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Trial registered on ANZCTR
Registration number
ACTRN12622001455752
Ethics application status
Approved
Date submitted
29/10/2022
Date registered
14/11/2022
Date last updated
3/04/2024
Date data sharing statement initially provided
14/11/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Comparing fasting to no fasting before catheterisation laboratory procedures.
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Scientific title
Safety and Care OF no Fasting prior to catheter laboratory procedures in Adults: a non-inferiority randomised control trial (SCOFF Trial)
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Secondary ID [1]
308307
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none
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Universal Trial Number (UTN)
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Trial acronym
SCOFF
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Catheterisation Procedures
328092
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Condition category
Condition code
Cardiovascular
325146
325146
0
0
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Coronary heart disease
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Cardiovascular
325147
325147
0
0
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Other cardiovascular diseases
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Anaesthesiology
325148
325148
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
No fasting requirements of solids or liquids.
Patients in the interventional group are allowed to eat and drink as they please.
Patients will be questioned as to the last time of food and drink intake prior to the procedure.
This will be for pacemaker and defibrillator procedures as well as diagnostic and interventional cardiac angiography procedures.
Structural heart disease interventions, requirement for calcium modification therapy, electrophysiology studies and cardiac resynchronisation therapy procedures will be excluded
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Intervention code [1]
324758
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Treatment: Other
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Comparator / control treatment
Solid food fasting for 6 hours prior to catheterisation laboratory procedure.
Clear liquid fasting for 2 hours prior to catheterisation laboratory procedure.
Patients will be questioned about last food and drink intake.
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Control group
Active
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Outcomes
Primary outcome [1]
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Composite primary endpoint of procedure related aspiration, hypotension, hyperglycaemia and hypoglycaemia.
Blood pressure measured by invasive catheterisation when available or non-invasive sphygmomanometer.
Blood sugar level (BSL) will be checked with a finger prick sample.
Aspiration pneumonia will be determined by clinician assessment in combination with chest radiography.
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Assessment method [1]
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0
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Timepoint [1]
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Follow-up until hospital discharge.
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Secondary outcome [1]
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Mortality
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Assessment method [1]
415378
0
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Timepoint [1]
415378
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30 days post procedure
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Secondary outcome [2]
415379
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Readmission collected via national stroke and readmission database.
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Assessment method [2]
415379
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Timepoint [2]
415379
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30 days post procedure
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Secondary outcome [3]
415380
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Procedure related non-invasive ventilation (NIV) requirement.
Clinician assessment at the time of the procedure and review of medical records
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Assessment method [3]
415380
0
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Timepoint [3]
415380
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Until discharge
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Secondary outcome [4]
415381
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Procedure related Intubation requirement based on clinician review and review of medical records.
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Assessment method [4]
415381
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Timepoint [4]
415381
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Until discharge
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Secondary outcome [5]
415382
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Procedure related Acute Kidney Injury
Review of serology results on medical records.
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Assessment method [5]
415382
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Timepoint [5]
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72 hours post procedure
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Secondary outcome [6]
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Patient reported satisfaction utilising the Popovich Preoperative Fasting Questionnaire.
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Assessment method [6]
415383
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Timepoint [6]
415383
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Immediately post procedure
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Secondary outcome [7]
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Health-related quality of life assessed using the EQ5D
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Assessment method [7]
415384
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Timepoint [7]
415384
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Immediately post procedure
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Secondary outcome [8]
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New ICU admission based on clinician review and electronic medical records.
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Assessment method [8]
415385
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Timepoint [8]
415385
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Immediately post procedure
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Eligibility
Key inclusion criteria
• Aged over 18 years of age.
• Are referred for catheterisation laboratory procedures including coronary angiography, percutaneous coronary intervention and device implantation or replacement (pacemakers and defibrillators).
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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
• Pregnant or breastfeeding females.
• Inability to provide informed consent.
• Requirement for a general anaesthetic.
• Complex catheterisation laboratory interventions
o Chronic total occlusion, rotational atherectomy, shockwave lithotripsy or planned mechanical support (IABP/Impella)
o Balloon aortic valvuloplasty, transcatheter aortic valve implantation, mitral valve clipping
o Electrophysiologic studies – diagnostic and ablation
o Biventricular Cardiac Resynchronisation Therapy
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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)
Open label. Allocation is not concealed. Blinded endpoint adjudication committee.
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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
Parallel
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Other design features
Prospective, randomised, open label, blinded endpoint (PROBE) design
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
5/10/2022
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Date of last participant enrolment
Anticipated
3/02/2024
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Actual
14/09/2023
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Date of last data collection
Anticipated
31/05/2024
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Actual
23/10/2023
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Sample size
Target
700
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Accrual to date
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Final
716
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
23478
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John Hunter Hospital - New Lambton
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Recruitment hospital [2]
23479
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Tamworth Rural Referral Hospital - Tamworth
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Recruitment hospital [3]
23480
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Gosford Hospital - Gosford
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Recruitment hospital [4]
24359
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Belmont Hospital - Belmont
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Recruitment hospital [5]
24360
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The Maitland Hospital - Maitland
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Recruitment hospital [6]
24361
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Calvary Mater Newcastle - Waratah
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Recruitment postcode(s) [1]
38886
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2305 - New Lambton
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Recruitment postcode(s) [2]
38887
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2340 - Tamworth
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Recruitment postcode(s) [3]
38888
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2250 - Gosford
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Recruitment postcode(s) [4]
39943
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2280 - Belmont
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Recruitment postcode(s) [5]
39944
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2320 - Maitland
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Recruitment postcode(s) [6]
39945
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2298 - Waratah
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Funding & Sponsors
Funding source category [1]
312555
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Hospital
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Name [1]
312555
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John Hunter Hospital
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Address [1]
312555
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Cardiovascular Department, John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, 2305.
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Country [1]
312555
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Australia
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Primary sponsor type
Hospital
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Name
John Hunter Hospital
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Address
Lookout Road, New Lambton Heights New South Wales 2305
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Country
Australia
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Secondary sponsor category [1]
314159
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None
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Name [1]
314159
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Address [1]
314159
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Country [1]
314159
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
311882
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Hunter New England Research Ethics Committee
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Ethics committee address [1]
311882
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Level 3, Pod, HMRI, Lot 1, Kookaburra Circuit, New Lambton Heights NSW 2305
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Ethics committee country [1]
311882
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Australia
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Date submitted for ethics approval [1]
311882
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22/03/2022
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Approval date [1]
311882
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30/08/2022
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Ethics approval number [1]
311882
0
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Summary
Brief summary
Fasting is standard of care prior to catheter laboratory procedures. The purpose of this is to reduce the risk of aspiration events during procedural sedation. Generally, this involves 6 hours of solid food fasting with 2 hours of clear fluid fasting. Currently there are limited prospective data reviewing the utility of fasting versus no fasting prior to catheterisation procedures. Recently the CHOW NOW study based in America performed a randomised control trial assessing this question. They demonstrated non-inferiority of no-fasting with a pre-specified margin of 5.9%. We wish to assess the non-inferiority of no fasting for catheterisation laboratory procedures in a multicentre trial with a narrower non-inferiority margin of 3%. Fasting prior to procedures may be associated with patient discomfort and distress. In addition, there are some populations where oral intake is important to prevent adverse events. Examples include those with chronic kidney disease where dehydration, potentially precipitated by fasting, associates with increased risk of contrast induced nephropathy. Moreover, patients are frequently cancelled due to lack of fasting. Relinquishing prerequisites for fasting prior to procedures may assist in providing expedited patient care and reduce adverse events related to underlying disease. The main risk associated with no fasting is that of aspiration pneumonia. In the CHOW NOW study, only 0.7% of the non-fasting group experienced this adverse event. This is an uncommon and treatable complication. Risks of fasting (dehydration, hypotension, hypoglycaemia, contrast induced nephropathy, patient discomfort) may outweigh the benefits in preventing the uncommon event of aspiration pneumonia. Though a randomised trial has already been performed, the American Society of Anaesthesiologists has requested more data prior to the acceptance of no fasting before simple catheterisation laboratory procedures.
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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
122710
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Dr David Ferreira
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Address
122710
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Cardiovascular Department, John Hunter Hospital, Lookout Road, New Lambton Heights New South Wales 2305
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Country
122710
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Australia
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Phone
122710
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+61 02 4921 4200
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Fax
122710
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Email
122710
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[email protected]
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Contact person for public queries
Name
122711
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David Ferreira
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Address
122711
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Cardiovascular Department, John Hunter Hospital, Lookout Road, New Lambton Heights New South Wales 2305
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Country
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Australia
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Phone
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+61 02 4921 4200
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Fax
122711
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Email
122711
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[email protected]
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Contact person for scientific queries
Name
122712
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David Ferreira
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Address
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Cardiovascular Department, John Hunter Hospital, Lookout Road, New Lambton Heights New South Wales 2305
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Country
122712
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Australia
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Phone
122712
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+61 02 4921 4200
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Fax
122712
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Email
122712
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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 patient data will be shared in entirety. This will include demographic data, serology results, primary and secondary outcomes, patient satisfaction and quality of life results as well as 30-day follow-up.
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When will data be available (start and end dates)?
Available starting immediately post-trial cessation and ending 5 years post-trial cessation
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Available to whom?
Reputable researchers with sound proposals.
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Available for what types of analyses?
Any proposals deemed suitable by the steering committee.
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How or where can data be obtained?
Contacting the PI:
[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
Source
Title
Year of Publication
DOI
Dimensions AI
Safety and care of no fasting prior to catheterization laboratory procedures: a non-inferiority randomized control trial protocol (SCOFF trial)
2023
https://doi.org/10.1093/ehjopen/oead111
N.B. These documents automatically identified may not have been verified by the study sponsor.
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