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Trial registered on ANZCTR
Registration number
ACTRN12615000883516
Ethics application status
Approved
Date submitted
2/07/2015
Date registered
24/08/2015
Date last updated
5/08/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Biopatch (trademark) or Kendall (trademark) AMD Foam Disc to reduce the incidence of Central-Line-Associated Blood Stream Infection: A pilot randomized controlled trial
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Scientific title
Among hospital patients requiring a central line is Biopatch (trademark) or Kendall (Trademark) AMD Foam Disc more effective in preventing central-line-associated blood stream infection? A randomized controlled trial
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Secondary ID [1]
287036
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None
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Universal Trial Number (UTN)
U1111-1171-7823
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Trial acronym
The CLABSI trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Central catheter related blood stream infection
295501
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Condition category
Condition code
Infection
296011
296011
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0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Kendall 'Trademark' AMD Foam Disc ('Registered Trademark') is a foam disk containing 0.5% polyhexamethylene biguanide (PHMB), a broad spectrum antimicrobial that is effective up to 7-days (Covidien, Basingstoke, UK). The disc is administered as a dressing sponge which sits directly against the skin at the site of central line insertion. The disk is left in place for 7-days, unless there is a reason for removal or replacement (eg soiled dressing, treatment completed). The disk is placed by whoever inserts the catheter or by whoever changes the dressing. Adherence will be monitored by daily inspection of the site by a research nurse.
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Intervention code [1]
292242
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Prevention
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Comparator / control treatment
Biopatch 'Trademark' (Ethicon Inc, Somerville, NJ, USA) is a chlorhexidine impregnated disc that is designed to release 2% chlorhexidine and inhibit bacterial and fungal growth for a number of days. The disc is administered as a dressing sponge which sits directly against the skin at the site of central line insertion. The disk is left in place for 7-days, unless there is a reason for removal or replacement (eg soiled dressing, treatment completed). The disk is placed by whoever inserts the catheter or by whoever changes the dressing. The disk is currently part of the standard dressing at the research hospital. Adherence to the study protocol will be monitored by daily inspection of the site by a research nurse.
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Control group
Active
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Outcomes
Primary outcome [1]
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Laboratory confirmed number of central line associated blood stream infections (CLABSI) per 10,000 line-days. Diagnosis will be made based on a presence of a bloodstream infection that is not secondary to an infection at another body site and where a central line has been in place for >2 days.
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Assessment method [1]
295471
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Timepoint [1]
295471
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Daily monitoring for CLABSI from time of central line insertion until time of central line removal.
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Secondary outcome [1]
315652
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All cause blood stream infection defined as any positive blood culture that meets the Centers for Disease Control criteria for Laboratory Confirmed Bloodstream Infection (LCBSI)
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Assessment method [1]
315652
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Timepoint [1]
315652
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Daily monitoring for infection from time of central line insertion until time of central line removal.
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Secondary outcome [2]
315653
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Cost effectiveness defined as direct costs to the hospital for the total episode of care, including costs of device and dressing replacement in addition to the costs of treating CVAD complications.
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Assessment method [2]
315653
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Timepoint [2]
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Assessed from time of central line insertion to time of hospital discharge.
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Secondary outcome [3]
315654
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Skin colonization rate assessed by microscopy evaluation from skin swab at insertion site.
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Assessment method [3]
315654
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Timepoint [3]
315654
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On removal of the patch
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Secondary outcome [4]
315655
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Adverse events, such as skin rash, blisters, local or systemic reaction to either of the products.
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Assessment method [4]
315655
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Timepoint [4]
315655
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Signs or symptoms of any adverse reactions will be assessed daily by the research nurse.
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Secondary outcome [5]
315656
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Patient satisfaction will be assessed by asking patients about the the products
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Assessment method [5]
315656
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Timepoint [5]
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On removal of the patch
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Secondary outcome [6]
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Staff satisfaction will be assessed by interviewing staff about their experience of using the products
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Assessment method [6]
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Timepoint [6]
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At the end of the study
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Secondary outcome [7]
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Feasibility outcome 'Eligibility' assessed as at least 80 percent of patients screened will be eligible
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Assessment method [7]
316581
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Timepoint [7]
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This outcome will be assessed at the end of the recruitment period
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Secondary outcome [8]
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Feasibility outcome 'Recruitment' assessed as at least 80 percent of eligible participants will enroll
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Assessment method [8]
316582
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Timepoint [8]
316582
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This outcome will be assessed at the end of the recruitment period
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Secondary outcome [9]
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Feasibility outcome 'treatment fidelity' assessed as at least 95 percent of patients will receive the correct dressing
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Assessment method [9]
316583
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Timepoint [9]
316583
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This outcome will be assessed daily during routine site inspections by the research nurse
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Secondary outcome [10]
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Feasibility outcome 'Retention' assessed as less than 5% of patients will be lost to follow up
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Assessment method [10]
316584
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Timepoint [10]
316584
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This outcome will be assessed at the data collection period
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Eligibility
Key inclusion criteria
Patients who are 16 years of age or older
Requiring a central catheter for at least three days
No previous central catheter this admission
Informed consent to participate
Central venous catheter inserted in Department of Medical Imaging, the Wattlebrae Day Therapy Unit or ICU
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Minimum age
16
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
Current bloodstream infection
Non-English speakers without interpreter
Previous enrolment in the current study
Known allergy to chlorhexidine or PHMB
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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)
Eligible, consenting patients will be allocated to their group using an automated allocation group generator which is built into a hand held device.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be via a centralised web-based service
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Masking / blinding
Open (masking not 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 2 / Phase 3
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
The sample size for this pilot study will be based upon the requirements to assess feasibility. A sample of 50 per group will be sufficient to warrant extension to the larger trial if feasibility is established. Consequently, no statistical tests to assess differences between groups will be performed on pilot study data, and only descriptive data will be reported. Analysis will be performed using the intention-to-treat principle, meaning all patients will be analysed in the group to which they were assigned.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/11/2015
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Actual
1/02/2016
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Date of last participant enrolment
Anticipated
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Actual
13/07/2016
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Date of last data collection
Anticipated
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Actual
26/07/2016
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Sample size
Target
100
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Accrual to date
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Final
100
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
3999
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Royal Brisbane & Womens Hospital - Herston
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Recruitment postcode(s) [1]
9918
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4006 - Herston
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Griffith University
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Address [1]
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170 Kessels Rd
Nathan 4111
QLD
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Royal Brisbane and Womens Hospital
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Address
Butterfield Street
Herston 4006
QLD
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Joan Webster
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Address [1]
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Research & Development Unit
Level 2, Building 34
Royal Brisbane and Women's Hospital
Butterfield Street
Herston
QLD 4006
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Country [1]
290261
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Brisbane and Womens Hospital
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Ethics committee address [1]
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Level 7 Block 7 Royal Brisbane and Women's Hospital Butterfield Street Herston QLD 4029
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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30/06/2015
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Approval date [1]
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13/07/2015
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Ethics approval number [1]
293119
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Summary
Brief summary
A dressing containing chlorhexidine (Biopatch 'Trademark') has been introduced at the RBWH for all patients requiring a CVC. The dressing is expensive and the evidence for its effectiveness is contradictory. In related work we have some preliminary data showing that Biopatch may not be as effective as first thought in destroying potentially harmful bacteria. Another product, ‘Kendall 'Trademark' AMD Foam Disc’ has shown promise and we propose to compare the two antimicrobial dressings.
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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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Prof Joan Webster
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Address
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Research & Development Unit
Level 2, Bld 34
Royal Brisbane and Women's Hospital
Butterfield Street
Herston
QLD 4006
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Country
58562
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Australia
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Phone
58562
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+61 7 3646 8590
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Fax
58562
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Email
58562
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[email protected]
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Contact person for public queries
Name
58563
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Joan Webster
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Address
58563
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Research & Development Unit
Level 2, Bld 34
Royal Brisbane and Women's Hospital
Butterfield Street
Herston
QLD 4006
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Country
58563
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Australia
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Phone
58563
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+61 7 3646 8590
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Fax
58563
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Email
58563
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[email protected]
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Contact person for scientific queries
Name
58564
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Joan Webster
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Address
58564
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Research & Development Unit
Level 2, Bld 34
Royal Brisbane and Women's Hospital
Butterfield Street
Herston
QLD 4006
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Country
58564
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Australia
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Phone
58564
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+61 7 3646 8590
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Fax
58564
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Email
58564
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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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