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Trial registered on ANZCTR
Registration number
ACTRN12615000680561
Ethics application status
Approved
Date submitted
24/05/2015
Date registered
1/07/2015
Date last updated
22/11/2018
Date data sharing statement initially provided
22/11/2018
Date results provided
22/11/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Capsule Repair After Arthroscopic Surgery of the Hip
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Scientific title
MRI and functional outcomes following capsule repair after arthroscopic hip surgery.
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Secondary ID [1]
286795
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Nil
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Universal Trial Number (UTN)
U1111-1145-1898
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Trial acronym
N/A
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Femoroacetabular Impingement
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Condition category
Condition code
Musculoskeletal
295414
295414
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0
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Other muscular and skeletal disorders
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Surgery
295590
295590
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The Intervention is repair of the hip capsule at the end of an arthroscopic hip surgery. This consists of 2-4 heavy (number 2) surgical sutures passed with a special instrument (Arthrocare Speed stitch). The procedure adds about 5-10 minutes to a 60-90 minute operation.
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Intervention code [1]
291953
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Treatment: Surgery
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Comparator / control treatment
The control is arthroscopic hip surgery performed without closure of the capsule. This has been the standard of care for the past 10 years internationally.
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Control group
Active
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Outcomes
Primary outcome [1]
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(1) iHOT Version 12
This is a validated patient generated subjective outcome measure of hip function.
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Assessment method [1]
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Timepoint [1]
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6 weeks, 6 months, 1 year, 2 years
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Primary outcome [2]
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(2) Marx activity score
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Assessment method [2]
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Timepoint [2]
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3,6,12 and 24 months
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Primary outcome [3]
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(3) ROM and stability testing.
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Assessment method [3]
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Timepoint [3]
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3,6,12 and 24 months
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Secondary outcome [1]
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(4) Post op VAS (days 3,7,21), (this is also a primary outcome)
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Assessment method [1]
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Timepoint [1]
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Day 3,7,21
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Secondary outcome [2]
315289
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blood loss, (from operative record) capsulitis,(from routine clinic notes at follow up) number of days off
work, (from patient follow up visit notes) number of days off sports, pain killers taken, days till return to
run/bike/play.(All from patient follow up visits directly questioning patient) Documentation of mishaps / accidents with immediate
worsening of pain for a period of days or weeks or "setbacks" where the
hip pain has worsened for a period of days or weeks (Direct questions from patient clinic follow up visits)
(composite secondary outcome)
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Assessment method [2]
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Timepoint [2]
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3,7,21 days
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Secondary outcome [3]
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(2) MRI will be conducted at 6 weeks and 6 months post op to evaluate
capsular healing status (primary radiological outcome measure), intra
articular adhesions, extra articular scarring, labrum/cartilage status and
resection assessment. This MRI will be paid by department funds
The MRI features are a composite secondary outcome
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Assessment method [3]
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Timepoint [3]
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6 weeks and 6 months
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Eligibility
Key inclusion criteria
Inclusion Criteria
(1) Male or female patients aged between 18-51
(2) Healthy patients undergoing hip arthroscopy due to Cam or
mixed FAI
(3) No major osteoarthritic (OA) changes according to X-Ray
and surgery observation (Tonnis 0-1)
(4) No previous hip surgery
(5) No other influential disabilities in lower limbs
(6) No chronic use of NSAID, analgesics, steroids or
chemotherapy drugs
(7) Base line activity level (Tegner 3 and above)
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Minimum age
18
Years
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Maximum age
51
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
Exclusion Criteria
(1) Patients with concomitant disease that may affect joints
(2) Patients with major ligamentous laxity
(3) Patients who have undergone only minor vertical
capsulotomy (as in small pincer only lesions)
(4) Patients with extreme range of motion needs (such as ballet
dancers)
(5) Patients suffering from connective tissue disease
(6) Patients suffering from bilateral symptomatic FAI that are
being operated on for their first hip
(7) Patients with relative or proven dysplastic hip determined by
center edge angle and/or extreme version abnormalities as
measured on apical CT/MR cuts and pelvic XR
(8) Patients who needed Ilio-Psoas release
(9) Patients whose cartilage hip status was defined as advanced
OA during surgery
(10) Patients who following surgery would be instructed to avoid
full weight bearing on the operated hip for more than 4
weeks
(11) Concomitant use of PRP (platelet rich plasma) or hyaluronic acid
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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)
Description of Population to be Enrolled
a) The study will enroll approximately 60 individuals, 30 in each treatment
group, who have elected to undergo a hip arthroscopy due to labral or
cartilage pathologies as a result of Femoroacetabular Impingement.
b) Screening Procedures: Individuals will be recruited from current patients who are
being evaluated to undergo arthroscopic surgery for FAI as well as new patients.
Patients will be seen in Dr. Mei-Dan’s and Dr Brick's clinic and evaluated for involvement in the study
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Stage 2: Randomization
i) Randomization will be performed by the surgeons/investigators
before the surgical procedure is about to conclude. Due to the
necessity of intra-operative evaluation of the hip cartilage for
evidence of OA, (which could exclude a patient from participation in
the study), randomization cannot be performed prior to this point.
ii) Sixty sealed envelopes, 30 of which are labeled “Treatment” or “Control”, will
be prepared prior to the initiation of the study, and will be placed in a closed
box in the operating room. After the technical aspects of the surgical
procedure have been completed, all pathologies were addressed, and before
skin closure, the nurse will open a sealed envelope and notify the surgeon if
capsular repair is to be performed. Patients will be (and stay) blinded to the treatment given
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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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
18/06/2014
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Actual
18/06/2014
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Date of last participant enrolment
Anticipated
20/01/2015
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Actual
20/01/2015
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Date of last data collection
Anticipated
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Actual
31/10/2017
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Sample size
Target
60
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Accrual to date
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Final
60
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Recruitment outside Australia
Country [1]
6900
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New Zealand
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State/province [1]
6900
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Auckland
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Country [2]
21060
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United States of America
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State/province [2]
21060
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Colorado
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Smith and Nephew
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Address [1]
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Unit A 36 Hillside Road
Wairau Valley
Auckland 0627
New Zealand
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Matthew Brick
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Address
Orthosports North Harbour (private surgical practice of Dr Matthew Brick)
17 Antares Place
Mairangi Bay
Auckland 0632
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Nil
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Address [1]
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NIl
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Country [1]
290016
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Omer Mei-Dan
University of Colorado Sports Medicine Dept
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Address [1]
278479
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University of Colorado Sports Medicine Dept
465 University avenue
Colorado
Boulder 80302
USA
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Country [1]
278479
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United States of America
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
292900
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HDEC
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Ethics committee address [1]
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1 the Terrace PO Box 5013 Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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16/07/2013
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Approval date [1]
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19/07/2013
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Ethics approval number [1]
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13/STH/71
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Summary
Brief summary
Hip arthroscopy is a surgical technique used to address intra-articular cartilage and labral pathologies. Hip joint stability is determined by static (osseous, labral, and capsuloligamentous) and dynamic (neuromuscular and adhesional forces) factors. Understanding of the hip capsuloligamentous complex and its importance to hip stability, post operative function level, and pain continues to grow. Capsulotomy is commonly used in hip arthroscopy to allow visualization and instrument navigation however the optimal technique, amount of resection, and indications for capsular repair remain unknown. As the arthroscopic treatment of FAI has rapidly developed over the past 10 years, leaving the capsule open has been the common standard. Lately, capsular repair is increasingly considered, as concerns are raised regarding long term effects of extensive capsulotomies and occasional reports of devastating post operative side effects, such as post arthroscopy dislocation or subtle instability resulting in rapid osteoarthritis, are being published. It should be noted that these complications have only been seen in patients with a shallow hip socket or hyperlaxity, both of which are exclusion criteria for this study. Our hypothesis is that capsular repair, after cam FAI surgery, requiring moderate capsulotomy, would result in better patient outcomes, in the short, mid ad long term, both clinically and radiographically.
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Trial website
Nil
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Trial related presentations / publications
Nil
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Public notes
NIl
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Contacts
Principal investigator
Name
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Dr Matthew Brick
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Address
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Millennium Institute
17 Antares Place
Mairangi Bay
Auckland 0632
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Country
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New Zealand
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Phone
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+64 9 4772080
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Fax
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+64 9 4750376
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Email
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[email protected]
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Contact person for public queries
Name
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Matthew Brick
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Address
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Millennium Institute
17 Antares Place
Mairangi Bay
Auckland 0632
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Country
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New Zealand
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Phone
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+64 9 4772080
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Matthew Brick
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Address
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Millennium Institute
17 Antares Place
Mairangi Bay
Auckland 0632
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Country
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New Zealand
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Phone
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+64 9 477 2080
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Fax
57556
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+64 9 4750376
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Email
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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
No need to share data with other researchers as this is a stand-alone trial.
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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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