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Trial registered on ANZCTR
Registration number
ACTRN12618000358246
Ethics application status
Approved
Date submitted
2/02/2018
Date registered
9/03/2018
Date last updated
11/01/2019
Date data sharing statement initially provided
11/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Vitamin D and falls in people with stroke
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Scientific title
The trajectory of Vitamin D and other biomarkers in older people in first 12 months after stroke and the relationship of these biomarkers with falls.
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Secondary ID [1]
293721
0
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:
Stroke
306070
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Condition category
Condition code
Injuries and Accidents
305207
305207
0
0
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Other injuries and accidents
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Stroke
305209
305209
0
0
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Ischaemic
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Diet and Nutrition
305210
305210
0
0
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Other diet and nutrition 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
The research program involves prospective observational study of vitamin D and other biochemical marker levels in the first twelve months after stroke, with falls, injury and physical function data also collected prospectively. The aims are to describe vitamin D and other biomarker levels in the first twelve months after stroke, To evaluate the associations between vitamin D, falls, injury and functional outcomes, including strength, balance and walking, and to determine existing levels of vitamin D supplementation in people with stroke.
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Intervention code [1]
299975
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Early Detection / Screening
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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]
304670
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Serum levels of vitamin D.
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Assessment method [1]
304670
0
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Timepoint [1]
304670
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outcomes are assessed at 3 (primary timepoint) 6, 9, and 12 months post-enrolment
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Primary outcome [2]
304671
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Serum levels of Highly sensitive C-reactive protein
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Assessment method [2]
304671
0
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Timepoint [2]
304671
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outcomes are assessed at 3 (primary timepoint) 6, 9, and 12 months post-enrolment
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Primary outcome [3]
304893
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Serum levels of parathyroid hormone
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Assessment method [3]
304893
0
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Timepoint [3]
304893
0
outcomes are assessed at 3 (primary timepoint) 6, 9, and 12 months post-enrolment
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Secondary outcome [1]
342728
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Number of fractures as a result of falls (including site and type of fracture)
Number of fractures will be assessed by the phsyiotherapist recording any fractures at the 0, 6, and 12 month assessment, and the researcher who conducts the monthly phone calls recording any change in health and service provision.
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Assessment method [1]
342728
0
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Timepoint [1]
342728
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outcomes are assessed at 0, 6 and 12 months post-enrolment
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Secondary outcome [2]
342729
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Number of injurious falls including severity of injuries (NDNQI® Injury Falls Measure)
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Assessment method [2]
342729
0
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Timepoint [2]
342729
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outcomes are assessed at 0, 6 and 12 months post-enrolment
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Secondary outcome [3]
342730
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balance/gait status
outcome measure
• functional sit to stand performance (secs)
• step test score
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Assessment method [3]
342730
0
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Timepoint [3]
342730
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outcomes are assessed at 0, 6 and 12 months post-enrolment
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Secondary outcome [4]
343550
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Number of falls (as defined by “as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level”). Falls prior to the initial assessment are assessed retrospectively by participant recall of falls in the previous 12 months. Falls in the observation period are collected prospectively by participants by recording any falls on a falls calendar, and confirmation of falls by researchers by monthly phones calls to participants.
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Assessment method [4]
343550
0
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Timepoint [4]
343550
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outcomes are assessed at 0, 6 and 12 months post-enrolment
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Secondary outcome [5]
343559
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existing levels of vitamin D supplementation in people with stroke through intitial recruitment interview
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Assessment method [5]
343559
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Timepoint [5]
343559
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At enrolment to study
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Secondary outcome [6]
343560
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Serum levels of Highly sensitive C-reactive triglycerides
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Assessment method [6]
343560
0
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Timepoint [6]
343560
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outcomes are assessed at 0, 6 and 12 months post-enrolment
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Eligibility
Key inclusion criteria
(1) aged at least 50 years, and for women post menopausal,
(2) admitted to hospital with first ever ischaemic stroke, confirmed by imaging preferably MRI (if MRI contraindicated, then evidence of stroke on CT),
(3) able to give informed consent or a person responsible providing informed consent,
(4) previously (prior to stroke) active and able to walk independently with/without aid in the community,
(5) previously (prior to stroke) residing in the community or a retirement village, and
(6) are likely to be discharged to non residential aged care accommodation on discharge from hospital.
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Minimum age
50
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
People will be excluded if they are
• Haemorrhagic stroke,
• receiving palliative care, and/or
• have kidney or liver conditions affecting vitamin D levels.
If female the participant can not be pre-menopausal.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
Sample
A sample of fifty participants is required to provide a spread of participants with low vs normal vitamin D levels and a spread of people with/without supplementation at baseline. This is based on data from Batchelor (PhD Thesis, 2010) in which 15% of people returning home after stroke rehabilitation were already on vitamin D supplementation, and a further 25% for which vitamin D supplementation had been recommended, without establishment of vitamin D levels. While this study will not be fully powered to detect definitive differences in falls rates in relation to vitamin D, the sample size will be sufficient to detect a difference in Step Test performance between those with low vs normal vitamin D at final assessment (33% reduction in step test score in low vitamin D group – mean 8, sd=7, a = 0.05, power = 0.80).
Analysis
Data will be analysed by NARI research staff using quantitative methods. Descriptive statistics will be generated for all baseline data including vitamin D levels and other markers. Bivariate analysis will be used to identify differences in vitamin D/PTH/inflammatory markers between fallers and non-fallers and between those with no or one fall and those who have recurrent falls and between those with high vs low levels of physical function. Negative binomial regression will be used to determine difference in rate of falls between those with vitamin D deficiency and those without (significance p < 0.05).
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
19/03/2018
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Actual
19/04/2018
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Date of last participant enrolment
Anticipated
30/04/2019
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Actual
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Date of last data collection
Anticipated
29/04/2020
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Actual
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Sample size
Target
50
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Accrual to date
13
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
9946
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St Vincent's Hospital (Melbourne) Ltd - Fitzroy
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Recruitment hospital [2]
9948
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Royal Melbourne Hospital - City campus - Parkville
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Recruitment hospital [3]
9949
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Royal Melbourne Hospital - Royal Park campus - Parkville
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Recruitment postcode(s) [1]
18759
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3065 - Fitzroy
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Recruitment postcode(s) [2]
18761
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3050 - Parkville
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Funding & Sponsors
Funding source category [1]
298338
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Charities/Societies/Foundations
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Name [1]
298338
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Perpetual Trustees (Samuel Nissen Foundation)
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Address [1]
298338
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Level 18
Angel Place
123 Pitt Street
Sydney, New South Wales
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Country [1]
298338
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
National Ageing Research Institute
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Address
PO Box 2127
Royal Melbourne Hospital
Victoria 3050
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Country
Australia
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Secondary sponsor category [1]
297453
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Hospital
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Name [1]
297453
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St Vincents Hospital Melbourne
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Address [1]
297453
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41 Victoria Parade
Fitzroy
Victoria 3065
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Country [1]
297453
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299329
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St Vincent’s Hospital Melbourne Human Research Ethics Committee (HREC)
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Ethics committee address [1]
299329
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41 Victoria Parade Fitzroy Victoria 3065
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Ethics committee country [1]
299329
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Australia
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Date submitted for ethics approval [1]
299329
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Approval date [1]
299329
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05/01/2018
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Ethics approval number [1]
299329
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HREC Reference Number: HREC/17/SVHM/205 St Vincent’s HREC Ref: HREC 208/17
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Summary
Brief summary
This project is a world first and vital step towards developing an effective falls prevention intervention for the large numbers of Australian stroke survivors. Fifty people aged over 50 years old with a diagnosis of first ever stroke will be recruited and monitored for 12 months for falls, falls injury, serum levels of vitamin D, parathyroid hormone, highly sensitive C-reactive protein and triglycerides, and strength, balance and walking in people after stroke. This project will produce detailed information and understanding about the link between vitamin D and falls in stroke survivors, an essential step in enabling the development and evaluation of effective falls prevention interventions (e.g. Vitamin D supplementation) for stroke survivors. The outcomes will enable clinicians and researchers to develop evidence-based interventions that will be implemented and tested in future projects in order to reduce falls and falls injury in older people after stroke and to improve their quality of life. The data produced by this project will mean that future phases of this work will attract government and other funding, such as National Health and Medical Research Funding. Overall impact will be measured by the development of a successful intervention that reduces falls in people with stroke. Aims 1. Describe the trajectory of vitamin D levels in people in the first twelve months after stroke. 2. Describe the relationship between vitamin D levels, physical function (strength and balance), falls and injury in people in the twelve months after stroke. 3. Determine the relationship between other related biochemical markers (parathyroid hormone, C reactive protein and triglycerides) and falls in the twelve months after stroke. Research Questions: 1. What is the trajectory of vitamin D levels in the first 12 months after stroke? 2. What is the current use of vitamin D supplementation in first 12 months after stroke? 3. Is vitamin D deficiency associated with physical function and falls in the twelve months following stroke? 4. Is vitamin D deficiency associated with injury severity following a fall in the twelve months after a stroke? 5. What is the relationship between other biochemical markers (parathyroid hormone, highly sensitive C-reactive protein and triglycerides) and falls in stroke survivors in the first twelve months?
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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
80078
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Dr Frances Batchelor
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Address
80078
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NARI
PO Box 2127
Royal Melbourne Hospital
Victoria 3050
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Country
80078
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Australia
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Phone
80078
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+61 3 8387 2305
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Fax
80078
0
+61 3 9387 4030
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Email
80078
0
[email protected]
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Contact person for public queries
Name
80079
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Sue Williams
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Address
80079
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NARI
PO Box 2127
Royal Melbourne Hospital
Victoria 3050
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Country
80079
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Australia
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Phone
80079
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+61 3 8387 2305
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Fax
80079
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+61 3 9387 4030
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Email
80079
0
[email protected]
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Contact person for scientific queries
Name
80080
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Frances Batchelor
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Address
80080
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NARI
PO Box 2127
Royal Melbourne Hospital
Victoria 3050
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Country
80080
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Australia
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Phone
80080
0
+61 3 8387 2305
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Fax
80080
0
+61 3 9387 4030
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Email
80080
0
[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
Has not been discussed by project team. For discussion at next project meeting
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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
Source
Title
Year of Publication
DOI
Embase
Biomarker Application for Precision Medicine in Stroke.
2020
https://dx.doi.org/10.1007/s12975-019-00762-3
N.B. These documents automatically identified may not have been verified by the study sponsor.
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