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Trial registered on ANZCTR
Registration number
ACTRN12621000791831
Ethics application status
Approved
Date submitted
13/04/2021
Date registered
23/06/2021
Date last updated
30/05/2023
Date data sharing statement initially provided
23/06/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Percutaneous Decannulation of Extracorporeal Membrane Oxygenation Using MANTA Vascular Closure Device
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Scientific title
Feasibility of Percutaneous Decannulation of Extracorporeal Membrane Oxygenation Using MANTA Vascular Closure Device in Adults
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Secondary ID [1]
303896
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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:
Extracorporeal Membrane Oxygenation
321474
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Condition category
Condition code
Cardiovascular
319235
319235
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Following VA-ECMO decannulation, the MANTA Vascular Closure Device will be used for percutaneous closure of the large bore arterial cannula site (as opposed to open surgery). The percutaneous closure will be performed by an interventional cardiologist in the cardiac catheter laboratory with an intensive care specialist and cardiothoracic or vascular surgeon on standby. The intervention will be delivered once. A Teleflex Medical (device manufacturer) representative will be available to the interventional team to ensure that the device is used in keeping with manufacturer specifics.
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Intervention code [1]
320200
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Treatment: Devices
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Comparator / control treatment
No control (single arm feasibility study)
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Puncture closure without the use of surgical or additional endovascular intervention
Assessment: Trial team notification by the multidisciplinary medical team, patient medical records.
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Assessment method [1]
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Timepoint [1]
327104
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72 hours
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Secondary outcome [1]
393797
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Access site or access-related vascular injury (dissection, stenosis, perforation, rupture, AV fistula, pseudoaneurysm, haematoma, irreversible nerve injury, compartment syndrome, percutaneous closure device failure)
Assessment: Trial team notification by the multidisciplinary medical team, investigations as per the standard of care (if conducted by the treating team), patient medical records.
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Assessment method [1]
393797
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Timepoint [1]
393797
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30 days
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Secondary outcome [2]
393798
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Distal embolization requiring surgery or resulting in amputation or irreversible end-organ damage
Assessment: Trial team notification by the multidisciplinary medical team, patient medical records.
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Assessment method [2]
393798
0
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Timepoint [2]
393798
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30 days
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Secondary outcome [3]
393799
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Unplanned endovascular or surgical intervention associated with death, major bleeding, visceral ischaemia or neurological impairment
Assessment: Trial team notification by the multidisciplinary medical team, patient medical records.
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Assessment method [3]
393799
0
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Timepoint [3]
393799
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30 days
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Secondary outcome [4]
393800
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Any new ipsilateral lower extremity ischaemia
Assessment: Trial team notification by the multidisciplinary medical team, patient medical records.
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Assessment method [4]
393800
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Timepoint [4]
393800
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30 days
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Secondary outcome [5]
393801
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Surgery for access site-related nerve injury or permanent access site related nerve injury
Assessment: Trial team notification by the multidisciplinary medical team, patient medical records.
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Assessment method [5]
393801
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Timepoint [5]
393801
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30 days
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Secondary outcome [6]
393802
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Life threatening or disabling bleeding (BARC 3b, 3c, 5)
Assessment: Trial team notification by the multidisciplinary medical team, investigations as per the standard of care (if conducted by the treating team), patient medical records.
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Assessment method [6]
393802
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Timepoint [6]
393802
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30 days
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Secondary outcome [7]
393803
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Major bleeding (BARC 3a)
Assessment: Trial team notification by the multidisciplinary medical team, investigations as per the standard of care (if conducted by the treating team), patient medical records.
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Assessment method [7]
393803
0
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Timepoint [7]
393803
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30 days
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Secondary outcome [8]
393804
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Access site related infection requiring intravenous antibiotics
Assessment: Trial team notification by the multidisciplinary medical team, investigations as per the standard of care (if conducted by the treating team), patient medical records.
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Assessment method [8]
393804
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Timepoint [8]
393804
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30 days
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Eligibility
Key inclusion criteria
- Deemed appropriate by the multi-disciplinary team discussion including ICU physician, cardiothoracic surgeon, vascular surgeon, and interventional cardiologist.
- Suitable vascular anatomy as established by vascular ultrasound.
- Suitable body habitus (body mass index >20kg/m2 and <40 kg/m2).
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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
- Non femoral ECMO.
- Thrombus in CFA/SFA .
- Track depth on ultrasound exceeding 7cm.
- Puncture site of arterial cannula close to bifurcation , or other unfavourable features such as heavily calcified CFA.
- Arterial re-cannulation cases.
- ECMO > 14 days in situ.
- Known bleeding disorder including thrombocytopenia (platelet count <50 000 cells/µL), thrombasthenia, haemophilia, von Willebrand disease.
- Cannula site infection.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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
Single group
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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
As this is a pilot study, only descriptive statistics will be used. Normally distributed continuous data will be expressed as mean (± SD). Non-normally distributed data will be expressed in median (range). Categorical variables will be expressed as number (percentage).
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/06/2022
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Actual
1/11/2022
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Date of last participant enrolment
Anticipated
1/06/2023
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Actual
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Date of last data collection
Anticipated
30/06/2023
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Actual
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Sample size
Target
20
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Accrual to date
5
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
19064
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The Alfred - Melbourne
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Recruitment postcode(s) [1]
33614
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3004 - Melbourne
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Funding & Sponsors
Funding source category [1]
308284
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Commercial sector/Industry
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Name [1]
308284
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Teleflex Medical Australia
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Address [1]
308284
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253 Wellington Road, Mulgrave, VIC 3170
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Country [1]
308284
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Australia
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Primary sponsor type
Individual
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Name
Antony Walton
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Address
Department of Cardiology
Alfred Hospital
Heart Centre, Level 3 Phillip Block, 55 Commercial Road, Melbourne, VIC, 3004
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Country
Australia
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Secondary sponsor category [1]
309088
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Individual
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Name [1]
309088
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Vincent Pellegrino
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Address [1]
309088
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Intensive Care Unit
Alfred Hospital
55 Commercial Road, Melbourne, VIC, 3004
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Country [1]
309088
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308258
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Alfred HREC
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Ethics committee address [1]
308258
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55 Commercial Road, Melbourne, VIC, 3004
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Ethics committee country [1]
308258
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Australia
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Date submitted for ethics approval [1]
308258
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26/04/2021
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Approval date [1]
308258
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27/05/2021
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Ethics approval number [1]
308258
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Summary
Brief summary
VA-ECMO is a life-saving therapy in patients with cardiovascular or respiratory failure. The use of VA-ECMO is increasing and has doubled globally in the last 5 years. Percutaneous cannulation can be achieved using ultrasound guidance, even in unfavourable clinical and/or environmental conditions. If the patient recovers and can be weaned from VA-ECMO, or if ongoing VA-ECMO support is futile and no longer meets its intended goals, withdrawal of the VA-ECMO is required. Removal of the large (15-21F) femoral arterial cannulas is typically performed in an open surgical procedure. However, surgical decannulation is associated with several complications such as bleeding, delayed wound healing and infections. In addition, there is an increased strain on healthcare resources: patients need a vascular or cardiac surgeon, general anaesthesia, theatre time with support of a perfusionist, and transport to and from the theatre. To circumvent this, manual compression and suture-based vascular closure devices have been used in VA-ECMO decannulation, but both were associated with an increased risk of bleeding (5-10%) or requiring additional steps during initial VA-ECMO cannulation. The MANTA vascular closure device is a collagen plug based device, that is increasingly used in large bore interventional therapies such as transcatheter aortic valve implantation, endovascular aneurysm repair or periprocedural of left ventricular assist devices. This is a non-randomised open-label feasibility study. We aim to include 20 patients on VA-ECMO in which decannulation of ECMO support is pursued by the treating team, to investigate the safety and feasibility of percutaneous decannulation of femoral VA-ECMO using the MANTA VCD.
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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
110106
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A/Prof Antony Walton
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Address
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Department of Cardiology
Alfred Health
Heart Centre, Level 3 Phillip Block, 55 Commercial Road, Melbourne, VIC, 3004
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Country
110106
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Australia
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Phone
110106
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+61 3 9426 6693
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Fax
110106
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Email
110106
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[email protected]
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Contact person for public queries
Name
110107
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Antony Walton
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Address
110107
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Department of Cardiology
Alfred Health
Heart Centre, Level 3 Phillip Block, 55 Commercial Road, Melbourne, VIC, 3004
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Country
110107
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Australia
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Phone
110107
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+61 3 9426 6693
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Fax
110107
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Email
110107
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[email protected]
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Contact person for scientific queries
Name
110108
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Antony Walton
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Address
110108
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Department of Cardiology
Alfred Health
Heart Centre, Level 3 Phillip Block, 55 Commercial Road, Melbourne, VIC, 3004
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Country
110108
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Australia
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Phone
110108
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+61 3 9426 6693
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Fax
110108
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Email
110108
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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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