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Trial registered on ANZCTR
Registration number
ACTRN12613001297718
Ethics application status
Approved
Date submitted
18/11/2013
Date registered
21/11/2013
Date last updated
15/04/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of a pelvic floor muscle training program in patients who have undergone surgery for bowel cancer
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Scientific title
Effect of a pelvic floor muscle training program in patients who have undergone anterior resection surgery for colorectal cancer
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Secondary ID [1]
283595
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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:
Pelvic floor symptoms
290517
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Bowel cancer
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Condition category
Condition code
Physical Medicine / Rehabilitation
290904
290904
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0
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Other physical medicine / rehabilitation
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Cancer
290935
290935
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0
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Bowel - Back passage (rectum) or large bowel (colon)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is general rehabilitation plus pelvic floor muscle training program. The general rehabilitation will consist of a multidisciplinary education and exercise program, which will be provided as group sessions twice weekly for 8 weeks . Each session will last approximately one hour. The education component will include advice about nutrition, exercise, fatigue management and coping with stress and will be provided in a group format. Information will be delivered by a range of clinicians (physiotherapists, occupational therapists, psychologists, and dieticians). The exercise component will include an exercise training program supervised by a physiotherapist. The pelvic floor muscle training program will consist of physiotherapy-supervised pelvic floor muscle training sessions and bladder and bowel function advice over 12 sessions, twice weekly for 6 weeks. The training program will use a combination of 7 individual and 5 group sessions. Biofeedback will be used to facilitate pelvic floor muscle function. The training sessions will be approximately one hour long. The duration of intervention is eight weeks. To encourage adherence to the intervention protocols, telephone calls from a physiotherapist and a self report diary to record training adherence will be provided.
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Intervention code [1]
288282
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Rehabilitation
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Comparator / control treatment
General rehabilitation alone, twice weekly for 8 weeks, group sessions
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Control group
Active
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Outcomes
Primary outcome [1]
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Pelvic floor symptoms as assessed using the Australian Pelvic Floor Questionnaire and the International Consultation on Incontinence Questionnaire Bowel module
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Assessment method [1]
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Timepoint [1]
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at baseline, immediately post-intervention, and at 6, 12, 24, and 60 months following baseline
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Secondary outcome [1]
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Anorectal muscle function as assessed using anal manometry
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Assessment method [1]
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Timepoint [1]
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at baseline, immediately post-intervention, and at 6 months following baseline
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Secondary outcome [2]
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Pelvic floor muscle function as assessed using transperineal ultrasound
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Assessment method [2]
305545
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Timepoint [2]
305545
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at baseline, immediately post-intervention, and at 6 months following baseline
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Secondary outcome [3]
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Functional capacity as assessed using the six-minute walk test and the Incremental Shuttle Walk Test
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Assessment method [3]
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Timepoint [3]
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at baseline, immediately post-intervention, and at 6 months following baseline
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Secondary outcome [4]
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General muscle strength as assessed using a hand-held dynamometer
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Assessment method [4]
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Timepoint [4]
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at baseline, immediately post-intervention, and at 6 months following baseline
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Secondary outcome [5]
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Physical activity as assessed using the International Physical Activity Questionnaire
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Assessment method [5]
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Timepoint [5]
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at baseline, immediately post-intervention, and at 6, 12, 24, and 60 months following baseline
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Secondary outcome [6]
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Psychological distress as assessed using the Hospital Anxiety and Depression Scale
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Assessment method [6]
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Timepoint [6]
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at baseline, immediately post-intervention, and at 6, 12, 24, and 60 months following baseline
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Secondary outcome [7]
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Health-related quality of life as assessed using the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) and the updated colorectal cancer module (QLQ-CR29)
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Assessment method [7]
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Timepoint [7]
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at baseline, immediately post-intervention, and at 6, 12, 24, and 60 months following baseline
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Secondary outcome [8]
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Global response change score as assessed using the Global Rating of Change
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Assessment method [8]
305555
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Timepoint [8]
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at baseline, immediately post-intervention, and at 6, 12, 24, and 60 months following baseline
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Secondary outcome [9]
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Bladder and bowel function as assessed using a diary
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Assessment method [9]
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Timepoint [9]
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at baseline, immediately post-intervention, and at 6 months following baseline
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Secondary outcome [10]
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Overall survival as assessed by data linkage to medical records
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Assessment method [10]
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Timepoint [10]
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at one year, two years, and five years after baseline
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Secondary outcome [11]
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Feasibility as assessed by the recruitment rate, adherence, withdrawals, and adverse events. There are minimal risks associated with the rehabilitation and measurement tests. Participants may feel some general muscle discomfort after exercise, which is a normal response to exercise. Assessment of the pelvic floor muscles is usually painless; however, some patients may experience a feeling of embarrassment.
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Assessment method [11]
305559
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Timepoint [11]
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at baseline, immediately post-intervention, and at 6, 12, 24, and 60 months following baseline
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Eligibility
Key inclusion criteria
Patients who have undergone anterior resection for histologically confirmed, stage I-III colorectal cancer; have an Eastern Cooperative Oncology Group performance status of between 0-2 (0 = fully active, 2 = up and about for 50% of a day); and have sufficient English language skills to participate
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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
Patients who are pregnant or up to 12 months postpartum, have a permanent ostomy, have severe physical/psychiatric impairments, presence of other malignancies or have received post-operative supervised exercise or rehabilitation in the preceeding 12 months
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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)
After recruitment and baseline testing, participants will be randomized by an independent, off-site, computer generated random number sequence into two groups and inserted into sealed opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The random allocation sequence will be generated using computer-generated random number sequence.
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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
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Type of endpoint/s
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Statistical methods / analysis
Repeated-measures analysis of variance will be used to compare the mean differences between- and within-groups. All analyses will be tested with a significance level of p < 0.05 using the intention to treat principle. The sample size calculation is based upon finding a 1.6-point difference with a standard deviation of 1.7 in the bowel function score of Australian Pelvic Floor Questionnaire, giving 18 patients per group. Allowing 20% for drop outs, a total of 44 patients will be needed to detect a change in the primary outcome measure.
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Recruitment
Recruitment status
Withdrawn
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Reason for early stopping/withdrawal
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Date of first participant enrolment
Anticipated
3/03/2014
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Actual
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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
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Actual
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Sample size
Target
44
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
288275
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Hospital
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Name [1]
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Cabrini Institute
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Address [1]
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Cabrini Institute
154 Wattletree Road
Malvern Victoria 3144
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Country [1]
288275
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Australia
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Primary sponsor type
University
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Name
The University of Melbourne
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Address
Physiotherapy
Melbourne School of Health Sciences
The University of Melbourne
Alan Gilbert Building
161 Barry Street, Carlton
Victoria 3053
AUSTRALIA
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Country
Australia
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Secondary sponsor category [1]
286990
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Hospital
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Name [1]
286990
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Cabrini Institute
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Address [1]
286990
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Cabrini Institute
154 Wattletree Road
Malvern Victoria 3144
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Country [1]
286990
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Australia
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Ethics approval
Ethics application status
Approved
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Summary
Brief summary
The study is investigating the effectiveness of pelvic floor muscle (PFM) training plus general multidisciplinary rehabilitation in patients who have undergone bowel cancer surgery. Who is it for? You may be eligible to join this study if you are aged 18 years and over, have undergone anterior resection for stage I – III bowel cancer, and are able to walk and manage self-care, out of bed more than 50% of waking hours (Eastern Cooperative Oncology Group performance status 0 – 2). Trial details Participants in this study will be randomly (by chance) divided into one of two groups. Participants in one group will receive general multidisciplinary rehabilitation and PFM training program. The general multidisciplinary rehabilitation will consist of a multidisciplinary group education and exercise program, which will be provided twice weekly for 8 weeks. Each session will last approximately one hour. The education component will include advice about nutrition, exercise, fatigue management and coping with stress. Information will be delivered by a range of clinicians (physiotherapists, occupational therapists, psychologists, and dieticians). The exercise component will include a general (combined aerobic and resistance) exercise training program supervised by a physiotherapist. The PFM training program will consist of physiotherapy-supervised pelvic floor muscle training sessions, and bladder and bowel function advice over 12 sessions. Biofeedback will be used to facilitate pelvic floor muscle function. The training sessions will be approximately one hour long. The duration of intervention is eight weeks. Participants in the second group will only receive the general multidisciplinary rehabilitation twice weekly for 8 weeks. All participants will be required to complete some questionnaires and tests (e.g. transperineal ultrasound, six-minute walk test, etc) at the end of the intervention, and at 6, 12, 24 and 60 months from baseline to evaluate their pelvic floor symptoms and outcomes.
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Trial website
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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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Dr Helena Frawley
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Address
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Alan Gilbert Building, 161 Barry Street, The University of Melbourne Carlton 3053 Victoria, Australia
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Country
44326
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Australia
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Phone
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+61 3 8344 4837
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Fax
44326
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Email
44326
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[email protected]
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Contact person for public queries
Name
44327
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Helena Frawley
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Address
44327
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Alan Gilbert Building, 161 Barry Street, The University of Melbourne Carlton 3053 Victoria, Australia
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Country
44327
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Australia
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Phone
44327
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+61 3 8344 4837
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Fax
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Email
44327
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[email protected]
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Contact person for scientific queries
Name
44328
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Helena Frawley
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Address
44328
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Alan Gilbert Building, 161 Barry Street, The University of Melbourne Carlton 3053 Victoria, Australia
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Country
44328
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Australia
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Phone
44328
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+61 3 8344 4837
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Fax
44328
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Email
44328
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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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