criteria
(1) First-ever stroke (excluding subarachnoid haemorrhage)
(2) discharged from hospital
(3) consented to participate in the trial
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Minimum age
45
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
Individuals will be excluded if they: (a) have significant impairments precluding participation (e.g., aphasia, psychiatric conditions or cognitive impairment [defined as Mini Mental State Examination (MMSE) <23]); (b) are unable to converse in English, which would impact assessment and intervention delivery; (c) cannot give informed consent; (e) are known to have another condition likely to impact their participation in the trial (e.g., life-threatening condition other than cardiovascular disease); (d) receiving psychiatric or clinical psychology treatment that can contaminate the study intervention; or (e) are likely to move out of the study area after discharge.
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Study design
Purpose of the study
Prevention
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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)
Randomisation will be concealed via an on-line Internet randomisation service.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A stratified minimization randomization algorithm will be used to balance possible prognostic factors (ie, age [10 year bands], stroke severity [Barthel Index =18, >18], sex, and ethnicity [European, non-European]) across the two groups.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
The trial is powered to provide 85% power at a = 0·05 (two sided) to detect a 0·3 mmol/l difference in LDL- cholesterol and 80% power to detect a 5 mmHg difference in SBP , respectively, between UC and MI groups, assuming 10% loss to follow-up.
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Phase
Not Applicable
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Type of endpoint/s
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
1/04/2011
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Actual
25/03/2011
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Date of last participant enrolment
Anticipated
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Actual
20/12/2013
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Date of last data collection
Anticipated
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Actual
20/12/2014
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Sample size
Target
386
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Accrual to date
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Final
386
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Recruitment outside Australia
Country [1]
2838
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New Zealand
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State/province [1]
2838
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Hamilton
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Country [2]
2839
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New Zealand
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State/province [2]
2839
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Auckland
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Health Research Council of New Zealand
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Address [1]
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Level 3
Stanley Street
Auckland 1010
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Country [1]
257551
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New Zealand
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Primary sponsor type
Government body
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Name
AUT University
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Address
AUT North Shore Campus
90 Akoranga Dr
Northcote 0627
Auckland
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Country
New Zealand
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Secondary sponsor category [1]
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Government body
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Name [1]
256772
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University of Auckland
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Address [1]
256772
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Private bag 92019
Auckland
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Country [1]
256772
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
259575
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Northern Region X Ethics Committee
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Ethics committee address [1]
259575
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3rd Floor, Unisys Building, 650 Great South Road, Penrose Auckland
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Ethics committee country [1]
259575
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New Zealand
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Date submitted for ethics approval [1]
259575
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24/08/2010
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Approval date [1]
259575
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09/02/2011
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Ethics approval number [1]
259575
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NTX/10/09/091
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Summary
Brief summary
The primary aim of this trial is to evaluate if motivational interviews (MI) promote adherence to recommended life-style changes and secondary prevention strategies to reduce stroke re-occurrence as compared with usual care. We hypothesise that community-based secondary stroke prevention via MI will effectively improve adherence to medications and life-style changes recommended by treating physicians at and after hospital discharge during the first 12 months after the initial stroke.
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Trial website
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Trial related presentations / publications
1. Krishnamurthi, R.V, Witt, E., Barker-Collo, S., McPherson, K., Davis-Martin, K., Bennett, D., Rush, E., Starkey, N., Parag, V., Rathnasabapathy, Y., Jones, A., Brown, P., Te Ao, B., Feigin, V. on behalf of the ARCOS IV Programme Group. Reducing recurrent stroke: Methodology of the Motivational Interviewing in Stroke (MIST) randomised clinical trial. International Journal of Stroke 9(1), 133-139. 2014. 2. 11. Barker-Collo, S., Krishnamurthi, R., Witt, E., Feigin, V., Jones, A., McPherson, K., Starkey, N., Parag, V., Jiang, Y., Barber, P.A., Rush, E., Bennett, D., Arroll, B. Improving adherence to secondary stroke prevention strategies through Motivational Interviewing: Randomized Controlled Trial (2015). Stroke, 46(12), 3451-3458. 2015.
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Public notes
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Contacts
Principal investigator
Name
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Prof Valery Feigin
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Address
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National Institute for Stroke and Applied Neurosciences
AUT University,
90 Akoranga Drive
Northcote 0627
Auckland
New Zealand
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Country
31580
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New Zealand
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Phone
31580
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+64 (9) 921 9166
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Fax
31580
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+64 (9) 921 9620
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Email
31580
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[email protected]
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Contact person for public queries
Name
14827
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Valery Feigin
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Address
14827
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National Institute for Stroke & Applied Neurosciences
AUT University
AUT North Shore Campus
AA254, 90 Akoranga Dr
Northcote 0627
Auckland
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Country
14827
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New Zealand
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Phone
14827
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+64 9 921 9166
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Fax
14827
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+64 9 921 9620
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Email
14827
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[email protected]
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Contact person for scientific queries
Name
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Valery Feigin
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Address
5755
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National Institute for Stroke & Applied Neurosciences
AUT University
AUT North Shore Campus
AA254, 90 Akoranga Dr
Northcote 0627
Auckland
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Country
5755
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New Zealand
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Phone
5755
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+64 9 921 9166
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Fax
5755
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+64 9 921 9620
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Email
5755
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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
No additional documents have been identified.
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