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Trial registered on ANZCTR
Registration number
ACTRN12615000047594
Ethics application status
Approved
Date submitted
21/12/2014
Date registered
21/01/2015
Date last updated
11/12/2019
Date data sharing statement initially provided
4/12/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Serum activin, gene expression, muscle mass and function in people with critical illness (SAGE-MUSCLE): an observational cohort study
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Scientific title
Serum activin, gene expression, muscle mass and function in people with critical illness (SAGE-MUSCLE): an observational cohort study
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Secondary ID [1]
284550
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Nil
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Universal Trial Number (UTN)
U1111-1156-4189
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Trial acronym
SAGE-MUSCLE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Intensive Care Unit Aquired Weakness
290736
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Condition category
Condition code
Physical Medicine / Rehabilitation
292177
292177
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0
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Physiotherapy
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Observation of gene expression, serum activin levels, muscle mass and function in patients who have invasive mechanincal ventilation for at lease 48 hours and are expected to be in intensive care unit for 120 hours. Gene expression will be measured once on day 5 of ICU admission. Serum activin will be measured daily while the patient is in ICU. Muscle mass will be measured once on discharge from acute hospital. Muscle function will be measured at 4 time points: on awakening, first standing occasion, discharge from ICU, discharge from acute hospital.
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Intervention code [1]
289325
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Not applicable
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Comparator / control treatment
Not applicable - Observational study
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Serum activin level
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Assessment method [1]
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Timepoint [1]
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Daily until discharge from ICU
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Primary outcome [2]
293899
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Needle muscle biopsy of the quadriceps with ultrasound guidance will be required to allow extraction of RNA. Target genes will be analysed by reverse transcription polymerase chain reaction (RT-PCR).
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Assessment method [2]
293899
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Timepoint [2]
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120 hours after admission to ICU
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Primary outcome [3]
293900
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Six-Minute Walk test
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Assessment method [3]
293900
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Timepoint [3]
293900
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On acute hospital discharge
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Secondary outcome [1]
308115
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Grip Strength measured with a hand held dynamometer.
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Assessment method [1]
308115
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Timepoint [1]
308115
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On awakening; first standing occasion; discharge to ward and discharge from acute hospital.
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Secondary outcome [2]
312114
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Knee extension strength knee measured using Medical Research Council Scale for manual muscle testing.
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Assessment method [2]
312114
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Timepoint [2]
312114
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On awakening; first standing occasion; discharge to ward and discharge from acute hospital.
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Secondary outcome [3]
312115
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Timed Up and Go Test.
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Assessment method [3]
312115
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Timepoint [3]
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On acute hospital discharge.
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Secondary outcome [4]
312116
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Physical Function in ICU test (PFIT)
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Assessment method [4]
312116
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Timepoint [4]
312116
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On first standing occasion and on discharge to ward
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Secondary outcome [5]
312118
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Discharge destination
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Assessment method [5]
312118
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Timepoint [5]
312118
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On discharge from acute hospital
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Secondary outcome [6]
312119
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ICU length of stay
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Assessment method [6]
312119
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Timepoint [6]
312119
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On discharge from ICU
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Secondary outcome [7]
312120
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Hospital length of stay
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Assessment method [7]
312120
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Timepoint [7]
312120
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On discharge from acute hospital
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Eligibility
Key inclusion criteria
Have invasive mechanical ventilation for at least 48 hours and;
Are expected to be in ICU for at least 120 hours
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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
Aged < 18;
They have a proven or suspected acute primary neurological process likely to result in global impairment of conscious level/cognition or prolonged weakness or;
Death is deemed imminent or inevitable.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Descriptive statistics will be used to describe observations and frequency data and analysed according to normality of distribution (tested via Kolmogorov-Smirnov test) with subsequent parametric or non-parametric equivalent tests chosen as appropriate. Exploratory graphical analyses of serum activin levels; gene expression and muscle mass/function trends will be conducted where appropriate.
Associations between activin levels and gene expression analyses with physical strength outcomes will be investigated using latent growth curve analysis using AMOS version 19. By using latent growth curve analysis, we will be investigating the change in physical strength and how this relates to changes in either activin or gene expression. Using this analysis approach, a pilot sample size of 20 will allow pilot analysis associations between activin levels and physical strength. Future funding will be sought to test a total sample size of 80, which will provide 85% power to detect associations between activin levels and physical strength of effect size =0.50 assuming a mean of 5 assessment points. Patient numbers for gene expression analyses are pilot and will be used to source additional funding if proof-of-concept exists
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
31/01/2015
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Actual
6/02/2017
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Date of last participant enrolment
Anticipated
31/12/2018
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Actual
9/09/2018
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Date of last data collection
Anticipated
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Actual
9/12/2018
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Sample size
Target
36
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Accrual to date
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Final
36
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
3292
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Frankston Hospital - Frankston
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Recruitment hospital [2]
3294
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Western Hospital - Footscray
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Recruitment postcode(s) [1]
9076
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3199 - Frankston
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Recruitment postcode(s) [2]
9078
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3011 - Footscray
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Footscray Hospital
Western Health Research Grant
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Address [1]
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Footscray Hospital
Gordon St
Footscray VIC
3011
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Country [1]
290464
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Australia
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Funding source category [2]
290465
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Other Collaborative groups
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Name [2]
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Australian Institute for Musculoskeletal Science
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Address [2]
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Western Centre for Health Research and Education
Sunshine Hospital
176 Furlong Road St Albans, VIC 3021
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Country [2]
290465
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Australia
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Primary sponsor type
Hospital
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Name
Footscray Hospital Western Health
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Address
Gordon St
Footscray VIC
3011
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Country
Australia
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Secondary sponsor category [1]
289166
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None
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Name [1]
289166
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Address [1]
289166
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Country [1]
289166
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
292136
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Monash Health HREC
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Ethics committee address [1]
292136
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246 Clayton Road Clayton Victoria 3168
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Ethics committee country [1]
292136
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Australia
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Date submitted for ethics approval [1]
292136
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23/07/2014
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Approval date [1]
292136
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04/09/2014
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Ethics approval number [1]
292136
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HREC/14/SHA/26
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Summary
Brief summary
Intensive Care Unit (ICU) services cost the Australian economy at least $1.1 billion annually, excluding the cost of longterm morbidity. In particular, patients with a long length of stay in ICU (> 10-14 days) consume a disproportionate amount of resources. A quarter of these patients suffer a severe weakness syndrome defined as ICU-acquired weakness (ICUAW). This catastrophic syndrome results in significant limitations to people being able to perform their usual activities required for living (e.g. standing, walking, brushing teeth, showering, toileting or feeding themselves). People who suffer ICU acquired weakness are more likely to die and experience worse physical function and quality of life up to ten years following their ICU admission. The specific cell level interactions that influence this weakness syndrome are yet to be fully understood. The protein activin limits muscle growth and causes severe muscle wasting. It has recently been shown to not only have strong regulatory effects on muscle mass in mice with cancer, and when blocked, beneficial effects such as reversal of muscle loss. It is known that blood activin levels are significantly higher in people with critical illness who have infection, however the effect this has on muscle mass and weakness has not been established in this setting. There is also emerging evidence that there may be differences in the genes that turn on and off in people within the first 5 days of an ICU stay. It is logical that genes might also turn on and off differently in people who develop severe weakness in ICU compared to those who don‘t. However no studies have looked at differences in these gene patterns and compared them with changes in weakness or the ability to breathe independently. The project will compare levels of the protein activin and gene expression patterns (i.e. differences in genes turning on and off) in people admitted to the ICU with and without severe weakness. The investigators will also test muscle strength and the ability of the patient to do functional tasks (e.g. stand up, walk) and the project aims to provide proof-of-concept of an association between protein and gene measurements with muscle strength and function in ICU patients. the results will be used to design future projects investigating i) mechanisms associated with the development of clinically significant weakness and possible therapeutic pathways and ii) prevention strategies to reduce exposure to agents associated with severe weakness in ICU.
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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 Elizabeth Skinner
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Address
44962
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Footscray Hospital
Gordon St
Footscray VIC
3011
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Country
44962
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Australia
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Phone
44962
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+61419101708
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Fax
44962
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Email
44962
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[email protected]
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Contact person for public queries
Name
44963
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Elizabeth Skinner
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Address
44963
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Footscray Hospital
Gordon St
Footscray VIC
3011
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Country
44963
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Australia
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Phone
44963
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+61419101708
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Fax
44963
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Email
44963
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[email protected]
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Contact person for scientific queries
Name
44964
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Elizabeth Skinner
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Address
44964
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Footscray Hospital
Gordon St
Footscray VIC
3011
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Country
44964
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Australia
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Phone
44964
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+61419101708
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Fax
44964
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Email
44964
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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
Not included in the informed consent form.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
603
Informed consent form
365476-(Uploaded-04-12-2018-08-52-31)-Study-related document.docx
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.
Download to PDF