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Trial registered on ANZCTR
Registration number
ACTRN12621000026820
Ethics application status
Approved
Date submitted
1/10/2020
Date registered
14/01/2021
Date last updated
14/01/2021
Date data sharing statement initially provided
14/01/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Relative contribution of trends in cardiovascular disease event rates and case fatality to declines in mortality: an international population-based comparative study
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Scientific title
Relative contribution of trends in cardiovascular disease event rates and case fatality to declines in mortality during 2002 to 2015: an international retrospective population-based comparative study
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Secondary ID [1]
302383
0
Nil known
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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:
Cardiovascular disease
319170
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Condition category
Condition code
Cardiovascular
317135
317135
0
0
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Coronary heart disease
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Stroke
317137
317137
0
0
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Ischaemic
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Stroke
317139
317139
0
0
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Haemorrhagic
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Public Health
317140
317140
0
0
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Epidemiology
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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
Observational.
All people experiencing a cardiovascular disease (CVD) hospitalisation or death between 1st January 2002 and 31st December 2015 in England, New South Wales (Australia), New Zealand, and Ontario (Canada) will be identified. Person-linked administrative health datasets from each jurisdiction will be used for identification of all specified CVD events. Specified CVD events include myocardial infarction, acute stroke, coronary heart disease, cerebrovascular disease, and a grouping for all CVD events.
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Intervention code [1]
318680
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Not applicable
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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]
325226
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Cardiovascular disease mortality.
This outcome will be obtained from linked mortality datasets from each jurisdiction. Each dataset contains all CVD deaths from 2002 to 2015 and includes deaths in people hospitalised with CVD and CVD deaths occurring out of hospital.
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Assessment method [1]
325226
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Timepoint [1]
325226
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Annual CVD mortality rates.
Annual cardiovascular disease mortality rates from 2002-2015 will be estimated following receipt of full study datasets.
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Primary outcome [2]
326138
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CVD event rates (composite of nonfatal and fatal CVD events).
This outcome will be obtained from linked hospitalisation and mortality datasets from each jurisdiction. Each dataset contains all CVD hospitalisations and deaths from 2002 to 2015 and includes deaths in people hospitalised with CVD and CVD deaths occurring out of hospital.
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Assessment method [2]
326138
0
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Timepoint [2]
326138
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Annual CVD event rates.
Annual cardiovascular disease event rates from 2002-2015 will be estimated following receipt of full study datasets.
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Secondary outcome [1]
387273
0
Myocardial infarction mortality.
This outcome will be obtained from linked mortality datasets from each jurisdiction. Each dataset contains all CVD deaths from 2002 to 2015 and includes deaths in people hospitalised with CVD and CVD deaths occurring out of hospital.
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Assessment method [1]
387273
0
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Timepoint [1]
387273
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Annual myocardial infarction mortality rates.
Annual MI mortality rates from 2002-2015 will be estimated following receipt of full study datasets.
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Secondary outcome [2]
387274
0
Stroke mortality (composite of ischaemic, haemorrhagic and unspecified stroke subtypes).
This outcome will be obtained from linked mortality datasets from each jurisdiction. Each dataset contains all CVD deaths from 2002 to 2015 and includes deaths in people hospitalised with CVD and CVD deaths occurring out of hospital.
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Assessment method [2]
387274
0
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Timepoint [2]
387274
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Annual stroke mortality rates
Annual stroke mortality rates from 2002-2015 will be estimated following receipt of full study datasets.
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Secondary outcome [3]
390226
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Myocardial infarction event rates (composite of nonfatal and fatal MI events).
This outcome will be obtained from linked hospitalisation and mortality datasets from each jurisdiction. Each dataset contains all CVD hospitalisations and deaths from 2002 to 2015 and includes deaths in people hospitalised with CVD and CVD deaths occurring out of hospital.
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Assessment method [3]
390226
0
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Timepoint [3]
390226
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Annual myocardial infarction event rates.
Annual MI event rates from 2002-2015 will be estimated following receipt of full study datasets.
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Secondary outcome [4]
390227
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Stroke event rates (composite of nonfatal and fatal CVD events).
This outcome will be obtained from linked hospitalisation and mortality datasets from each jurisdiction. Each dataset contains all CVD hospitalisations and deaths from 2002 to 2015 and includes deaths in people hospitalised with CVD and CVD deaths occurring out of hospital.
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Assessment method [4]
390227
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Timepoint [4]
390227
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Annual stroke event rates.
Annual stroke event rates from 2002-2015 will be estimated following receipt of full study datasets.
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Eligibility
Key inclusion criteria
All hospitalisations and deaths which meet the specific requirements for each condition, based on International Classification of Disease coding, diagnosis or cause of death fields, and time period (admissions and deaths occurring between 01 January 2002 and 31 December 2015).
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Minimum age
30
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
Criteria will be imposed which exclude patients with low probability of a major cardiovascular event, such as short length of stay and elective admissions for acute events such as myocardial infarction or stroke.
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Study design
Purpose
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Duration
Longitudinal
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
Event rates and case fatality for each cardiovascular condition will be age-standardised using the direct method. Temporal trends for each will be calculated using appropriate age-adjusted regression models. Effects of differing inputs on mortality trends will be analysed, and compared across jurisdictions.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
9/01/2017
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Date of last participant enrolment
Anticipated
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Actual
9/01/2017
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Date of last data collection
Anticipated
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Actual
9/01/2017
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Sample size
Target
3000000
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Accrual to date
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Final
3000000
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment outside Australia
Country [1]
23036
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New Zealand
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State/province [1]
23036
0
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Country [2]
23037
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United Kingdom
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State/province [2]
23037
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England
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Country [3]
23038
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Canada
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State/province [3]
23038
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Ontario
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Funding & Sponsors
Funding source category [1]
306811
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Government body
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Name [1]
306811
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National Health and Medical Research Council of Australia
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Address [1]
306811
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16 Marcus Clarke St, Canberra ACT 2601
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Country [1]
306811
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Australia
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Primary sponsor type
University
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Name
University of Melbourne
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Address
Parkville VIC 3010
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Country
Australia
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Secondary sponsor category [1]
307363
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None
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Name [1]
307363
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Address [1]
307363
0
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Country [1]
307363
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306967
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NSW Population &Health Services Research Ethics Committee
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Ethics committee address [1]
306967
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Level 4, 1 Reserve Road St Leonards NSW 2065
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Ethics committee country [1]
306967
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Australia
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Date submitted for ethics approval [1]
306967
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01/08/2016
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Approval date [1]
306967
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30/09/2016
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Ethics approval number [1]
306967
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2016/09/654
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Summary
Brief summary
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in developed countries. Although CVD mortality rates have declined markedly over the past 3 decades, the burden remains high in many countries, and the rising prevalence of obesity and diabetes may impact on these trends. Some conditions such as coronary heart disease and stroke are significant contributors to the burden of CVD mortality. Previous international studies such as the WHO-led MONICA study investigated the contribution of changes in case fatality and event rates to trends in myocardial infarction related mortality. No recent studies have provided international comparisons across these important measures. The results of this study will show how effective changes in treatment and prevention for CVD are at a whole-population level, and the ability to compare these data across countries enhances interpretation of the relative contributions of each.
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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
105618
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Prof Philip Clarke
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Address
105618
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Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK
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Country
105618
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United Kingdom
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Phone
105618
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+44 1865 289272
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Fax
105618
0
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Email
105618
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[email protected]
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Contact person for public queries
Name
105619
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Philip Clarke
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Address
105619
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Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK
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Country
105619
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United Kingdom
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Phone
105619
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+44 1865 289272
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Fax
105619
0
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Email
105619
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[email protected]
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Contact person for scientific queries
Name
105620
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Lee Nedkoff
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Address
105620
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The University of Western Australia
M431, 35 Stirling Hwy, Crawley, WA 6009
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Country
105620
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Australia
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Phone
105620
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+61 8 6488 8761
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Fax
105620
0
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Email
105620
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
The data used for this study are de-identified population level data from each country/jurisdiction (England, New South Wales, Ontario, New Zealand), provided by the relevant Departments of Health in each country. The data are provided to researchers under agreements and ethics approvals meaning that individual level data cannot be shared outside each research institution.
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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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