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Trial registered on ANZCTR
Registration number
ACTRN12624000024549
Ethics application status
Approved
Date submitted
29/11/2023
Date registered
11/01/2024
Date last updated
7/04/2024
Date data sharing statement initially provided
11/01/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluating continuous glucose monitoring and metabolic profiles in adults with Cystic Fibrosis Related Diabetes (CFRD).
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Scientific title
A randomised cross-over trial evaluating glycaemic, clinical and psychometric effects associated with the use continuous glucose monitoring (CGM) in adults with Cystic Fibrosis Related Diabetes (CFRD).
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Secondary ID [1]
311038
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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:
cystic fibrosis related diabetes
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insulin deficiency
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metabolic health
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Condition category
Condition code
Metabolic and Endocrine
328875
328875
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0
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Diabetes
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Respiratory
328876
328876
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0
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Other respiratory disorders / diseases
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Human Genetics and Inherited Disorders
328877
328877
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0
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Cystic fibrosis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This will be a single-centre, open-label prospective, randomized crossover trial with an embedded Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) evaluation framework. The trial will randomize eligible participants with confirmed cystic fibrosis (CF)-related diabetes on insulin to compare continuous glucose monitoring (CGM) with the Freestyle Libre 2 system with standard care (fingerstick blood glucose monitoring) with cross over at 3-months.
The Freestyle libre 2 continuous glucose monitoring device (Abbott Diabetes) is approved for use in people with diabetes on insulin and forms part of standard clinical care for all people above 4 years of age living with type 1 diabetes in Australia. This device will be used according to manufacturer instructions in adults with confirmed cystic fibrosis related diabetes and compared to fingerstick blood glucose monitoring.
The CGM consists of a sensor and reader. The sensor is encompassed within a sterile application device that is designed to be inserted independently by the person wearing the CGM. The sensor (size of a 20-cent coin) is applied to the back of the upper arm and involves the insertion of a thin, flexible, sterile fibre (5mm long) into the subcutaneous tissue where it remains in-situ for 14 days. The reader is an application that can be downloaded onto a Smartphone which enables it to function as a reader when scanned over the sensor. The Freestyle Libre 2 system records an interstitial glucose reading every 10-15 minutes. The sensor system is kept in place by an adhesive. This CGM system has been validated for use in people with CF. Sensor usage metrics will be used to provide information on engagement of the individual wearing CGM with the system.
CGM onboarding will be provided by a credentialed diabetes educator using face-to-face and/or online educational resources. There will be no washout period.
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Intervention code [1]
327483
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Treatment: Devices
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Comparator / control treatment
Standard care of CF-related diabetes which includes multiple daily fingerstick blood glucose monitoring. This includes usually 3-4 fingerstick blood glucose checks per day prior to breakfast, lunch, dinner and before bed. Participants will be asked to keep a logbook of recorded BGLs
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Control group
Active
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Outcomes
Primary outcome [1]
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Primary outcome will be change from baseline to follow-up in Hemoglobin A1c (HbA1c) between continuous glucose monitoring and standard care.
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Assessment method [1]
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Plasma HbA1c
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Timepoint [1]
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Checked at baseline (0 months), cross-over (3-months) and study end (6 months)
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Secondary outcome [1]
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Diabetes distress
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Assessment method [1]
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Diabetes distress scale (DDS17)
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Timepoint [1]
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0 months, 3 months and 6 months after the start of the study
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Secondary outcome [2]
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RE-AIM implementation outcomes
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Assessment method [2]
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Reach: - participants approached versus recruited
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Timepoint [2]
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post-trial follow-up within 1 month after trial completion
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Secondary outcome [3]
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hypoglycaemic anxiety
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Assessment method [3]
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Hypoglycaemic fear survey
Hypoglycaemic confidence scores
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Timepoint [3]
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0 months, 3 months and 6 months after the start of the study
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Secondary outcome [4]
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Glucose monitoring satisfaction
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Assessment method [4]
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Visual analogue scale
glucose monitoring survey
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Timepoint [4]
430022
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0 months, 3 months and 6 months after the start of the study
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Secondary outcome [5]
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RE-Aim Implementation outcomes
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Assessment method [5]
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Effectiveness: mean percentage time-in-range (sensor glucose 3.9–10mmol/L) during CGM wear
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Timepoint [5]
430023
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post-trial follow-up within 1 month after trial completion
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Secondary outcome [6]
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RE-Aim Implementation outcomes
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Assessment method [6]
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Adoption: percentage CGM sensor usage
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Timepoint [6]
430024
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post-trial follow-up within 1 month after trial completion
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Secondary outcome [7]
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RE-Aim Implementation outcomes
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Assessment method [7]
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Implementation: adherence to clinical encounters and recommendations
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Timepoint [7]
430025
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post-trial follow-up within 1 month after trial completion
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Secondary outcome [8]
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RE-AIM Implementation outcomes
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Assessment method [8]
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Maintenance: integration of CGM into model of care
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Timepoint [8]
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post-trial follow-up within 1 month after trial completion
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Eligibility
Key inclusion criteria
• Age of >21 years
• On insulin therapy
• Confirmed CFRD based on current ADA criteria
• Most recent HbA1c above the target of 7.0%
• Participant being able to complete the study protocol
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Minimum age
21
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
• Unable to use Smartphone application
• Unable to self-insert CGM
• Incompatible Smartphone
• Lacking capacity to engage in all aspects of study protocol
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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)
allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation
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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
Crossover
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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
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
20/05/2024
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Actual
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Date of last participant enrolment
Anticipated
31/12/2024
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
36
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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The Prince Charles Hospital - Chermside
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Recruitment postcode(s) [1]
41730
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4032 - Chermside
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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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Cystic Fibrosis Australia Diabetes & Innovation Grant
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Address [1]
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CFA PO Box 268, North Ryde NSW 1670
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Country [1]
315693
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Australia
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Primary sponsor type
Hospital
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Name
Metro North Hospital and Health Services
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Address
Block 7, Level 7, Royal brisbane and Women's Hospital, Herston QLD 4029
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Country
Australia
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Secondary sponsor category [1]
317369
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None
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Name [1]
317369
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Address [1]
317369
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Country [1]
317369
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314222
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Metro North Health Human Research Ethics Committee B
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Ethics committee address [1]
314222
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Building 14 Rode Road CHERMSIDE QLD 4032
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Ethics committee country [1]
314222
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Australia
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Date submitted for ethics approval [1]
314222
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04/12/2023
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Approval date [1]
314222
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15/01/2024
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Ethics approval number [1]
314222
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HREC/2023/MNHB/104428;
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Summary
Brief summary
In the era of disease-specific treatments improving life expectancy for adults with Cystic Fibrosis (CF), we face new challenges in their metabolic health. Our project focuses on the highest-risk group, specifically adults with CF-related diabetes. We will use continuous glucose monitoring to gather detailed blood sugar data, along with body metrics, clinical information and patient-reported outcomes. Research evidence will be used to advocate for access to diabetes technology, inform management to prevent diabetes-related complications, and profile metabolic status. This endeavor will deliver novel insights that will also be foundational in informing strategies to optimise metabolic health in this population.
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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 Shanal Kumar
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Address
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Adult Cystic Fibrosis Centre, Jacaranda Drive, The Prince Charles Hospital, Chermside 4032
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Country
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Australia
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Phone
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+610731394770
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Shanal Kumar
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Address
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Adult Cystic Fibrosis Centre, Jacaranda Drive, The Prince Charles Hospital, Chermside 4032
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Country
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Australia
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Phone
130839
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+610731394770
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Shanal Kumar
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Address
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Adult Cystic Fibrosis Centre, Jacaranda Drive, The Prince Charles Hospital, Chermside 4032
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Country
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Australia
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Phone
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+61073139 4770
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Fax
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Email
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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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