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Trial registered on ANZCTR
Registration number
ACTRN12618001359224
Ethics application status
Approved
Date submitted
2/07/2018
Date registered
13/08/2018
Date last updated
22/10/2021
Date data sharing statement initially provided
30/10/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Remote Monitoring impact on cardiac arrhythmia detection in Adults with Implantable Loop Recorders
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Scientific title
A Randomised, Controlled Trial of Remote Monitoring versus office-based follow-up for cardiac arrhythmia detection in Adults with Implantable Loop Recorders.
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Secondary ID [1]
295282
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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:
Syncope.
308459
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Embolic stroke.
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Condition category
Condition code
Cardiovascular
307442
307442
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Cardiovascular
307443
307443
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0
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Other cardiovascular diseases
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Stroke
307924
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0
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Ischaemic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Remote monitors will be provided for use with implantable loop recorders (already implanted separate to this study) for participants to keep at home. A remote monitoring service will be provided with one phone call at 6 weeks after commencement (to confirm there are no issues with the operation of the home monitor, and to address any queries regarding its use), and no office visits required. Any transmitted events will be acted on within the next business day. The trial monitoring period will be for 12 months. For any significant symptoms or events (such as syncope or severe pre-sycnope), participants may notify and have an additional device check done or attend for an office/hospital visit at the time.
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Intervention code [1]
301614
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Diagnosis / Prognosis
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Comparator / control treatment
Followup for implantable loop recorders with office visits for device checking at standard intervals of 6 weeks, 6, and 12 months after implantation. For any significant symptoms or events, participants may notify and have a device check done or attend for an office/hospital visit at the time.
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Control group
Active
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Outcomes
Primary outcome [1]
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Time to first hospital admission, as reported by participants and assessed at final follow-up visit at 12 months.
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Assessment method [1]
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Timepoint [1]
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End of follow-up of 12 months after randomisation.
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Primary outcome [2]
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Frequency of Hospital admission, as reported by participants and assessed at final follow-up visit at 12 months.
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Assessment method [2]
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Timepoint [2]
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End of follow-up of 12 months after randomisation.
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Primary outcome [3]
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Time from randomisation to detection of significant arrhythmia by the ILR (tachycardia or bradycardia clinically likely to cause syncope, or >5.5 minutes of new atrial fibrillation).
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Assessment method [3]
306897
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Timepoint [3]
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End of follow-up of 12 months after randomisation.
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Secondary outcome [1]
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Physician time spent in total, for each monitoring strategy. Data on time spent collected at the time of patient reviews/interactions/monitoring data review.
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Assessment method [1]
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Timepoint [1]
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End of follow-up of 12 months after randomisation.
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Secondary outcome [2]
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Physician time spent - average per-patient for each monitoring strategy. Data on time spent collected at the time of patient reviews/interactions/monitoring data review.
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Assessment method [2]
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Timepoint [2]
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End of follow-up of 12 months after randomisation.
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Secondary outcome [3]
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Patient satisfaction assessed on survey specifically designed for this study with scale of 1 to 5 for all responses.
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Assessment method [3]
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Timepoint [3]
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End of follow-up of 12 months after randomisation.
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Secondary outcome [4]
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Physician satisfaction assessed on survey specifically designed for this study with scale of 1 to 5 for all responses.
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Assessment method [4]
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Timepoint [4]
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End of follow-up of 12 months after randomisation.
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Secondary outcome [5]
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Safety and Tolerability - Major adverse cardiac and cerebrovascular events (MACCE) (non-fatal MI, non-fatal stroke, CV death, cardiac hospitalisation due to heart failure). Data collected from patient medical records and by patient self-report.
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Assessment method [5]
350048
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Timepoint [5]
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End of follow-up of 12 months after randomisation.
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Eligibility
Key inclusion criteria
Participants with standard indications for an implantable loop recorder.
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Minimum age
17
Years
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Maximum age
100
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
Pregnant or breastfeeding females.
Inability to provide informed consent.
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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)
Allocation is not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple computer generated randomisation.
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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
Safety/efficacy
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Statistical methods / analysis
Continuous variables will be reported as mean ± standard deviation or as median and percentiles if appropriate. Normally distributed variables will be compared using the paired Student’s t-test. Otherwise comparisons between both the groups will be performed using the Mann–Whitney U test. Categorical variables will be stated as absolute and relative frequencies and compared using the Chi-square test. All tests are two-tailed. A P-value of <0.05 will be considered as statistically significant. Analysis will be performed of a full analysis set (all participants randomised), as well as on a modified intention to treat (all participants allocated to a monitoring strategy (remote monitoring or office-based), and on a per-protocol basis.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
18/04/2018
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Date of last participant enrolment
Anticipated
18/04/2019
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Actual
10/09/2019
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Date of last data collection
Anticipated
30/04/2020
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Actual
10/02/2020
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Sample size
Target
100
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Accrual to date
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Final
100
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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John Hunter Hospital - New Lambton
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Recruitment hospital [2]
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Lingard Private Hospital - Merewether
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Recruitment postcode(s) [1]
23094
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2305 - New Lambton
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Recruitment postcode(s) [2]
23095
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2291 - Merewether
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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John Hunter Hospital, Department of Cardiology
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Address [1]
299874
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Level 3,
Lookout Road
New Lambton Heights
NSW 2305
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Country [1]
299874
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Australia
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Primary sponsor type
Hospital
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Name
John Hunter Hospital, Department of Cardiology
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Address
Level 3,
Lookout Road
New Lambton Heights
NSW 2305
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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]
299225
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Address [1]
299225
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Country [1]
299225
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300745
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
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Locked Bag No 1 New Lambton NSW 2305
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Ethics committee country [1]
300745
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Australia
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Date submitted for ethics approval [1]
300745
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04/02/2018
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Approval date [1]
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15/03/2018
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Ethics approval number [1]
300745
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18/02/21/4.06
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Summary
Brief summary
Implantable loop recorders (ILR) are used to detect and define heart rhythm problems (cardiac arrhythmias) where symptoms are too infrequent to be captured on nonimplantable cardiac rhythm monitoring devices. Currently, the main accepted indication for implantation is recurrent syncope, with a recent addition of cryptogenic stroke as an indication also. Remote monitoring of other implanted cardiac devices (pacemakers and defibrillators) has become the standard of care, based on several randomised trials showing benefits extending across morbidity, mortality, cost effectiveness, and patient satisfaction. The benefits of remote monitoring of ILRs have not been clearly established. The purpose of this study is to assess the effect of remote monitoring. A comparison between usual office-visit follow-up and remote monitoring only with an initial period of phone-contact will be made. Remote monitoring should lead to action on ILR findings in a shorter time-frame than waiting for the next office visit.
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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 Bradley Wilsmore
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Address
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Cardiology Department
John Hunter Hospital
Lookout Road
New Lambton Heights NSW 2305
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Country
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Australia
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Phone
84674
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+61 2 4921 3000
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Fax
84674
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+61 2 4921 4210
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Email
84674
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[email protected]
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Contact person for public queries
Name
84675
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Bradley Wilsmore
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Address
84675
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Cardiology Department
John Hunter Hospital
Lookout Road
New Lambton Heights NSW 2305
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Country
84675
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Australia
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Phone
84675
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+61 2 4921 3000
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Fax
84675
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+61 2 4921 4210
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Email
84675
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[email protected]
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Contact person for scientific queries
Name
84676
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Bradley Wilsmore
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Address
84676
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Cardiology Department
John Hunter Hospital
Lookout Road
New Lambton Heights NSW 2305
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Country
84676
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Australia
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Phone
84676
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+61 2 4921 3000
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Fax
84676
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+61 2 4921 4210
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Email
84676
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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)?
Undecided
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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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