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Trial registered on ANZCTR
Registration number
ACTRN12616001378415
Ethics application status
Approved
Date submitted
12/09/2016
Date registered
5/10/2016
Date last updated
18/02/2022
Date data sharing statement initially provided
19/06/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Dietary management of uncomplicated diverticulitis: what is the effect of inpatient dietary restriction and discharge diet prescription on length of stay, recurrence and patient outcomes in patients admitted to an acute-care hospital in South-East Queensland, Australia?
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Scientific title
Conservative management of uncomplicated diverticulitis: what is the effect of inpatient dietary restriction and discharge diet prescription on length of stay, recurrence and patient outcomes in patients admitted to an acute-care hospital in South-East Queensland, Australia?
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Secondary ID [1]
290120
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None
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Universal Trial Number (UTN)
U1111-1187-4296
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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:
Uncomplicated Diverticulitis
300223
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Condition category
Condition code
Oral and Gastrointestinal
300100
300100
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
6
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Target follow-up type
Months
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Description of intervention(s) / exposure
Acute, uncomplicated diverticulitis is a gastrointestinal disorder for which dietary management guidelines exist, but are based on inconsistent, poor quality evidence. Patients admitted to the surgical ward between January 2017 and March 2019 with acute, uncomplicated diverticulitis, at an acute care hospital in South-east Queensland will be observed from admission to 6-months post discharge.
Usual practice will be observed, where dietary prescription will be given at the clinical discretion of the treating gastroenterologist and dietary advice will be provided accordingly by dietitians external to the project. Regular treatment will be observed and no intervention will be applied by researchers.
Observations will be made and statistical analysis will be carried out to determine whether differences in patient outcomes exist depending on:
1). The diet prescription they receive during admission (restricted [nil by mouth, clear fluid or free fluid hospital foodservice diet codes for the first 48hours post admission] or liberalised [soft, low fibre or full hospital foodservice diet codes for the first 48hours post admission]); and
2). The dietary fibre intake post discharge (high fibre diet [meeting or exceeding RDI of 30g for men and 25g for women] or standard diet [dietary fibre intake <RDI).
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Intervention code [1]
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Not applicable
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Comparator / control treatment
Control groups will be that receiving usual care:
1). Restricted inpatient diet
2). Standard dietary fibre intake post discharge
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Control group
Active
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Outcomes
Primary outcome [1]
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readmission to hospital using data linkage to hospital records
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Assessment method [1]
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Timepoint [1]
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30 days and 6 months post initial discharge
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Primary outcome [2]
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Hospital readmission length of stay using data linkage to hospital records
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Assessment method [2]
299582
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Timepoint [2]
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30 days post initial discharge
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Primary outcome [3]
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Gastrointestinal symptoms as determined by interview with participant
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Assessment method [3]
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Timepoint [3]
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One assessment within 24-48 hours post admission and at 30 days post initial discharge
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Secondary outcome [1]
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Patient Satisfaction using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ)
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Assessment method [1]
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Timepoint [1]
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At patient discharge
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Eligibility
Key inclusion criteria
Adult inpatients (18 years old and above) at Robina Hospital, Queensland, admitted to the surgical ward with a diagnosis of uncomplicated diverticulitis (Hinchey 0-Ib) diagnosed via CT scan and managed with conservative treatment (no surgery performed or drainage placed). A translator will be sought for non-English speaking patients.
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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
Patients will be excluded from the study if they are pregnant; unable to give informed consent; do not have CT-proven diagnosis; or are diagnosed to have complicated diverticulitis (Hinchey II and above).
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Study design
Purpose
Natural history
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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
There is estimated to be 84- 140 participants as predicted from current trends at at the hospital sites showing 3-5 admissions of eligible cases per week.
Statistical analysis will be completed using SPSS software. All data will be assessed for normality (Shapiro-Wilk test) or homogeneity of variance for continuous variables (Levene's Test). Mean +/- SD/SE for normal variables and median (inter-quartile range) for skewed variables will be used to report patient characteristics.
Liberalised Diet Group versus Restrictive Diet Group; Low Dietary Fibre Diet Group versus Standard Diet Group; and pairing of inpatient and discharge diet prescriptions will be tested for 1). association with hospital readmission and bristol stool chart type via binomial logistic regression adjusting for potentially confounding variables. 2). association with 30 day and 6 month hospital readmission length of stay and GSRS score via multiple linear regression adjusting for potentially confounding variables.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
18/10/2016
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Actual
9/01/2017
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Date of last participant enrolment
Anticipated
29/03/2019
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Actual
15/03/2019
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Date of last data collection
Anticipated
31/05/2021
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Actual
31/12/2021
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Sample size
Target
120
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Accrual to date
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Final
91
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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Robina Hospital - Robina
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Recruitment hospital [2]
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Gold Coast University Hospital - Southport
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Recruitment postcode(s) [1]
14270
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4226 - Robina
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Recruitment postcode(s) [2]
23311
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4215 - Southport
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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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Bond University
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Address [1]
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14 University Drive, Robina, QLD, 4226
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Country [1]
294499
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Australia
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Primary sponsor type
University
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Name
Bond University
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Address
14 University Drive, Robina, QLD, 4226
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Country
Australia
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Secondary sponsor category [1]
293363
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None
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Name [1]
293363
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Address [1]
293363
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Country [1]
293363
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Other collaborator category [1]
279222
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Hospital
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Name [1]
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Robina Hospital
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Address [1]
279222
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2 Bayberry Lane, Robina, QLD, 4226
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Country [1]
279222
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Australia
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Other collaborator category [2]
280233
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Hospital
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Name [2]
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Gold Coast University Hospital
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Address [2]
280233
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1 Hospital Blvd, Southport QLD 4215, Australia
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Country [2]
280233
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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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Gold Coast Hospital and Health Service (GCHHS) Human Research Ethics Committee (HREC)
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Ethics committee address [1]
295933
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Research and Ethics Communications Level 2, Block E, GoldCoast University Hospital 1 Hospital Boulevard, Southport, Qld 4215
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Ethics committee country [1]
295933
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Australia
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Date submitted for ethics approval [1]
295933
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23/09/2016
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Approval date [1]
295933
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16/12/2016
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Ethics approval number [1]
295933
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HREC/16/QGC/282
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Ethics committee name [2]
300930
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Bond University Human Research Ethics Committee
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Ethics committee address [2]
300930
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Research Services, Bond University University Drive Robina Queensland 4226
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Ethics committee country [2]
300930
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Australia
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Date submitted for ethics approval [2]
300930
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06/10/2016
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Approval date [2]
300930
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18/10/2016
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Ethics approval number [2]
300930
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15866
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Summary
Brief summary
It is known that modern Australian society is trending towards an ageing population combined with a poor intake of foods rich in dietary fibre such as wholegrains, fruits and vegetables. Therefore, as diverticulitis is highly prevalent in older adults, it is predicted to become even more prevalent in the future. In addition, it is also suggested that the disease is now occurring more commonly in younger ages. Furthermore, the evidence that is in existence to support current dietary managements is inconsistent, of poor quality and lacking in Australia. Therefore, observational research is warranted to explore the impact of current clinical practice in Australia upon patient and healthcare related outcomes. In adults admitted to an acute-care hospital with acute, uncomplicated diverticulitis in South-East Queensland, Australia, it is hypothesised that: 1). Participants who are prescribed and adhere to liberalised diets during hospital admission have less healthcare use and no difference in gastrointestinal symptom scores compared to those prescribed restricted (fluid only) diets. 2). Participants who follow a high fibre diet following discharge have lower healthcare use and gastrointestinal symptom scores than those following a standard diet. A Low or Negligible Risk (LNR) research application for ethical approval has been submitted as this study intends to be of low risk to research participants as the likelihood and severity of any risks to the patient is low. Possible risks include using vulnerable, sick patients as the study population as well as fatigue, inconvenience or discomfort of talking about personal issues. To minimise risks, high risk patients will be excluded from the study, patient involvement will be as minimal as possible by accessing medical records and eligible participants will be asked to provide informed consent. Data will also be gathered and kept in a de-identifiable format where possible with identifiable data stored in password protected electronic files or a locked filing cabinet. Researchers will be the only ones to have access to this information. The intended outcomes of this study include a greater understanding of acute uncomplicated diverticulitis. Future research that can stem from findings of this study, may then help to formulate best practice guidelines for the dietary management of acute, uncomplicated diverticulitis as such is currently non-existent. This would help to achieve cohesion across treating doctors and dietitians. It is believed that theses outcomes and associated potential benefits that this study can provide will far outweigh the possible minimal risks.
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Trial website
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Trial related presentations / publications
Poster Presentation: 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition (November 2017 – Gold Coast): Dietary fibre modification with or without antibiotics in the prevention of diverticulitis in adults with diverticular disease. Presented by Skye Marshall. Poster Presentation: 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition (November 2017 – Gold Coast): Evidence for dietary fibre modification for the prevention of acute, uncomplicated diverticulitis: a systematic literature review. Presented by Skye Marshall. Oral presentation: Gold Coast Health Research Week (November 2017 – Gold Coast): Influence of inpatient dietary restriction on acute uncomplicated diverticulitis: A pilot observational study. Presented by Megan Crichton. Oral presentation: Gold Coast Health Research Week (November 2017 – Gold Coast): Evidence for dietary fibre modification for the prevention of diverticulitis: a systematic literature review. Presented by Megan Crichton. Oral Presentation: Dietitians Association of Australia 2017: The 34th National Conference (May 2017 – Hobart): The effect of dietary fibre modification and bowel rest on patient and health care outcomes in patients admitted to hospital with acute, uncomplicated diverticulitis: A systematic literature review and meta-analysis. Presented by Camilla Dahl. Publication: Dahl C, Crichton M, Jenkins J, Nucera R, Mahoney S, Marshall S. Dietary fibre modification in the recovery and prevention of reoccurrence of acute, uncomplicated diverticulitis: A systematic review and meta-analysis. Nutrients. 2018;10:137.
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Public notes
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Contacts
Principal investigator
Name
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Mrs Romina Nucera
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Address
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Robina Hospital
2 Bayberry Lane
Robina, Qld, 4226
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Country
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Australia
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Phone
68934
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+61 (07) 5668 6000
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Fax
68934
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Email
68934
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[email protected]
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Contact person for public queries
Name
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Yvonne Chen
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Address
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Robina Hospital
2 Bayberry Lane
Robina, Qld, 4226
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Country
68935
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Australia
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Phone
68935
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+61 (07) 5668 6000
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Fax
68935
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Email
68935
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[email protected]
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Contact person for scientific queries
Name
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Skye Marshall
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Address
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Bond Institute of Health & Sport
2 Promethean Way
Robina, Qld, 4226
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Country
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Australia
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Phone
68936
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+61 7 559 55530
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Fax
68936
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Email
68936
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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)?
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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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