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Trial registered on ANZCTR
Registration number
ACTRN12616001573448
Ethics application status
Approved
Date submitted
7/11/2016
Date registered
14/11/2016
Date last updated
26/02/2019
Date data sharing statement initially provided
20/02/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The CRISP trial: a risk assessment tool to inform bowel cancer screening in general practice patients
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Scientific title
The CRISP Trial: a phase II RCT of a risk assessment and decision support tool for stratified colorectal cancer screening in primary care
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Secondary ID [1]
290424
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Nil
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Universal Trial Number (UTN)
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Trial acronym
CRISP
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Linked study record
ACTRN12615000155594
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Health condition
Health condition(s) or problem(s) studied:
Colorectal Cancer
300765
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Condition category
Condition code
Cancer
300604
300604
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0
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Bowel - Back passage (rectum) or large bowel (colon)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is a web based Colorectal cancer RISk Prediction tool (CRISP) risk assessment tool utilising a risk model to provide patients with a personalised risk assessment and colorectal cancer screening advice based on their risk.
Patients in the intervention group will be invited to complete the risk tool with a trained researcher prior to a consultation with their GP. The tool will take a maximum of 7 minutes and will be completed at baseline only. Participants will receive their risk of colorectal cancer and screening advice based on their risk which they will take with them into their consultation with their GP. All participants will also complete a survey collecting information about cancer risk perception, worry and bowel cancer screening intention and behaviour at baseline, 1 month, 6 months and 12 months after recruitment. The follow up survey should take no more than 15 minutes to complete and will be sent through the post or a link to the online survey will be sent via email.
We will ask for permission to access GP records, records from Medicare, Victorian Admissions and Emergency Dataset (VAED) and from the National Bowel Screening Program (NBCSP) 1, 3 and 5 years after the participants enrol to track the colorectal cancer screening they have had.
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Intervention code [1]
296257
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Early detection / Screening
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Comparator / control treatment
'Usual care' in a primary care clinic as well as general information about 'How to Cut Your Cancer Risk' from the Cancer Council of Victoria. 'Usual care' indicates screening for colorectal cancer will be based on the NHMRC guidelines for colorectal cancer screening. Control patients will be having a consultation without being provided with absolute risk of colorectal cancer.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary outcome will be the proportion of participants who have had risk-appropriate screening after 12 months' follow-up. Appropriateness of screening will be determined by their absolute 5-year risk of CRC, using a 1% threshold and completion of FOBT, colonoscopy no screening, or a referral to a Familial Cancer Centre for genetic counselling if indicated by their family history. Patient self-report at 12 months will tell us what screening each patient has had and this will be cross-checked with GP records, records from Medicare, Victorian Admissions and Emergency Dataset (VAED) and from the National Bowel Screening Program (NBCSP)
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Assessment method [1]
300016
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Timepoint [1]
300016
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12 months post recruitment
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Secondary outcome [1]
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Proportion of participants who have had risk-appropriate screening after 5 years' follow-up, measured as above for primary endpoint. We will ask for permission to access GP records, records from Medicare, Victorian Admissions and Emergency Dataset (VAED) and from the National Bowel Screening Program (NBCSP) to determine screening undertaken at 5 years.
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Assessment method [1]
328809
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Timepoint [1]
328809
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5 years post recruitment
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Secondary outcome [2]
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Risk perception: personal perceived risk, absolute and comparative, will be measured using an existing validated tool - the 'Family History Questionnaire'.
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Assessment method [2]
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Timepoint [2]
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Baseline, 1 month, 6 months and 12 months after recruitment
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Secondary outcome [3]
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Cancer worry using the Cancer Worry Scale
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Assessment method [3]
328811
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Timepoint [3]
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Baseline, 1 month, 6 months and 12 months after recruitment
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Secondary outcome [4]
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Intentions to have FOBT and/or colonoscopy in the next three months based on items from the Theory of Planned Behaviour
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Assessment method [4]
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Timepoint [4]
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Baseline, 1 month, 6 months and 12 months
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Secondary outcome [5]
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Clinical outcomes of screening tests, obtained from GP records including detection of pre-malignancies and colorectal cancer lesions
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Assessment method [5]
328997
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Timepoint [5]
328997
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Baseline, 1 month, 6 months, 12 months, 5 years after recruitment
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Secondary outcome [6]
329175
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Health service utilisation and health care costs. We will measure GP consultations, referrals for colonoscopy, and completion of FOBT. Costs of delivering the CRISP and control consultations will be calculated.
This includes assessment of GP consultations, colonoscopy services, FOBT and associated pathology services. Costs of delivering the CRISP and control consultations will also be calculated. Any other associated changes in health care utilisation will be captured through access to patients Medicare data.
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Assessment method [6]
329175
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Timepoint [6]
329175
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12 months post recruitment
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Eligibility
Key inclusion criteria
Primary care patients between 50 and 74 years old who have an appointment with their general practitioner (GP). This applies only to patients of consenting GPs who have been recruited into the trial.
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Minimum age
50
Years
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Maximum age
74
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
Anyone who has had a previous cancer diagnosis, has symptoms of colorectal cancer, is already having surveillance for bowel disease, or is not competent to consent in English will be excluded from being in the trial.
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Study design
Purpose of the study
Prevention
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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)
Yes, central randomisation by computer will be employed after enrolment
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The primary analysis will be a comparison between groups on the proportion of participants who have had appropriate CRC screening at 12 months using logistic regression with the randomisation stratification factor, general practice, as a covariate. The health economic analyses will combine a within trial and modelled analysis of the cost-effectiveness of implementing the CRISP tool.
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
1/03/2017
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Actual
9/05/2017
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Date of last participant enrolment
Anticipated
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Actual
4/05/2018
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Date of last data collection
Anticipated
4/05/2023
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Actual
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Sample size
Target
732
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Accrual to date
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Final
732
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
294828
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
294828
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Australia
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Funding source category [2]
294829
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Government body
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Name [2]
294829
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Victorian Cancer Agency
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Address [2]
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GPO Box 4057 (Level 15)
MELBOURNE VIC 3001
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Country [2]
294829
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Australia
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Primary sponsor type
University
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Name
University of Melbourne
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Address
200 Berkeley Street
Carlton VIC 3053
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Country
Australia
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Secondary sponsor category [1]
293671
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None
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Name [1]
293671
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Address [1]
293671
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Country [1]
293671
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296217
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University of Melbourne Human Ethics Committee
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Ethics committee address [1]
296217
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Ethics committee country [1]
296217
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Australia
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Date submitted for ethics approval [1]
296217
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28/10/2016
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Approval date [1]
296217
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16/12/2016
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Ethics approval number [1]
296217
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1647804
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Summary
Brief summary
This research is aiming to test an intervention led by the practice nurse in general practice to calculate and discuss people's individual risk of bowel cancer and screening tests in order to have risk appropriate screening to detect a malignancy or pre-malignancy as early as possible. Who is it for? Any primary care patient aged between 50 and 74 years who has an appointment with a general practitioner (GP) who is participating in the study. Anyone who has had a previous colorectal cancer diagnosis will not be eligible. Study details: Participants in this study will be randomly (by chance) allocated to one of two groups. Participants in one group will continue to receive the usual care in the primary care clinic. Participants in the other group will go through a web-based colorectal cancer risk assessment with the research nurse, who will then provide risk output and screening advice which can be discussed with their GP. Our primary aim is to determine well the risk assessment tool encourages patients to have and doctors to recommend colorectal cancer screening that is appropriate for the patient’s actual risk of developing the disease. The research is part of a larger body of research: the 'NHMRC Centre for Research Excellence for Reducing the Burden of Colorectal Cancer by Optimising Screening: Evidence to Clinical Practice'.
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Trial website
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Trial related presentations / publications
Walker, J. G., Macrae, F., Winship, I., Oberoi, J., Saya, S., Milton, S., ... & Galloway, L. (2018). The use of a risk assessment and decision support tool (CRISP) compared with usual care in general practice to increase risk-stratified colorectal cancer screening: study protocol for a randomised controlled trial. Trials, 19(1), 397. Emery, J. D., Pirotta, M., Macrae, F., Walker, J. G., Qama, A., Boussioutas, A., & Jenkins, M. (2018). 'Why don't I need a colonoscopy?': A novel approach to communicating risks and benefits of colorectal cancer screening. Australian Journal of General Practice, 47(6), 343
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Public notes
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Contacts
Principal investigator
Name
70030
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Prof Jon Emery
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Address
70030
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Centre for Cancer Research
Department of General Practice
Faculty of Medicine, Dentistry and Health Sciences
Level 10, 305 Grattan St,
Victorian Comprehensive Cancer Centre
University of Melbourne 3010
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Country
70030
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Australia
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Phone
70030
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+61385597044
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Fax
70030
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Email
70030
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[email protected]
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Contact person for public queries
Name
70031
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Jennifer G Walker
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Address
70031
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Centre for Cancer Research
Department of General Practice
Faculty of Medicine, Dentistry and Health Sciences
Level 10, 305 Grattan St,
Victorian Comprehensive Cancer Centre
University of Melbourne 3010
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Country
70031
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Australia
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Phone
70031
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+61385597048
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Fax
70031
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Email
70031
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[email protected]
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Contact person for scientific queries
Name
70032
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Jon Emery
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Address
70032
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Centre for Cancer Research
Department of General Practice
Faculty of Medicine, Dentistry and Health Sciences
Level 10, 305 Grattan St,
Victorian Comprehensive Cancer Centre
University of Melbourne 3010
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Country
70032
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Australia
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Phone
70032
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+61385597044
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Fax
70032
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Email
70032
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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
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
1411
Study protocol
Walker, J. G., Macrae, F., Winship, I., Oberoi, J....
[
More Details
]
1412
Ethical approval
371743-(Uploaded-20-02-2019-10-45-12)-Study-related document.pdf
1413
Informed consent form
371743-(Uploaded-20-02-2019-10-48-34)-Study-related document.pdf
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
The use of a risk assessment and decision support tool (CRISP) compared with usual care in general practice to increase risk-stratified colorectal cancer screening: Study protocol for a randomised controlled trial.
2018
https://dx.doi.org/10.1186/s13063-018-2764-7
Embase
The Colorectal cancer RISk Prediction (CRISP) trial: a randomised controlled trial of a decision support tool for risk-stratified colorectal cancer screening.
2023
https://dx.doi.org/10.3399/BJGP.2022.0480
N.B. These documents automatically identified may not have been verified by the study sponsor.
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