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Trial registered on ANZCTR
Registration number
ACTRN12621000274875
Ethics application status
Approved
Date submitted
5/02/2021
Date registered
11/03/2021
Date last updated
21/07/2024
Date data sharing statement initially provided
11/03/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluating the effect of a home training program on hand function in people with Parkinson’s disease,
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Scientific title
Effect of home-based task-related training on hand function in people with Parkinson’s disease: A pilot randomised controlled feasibility study.
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Secondary ID [1]
300502
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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:
Parkinson's disease
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Condition category
Condition code
Neurological
318264
318264
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0
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Parkinson's disease
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Physical Medicine / Rehabilitation
318391
318391
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0
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Physiotherapy
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Physical Medicine / Rehabilitation
318392
318392
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0
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Occupational therapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is a 4-week hand training program based on motor learning principles and delivered by registered physiotherapists and/or occupational therapists trained in the program. In accordance with motor skill learning and task-related training theory, each participant's home program will be individualised and appropriately progressed to maintain sufficient challenge.
Step 1. Introduction to the program.
The participant will be introduced to their individualised training program and the technology in a single one-hour face-to-face session in their home. The therapist will provide participants with home exercise instructions using an online exercise prescription application (Physitrack® https://www.physitrack.com) with uploaded tailored exercises (video and description).
These videos have been developed by the researchers and uploaded to the Physitrack software. The therapist will individualise the home program by choosing videos based on the participant's difficulties and goals. Home programs will include practicing object grasp and manipulation skills, and training of daily activities which require fine manipulation e.g writing and using cutlery.
2. The 4-week intervention.
Intervention group participants will be asked to complete three practice sessions of 30 minutes per week comprised of targeted exercises and activities, and will be encouraged to incorporate learned strategies into the performance of everyday tasks.
Participants will access their exercise program via their own computer or smartphone or a tablet supplied by the researchers. This system will enable participants to record and monitor their exercise completion. Exercise completion will be viewed by the therapists remotely.
In addition, participants will attend a weekly 30-minute telerehabilitation session with the therapist to review and progress the focused activities and provide feedback on activity performance and training.
Home programs will be progressed by changing the attributes of the tasks e.g difficulty can be increased by changing the object (weight, size, texture).
3. Follow-up telerehabilitation coaching session.
After the intensive 4-week program, participants will receive a single, monthly 30-minute telerehabilitation coaching session in weeks 8 and 12 to discuss progress and review transfer of skills in to everyday activities.
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Intervention code [1]
319518
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Rehabilitation
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Comparator / control treatment
The control group will not receive an intervention. They will continue with their standard care which can include exercise or physiotherapy programs developed for people with Parkinson's disease..
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Control group
Active
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Outcomes
Primary outcome [1]
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Recruitment (composite)
Recruitment rate - determined by number of eligible participants screened vs. number of participants enrolled as assessed by an audit of the study database.
Recruitment data (the number and reasons for exclusion of potential participants and those who decline) will also be recorded.
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Assessment method [1]
326245
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Timepoint [1]
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Following completion of study recruitment.
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Primary outcome [2]
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Acceptability of the hand training program and mode of delivery (Intervention group only) - assessed using a study-specific questionnaire.
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Assessment method [2]
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Timepoint [2]
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4 weeks post-commencement of the intervention.
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Primary outcome [3]
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Adherence to the hand training program (Intervention group only) -
1. Training diary - participants receiving the intervention will complete a study-specific training diary
2. Physitrack app - data on participant access to the home program.
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Assessment method [3]
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Timepoint [3]
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4 weeks post-commencement of the intervention
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Secondary outcome [1]
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Self-reported hand function (Activity questionnaires) - evaluated using two validated measures, the Manual Ability Measure 36 (MAM-36) and Dexterity Questionnaire 24 (DextQ-24).
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Assessment method [1]
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Timepoint [1]
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Pre-intervention and 4, 12 & 24 weeks post-commencement of the intervention.
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Secondary outcome [2]
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Hand dexterity - measured with the Purdue Pegboard Test
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Assessment method [2]
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Timepoint [2]
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Pre-intervention and 4, 12 & 24 weeks post-commencement of the intervention.
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Secondary outcome [3]
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Retention rate (primary outcome) - determined by the number of participants at baseline vs. number of participants retained in the study at 4, 12 and 24 weeks post-commencement of the intervention. Assessed by an audit of the study database.
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Assessment method [3]
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Timepoint [3]
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4, 12 and 24 weeks post-commencement of the intervention
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Eligibility
Key inclusion criteria
1. A diagnosis of idiopathic PD confirmed by a neurologist
2. Mild to moderate PD (Hoehn & Yahr Staging Scale score of I-III in the ‘on’ phase of the medication cycle)
3. Limitations in daily hand function
4. A stable levodopa medication regime (no changes to medications in the 4 weeks before commencement of the program
5. Independent community living
6. Adequate computer proficiency to participate in web-based video conferencing
7. Sufficient comprehension of English to complete data collection, understand training instructions and give informed consent.
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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
1. A Deep Brain Stimulator device in situ
2. Neurological conditions other than Parkinson's disease
3. Major musculoskeletal comorbidities of the arms and/or hands
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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)
Group allocation will be concealed by the use of consecutively numbered opaque envelopes retained by an independent person in a locked location.
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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 assessing the outcomes
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Intervention assignment
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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
As the proposed study is a pilot trial designed primarily to investigate the feasibility of the intervention, descriptive statistics will be performed on feasibility measures (recruitment, retention and adherence rates), number of adverse events, and measures of acceptability of the program..
Participant characteristics will be summarised with descriptive statistics.
To explore effectiveness, between group comparisons will be presented as means and confidence intervals, or nonparametric medians and interquartile ranges as appropriate at each time point.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/04/2021
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Actual
24/02/2022
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Date of last participant enrolment
Anticipated
1/10/2021
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Actual
9/11/2023
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Date of last data collection
Anticipated
1/04/2022
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Actual
21/06/2024
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Sample size
Target
20
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Accrual to date
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Final
20
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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North Eastern Rehabilitation Centre - Ivanhoe
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Recruitment hospital [2]
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Royal Melbourne Hospital - City campus - Parkville
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Recruitment postcode(s) [1]
32852
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3079 - Ivanhoe
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Recruitment postcode(s) [2]
32853
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3050 - Parkville
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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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Parkinson's Victoria
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Address [1]
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587 Canterbury Rd, Surrey Hills Victoria, 3127
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Country [1]
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Australia
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Primary sponsor type
University
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Name
The University of Melbourne
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Address
The University of Melbourne,
Grattan Street, Parkville, Victoria, 3010
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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]
305267
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Address [1]
305267
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Country [1]
305267
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305327
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University of Melbourne Human Ethics Research Committee
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Ethics committee address [1]
305327
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The University of Melbourne, Grattan Street, Parkville, Victoria, 3010 Australia
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Ethics committee country [1]
305327
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Australia
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Date submitted for ethics approval [1]
305327
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19/08/2020
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Approval date [1]
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27/08/2020
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Ethics approval number [1]
305327
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1852212.2
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Summary
Brief summary
Impaired hand function is a common cause of everyday disability for people with Parkinson’s disease (PD) and can contribute to difficulties in work and leisure activities and daily tasks such as personal care and dressing. Changes in dexterity are also closely associated with reduced quality of life. Despite this, there is little evidence to guide physiotherapy or occupational therapy management of this problem. The primary aim of this pilot randomised controlled trial is to investigate the whether this novel home-based training program, targeted to improving hand function in people with PD, is feasible and acceptable to participants. Participants will be randomly allocated into a training group or a usual care group. The training group will undertake a home-based hand training program and the control group will continue with their usual care. Participants in the training group will be provided with home exercise instructions using an online exercise prescription application with uploaded exercises and will be asked to complete the training for 30 minutes, three times a week for four weeks, The training program will be monitored remotely once a week via telerelerehabilitation. Following the 4-week program there will be two further 30-minute telerehabilitation coaching sessions at 8 and 12 weeks. Main outcome measures relate to feasibility and include recruitment and retention, participant adherence and satisfaction with the program, and adverse events. Secondary outcomes are associated with the effectiveness of the program and include assessment of fine hand skills and self-reported hand function. Participants will be assessed before randomisation (baseline), post-training (4 weeks), and at 12 weeks and 24 weeks. We hypothesise that the study will show good feasibility with strong retention, adherence and high satisfaction with the program.
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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 Elizabeth Proud
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Address
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Department of Physiotherapy, School of Health Sciences
Level 7, Alan Gilbert Building,
The University of Melbourne,
Grattan Street, Parkville, Victoria, 3010
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Country
100010
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Australia
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Phone
100010
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+61411030318
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Fax
100010
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Email
100010
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[email protected]
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Contact person for public queries
Name
100011
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Elizabeth Proud
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Address
100011
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Department of Physiotherapy, School of Health Sciences,
Level 7, Alan Gilbert Building,
The University of Melbourne,
Grattan Street, Parkville, Victoria, 3010
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Country
100011
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Australia
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Phone
100011
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+61 3 8344 3920
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Fax
100011
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Email
100011
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[email protected]
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Contact person for scientific queries
Name
100012
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Elizabeth Proud
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Address
100012
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Department of Physiotherapy, School of Health Sciences,
Level 7, Alan Gilbert Building,
The University of Melbourne,
Grattan Street, Parkville, Victoria, 3010
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Country
100012
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Australia
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Phone
100012
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+61411030318
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Fax
100012
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Email
100012
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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)?
Yes
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What data in particular will be shared?
Individual participant data underlying published results only
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When will data be available (start and end dates)?
Beginning 3 months and ending 5 years following main results publication.
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Available to whom?
On a case by case basis at the discretion of the study team and The University of Melbourne.
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Available for what types of analyses?
For IPD meta-analyses.
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How or where can data be obtained?
Access subject to approvals by Principal Investigator (
[email protected]
)
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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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