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Trial registered on ANZCTR
Registration number
ACTRN12621001721897
Ethics application status
Approved
Date submitted
14/07/2021
Date registered
16/12/2021
Date last updated
17/11/2022
Date data sharing statement initially provided
16/12/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
ImmuneCAP: Immune responses in severe community acquired pneumonia
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Scientific title
ImmuneCAP: Tissue-resident memory T cell response in severe community acquired pneumonia
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Secondary ID [1]
304773
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None
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Universal Trial Number (UTN)
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Trial acronym
ImmuneCAP
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Community Acquired Pneumonia
322827
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Sepsis
322828
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COVID-19
323438
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Condition category
Condition code
Respiratory
320417
320417
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0
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Other respiratory disorders / diseases
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Infection
320991
320991
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0
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Other infectious diseases
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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
We will analyse tissue samples (blood and bronchial washings) of patients with severe community acquired pneumonia (CAP) and compare these with patients without CAP. Samples will be collected during the intensive care admission by an appropriately trained intensive care doctor or nurse within 72 hours of intubation. Bronchial washings will be collected via a formal bronchoscope if clinically indicated or by passing a catheter through an endotracheal tube and introducing and aspirating a small amount of sterile saline solution (10-20ml). Blood samples will be collected via a central line, arterial line or via venesection when clinically indicated. Outcomes will be assessed at discharge from hospital via the electronic patient record with no further participant involvement post discharge.
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Intervention code [1]
321155
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Diagnosis / Prognosis
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Comparator / control treatment
Control groups will be participants with non infective causes of lung inflammation and participants without infection or lung inflammation
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Control group
Active
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Outcomes
Primary outcome [1]
328250
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Survival as determined by review of the electronic patient record
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Assessment method [1]
328250
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Timepoint [1]
328250
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Hospital discharge
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Primary outcome [2]
328768
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Tissue resident memory response as determined by flow cytometry
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Assessment method [2]
328768
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Timepoint [2]
328768
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At time of sample collection within 72 hour of intubation
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Secondary outcome [1]
398252
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Days free of mechanical ventilation as determined by review of the electronic patient record
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Assessment method [1]
398252
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Timepoint [1]
398252
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28 days post initial intubation
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Secondary outcome [2]
400271
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Acute Physiology and Chronic Health Evaluation (APACHE) Score assessed via the electronic patient record
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Assessment method [2]
400271
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Timepoint [2]
400271
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24 hours after admission to Intensive Care
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Secondary outcome [3]
401978
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PaO2 in mmHg/FiO2 as fraction of 1.0 (lowest) as determined by review of the electronic patient record
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Assessment method [3]
401978
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Timepoint [3]
401978
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in first 72 hours of admission
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Secondary outcome [4]
401979
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Sequential Organ Failure Assessment Score as assessed by review of the electronic patient record
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Assessment method [4]
401979
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Timepoint [4]
401979
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At time of sample acquisition within 72 hours of intubation
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Secondary outcome [5]
401980
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Bronchial washing mRNA analysis
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Assessment method [5]
401980
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Timepoint [5]
401980
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At time of sample acquisition within 72 hours of intubation
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Secondary outcome [6]
403709
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Peripheral blood mRNA analysis
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Assessment method [6]
403709
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Timepoint [6]
403709
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At time of sample acquisition within 72 hours of intubation
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Eligibility
Key inclusion criteria
Admitted to a critical care setting
• A diagnosis of community acquired pneumonia has been made by the treating physicians
based on the following criteria;
- Symptoms and/or signs consistent with a lower respiratory tract infection
- Radiological evidence of new onset consolidation on a chest x-ray or CT scan
• Mechanically ventilated for less than 72 hours
• Age equal to or greater than 18 years old
• Participant consent or person responsible consent
• Patients with confirmed COVID-19 disease meeting the criteria for CAP will be included in
the study
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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
Previously included in the study
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Case control
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Timing
Prospective
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Statistical methods / analysis
Associations between wet-lab data and clinical parameters will be determined by Spearman’s Correlation. RNA will be analysed using the Nanostring nCounter
Sprint machine and RNA panels analysed using the nSolver (Nanostring, Seattle, USA) and g:profiler software (https://biit.cs.ut.ee/gprofiler/) to generate volcano plots and Pathway Analysis “Manhattan plots”, respectively. Single-cell protein-RNA analysis will be analysed on the BD machine and using the in-built pipeline
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
1/08/2021
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Date of last participant enrolment
Anticipated
1/08/2026
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Actual
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Date of last data collection
Anticipated
1/11/2026
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Actual
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Sample size
Target
75
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Accrual to date
31
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
19963
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Royal North Shore Hospital - St Leonards
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Recruitment hospital [2]
19964
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St Vincent's Private Hospital (Darlinghurst) - Darlinghurst
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Recruitment hospital [3]
19965
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Prince of Wales Private Hospital - Randwick
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Recruitment postcode(s) [1]
34671
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2065 - St Leonards
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Recruitment postcode(s) [2]
34672
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2010 - Darlinghurst
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Recruitment postcode(s) [3]
34673
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2031 - Randwick
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Funding & Sponsors
Funding source category [1]
309144
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Charities/Societies/Foundations
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Name [1]
309144
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Intensive Care Foundation Australia and New Zealand
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Address [1]
309144
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Suite 1.01, Level 1, 277 Camberwell Road
Camberwell, VIC 3124
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Country [1]
309144
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Australia
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Funding source category [2]
309148
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University
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Name [2]
309148
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University of New South Wales
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Address [2]
309148
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Level 6, Wallace Wurth Building
High Street, UNSW Australia
Kensington NSW 2052
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Country [2]
309148
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Australia
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Primary sponsor type
Other
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Name
The George Institute for Global Health
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Address
Level 5, 1 King Street
Newtown 2042
NSW, Australia
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Country
Australia
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Secondary sponsor category [1]
310098
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None
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Name [1]
310098
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Address [1]
310098
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Country [1]
310098
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
309010
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Northern Sydney Local Health District
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Ethics committee address [1]
309010
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NSLHD Research Office, Level 13 Kolling Building, Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065
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Ethics committee country [1]
309010
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Australia
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Date submitted for ethics approval [1]
309010
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04/08/2020
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Approval date [1]
309010
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17/09/2020
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Ethics approval number [1]
309010
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2020/ETH00047
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Summary
Brief summary
Community acquired pneumonia (CAP) is an infection of the lungs where the lungs become inflamed. CAP is most commonly caused by bacterial infections however during the seasonal ‘flu epidemics and novel pandemics such as COVID-19, viral infections may predominate. Severe CAP requires treatment in an intensive care unit (ICU) and often support of breathing with a ventilator. In Australia pneumonia is the most common infection treated in ICU and unfortunately often proves fatal. Additionally, there is a large economic cost and survivors are often left with significant reductions in their quality of life. The body’s immune responses in the lung is designed to kill and eliminate the bacteria or viruses causing the infection but can also cause collateral damage to the lung through inflammation and injury. the lung has specialised immune cells called Tissue Resident Memory T-cells, (TRM)that play a crucial role in protecting the lung against bacteria and viruses. As the name suggests this specialised type of immune cells are ‘resident’ in the lung tissues and are not detected in the circulating blood. In this preliminary study we will evaluate a system to collect and study TRM -cells in mechanically ventilated patients with severe CAP. We will compare the immune responses of patients with severe CAP caused by COVID-19, other viral infections and bacterial infections. We will also compare patients with severe CAP to two different control groups. The first control group will be mechanically ventilated patients with lung injury not caused by infection. The second control group will be mechanically ventilated patients without evidence of lung injury. Studying the local immune response in this way will offer insights into how severe CAP occurs, may help identify which patients are going to need to most support and may identify new treatments for this important condition.
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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
112638
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Dr Christopher Andersen
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Address
112638
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Intensive Care Department
Royal North Shore Hospital
Reserve Road
St Leonards NSW 2065
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Country
112638
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Australia
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Phone
112638
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+61294632580
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Fax
112638
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Email
112638
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[email protected]
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Contact person for public queries
Name
112639
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Christopher Andersen
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Address
112639
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Intensive Care Department
Royal North Shore Hospital
Reserve Road
St Leonards NSW 2065
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Country
112639
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Australia
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Phone
112639
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+61294632580
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Fax
112639
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Email
112639
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[email protected]
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Contact person for scientific queries
Name
112640
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Christopher Andersen
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Address
112640
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Intensive Care Department
Royal North Shore Hospital
Reserve Road
St Leonards NSW 2065
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Country
112640
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Australia
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Phone
112640
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+61294632580
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Fax
112640
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Email
112640
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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?
De-identified data may be shared following approval from the study management team
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When will data be available (start and end dates)?
At the conclusion of the recruitment and follow up period, anticipated to be 01/08/2024, the data will be retained for a minimum of 5 years as per institutional requirements
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Available to whom?
Non commercial researchers with appropriate Human Research Ethics Committee approval
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Available for what types of analyses?
Database analyses
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How or where can data be obtained?
By contacting the study coordinator via The George Institute for Global Health
[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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