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Trial registered on ANZCTR
Registration number
ACTRN12616000681459
Ethics application status
Approved
Date submitted
5/05/2016
Date registered
25/05/2016
Date last updated
18/08/2024
Date data sharing statement initially provided
18/08/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Next generation assessments of physical function in intensive care unit survivors - validity of two Fitbit tracking devices and smartphone apps
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Scientific title
Next generation assessments of physical function in intensive care unit survivors -Validity of two FitBit activity tracking devices and smart phone apps
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Secondary ID [1]
288982
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None
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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:
Critical Illness
298380
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Physical function
298381
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Condition category
Condition code
Physical Medicine / Rehabilitation
298484
298484
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0
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Physiotherapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In the outpatient department of the hospital, participants will be provided with a smartphone application (Health App - with the smartphone worn in a pocket) and two wearable devices (Fitbit One worn clipped to the waistband and Fitbit Flex worn on the wrist). They will complete the gold standard battery of physical function tests for approximately 30 minutes as well as conduct a 10 minute treadmill walk while wearing the devices, including the smartphone. The participants will be asked to wear the devices and to carry the smartphone for a 7-day period for as much of the 24 hours as possible in their usual living accommodations. After Day 7, they will undergo a twenty minute telephone assessment of physical function, relay the data from the smartphone applications and be prompted to return the wearable devices via the pre-paid envelope.
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Intervention code [1]
294681
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Other interventions
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Comparator / control treatment
The gold standard tests include:
1. Step count - counted directly on a treadmill by the research assistant
2. Functional Independence Measure (FIM)
3. Six minute walk test
4. Grip strength
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Control group
Active
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Outcomes
Primary outcome [1]
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Concurrent validity of the three devices (Smartphone application; "Fitbit One" waist accelerometer; "Fitbit Flex" wrist accelerometer) as assessed by 95% limits of agreement between the device step counts and directly counted steps during the treadmill walk test.
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Assessment method [1]
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Timepoint [1]
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Baseline (3 or 6 months post ICU admission)
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Primary outcome [2]
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Concurrent validity of the three devices (smartphone application; "Fitbit One" waist accelerometer; "Fitbit Flex" wrist accelerometer) as assessed by 95% limits of agreement between the device step counts and "Gold Standard" measurements of physical function the Functional Independence Measure (FIM), and two additional measures of physical function - the six minute walk test and grip strength.
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Assessment method [2]
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Timepoint [2]
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1 week post baseline assessment
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Primary outcome [3]
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Concurrent validity of the telephone assessment as assessed by 95% limits of agreement between the three instruments (Extended Glasgow Coma Scale (GOS-E); Rivermead Mobility Index (RMI); EuroQol-5D-5L, WHODAS) and the three "Gold Standard" measurements of physical function (Functional Independence Measure (FIM), 6 minute walk test, Grip strength).
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Assessment method [3]
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Timepoint [3]
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1 week post baseline assessment
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Secondary outcome [1]
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Fraction of patients on which the device was worn for at least 16 hours per day for both the Fitbit one and the Fitbit flex.
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Assessment method [1]
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Timepoint [1]
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1 week post baseline
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Eligibility
Key inclusion criteria
Participants who were previously admitted to the Intensive Care Unit (ICU) and mechanically ventilated for at least 48 hours and who:
1. report being able to walk continuously for at least 10 minutes prior to ICU admission
2. own a smartphone
3. live within 40km of the recruiting hospital
4. admitted to ICU in the previous 6 months
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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
1. The ICU-requiring injury prevents post-discharge ambulation (e.g. traumatic lower limb amputation)
2. Inadequate English spoken to enable completion of assessments
3. Pregnancy
4. Severe cognitive or neurological deficits likely to impact the ability to complete assessments
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Non-randomised 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
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Who is / are masked / blinded?
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Intervention assignment
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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
There is no universally accepted standard as to how precise the 95% CI for the limits of agreement need to be in order to be clinically useful. The sample size of 60 is based on our interpretation of the clinical literature regarding acceptably precise measurement, at feasible cost, as well as having at least as great precision as those published.
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.
Concurrent validity will be tested for each of the three devices, using a Bland-Altman plot to calculate the 95% limits of agreement between device step counts and the gold standard of directly counted steps (i.e. Smartphone app vs. direct step count; Fitbit One vs. direct step count and Fitbit Flex vs. direct step count). The device that has the smallest 95% limits of agreement will demonstrate the best concurrent validity of the three.
Concurrent validity will be tested for each of the three devices and each gold standard measure, using a Bland-Altman plot to calculate the 95% limits of agreement (i.e. nine Bland-Altman plots: Smartphone app vs FIM; Fitbit One vs FIM and Fitbit Flex vs FIM; repeated for 6MWT and grip strength respectively). The limits of agreement will be compared across the three gold standard tests to analyse whether step count can replace measurement of any of these outcomes in clinical trials; they will also be visually inspected for evidence of floor or ceiling effects.
Concurrent validity will be tested for each telephone assessment and each gold standard measure, using a Bland-Altman plot to calculate the 95% limits of agreement (i.e. nine Bland-Altman plots: FIM vs. GOSE; FIM vs. EQ-5D; FIM vs. Rivermead Mobility Index; repeated for 6MWT and grip strength respectively). The limits of agreement will be compared across the three gold standard tests to analyze whether the telephone measures can replace measurement of any of these outcomes in clinical trials.
Chi-square statistics will be used to assess for pairwise differences between the devices.
We will also include scatter plots as physical function is a complex variable.
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Recruitment
Recruitment status
Withdrawn
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Reason for early stopping/withdrawal
Lack of funding/staff/facilities
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Date of first participant enrolment
Anticipated
30/05/2016
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Actual
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Date of last participant enrolment
Anticipated
30/12/2017
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Alfred - Prahran
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Recruitment hospital [2]
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Footscray Hospital - Footscray
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Recruitment hospital [3]
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Sunshine Hospital - St Albans
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Recruitment postcode(s) [1]
13045
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3004 - Melbourne
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Recruitment postcode(s) [2]
13046
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3011 - Footscray
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Recruitment postcode(s) [3]
13049
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3021 - St Albans
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Intensive Care Foundation
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Address [1]
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Level 2,
10 Ievers Terrace,
Carlton VIC 3053
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Australia and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University
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Address
The Alfred Centre
Level 6
99 Commercial Road
Melbourne VIC 3004
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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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Address [1]
292160
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Country [1]
292160
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294857
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Alfred Health Human Ethics Committee
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Ethics committee address [1]
294857
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Office of Ethics and Research Governance Ground Floor, Linay Pavilion Alfred Hospital 55 Commercial Road Melbourne VICTORIA 3004
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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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25/02/2016
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Approval date [1]
294857
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06/04/2016
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Ethics approval number [1]
294857
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HREC/16/Alfred/10 (Local Reference: Project 57/16)
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Ethics committee name [2]
294858
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Western Health Low Risk Human Research Ethics Panel
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Ethics committee address [2]
294858
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Office for Research 3rd Floor, Western Centre for Health Research and Education Sunshine Hospital Furlong Rd. St Albans VIC 3021
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Ethics committee country [2]
294858
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Australia
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Date submitted for ethics approval [2]
294858
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Approval date [2]
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07/01/2016
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Ethics approval number [2]
294858
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LNR/15/WH/205
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Summary
Brief summary
This project will compare two "next generation" methods of measurement of physical function to the accepted gold standard assessment of physical function: in-person testing using validated physical function outcome measures. We will measure physical activity using (1) wearable devices and smartphone applications and (2) a telephone assessment of global function; we will compare these convenient at home assessments to the gold standard in-person assessments in order to quantify the validity and feasibility of these new approaches to inform future clinical trial design. The results will be used both within Australia and New Zealand, and internationally, to design future RCTs aiming to measure post discharge and long term physical function outcomes. Moreover, our results will also inform the design of new in-home monitoring strategies for post-ICU clinics and interventions.
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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 Carol Hodgson
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Address
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Department of Epidemiology and Preventive Medicine
School of Public Health and Preventive Medicine
Monash University
The Alfred Centre
99 Commercial Road
Melbourne VIC 3004
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Country
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Australia
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Phone
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+61, 3, 9903 0598
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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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Carol Hodgson
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Address
65123
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Department of Epidemiology and Preventive Medicine
School of Public Health and Preventive Medicine
Monash University
The Alfred Centre
99 Commercial Road
Melbourne VIC 3004
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Country
65123
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Australia
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Phone
65123
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+61, 3, 9903 0598
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Fax
65123
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Email
65123
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[email protected]
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Contact person for scientific queries
Name
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Carol Hodgson
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Address
65124
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Department of Epidemiology and Preventive Medicine
School of Public Health and Preventive Medicine
Monash University
The Alfred Centre
99 Commercial Road
Melbourne VIC 3004
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Country
65124
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Australia
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Phone
65124
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+61, 3, 9903 0598
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Fax
65124
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Email
65124
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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
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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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