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Trial registered on ANZCTR
Registration number
ACTRN12620000014954
Ethics application status
Approved
Date submitted
11/12/2019
Date registered
14/01/2020
Date last updated
14/01/2020
Date data sharing statement initially provided
14/01/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of Oral Appliance Therapy (OAT) for Obstructive Sleep Apnoea (OSA) on markers of cardiovascular risk
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Scientific title
A pilot sham-controlled trial of effect of Oral Appliance Therapy (OAT) for Obstructive Sleep Apnoea (OSA) on intermediary markers of cardiovascular risk
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Secondary ID [1]
300058
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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:
Obstructive Sleep Apnoea
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Cardiovascular Disease
315645
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Condition category
Condition code
Respiratory
313870
313870
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0
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Sleep apnoea
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Cardiovascular
314066
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Oral Appliance Therapy (OAT) for Obstructive Sleep Apnoea
OAT is a recommended therapy for OSA. The therapy entails wearing a customised dental device during sleep. The device is digitally milled from dental impressions obtained by a dentist, and hence each device is customised to an individual's dentition.
In this trial OAT will be implemented by a dentist with previous experience in OAT. OAT will be monitored by the treating dentist throughout the trial.
Participants will attend an initial dental visit to obtain impressions to manufacture the device (~1 hour).
The device will be fitted by the dentist at a second visit (~40 minutes).
Participants will be instructed to wear the device whenever they sleep for the duration of the trial (6 months).
Participants will have follow-up dental visits at mid-point (3 months) and end of the trial (6 months, ~30 minutes per visit). Participants will have opportunity for additional dental visits on an ad hoc basis if there are any issues which require assessment by the dentist, such as issues with device fit.
All devices are fitted with an objective compliance monitor, a small temperature-sensing chip which is embedded within the appliance material. Compliance data will be downloaded from the chip using a reading station at study visits.
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Intervention code [1]
316332
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Treatment: Devices
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Comparator / control treatment
Sham oral appliance (without therapeutic mechanism of action).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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change in 24 hour blood pressure (peripheral and central measured by Oscar 2 ambulatory blood pressure monitor with SphygmoCor)
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Assessment method [1]
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Timepoint [1]
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3 and 6 (primary endpoint) months post intervention commencement
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Primary outcome [2]
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change in endothelial function (flow mediated dilation of brachial artery by ultrasound)
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Assessment method [2]
322266
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Timepoint [2]
322266
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3 and 6 (primary endpoint) months post intervention commencement
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Primary outcome [3]
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change in arterial stiffness (pulse wave velocity)
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Assessment method [3]
322267
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Timepoint [3]
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3 and 6 (primary endpoint) months post intervention commencement
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Secondary outcome [1]
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Adherence to therapy (data download from sensor chip in appliance)
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Assessment method [1]
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Timepoint [1]
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Daily usage over 6 month intervention period
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Secondary outcome [2]
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OAT efficacy, change in sleep apnea events as assessed by overnight polysomnography
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Assessment method [2]
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Timepoint [2]
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6 months post intervention commencement
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Secondary outcome [3]
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Change in subjective daytime sleepiness (Epworth Sleepiness Score)
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Assessment method [3]
377908
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Timepoint [3]
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3 and 6 months post intervention commencement
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Secondary outcome [4]
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Change in health related quality of life (SF-36 questionnaire)
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Assessment method [4]
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Timepoint [4]
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3 and 6 months post intervention commencement
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Secondary outcome [5]
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Change in disease-related quality of life (Functional Outcomes of Sleep Questionnaire)
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Assessment method [5]
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Timepoint [5]
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3 and 6 months post intervention commencement
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Secondary outcome [6]
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change in autonomic function (heart rate variability, ECG)
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Assessment method [6]
377913
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Timepoint [6]
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3 and 6 months post intervention commencement
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Secondary outcome [7]
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change in carotid intima media thickness (ultrasound)
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Assessment method [7]
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Timepoint [7]
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3 and 6 months post intervention commencement
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Secondary outcome [8]
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change in autonomic function (blood pressure variability, Human Non-Invasive Blood Pressure System, NIBP )
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Assessment method [8]
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Timepoint [8]
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3 and 6 months post intervention commencement
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Secondary outcome [9]
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change in autonomic function (baroreceptor reflex function, Human Non-Invasive Blood Pressure System, NIBP)
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Assessment method [9]
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Timepoint [9]
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3 and 6 months post intervention commencement
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Secondary outcome [10]
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OAT efficacy, change in oxygen saturation assessed by home oximtery
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Assessment method [10]
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Timepoint [10]
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6 months post intervention commencement
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Eligibility
Key inclusion criteria
Obstructive Sleep Apnoea (with ODI(4%) > 15 events/hour)
Framingham risk score >15%
BMI < 35 kgm2
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Minimum age
18
Years
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Maximum age
65
Years
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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
Previous use of OAT for OSA
Use of any OSA therapy in the prior 3 months
Contra-indications to OAT (as determined by dentist (e.g. periodontal disease, insufficient number of teeth to retain the device)
Need for immediate OSA therapy as assessed by a sleep physician (e.g. commercial drivers)
Women who are lactating or pregnant
Established cardio- or cerebro-vascular disease (e.g. stroke, coronary heart disease, heart failure, cardiomyopathy, congenital heart disease)
Central Sleep Apnoea (>10% central events)
Co-existing sleep disorder or lung disease (e.g. COPD)
Inability to provide informed consent
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Study design
Purpose of the study
Treatment
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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)
centralised randomisation by computer
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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
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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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
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
30/01/2020
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Actual
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Date of last participant enrolment
Anticipated
31/01/2021
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Actual
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Date of last data collection
Anticipated
31/07/2021
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Actual
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Sample size
Target
105
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Royal North Shore Hospital - St Leonards
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Recruitment hospital [2]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment postcode(s) [1]
28811
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2065 - St Leonards
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Recruitment postcode(s) [2]
28812
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2050 - Camperdown
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Rebecca L Cooper Medical Foundation
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Address [1]
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26/100 New South Head Rd, Sydney NSW 2027
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Northern Sydney Local Health District
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Address
Douglas Building, Level 5 Reserve Rd, St Leonards NSW 2065
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Country
Australia
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Secondary sponsor category [1]
304778
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None
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Name [1]
304778
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Address [1]
304778
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Country [1]
304778
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
304940
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Northern Sydney Local Health District
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Ethics committee address [1]
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Douglas Building, Level 5 Reserve Rd, St Leonards NSW 2065
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Ethics committee country [1]
304940
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Australia
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Date submitted for ethics approval [1]
304940
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Approval date [1]
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04/09/2019
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Ethics approval number [1]
304940
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Summary
Brief summary
The purpose of this pilot trial is to provide preliminary evidence for any effect of Oral Appliance Therapy (OAT) for Obstructive Sleep Apnoea (OSA) on a range of intermediary cardiovascular risk markers (vs. control group) in sleep clinic patients with OSA identified to be at high cardiovascular risk (Framingham risk assessment) but without established cardiovascular disease. Intermediary cardiovascular risk markers (peripheral and central blood pressure, arterial stiffness, endothelial function, autonomic function, carotid intima-media thickness, and blood biomarkers) will be assessed at 3 and 6 months post OAT implementation. Efficacy of OAT in controlling OSA at the end of study and adherence to OAT over the study period will also be assessed. The recruitment target is 105 participants, aiming for 35 in the control arm and 70 in the OAT arm. The OAT arm recruitment has been inflated due to known variations in OAT efficacy to aim to achieve 35 participants who show high efficacy to OAT. Data from this pilot trial will be used to inform future trials of OAT for cardiovascular disease prevention.
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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 Kate Sutherland
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Address
98706
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Dept of Respiratory and Sleep Medicine
Royal North Shore Hospital
Pacific Highway
St Leonards NSW 2065
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Country
98706
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Australia
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Phone
98706
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+61 02 9463 2924
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Fax
98706
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Email
98706
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[email protected]
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Contact person for public queries
Name
98707
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Kate Sutherland
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Address
98707
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Dept of Respiratory and Sleep Medicine
Royal North Shore Hospital
Pacific Highway
St Leonards NSW 2065
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Country
98707
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Australia
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Phone
98707
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+61 02 9463 2924
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Fax
98707
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Email
98707
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[email protected]
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Contact person for scientific queries
Name
98708
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Kate Sutherland
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Address
98708
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Dept of Respiratory and Sleep Medicine
Royal North Shore Hospital
Pacific Highway
St Leonards NSW 2065
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Country
98708
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Australia
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Phone
98708
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+61 02 9463 2924
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Fax
98708
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Email
98708
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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
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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