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Trial registered on ANZCTR
Registration number
ACTRN12616000488404
Ethics application status
Approved
Date submitted
7/04/2016
Date registered
14/04/2016
Date last updated
29/07/2021
Date data sharing statement initially provided
8/04/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Understanding chronic pain after breast cancer surgery
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Scientific title
Factors Influencing pain and recovery after breast cancer surgery
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Secondary ID [1]
288943
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nil known
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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:
Persistent Post-surgical Pain
298300
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Breast Cancer
298348
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Condition category
Condition code
Anaesthesiology
298426
298426
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0
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Pain management
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Cancer
298458
298458
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0
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Breast
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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
Exposure:
Breast cancer surgery
Conditions observed:
1. Persistent pain lasting more than 6 months following breast cancer surgery.
2. The patient genotype associated with moderate to severe persistent pain following breast cancer surgery.
3. The epigenetic changes associated with these candidate genes to relate these with the development of moderate to severe persistent pain after breast cancer surgery.
4. The clinical, psychological and neurophysiological factors associated with persistent pain following breast cancer surgery.
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Intervention code [1]
294417
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Chronic pain after breast cancer surgery using the Numerical Rating Scale (NRS), Brief Pain Inventory (BPI), Short Form McGill Pain Questionnaire 2 (SF-MPQI 2), Douleur Neuropathique en 4 interview (DN4 Interview),
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Assessment method [1]
297913
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Timepoint [1]
297913
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6 months after primary breast cancer surgery
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Primary outcome [2]
297914
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Candidate genes associated with moderate to severe persistent pain after breast cancer surgery. Analysing Single Nucleotide Polymorphisms (SNPs) of genes from patient DNA extracted from blood using PCR-RFLP and Sequenom MassARRAY iPlex technology.
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Assessment method [2]
297914
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Timepoint [2]
297914
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6 months after primary breast cancer surgery
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Primary outcome [3]
297915
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Longitudinal epigenetic changes of the candidate genes associated with persistent pain after breast cancer surgery. Analysing longitudinal changes to mRNA by quantitative PCR of the RT–PCR cDNA product using appropriate TaqMan (Registered Trademark) Gene Expression Assay probes to assess transcriptional expression of candidate genes extracted from patient blood.
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Assessment method [3]
297915
0
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Timepoint [3]
297915
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Immediately post op (in the post anaesthesia care unit), 24 hours, 2 weeks and 6 months after primary breast cancer surgery
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Secondary outcome [1]
322604
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Functional impairment in patients with moderate to severe persistent pain following breast cancer surgery, using disabilities of the arm, shoulder and hand questionnaire (DASH).
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Assessment method [1]
322604
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Timepoint [1]
322604
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6 months after primary breast cancer surgery
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Secondary outcome [2]
322740
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Emotional distress using Depression, Anxiety and Stress Scale questionnaire (DASS21).
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Assessment method [2]
322740
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Timepoint [2]
322740
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Immediately before primary breast cancer surgery (Pre-op) and 6 months after primary breast cancer surgery
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Secondary outcome [3]
322741
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Pre-existing pain experience using Numerical Rating Scale (NRS) and Brief Pain Inventory (BPI)
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Assessment method [3]
322741
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Timepoint [3]
322741
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Immediately before primary breast cancer surgery (Pre-op)
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Secondary outcome [4]
322742
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Acute post operative pain using Numerical Rating Scale (NRS)
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Assessment method [4]
322742
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Timepoint [4]
322742
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Immediately post op (in the post anaesthesia care unit), 24h, and 2 weeks after primary breast cancer surgery
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Secondary outcome [5]
322743
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Acute post operative pain interference using Brief Pain Inventory (BPI)
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Assessment method [5]
322743
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Timepoint [5]
322743
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24 hours, and 2 weeks after primary breast cancer surgery
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Secondary outcome [6]
322744
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Nociceptive function using Quantitative Sensory Testing (QST)
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Assessment method [6]
322744
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Timepoint [6]
322744
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Immediately before primary breast cancer surgery (Pre-op) and 6 months after primary breast cancer surgery
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Secondary outcome [7]
322745
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Longitudinal epigenetic changes of the candidate genes associated with persistent pain after breast cancer surgery. Analysing DNA CpG methylation to assess longitudinal expression of candidate genes extracted from patient blood using Sequenom MassARRAY.
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Assessment method [7]
322745
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Timepoint [7]
322745
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Immediately post op (in the post anaesthesia care unit), 24 hours, 2 weeks and 6 months after primary breast cancer surgery
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Secondary outcome [8]
322746
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Risk factor for developing persistent pain after breast cancer surgery. Review of patient demographics, medical and surgical record.
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Assessment method [8]
322746
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Timepoint [8]
322746
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6 months after primary breast cancer surgery
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Eligibility
Key inclusion criteria
1. Diagnosis of breast cancer
2. Undergoing surgery for breast cancer (mastectomy, breast conserving surgery with sentinel node biopsy and / or axillary clearance)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Previous aesthetic surgery.
2. Patients who are unable to understand English.
3. Patients who are unable to give informed consent.
4. Patients with recurrent disease or distant metastases.
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
1/08/2016
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Actual
7/10/2016
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Date of last participant enrolment
Anticipated
3/06/2019
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Actual
18/08/2020
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Date of last data collection
Anticipated
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Actual
3/09/2020
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Sample size
Target
220
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Accrual to date
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Final
173
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Recruitment outside Australia
Country [1]
7788
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New Zealand
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State/province [1]
7788
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Auckland
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Funding & Sponsors
Funding source category [1]
293308
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Hospital
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Name [1]
293308
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North Shore Hospital
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Address [1]
293308
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Department of Anaesthesiology and Perioperative Medicine,
North Shore Hospital, Private Bag 93503,
Takapuna, North Shore City 0740
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Country [1]
293308
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New Zealand
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Funding source category [2]
302426
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Charities/Societies/Foundations
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Name [2]
302426
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ANZCA research foundation
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Address [2]
302426
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ANZCA House,
630 St Kilda Road,
Melbourne, Victoria 3004,
Australia.
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Country [2]
302426
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Australia
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Primary sponsor type
Individual
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Name
Dr Daniel Chiang
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Address
Department of Anaesthesiology and Perioperative Medicine,
North Shore Hospital, Private Bag 93503,
Takapuna, North Shore City 0740
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Country
New Zealand
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Secondary sponsor category [1]
292119
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None
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Name [1]
292119
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None
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Address [1]
292119
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none
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Country [1]
292119
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294782
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Health and Disability Ethics Committee
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Ethics committee address [1]
294782
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Ministry of Health Freyberg Building 20 Aitken Street PO Box 5013 Wellington 6011
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Ethics committee country [1]
294782
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New Zealand
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Date submitted for ethics approval [1]
294782
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07/04/2016
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Approval date [1]
294782
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04/07/2016
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Ethics approval number [1]
294782
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16/NTA/55
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Summary
Brief summary
Significance: International studies indicate that 35%-60% of patients experience persistent pain after breast cancer surgery, impacting negatively on physical function and quality of life. There is a paucity of data from Australasia. As surgery is the major treatment modality for over 3000 new cases of breast cancer diagnosed each year in New Zealand alone, it can be postulated that persistent pain after breast cancer surgery is a large but unmeasured occult problem. Context: The project is a single centre study at Waitemata District Health Board, a tertiary referral centre consisting of three surgical sites, that conducts more than 400 surgeries for breast cancer annually. It will involve specialist researchers from North Shore Hospital (Pain Medicine and Anaesthesia), The University of Auckland (Pharmacogenetics and Epigenetics), AUT University (Pain Neurobiology) and The University of Adelaide (Genetics and Opioids). Aims and Objectives: 1). To assess the relationship between patients’ genotype and the risk of developing moderate to severe persistent pain after breast cancer surgery. 2). To investigate possible epigenetic mechanisms influencing the transcription of key candidate genes to provide a possible mechanism for developing persistent pain following breast cancer surgery. 3). To assess the relationship between clinical, psychological and neurophysiological factors with persistent pain after breast cancer surgery. Hypothesis: 1). Inherited polymorphisms in certain genes are associated with an increased risk for developing moderate to severe persistent pain after breast cancer surgery. 2). Epigenetic regulation of transcription of these genes underlies the transition to persistent pain after breast cancer surgery. 3). A combination of clinical, psychological, neurophysiological and genetic factors will be predictors of persistent pain after breast cancer surgery. Design and Methods: Prospective cohort study of patients undergoing breast cancer surgery. Patient review before surgery, immediately after surgery, at 24 h, 2 weeks and 6 months. Pain measurement and blood collection for candidate gene analysis and longitudinal epigenetic regulation association studies at each review. Quantitative Sensory Testing (QST) preoperatively and at 6 months. Outcomes: 1). Incidence of persistent pain for more than 6 months after breast cancer surgery. 2). Identification of genes associated with moderate to severe persistent pain (NRS greater than 4). 3). Identification of longitudinal epigenetic regulation of genes associated with developing moderate to severe persistent pain. 4). Identification of clinical, psychological and neurophysiological factors associated with moderate to severe persistent pain. Inclusion Criteria: Women, 18 years and over, Undergoing breast cancer surgery (Mastectomy, Breast conserving surgery with sentinel node biopsy and/or axillary clearance)
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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 Daniel Chiang
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Address
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Department of Anaesthesiology and Perioperative Medicine,
North Shore Hospital, Private Bag 93503,
Takapuna, North Shore City 0740
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Country
64470
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New Zealand
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Phone
64470
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+64 21 027 67 220
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Fax
64470
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Email
64470
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[email protected]
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Contact person for public queries
Name
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Daniel Chiang
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Address
64471
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Department of Anaesthesiology and Perioperative Medicine,
North Shore Hospital, Private Bag 93503,
Takapuna, North Shore City 0740
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Country
64471
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New Zealand
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Phone
64471
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+64 21 027 67 220
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Fax
64471
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Email
64471
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[email protected]
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Contact person for scientific queries
Name
64472
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Daniel Chiang
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Address
64472
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Department of Anaesthesiology and Perioperative Medicine,
North Shore Hospital, Private Bag 93503,
Takapuna, North Shore City 0740
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Country
64472
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New Zealand
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Phone
64472
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+64 21 027 67 220
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Fax
64472
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Email
64472
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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
Patients are deidentified and this study does not involve an intervention.
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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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