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Trial registered on ANZCTR
Registration number
ACTRN12617000562370
Ethics application status
Approved
Date submitted
19/04/2017
Date registered
21/04/2017
Date last updated
11/03/2020
Date data sharing statement initially provided
11/03/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
A comparison of arterial and blood gas analyses in sleep studies
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Scientific title
GAS (Gas Analysis in Sleep) study: a comparison of arterial and venous blood gas analyses in sleep study participants
CapGAS substudy: a comparison of arterial and capillary blood gas analyses in sleep study participants
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Secondary ID [1]
291655
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Nil known
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Universal Trial Number (UTN)
U1111-1195-2949
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Trial acronym
GAS Study
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Linked study record
None
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Health condition
Health condition(s) or problem(s) studied:
Hypoventilation
302810
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Condition category
Condition code
Respiratory
302304
302304
0
0
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Other respiratory disorders / diseases
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Respiratory
302305
302305
0
0
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Sleep apnoea
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A venous blood gas will be taken as paired with each arterial blood gas (generally two per patient in a one night sleep study at the commencement and end of the study). Transcutaneous measurements of CO2, if taken as part of the sleep study, will also be recorded, along with the time between blood samples and relevant personal information.
In the ethics-approved substudy, on completion of enrolment for venous and arterial blood gas comparisons, further participants will be recruited to compare capillary and arterial blood gases. Information on patient preference on sampling technique is recorded.
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Intervention code [1]
297741
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Diagnosis / Prognosis
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Comparator / control treatment
The study compares the values obtained from venous and arterial blood gas measurements and non-invasive percutaneous measurements. Each patient provides both "treatment" and "control" data.
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Control group
Active
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Outcomes
Primary outcome [1]
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Relationship between arterial and venous blood gas carbon dioxide tensions in terms of absolute and relative bias (a composite outcome). This is assessed statistically by comparing the values from arterial and venous blood gases. In the independently-analysed CapGAS substudy the comparison will be between capillary and arterial blood gases.
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Assessment method [1]
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Timepoint [1]
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At the time blood gases would otherwise be taken for the sleep study, which is generally at the start of the study (before sleep) and the end of the study (upon waking in the morning).
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Primary outcome [2]
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Relationship between arterial and venous blood gas carbon dioxide tensions in terms of a Bland-Altman plot and 95% limits of agreement. This is assessed statistically by comparing the values from arterial and venous blood gases. In the independently-analysed CapGAS substudy the comparison will be between capillary and venous blood gases.
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Assessment method [2]
301833
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Timepoint [2]
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At the time blood gases would otherwise be taken for the sleep study, which is generally at the start of the study (before sleep) and the end of the study (upon waking in the morning).
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Secondary outcome [1]
333656
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Comparison of the difference of (percutaneous carbon dioxide vs venous carbon dioxide measurements) and (percutaneous carbon dioxide vs arterial carbon dioxide measurements) as a single endpoint. This is assessed statistically by comparing the values from arterial and venous blood gases and the percutaneous carbon dioxide measurement recorded at the time of taking the blood gases. In the CapGAS substudy, capillary samples replace venous samples.
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Assessment method [1]
333656
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Timepoint [1]
333656
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At the time blood gases would otherwise be taken for the sleep study, which is generally at the start of the study (before sleep) and the end of the study (upon waking in the morning).
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Secondary outcome [2]
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Data modelling to illustrate any evident consistent relationships between venous and ABG pCO2 when measured twice in the same patient over the course of the sleep study.
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Assessment method [2]
333959
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Timepoint [2]
333959
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At the time blood gases would otherwise be taken for the sleep study, which is generally at the start of the study (before sleep) and the end of the study (upon waking in the morning).
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Secondary outcome [3]
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Data modelling to illustrate how the pvCO2-paCO2 relationship is affected by pH, haemoglobin, oxygen saturation, bicarbonate or a combination of these.
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Assessment method [3]
333978
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Timepoint [3]
333978
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At the time blood gases would otherwise be taken for the sleep study, which is generally at the start of the study (before sleep) and the end of the study (upon waking in the morning).
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Secondary outcome [4]
333979
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Relationship between arterial and venous blood gas pH in terms of a Bland-Altman plot and 95% limits of agreement. This is assessed statistically by comparing the values from arterial and venous blood gases.
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Assessment method [4]
333979
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Timepoint [4]
333979
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At the time blood gases would otherwise be taken for the sleep study, which is generally at the start of the study (before sleep) and the end of the study (upon waking in the morning).
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Secondary outcome [5]
333980
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Relationship between arterial and venous blood gas pH in terms of absolute and relative bias (a composite outcome). This is assessed statistically by comparing the values from arterial and venous blood gases.
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Assessment method [5]
333980
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Timepoint [5]
333980
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At the time blood gases would otherwise be taken for the sleep study, which is generally at the start of the study (before sleep) and the end of the study (upon waking in the morning).
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Secondary outcome [6]
381127
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To determine if capillary blood gas samples can be obtained more consistently than ABG samples and the time required to obtain a successful CAPgas or ABG.
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Assessment method [6]
381127
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Timepoint [6]
381127
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At the time blood gases would otherwise be taken for the sleep study, which is generally at the start of the study (before sleep) and the end of the study (upon waking in the morning).
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Secondary outcome [7]
381128
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To compare patient pain with arterial and capillary blood gas sampling using a rating scale.
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Assessment method [7]
381128
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Timepoint [7]
381128
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To compare operator preference between arterial and capillary blood gas sampling.
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Eligibility
Key inclusion criteria
Patients having a diagnostic, continuous positive airway pressure (CPAP) or ventilation sleep study which includes arterial blood gas analysis.
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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
Pregnancy, inability to consent, outside age group
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Study design
Purpose of the study
Diagnosis
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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)
The trial is randomised only as to the order of ABG and VBG collection, but participants are not randomised to a control group [there was no option above]. Patients will be allocated by sealed-envelope selection. Envelopes will be opaque and shuffled as well as is practicable.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Envelopes will be opaque and shuffled as well as is practicable.
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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
Crossover
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Other design features
Blinding will not be practicible.
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
Paired analysis of arterial and venous/capillary samples is to be made for carbon dioxide tension, pH, oxygen tension, oxygen saturation and total haemoglobin (as a marker of variability) by methods for testing measures. Correlation coefficients will be examined.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/05/2017
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Actual
28/06/2017
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Date of last participant enrolment
Anticipated
7/07/2017
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Actual
30/04/2019
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Date of last data collection
Anticipated
8/07/2017
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Actual
1/05/2019
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Sample size
Target
141
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Accrual to date
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Final
142
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
7816
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Austin Health - Austin Hospital - Heidelberg
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Recruitment postcode(s) [1]
15749
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3084 - Heidelberg
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Funding & Sponsors
Funding source category [1]
296155
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Hospital
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Name [1]
296155
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Austin Hospital
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Address [1]
296155
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145 Studley Rd, Heidelberg VIC 3084
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Country [1]
296155
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Australia
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Funding source category [2]
296156
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Other Collaborative groups
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Name [2]
296156
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Institute for Breathing and Sleep
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Address [2]
296156
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145 Studley Rd, Heidelberg VIC 3084
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Country [2]
296156
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Australia
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Primary sponsor type
Hospital
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Name
Austin Hospital
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Address
145 Studley Rd, Heidelberg VIC 3084
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Country
Australia
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Secondary sponsor category [1]
295056
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Other Collaborative groups
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Name [1]
295056
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Institute for Breathing and Sleep
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Address [1]
295056
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145 Studley Rd, Heidelberg VIC 3084
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Country [1]
295056
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297402
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Austin Health Human Research Ethics Committee
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Ethics committee address [1]
297402
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145 Studley Rd, Heidelberg VIC 3084
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Ethics committee country [1]
297402
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Australia
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Date submitted for ethics approval [1]
297402
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16/10/2016
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Approval date [1]
297402
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31/03/2017
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Ethics approval number [1]
297402
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HREC/16/Austin/441
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Summary
Brief summary
Patients having sleep/CPAP/ventilation (SCV) studies for chronic respiratory failure often require arterial blood to be taken for measurement of blood oxygen, pH and carbon dioxide measurement - so called arterial blood gases (ABGs). These measurements are used to assist in 1. identifying inadequate breathing 2. determining need for assisted ventilation in patients with known or possible ventilatory disorders (eg chronic respiratory or neuromuscular disease or reduced ventilatory capacity associated with obesity ( “obesity hypoventilation syndrome”) . 3. providing information to assist in modification of ventilator settings in such patients. An arterial blood sample is somewhat more difficult to obtain and generally believed to be more painful than a venous sample (venous blood gases (VBGs)), but there is currently no evidence that VBGs can adequately replace the role of ABGs in this setting. The project will involve taking a venous blood sample for VBGs at the same time as the standard arterial blood sample (for ABGs) from patients already having SCV studies already including ABGs. The results from the arterial and venous samples will be compared. The study will involve an additional paired blood test for each ABG (estimated two per patient), during the same visit and should take minimal extra time (estimated 10 minutes total). At the end of the study we will compare the ABG and VBG measurements to see if we can use venous gases as a reliable alternative to ABGs in future. The data may also be used to see if we can use an equation to better approximate the arterial values from VBGs and if there is a consistent relationship between VBGs and transcutaneous measurements (across skin) of carbon dioxide, which are already being measured.
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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
73926
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Prof Christine McDonald
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Address
73926
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Austin Health
145 Studley Rd, Heidelberg VIC 3084
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Country
73926
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Australia
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Phone
73926
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+61394965000
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Fax
73926
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Email
73926
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[email protected]
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Contact person for public queries
Name
73927
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Christine McDonald
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Address
73927
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Austin Health
145 Studley Rd, Heidelberg VIC 3084
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Country
73927
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Australia
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Phone
73927
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+61394965000
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Fax
73927
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Email
73927
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[email protected]
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Contact person for scientific queries
Name
73928
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Steven Lindstrom
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Address
73928
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Austin Health
145 Studley Rd, Heidelberg VIC 3084
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Country
73928
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Australia
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Phone
73928
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+61394965000
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Fax
73928
0
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Email
73928
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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
Some data collected prior to 25th October 2018.
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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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