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Trial registered on ANZCTR
Registration number
ACTRN12616001152415
Ethics application status
Approved
Date submitted
14/08/2016
Date registered
24/08/2016
Date last updated
8/04/2022
Date data sharing statement initially provided
8/04/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
A Prospective observational trial to assess if thromboelastography (TEG) can be used to predict blood culture results in clinically septic patients.
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Scientific title
A Prospective observational trial to assess if thromboelastography (TEG) can be used to predict blood culture results in clinically septic patients
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Secondary ID [1]
289691
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
BC-TEG
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Sepsis
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coagulation
299492
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Condition category
Condition code
Infection
299475
299475
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0
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Other infectious diseases
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Blood
299476
299476
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0
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Clotting disorders
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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
Patients admitted to intensive care who fulfil Systemic Inflammatory Response Syndrome (SIRS) criteria and are clinically thought to have sepsis will have a sample of blood taken to perform a thromboelastogram (TEG) both at admission and on discharge. These results will be correlated with blood culture results from samples that have been taken at clinically appropriate times - no additional blood culture samples will be taken. The patient will not be clinically followed up after discharge for the purposes of this study.
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Intervention code [1]
295312
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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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To determine whether the TEG results from patients who are admitted to the ICU with clinically diagnosed sepsis (using SIRS criteria and clinical suspicion of an infectious source) are correlated to obtaining a positive blood culture result.
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Assessment method [1]
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Timepoint [1]
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The blood samples will be taken on admission to ICU.
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Secondary outcome [1]
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To determine if standard laboratory coagulation studies correlate with the TEG changes in culture positive sepsis
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Assessment method [1]
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Timepoint [1]
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Results from the routine blood tests taken on admission to ICU will be compared to blood samples taken for TEG at admission
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Secondary outcome [2]
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To determine if TEG changes on discharge from the ICU have resolved with clinical improvement
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Assessment method [2]
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Timepoint [2]
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Blood sample will be taken on discharge from ICU
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Secondary outcome [3]
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Diagnosis on admission to hospital, by review of hospital records
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Assessment method [3]
326932
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Timepoint [3]
326932
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At time of admissin
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Secondary outcome [4]
326933
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Diagnosis on admission to ICU, by review of hospital records
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Assessment method [4]
326933
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Timepoint [4]
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At time of admission
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Secondary outcome [5]
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Length of stay in the ICU, by review of hospital records
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Assessment method [5]
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Timepoint [5]
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At time of ICU discharge
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Secondary outcome [6]
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Source of sepsis, by review of hospital records
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Assessment method [6]
326935
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Timepoint [6]
326935
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At time of ICU discharge
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Secondary outcome [7]
326936
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Use of vasoactive drugs, by review of hospital records
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Assessment method [7]
326936
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Timepoint [7]
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At time of ICU discharge
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Secondary outcome [8]
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Hospital mortality, by review of hospital records
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Assessment method [8]
326937
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Timepoint [8]
326937
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At time of hospital discharge or death
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Eligibility
Key inclusion criteria
Patients admitted to ICU who;
- are aged >18 years
- Have SIRS; 2 of the following criteria on admission;
- Temperature >38 or <36
- Pulse rate >90/minute
- Respiratory rate >20/minute or PaCo2 <32mmHg
- White cell count >12 or >10% immature bands
- Clinical diagnosis of sepsis
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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
- Pre-existing diagnosis of a coagulation disorder
- On anticoagulant treatment eg heparin infusion, treatment dose low-molecular weight heparin, warfarin or oral anticoagulants
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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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
Completed
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Date of first participant enrolment
Anticipated
31/08/2016
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Actual
2/05/2017
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Date of last participant enrolment
Anticipated
31/07/2017
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Actual
5/04/2018
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Date of last data collection
Anticipated
31/08/2017
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Actual
5/04/2018
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Sample size
Target
50
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Accrual to date
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Final
50
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
6181
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Logan Hospital - Meadowbrook
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Recruitment postcode(s) [1]
13614
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4131 - Meadowbrook
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Funding & Sponsors
Funding source category [1]
294144
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Hospital
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Name [1]
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Logan Hospital Intensive Care Unit
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Address [1]
294144
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Logan Hospital
Cnr Armstrong and Loganlea Roads
Meadowbrook
QLD
4131
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Country [1]
294144
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Australia
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Primary sponsor type
Hospital
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Name
Intensive Care Unit, Logan Hospital
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Address
Cnr Armstrong and Loganlea Rds
Meadowbrook
QLD
4131
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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]
292974
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Address [1]
292974
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Country [1]
292974
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295555
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Metro South Human Research Ethics Committee
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Ethics committee address [1]
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Princess Alexandra hospital 199 Ipswich Road Woolloongabba 4102
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Ethics committee country [1]
295555
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Australia
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Date submitted for ethics approval [1]
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30/08/2016
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Approval date [1]
295555
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10/01/2017
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Ethics approval number [1]
295555
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Summary
Brief summary
This study will examine if there are changes in coagulation which can be detected by TEG that occur in patients with a bacteraemia before it has been detected in blood cultures. The benefits of being aware of these potential changes may include earlier consideration of non-infective causes of SIRS and altered antibiotic prescribing practices. In contrast, early identification of a potentially life-threatening infective process that is responsible for the SIRS presentation is essential to ensure ‘ideal outcomes’ for patients (1). It is a common and important clinical challenge to distinguish between those patients who have sepsis and those who have SIRS. A hypocoagulable state in sepsis is thought to be associated with increased mortality. Specifically, impaired fibrinolysis may be associated with a diagnosis of sepsis versus SIRS (2). On admission to ICU, patients generally have a set of routine admission bloods sampled; these may include full blood count, electrolytes, renal and hepatic function and a coagulation profile. Routine blood tests may also include blood cultures if the patient is thought to be septic. However, the routine coagulation profile sent to pathology is thought to provide limited clinical information when assessing in vivo hypocoaguable changes (2). Research has demonstrated that TEG parameter changes throughout an episode of sepsis may provide some predictive value for mortality and risk of bleeding (3). Recent research has aimed to identify early TEG parameters that may predict a positive blood culture result (4). The aim of our study is to identify blood changes detected by TEG that may indicate whether a patient has sepsis or a non-infective cause for SIRS. References; 1. Simpson S. New Sepsis Criteria; A change we should not make. Chest. 2016; 149(5). 2. Muller MC, Meijers JCM, Vroom MB, Juffermans NP. Utility of thromboelastography and/or thromboelastometry in adults with sepsis: a systematic review. Critical care (London, England). 2014; 18(1):R30-R. 3. Haase N, Ostrowski SR, Wetterslev J, Lange T, Moller MH, Tousi H, et al. Thromboelastography in patients with severe sepsis: a prospective cohort study. Intensive Care Medicine. 2015; 41(1):77-85. 4. Grant HW, Hadley GP. Prediction of neonatal sepsis by thromboelastography. Pediatric Surgery International. 1997; 12(4):289-92.
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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 Hayden White
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Address
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Director of Intensive Care
Logan Hospital
Cnr Armstrong and Loganlea Roads
Meadowbrook 4131
QLD
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Country
67454
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Australia
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Phone
67454
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+61 7 3299 8755
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Fax
67454
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+61 7 3299 8376
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Email
67454
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[email protected]
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Contact person for public queries
Name
67455
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Hayden White
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Address
67455
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Director of Intensive Care
Logan Hospital
Cnr Armstrong and Loganlea Roads
Meadowbrook 4131
QLD
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Country
67455
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Australia
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Phone
67455
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+61 7 3299 8755
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Fax
67455
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+61 7 3299 8376
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Email
67455
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[email protected]
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Contact person for scientific queries
Name
67456
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Hayden White
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Address
67456
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Director of Intensive Care
Logan Hospital
Cnr Armstrong and Loganlea Roads
Meadowbrook 4131
QLD
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Country
67456
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Australia
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Phone
67456
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+61 7 3299 8755
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Fax
67456
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+ 61 7 3299 8376
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Email
67456
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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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