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Trial registered on ANZCTR
Registration number
ACTRN12624000678594p
Ethics application status
Submitted, not yet approved
Date submitted
13/03/2024
Date registered
28/05/2024
Date last updated
28/05/2024
Date data sharing statement initially provided
28/05/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Treatment of functional gut symptoms in patients with quiescent inflammatory bowel disease and irritable bowel syndrome - A single-blinded parallel trial assessing efficacy of app-delivered gut-directed hypnotherapy versus psychoeducation
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Scientific title
Treatment of functional gut symptoms in patients with quiescent inflammatory bowel disease and irritable bowel syndrome - A single-blinded parallel trial assessing efficacy of app-delivered gut-directed hypnotherapy versus psychoeducation
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Secondary ID [1]
311677
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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:
Inflammatory Bowel Disease
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Irritable Bowel Syndrome
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Condition category
Condition code
Oral and Gastrointestinal
329835
329835
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0
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Inflammatory bowel disease
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Oral and Gastrointestinal
329836
329836
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will be randomised to receive app-delivered gut-directed hypnotherapy (GDH) or psychoeduation (control) for 6 weeks. Adherence to both interventions will be available through app analytics.
GDH: Participants receiving GDH treatment will download an app specifically designed for this study onto their personal mobile device. The mobile delivered app will guide participants through daily GDH recordings for six weeks, each recording taking approximately 15-20 minutes to complete. The GDH involves an induction whereby the participant is invited to relax before suggestions for the control and normalisation of gastrointestinal function are made to the subconscious mind. An example of a metaphor would be to ask the participant to imagine swallowing down medicine and imagining that this medicine provides healing and protection to the gastrointestinal tract thus reducing gastrointestinal symptoms. Hypnotherapy recordings have been prepared by a qualified hypnotherapist (SLP) with experience in the utilisation of GDH.
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Intervention code [1]
328143
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Treatment: Other
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Comparator / control treatment
Participants will be randomised to receive app-delivered gut-directed hypnotherapy (GDH) or psychoeduation (control) for 6 weeks. Adherence to both interventions will be available through app analytics.
Control: Participants receiving the control treatment will download an app specifically designed for this study onto their personal mobile device. The mobile delivered app will guide participants through daily psychoeducation for six weeks, each session taking approximately 10-15 minutes to complete. This will include information and support to better understand and cope with IBS such as, educating the participant on IBS, dispelling myths about IBS, explaining the brain–gut axis, the physiological stress response, and rationale for behavioral treatment. All psychoeducation is provided via written text
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Control group
Active
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Outcomes
Primary outcome [1]
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Co-primary endpoint will be IBS-SSS and a change of at least 30% abdominal pain from baseline, in line with Food and Drug Administration (FDA) recommendations for clinically significant change of IBS on completion of the intervention.
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Assessment method [1]
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IBS-Symptom Severity Scale (IBS-SSS)
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Timepoint [1]
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Baseline and at completion of the 6-week intervention
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Secondary outcome [1]
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Fatigue
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Assessment method [1]
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Daily - Fatigue Impact Scale (D-FIS)
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Timepoint [1]
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Baseline and at completion of the 6-week intervention
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Secondary outcome [2]
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Quality of Life
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Assessment method [2]
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Inflammatory Bowel Disease Quality of Life (IBDQ)
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Timepoint [2]
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Baseline and at completion of the 6-week intervention
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Secondary outcome [3]
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Physical, mental, and social health. This will be assessed as a composite outcome
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Assessment method [3]
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Patient-Reported Outcomes Measurement Information System (PROMIS)
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Timepoint [3]
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Baseline and at completion of the 6-week intervention
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Secondary outcome [4]
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Anxiety and Depression. This will be assessed as a composite outcome.
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Assessment method [4]
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Anxiety and Depression Test (K10)
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Timepoint [4]
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Baseline and at completion of the 6-week intervention
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Secondary outcome [5]
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Diet
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Assessment method [5]
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Monash University Comprehensive Nutrition Assessment Questionnaire (CNAQ)
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Timepoint [5]
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Baseline and at completion of the 6-week intervention
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Secondary outcome [6]
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Depression and Anxiety. This will be assessed as a composite outcome.
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Assessment method [6]
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Depression Anxiety Symptom Scale (DASS)
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Timepoint [6]
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Baseline and at completion of the 6-week intervention
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Secondary outcome [7]
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Psychiatric symptoms and psychological distress. This will be assessed as a composite outcome.
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Assessment method [7]
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The Symptom Checklist - 90 - Revised (SCL-90-R)
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Timepoint [7]
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Baseline and at completion of the 6-week intervention
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Secondary outcome [8]
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Biomarkers of Barrier Function
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Assessment method [8]
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blood and urine samples will be collected and evaluated via dual-sugar permeability test; liposaccharide-binding protein, soluble CD14; intestinal and fatty acid binding protein-2; cytokine profile using an ultrasensitive assay (TNF-a, IL-6, IL-1ß and IFN-y analysis via A/Prof Jason Tye-Din); and secreted phosphoprotein 24 (SPP24; measured by ELISA)
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Timepoint [8]
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Baseline and at completion of the 6-week intervention
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Secondary outcome [9]
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Microbiome and metabolomics analyses. This will be assessed as a composite outcome.
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Assessment method [9]
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DNA extraction and ‘shotgun metagenomic sequencing’ and supervised/quantitative analysis of faecal metabolites by (Gas Chromatography–Mass Spectrometry) GC-MS using a custom panel of standards for metabolites
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Timepoint [9]
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Baseline and at completion of the 6-week intervention
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Eligibility
Key inclusion criteria
Adults patients with quiescent IBD (determined by intestinal ultrasound (IUS)), and IBS (based on Rome criteria), who are on stable IBD therapy for at least two months.
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Minimum age
18
Years
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Maximum age
65
Years
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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
Exclusion criteria comprises patients unsuitable for IUS (e.g., obesity, predominant rectal disease), active IBD, coeliac disease, new IBS therapies for the prior four weeks, including change in diet, supplementary probiotics, prebiotics or any medication unrelated to IBD treatment, that might influence GI function, rectal disease with constipation, pregnancy or breastfeeding, ineligibility for Medicare or inability to speak or read English or give informed consent.
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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 using a randomisation table created by computer software
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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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
3/06/2024
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Actual
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Date of last participant enrolment
Anticipated
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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
126
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
316006
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Commercial sector/Industry
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Name [1]
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Mindset Health Pty Ltd
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Address [1]
316006
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
318155
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Country [1]
318155
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
314830
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
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https://www.alfredhealth.org.au/research/ethics-research-governance
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
314830
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08/04/2024
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Approval date [1]
314830
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Ethics approval number [1]
314830
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Summary
Brief summary
The treatment of inflammatory bowel disease (IBD) primarily involves targeting inflammation with pharmacological agents, but comorbidities, including functional gut symptoms (DGBI), are common and poorly defined within this population. DGBI diagnosis in IBD is challenging due to confounding factors and reliance on symptom-based criteria. Current assessment methods, such as clinical remission evaluation and biochemical markers, may not accurately identify DGBI in the absence of inflammation. Advances in assessment include intestinal ultrasound for detecting ongoing disease activity and identifying patients with increased intestinal permeability, potentially aiding in distinguishing functional gut symptoms from inflammation-associated symptoms. Limited evidence exists for efficacious treatments for DGBI in IBD, with a notable exception being a trial supporting the use of a low FODMAP diet for symptom relief in patients with quiescent disease. Gut-directed hypnotherapy (GDH) emerges as a potential therapy to reduce symptom burden, offering efficacy comparable to in-person sessions and superior to psychoeducation. However, research on GDH efficacy specifically in patients with truly quiescent IBD is still ongoing.
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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 Emma Halmos
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Address
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Block B, Level 6, The Alfred Centre, 99 Commerical Road, Melbourne VIC 3000
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Country
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Australia
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Phone
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+61 407324779
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Fax
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Email
132862
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[email protected]
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Contact person for public queries
Name
132863
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Emma Halmos
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Address
132863
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Block B, Level 6, The Alfred Centre, 99 Commerical Road, Melbourne VIC 3000
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Country
132863
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Australia
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Phone
132863
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+61 407324779
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Fax
132863
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Email
132863
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[email protected]
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Contact person for scientific queries
Name
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Emma Halmos
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Address
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Block B, Level 6, The Alfred Centre, 99 Commerical Road, Melbourne VIC 3000
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Country
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Australia
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Phone
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+61 407324779
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Fax
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Email
132864
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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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