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Trial registered on ANZCTR
Registration number
ACTRN12616000414415
Ethics application status
Approved
Date submitted
18/02/2016
Date registered
31/03/2016
Date last updated
10/07/2019
Date data sharing statement initially provided
10/07/2019
Date results provided
10/07/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The effects of medicinal cannabinoids on driving
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Scientific title
The effects of medicinal cannabinoids on driving in healthy adults with prior cannabis experience
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Secondary ID [1]
288440
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Nil known
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Universal Trial Number (UTN)
U1111-1179-8392
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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:
Driving ability under the influence of the cannabinoids tetrahydrocannabidiol (THC) and cannbidiol (CBD)
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Condition category
Condition code
Other
297652
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0
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The study is a randomized, crossover, double blind trial comparing the effects of .125g inhaled vaporized cannabis containing various concentrations of tetrahydrocannabinol (THC) and cannabidiol (CBD) on driving performance. Participants will complete 3 sessions, seperated by a washout period of 7 days. Participants will receive one of three varieties of cannabis per session, in a randomised and counter-balanced order. Cannabis types will include cannabis containing either: (a) high THC/low CBD (11% THC / <1% CBD), (b) high THC/high CBD (11% THC / 11% CBD) or (c) placebo. Study medications will be administered using a Volcano Medic vaporiser under the supervision of study staff.. To assess driving ability, participants will complete a 45-minute advanced driving simulation, beginning 15 minutes after drug administration. Participants will additionally complete a series of cognitive tests designed to measure reaction time. attentional processing and executive function. Biological samples (urine, blood and saliva) will be taken before and at a series of time points following drug administration. These will later be analysed for THC, CBD and endocannabinoids.
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Intervention code [1]
293766
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Other interventions
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Comparator / control treatment
The control arm of this study involves a placebo strain of cannabis that contains negligible amounts of THC and CBD. All participants will receive this placebo strain during one of the three sessions,
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The primary outcome measure is Standard deviation of lateral position (SDLP), which is measured by Oktal SCANeR Studio driving simulation software.
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Assessment method [1]
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Timepoint [1]
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The primary outcome is measured twice during two driving simulation tasks; the first occurs 30 minutes after drug administration, and the second ocurs 2 1/2 hours after drug administration.
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Secondary outcome [1]
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Subjective measures of drug effects and driving ability, assessed by a VAS ranging from 0-100. These include:
1. Strength of drug effect (No effect – Very strong)
2. Liking of drug effect (Disliked very much – Liked very much
3. Sedation (Not sedated – Very sedated)
4. Confidence in ability to drive safely (Not confident – Very confident)
This is a composite secondary outcome.
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Assessment method [1]
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Timepoint [1]
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+1, +2, + 3.25, +5hr post drug administration
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Secondary outcome [2]
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Cognitive Performance.
This is comprised of test performance on the following cognitive tasks:
Flankers task (measure of choice reaction time)
Digit-Symbol Substitution Task (measure of speed of information processing)
Rapid Visual Information Processing task (measure of alertness under cognitive demand)
Stop Signal Task (measure of ability to stop a planned response)
N-Back (measure of verbal working memory)
This is a composite secondary outcome.
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Assessment method [2]
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Timepoint [2]
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+1, +2, + 3.25, +5hr post drug administration
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Secondary outcome [3]
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Plasma cannabinoid concentrations, including includes measures of THC, THC-COOH, 11-OH-THC, CBD, and endocannanoids including 2-AG and anandamide.
This is a composite secondary outcome.
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Assessment method [3]
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Timepoint [3]
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+1, +2, + 3.25, +5hr post drug administration
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Secondary outcome [4]
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Oral fluid cannabinoid concentrations, incuding oral fluid of measures THC, THC-COOH, 11-OH-THC, and CBD.
This is a composite secondary outcome.
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Assessment method [4]
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Timepoint [4]
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+1, +2, + 3.25, +5hr post drug administration
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Secondary outcome [5]
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Mean speed and standard deviation of speed
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Assessment method [5]
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Timepoint [5]
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+30 minutes, + 150 minutes post drug administration
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Secondary outcome [6]
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Number of lane crossings
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Assessment method [6]
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Timepoint [6]
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+30 minutes, +150 minutes post drug administration
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Eligibility
Key inclusion criteria
(a) At least 18 years of age, and no more than 50 years of age
(b) Prior experience with cannabis (>10 lifetime exposures, <2x/week in previous 2 months)
(c) In possession of full Australian drivers license for at least 1 year
(d) Proficiency in English, and willing and capable of providing informed consent to the study procedures
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Minimum age
18
Years
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Maximum age
50
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
(a) Any clinically significant prior adverse response to cannabis, cannabinoid products or synthetic cannabinoids, as assessed by an Addiction Medicine specialist (e.g. panic or other anxiety attacks, arrhythmia, falls, seizures)
(b) Cannabis dependence (ICD-10 criteria)
(c) A desire to abstain from cannabis use
(d) Past year mood or anxiety disorder (DSM-V criteria)
(e) Lifetime manic episode or psychotic illness (DSM-V criteria), or suspected family history of schizophrenia
(f) Interest in treatment for cannabis use
(g) Hypertension, cardiovascular disease, chronic pulmonary disease or asthma
(h) Under 18 years of age or over 50 years of age
(i) Use of medications that may impact upon the metabolism and excretion of cannabinoids (e.g. CYP450 enyzme inducers/inhibitors), or may impact upon driving ability (e.g. mood stabilisers, sedatives); and
(j) Pregnancy (primary plasma hCG screen in women of child bearing potential, confirmed with blood test if urine test positive) and women of child bearing potential must agree to using a reliable form of contraception during and one month after completion of the project.
(k) Required to complete drug testing for cannabis (e.g. workplace testing; court order)
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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 administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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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
1/04/2017
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Actual
2/10/2017
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Date of last participant enrolment
Anticipated
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Actual
2/04/2018
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Date of last data collection
Anticipated
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Actual
30/04/2018
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Sample size
Target
21
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Accrual to date
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Final
14
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Royal Prince Alfred Hospital - Camperdown
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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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The Lambert Initiative for Cannabinoid Therapeutics at The University of Sydney
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Address [1]
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Level 6
Brain and Mind Centre
94 Mallet St Camperdown 2050
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Country [1]
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Australia
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Primary sponsor type
University
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Name
The University of Sydney
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Address
The University of Sydney
NSW 2006
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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n/a
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Address [1]
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n/a
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Country [1]
291522
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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SLHD Ethics Review Committee (RPAH Zone)
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Ethics committee address [1]
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c/- Research Development Office Royal Prince Alfred Hospital Missenden Road CAMPERDOWN NSW 2050
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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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07/12/2015
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Approval date [1]
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23/03/2016
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Ethics approval number [1]
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HREC/15/RPAH/552
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Summary
Brief summary
Following the recent decision made by the Australian Commonwealth government to enable the cultivation of cannabis crops for medicinal grade products, it is likely that medicinal cannabis products – plant matter or extracts – will become more available in Australia in the years to follow. Various states including NSW are also investing in clinical trials of cannabinoid medicines for a number of debilitating illnesses, including the use of vaporised leaf cannabis products containing THC (http://www.health.nsw.gov.au/cannabis/Pages/terminal-illness.aspx). In will therefore become increasingly relevant, from a road safety and medico-legal perspective, to better understand the effects of these medicines on driving. The psychoactive constituent of cannabis, THC, is only one of over 100 phytocannabinoids present in the Cannabis Sativa plant that may be promising therapeutic targets in medicine. CBD, for example, is a non-psychoactive cannabinoid with anti-inflammatory, neuroprotective antioxidant, anticonvulsive and antipsychotic properties. Preliminary studies suggest that in animal models CBD also modulates the pharmacological action of THC, dampening its psychotomimetic properties. The presence of phytocannabinoids other than THC (such as CBD) in some medicinal grade cannabinoid products distinguishes them from Australian street grade illicit cannabis, which contains very little to nil CBD. The presence of CBD could have important implications for the effects of cannabis-based medicines on driving. Although other medicines such as benzodiazepines, opioids, and some antidepressants have been shown to impair driving ability, NSW law permits a person who is taking these medicines to drive so long as the drivers’ mental or physical faculties are not affected [9]. The current legal framework for driving under the influence of cannabis (where it is a criminal offence to be driving if THC is detected in saliva – with no functional assessment) reflects the illegal status of cannabis and predates the emergence of medicinal cannabinoid preparations. The premise of the current proposal is to test the effects of a variety of medicinal cannabinoid preparations that differ in their concentrations of the cannabinoids THC and CBD. It is hypothesised that the impairing effects of THC will be modulated and possibly negated by the presence of CBD in medical grade cannabis. This study also seeks to test the efficacy of roadside testing equipment in discerning impaired from non-impaired driving. To establish if there are methods other than saliva testing that can predict driving impairment, this study will utilise an eye-tracking task, subjective measures and cognitive testing procedures.
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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 Iain McGregor
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Address
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School of Psychology
University of Sydney
Building A18
NSW 2006
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Country
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Australia
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Phone
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+61 2 9351 3571
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Fax
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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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Thomas Arkell
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Address
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Room 243
School of Psychology
University of Sydney
Building A18
NSW 2006
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Country
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Australia
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Phone
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+61 2 9351 3433
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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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Thomas Arkell
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Address
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Room 243
School of Psychology
University of Sydney
Building A18
NSW 2006
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Country
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Australia
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Phone
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+61 2 9351 3433
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Fax
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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)?
Yes
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What data in particular will be shared?
Individual participant data of published results only.
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When will data be available (start and end dates)?
Immediately following publication, no end date.
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Available to whom?
Only researchers who provide a methodologically sound proposal.
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Available for what types of analyses?
For meta-analyses.
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How or where can data be obtained?
Please contact the principal investigator (
[email protected]
).
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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
Source
Title
Year of Publication
DOI
Embase
Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition.
2019
https://dx.doi.org/10.1007/s00213-019-05246-8
N.B. These documents automatically identified may not have been verified by the study sponsor.
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