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Trial registered on ANZCTR
Registration number
ACTRN12612001215819
Ethics application status
Approved
Date submitted
2/11/2012
Date registered
16/11/2012
Date last updated
11/02/2021
Date data sharing statement initially provided
18/06/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Investigating the utility of the customised fetal growth chart: a randomised controlled trial
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Scientific title
Does a customised fetal growth chart compared to a non-customised fetal growth chart for use in routine antenatal care in singleton pregnancies reduce adverse perinatal outcome?
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Secondary ID [1]
281493
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Nil
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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:
Perinatal outcomes
287764
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Condition category
Condition code
Reproductive Health and Childbirth
288105
288105
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0
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Antenatal care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A customised fetal growth chart that is individualised for the specific pregnancy using maternal and pregnancy characteristics and can be used with routine measurements of fundal height. The intervention will be used at each antenatal visit after 24 weeks gestation by entering the fundal height measurement into the system, which will then plot it on the chart, with all previous measurements. The charts will be used up until delivery of the baby.
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Intervention code [1]
286006
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Early detection / Screening
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Comparator / control treatment
A non-customised fetal growth chart that can be used with routine measurements of fundal height. The intervention will be used at each antenatal visit after 24 weeks gestation by entering the fundal height measurement into the system, which will then plot it on the chart, with all previous measurements. The charts will be used up until delivery of the baby.
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Control group
Active
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Outcomes
Primary outcome [1]
288309
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Composite perinatal morbidity/mortality outcome (stillbirth, neonatal death, Apgar score at 5 minutes < 4, hypoglycaemia, stages 2-3 necrotizing enterocolitis [NEC] according to Bell's Criteria, hypoxic ischaemic encephalopathy [HIE] Sarnat stages 2 and 3, neonatal seizures, intraventricular haemorrhage [IVH] graded according to Papile's classification, admission to neonatal intensive care unit [NICU] > 4 days)
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Assessment method [1]
288309
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Timepoint [1]
288309
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Discharge of baby from hospital
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Secondary outcome [1]
299820
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Proportion of babies confirmed as SGA on ultrasound of those referred
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Assessment method [1]
299820
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Timepoint [1]
299820
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Discharge of baby from hospital
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Secondary outcome [2]
299821
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Proportion of babies confirmed as large-for-gestational age (LGA) on ultrasound of these referred
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Assessment method [2]
299821
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Timepoint [2]
299821
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Discharge of baby from hospital
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Secondary outcome [3]
299822
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Classification of SGA by Birthweight Appropriateness Quotient and/or population based charts
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Assessment method [3]
299822
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Timepoint [3]
299822
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Discharge of baby from hospital
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Secondary outcome [4]
299823
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Classification of LGA by Birthweight Appropriateness Quotient and/or population based charts
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Assessment method [4]
299823
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Timepoint [4]
299823
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Discharge of baby from hospital
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Secondary outcome [5]
299824
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Preterm birth (defined as birth less than <37 weeks and <34 weeks); identified from routinely collected data
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Assessment method [5]
299824
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Timepoint [5]
299824
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Discharge of baby from hospital
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Secondary outcome [6]
299825
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Proportion of caesarean sections (CS)/inductions for SGA/LGA; identified from routinely collected data
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Assessment method [6]
299825
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Timepoint [6]
299825
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Discharge of baby from hospital
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Secondary outcome [7]
299826
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Individual perinatal outcomes that comprise the primary outcome measure; identified from routinely collected data
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Assessment method [7]
299826
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Timepoint [7]
299826
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Discharge of baby from hospital
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Secondary outcome [8]
299827
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Perineal trauma; identified from routinely collected data
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Assessment method [8]
299827
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Timepoint [8]
299827
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Discharge of baby from hospital
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Secondary outcome [9]
299828
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Cost of interventions (such as ultrasound scans and antenatal/neonatal admissions); identified from routinely collected data
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Assessment method [9]
299828
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Timepoint [9]
299828
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Discharge of baby from hospital
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Secondary outcome [10]
299892
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Fetal distress; identified from routinely collected data
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Assessment method [10]
299892
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Timepoint [10]
299892
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Discharge of baby from hospital
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Secondary outcome [11]
299893
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Resuscitation (such as need for intubation); identified from routinely collected data
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Assessment method [11]
299893
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Timepoint [11]
299893
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Discharge of baby from hospital
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Secondary outcome [12]
299894
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Mechanical ventilation; identified from routinely collected data
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Assessment method [12]
299894
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Timepoint [12]
299894
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Discharge of baby from hospital
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Secondary outcome [13]
299895
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Chronic neonatal lung disease; identified from routinely collected data
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Assessment method [13]
299895
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Timepoint [13]
299895
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Discharge of baby from hospital
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Secondary outcome [14]
299896
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Shoulder dystocia; identified from routinely collected data
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Assessment method [14]
299896
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Timepoint [14]
299896
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Discharge of baby from hospital
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Eligibility
Key inclusion criteria
All women receiving routine antenatal care
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Minimum age
13
Years
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Maximum age
55
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Multiple gestation
Participation in GP shared care
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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)
To generate the growth chart to be used, the required parameters for the customisation process will be entered during the booking interview with the midwife. Once the first doctor’s visit has occurred, and the model of care (i.e. to exclude women accessing GP shared care) and plurality (i.e. to exclude multiple pregnancies) have been entered, the chart will be produced and saved in the electronic obstetric clinical system. The randomisation schedule will be saved into this same system and the chart (either standard or customised) will be generated based on the next allocation in the randomisation sequence.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A computer generated randomisation schedule will be generated prior to study commencement that will be used to allocate patients to either the standard chart or customised chart. Variable block randomisation will be used, as well as stratification by pregnancy risk (low risk and high risk). Women who are allocated to the obstetric model of care at the first doctor’s visit will be classified as high risk; all others will be low risk.
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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
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
1/02/2013
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Actual
26/03/2014
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Date of last participant enrolment
Anticipated
31/07/2019
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Actual
29/11/2017
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Date of last data collection
Anticipated
28/02/2021
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Actual
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Sample size
Target
4020
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Accrual to date
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Final
3993
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
2582
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Mater Mother's Hospital - South Brisbane
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Funding & Sponsors
Funding source category [1]
286272
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Hospital
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Name [1]
286272
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Mater Mothers Golden Casket Research Grant
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Address [1]
286272
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Raymond Terrace, South Brisbane, QLD, 4101
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Country [1]
286272
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Australia
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Primary sponsor type
Hospital
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Name
Mater Medical Research Institue
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Address
Raymond Terrace, South Brisbane, QLD, 4101
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Country
Australia
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Secondary sponsor category [1]
285069
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None
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Name [1]
285069
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Address [1]
285069
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Country [1]
285069
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288344
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Mater Health Services Human Research Ethics Committee
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Ethics committee address [1]
288344
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Raymond Terrace, South Brisbane, QLD, 4101
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Ethics committee country [1]
288344
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Australia
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Date submitted for ethics approval [1]
288344
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05/09/2012
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Approval date [1]
288344
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08/10/2012
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Ethics approval number [1]
288344
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1925M
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Summary
Brief summary
Adverse fetal growth is strongly associated with adverse pregnancy outcome for the fetus and newborn. Close monitoring of fetal growth is an essential component of antenatal care in order to try and reduce the resultant risks associated with adverse growth. It is standard practice to assess fetal growth by measuring symphyseal fundal height (SFH) at each antenatal visit and assessing the growth in line with a standard non-individualised growth chart. We have developed a customised growth chart that we hypothesise that when compared to a standard growth chart, reduces the risk of adverse pregnancy outcome through increased detection of adverse growth. Therefore, this study is a single centre, blinded, two-arm, randomised controlled trial to compare the detection rates of adverse growth (both slowed growth and accelerated growth) and adverse fetal and neonatal outcomes when using a customised fetal growth chart compared with a standard growth chart. The study will be run at the Mater Mothers’ Hospital Antenatal Clinic, with women randomly allocated to receive either the standard chart or customised chart. This chart will then be used throughout pregnancy to plot serial measurements of SFH to monitor fetal growth. We aim to reduce the rate of our composite perinatal morbidity outcome measure from 10% to 7.5%, which will require randomising 4,010 women. If our study hypothesis is proven, the low cost nature of this tool allows for the possibility of implementation into developing countries, as well as rural and remote Australian settings, that do not have sophisticated monitoring equipment. By implementing such a low cost solution to the difficult task of monitoring growth, there are potentially very large human and economic benefits from this research.
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Trial website
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Trial related presentations / publications
Gibbons K, Beckmann M, Flenady V, Gardener G, Gray P. Investigating the utility of the customised fetal growth chart: a randomised controlled trial. 8th International Conference on Fetal Growth; Berlin 2019.
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Public notes
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Contacts
Principal investigator
Name
34916
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A/Prof Kristen Gibbons
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Address
34916
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Level 2, Mater Research
Aubigny Place
Raymond Terrace
South Brisbane Qld 4101
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Country
34916
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Australia
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Phone
34916
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+61407966708
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Fax
34916
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Email
34916
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[email protected]
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Contact person for public queries
Name
18163
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Kristen Gibbons
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Address
18163
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Level 2, Mater Research
Aubigny Place
Raymond Terrace
South Brisbane Qld 4101
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Country
18163
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Australia
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Phone
18163
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+61407966708
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Fax
18163
0
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Email
18163
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[email protected]
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Contact person for scientific queries
Name
9091
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Kristen Gibbons
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Address
9091
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Level 2, Mater Research
Aubigny Place
Raymond Terrace
South Brisbane Qld 4101
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Country
9091
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Australia
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Phone
9091
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+61407966708
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Fax
9091
0
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Email
9091
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[email protected]
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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
This is confidential health data and IPD was not in the protocol
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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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