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Trial registered on ANZCTR
Registration number
ACTRN12624001293550
Ethics application status
Approved
Date submitted
2/10/2024
Date registered
24/10/2024
Date last updated
24/10/2024
Date data sharing statement initially provided
24/10/2024
Date results provided
24/10/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
A randomised controlled trial of online self-reported clinical information followed by clinical interview in mental health triaging via phone.
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Scientific title
A randomised controlled trial of time to complete triaging using online self-reported clinical information followed by clinical interview in mental health triaging via phone for adults who are referred to the Mental health line
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Secondary ID [1]
313090
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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:
Mental health conditions
335333
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Condition category
Condition code
Mental Health
331909
331909
0
0
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Anxiety
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Mental Health
331910
331910
0
0
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Depression
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Mental Health
331911
331911
0
0
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Eating disorders
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Mental Health
331912
331912
0
0
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Psychosis and personality disorders
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Mental Health
331913
331913
0
0
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Schizophrenia
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Mental Health
331914
331914
0
0
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Suicide
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Public Health
331915
331915
0
0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention: online mental health assessment (OMHA) which is a questionnaire to be completed by clients seeking assistance with their mental health. The questionnaire was developed using the NSW Health mental health triaging template as a guide. The clinical questions and the responses available for selection were designed by a team consisting of senior clinicians, including a panel of three psychiatrists and a clinical coordinator, in liaison with Aboriginal clinicians, and carer and consumer representatives. Online content was iteratively improved using feedback from Aboriginal clinicians, and carer and consumer representatives to make sure the content was culturally sensitive and easy to understand.
Procedures:
Eligible consented participants for psychiatry triaging will be randomly allocated to either control or intervention. Their GP will be informed about this study (by fax) and about the consent of their patient. In the experimental group, clients and carers will be sent a link to the online mental health assessment (OMHA) via email by a research assistant at the Mental Health Line. Once the client and carers complete the triaging using the OMHA which may take approximately 15 minutes, it will prepopulate the collected data into the triage documentation template and notify the relevant triage clinician. Then the clinician will review the documentation and conduct a shorter interview which may take approximately 10-15 minutes with the client over the phone and complete the triage documentation by doing the necessary editing and amendments. The research assistant will monitor the adherence to the intervention and record the time the triage clinician takes to complete triaging from the time he/she opens the prepopulated triage documents to the completion of documentation.
Who will deliver the intervention: triage clinicians.
Mode of delivery: over the phone.
Number of times the intervention will be delivered: once.
Location: Mental Health Line, Hunter New England Local Health District.
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Intervention code [1]
329647
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Treatment: Other
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Comparator / control treatment
The clients in the control group will undergo the mental health triaging and assessment as usual. The only difference is the use of online assessment in the intervention group. They will be asked all questions by the triage clinician pertaining to the information collected via the OMHA however these questions will be asked over the phone during the interview rather than completed independently beforehand by the participant in an online questionnaire,
Duration of the usual triage interview would be approximately 30 mins to complete,
Who will deliver the intervention: triage clinicians.
Mode of delivery: over the phone.
Number of times the intervention will be delivered: once.
Location: Mental Health Line, Hunter New England Local Health District.
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Control group
Active
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Outcomes
Primary outcome [1]
339520
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Time to complete triaging via the phone interview by triage clinician as indicated by call duration which is derived from routinely collected data by the health service
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Assessment method [1]
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Phone call duration which is derived from routinely collected data by the health service.
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Timepoint [1]
339520
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At completion of triaging process.
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Secondary outcome [1]
440307
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Acceptability of online mental health assessment to patients
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Assessment method [1]
440307
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Patients were asked to rate their experience with online triaging on a five-point scale (1 very good; 5 very poor).
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Timepoint [1]
440307
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At the completion of triaging and assessment
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Secondary outcome [2]
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Acceptability of online mental health assessment to clinicians.
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Assessment method [2]
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Clinicians were asked to rate their experience with online triaging on a five-point scale (1 very good; 5 very poor).
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Timepoint [2]
440771
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At the completion of triaging and assessment
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Secondary outcome [3]
440772
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Score for triage documentation quality
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Assessment method [3]
440772
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An audit of triage clinical documentation of both intervention and control arm will be conducted. Each documentation is scored against a standard checklist of clinical information which will be prepared by an expert panel. The total score reflects how well the document meets the standard.
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Timepoint [3]
440772
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At the completion of triaging and assessment
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Secondary outcome [4]
440773
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Cost-effectiveness
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Assessment method [4]
440773
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The economic analysis will be conducted from a healthcare perspective. A within trial cost-effectiveness analysis will be based on the mean difference over the 6 month trial period between usual care (phone triaging) and the intervention (OMHA) in the primary outcome variable: per cent reduction in clinician time required for triaging psychiatric referrals. This measure will be used for both control and intervention participants who meet the study’s inclusion criteria. Results will be expressed as an incremental cost effectiveness ratio (ICER) or the incremental cost per percent change in time for triaging.
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Timepoint [4]
440773
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After completion of the statistical analysis of triage time duration.
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Secondary outcome [5]
440774
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Proportion of eligible referrals
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Assessment method [5]
440774
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An audit of referrals.
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Timepoint [5]
440774
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At the end of the recruitment phase of the study.
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Secondary outcome [6]
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Recruitment rate
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Assessment method [6]
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Descriptive statistics using the recruitment data
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Timepoint [6]
440775
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At the end of the recruitment phase of the study.
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Secondary outcome [7]
440776
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Rate of successful completion of triage information using the OMHA
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Assessment method [7]
440776
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Descriptive statistics using the online triage data.
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Timepoint [7]
440776
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At the end of the recruitment phase of the study.
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Secondary outcome [8]
440777
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Cross-over rate (i.e. proportion of clients who required transfer from using OMHA to usual triaging)
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Assessment method [8]
440777
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Descriptive statistics using the online triage data.
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Timepoint [8]
440777
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At the end of the recruitment phase of the study.
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Eligibility
Key inclusion criteria
People 18 years and over.
English speaking.
Basic computer literacy required for using the OMHA.
Access to a computer/smartphone, internet and email.
Referred to the Mental health line via fax by their GP or other professionals.
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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
Minors under 18 years of age.
People who are unable to give consent due to intellectual disability, medical status or age.
People who require an interpreter.
People needing urgent psychiatric assessment as stated in the referral letter.
People who are in acute psychological distress (i.e. in a state of intolerable psychological pain or distress ).
People who are acutely psychotic or manic.
People who are acutely drugged or intoxicated.
Re-connect clients (flag in the Community Health Information Management Enterprise (CHIME) system).
People at increased risk of violence or suicide.
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Study design
Purpose of the study
Diagnosis
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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)
Concealed via a central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The randomisation sequence for patients was generated using SAS by the Data Sciences unit at the Hunter Medical Research Institute, and was kept concealed from both clinicians and patients.
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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
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
A mixed effects linear regression model will be used to assess the effect of the online triaging on duration of triage call.
Descriptive statistics will be calculated for triage call duration, clinicians, and the satisfaction survey. Continuous variable data is presented as mean (standard deviation; SD) or median (Q1, Q3), along with (min, max) depending on distribution. Comparisons between survey responses (the proportions of ratings on the five-point scale) for clients allocated to the intervention arm and those allocated to control arm will be performed using a Chi squared test.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
27/02/2020
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Date of last participant enrolment
Anticipated
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Actual
16/06/2022
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Date of last data collection
Anticipated
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Actual
16/06/2022
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Sample size
Target
160
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Accrual to date
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Final
377
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
317534
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Government body
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Name [1]
317534
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Hunter New England Health District
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Address [1]
317534
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Country [1]
317534
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Australia
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Primary sponsor type
Government body
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Name
Hunter New England Health District
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Address
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Country
Australia
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Secondary sponsor category [1]
319839
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None
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Name [1]
319839
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None
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Address [1]
319839
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Country [1]
319839
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316246
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
316246
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https://www.hnehealth.nsw.gov.au/research-office/research_ethics
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Ethics committee country [1]
316246
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Australia
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Date submitted for ethics approval [1]
316246
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Approval date [1]
316246
0
31/10/2018
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Ethics approval number [1]
316246
0
2018/ETH00546
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Summary
Brief summary
The study aimed to test whether the online mental health self-report by patients at home (or anywhere with internet and phone access) without necessarily presenting to an emergency department, to inform subsequent clinical triage contributed to reduction in the time required to complete triaging e and whether this novel approach was acceptable. Study hypotheses: 1) The intervention (online mental health self-report by patients prior to triage phone interview) reduces triage time compared to the usual triaging process; 2) The intervention is acceptable to clinicians and clients.
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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
137270
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Dr Irosh Fernando
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Address
137270
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Greater Newcastle Mental Health Service 72 Watt St, Newcastle, NSW, 2300
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Country
137270
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Australia
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Phone
137270
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+61 02 49647350
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Fax
137270
0
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Email
137270
0
[email protected]
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Contact person for public queries
Name
137271
0
Irosh Fernando
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Address
137271
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Greater Newcastle Mental Health Service 72 Watt St, Newcastle, NSW, 2300
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Country
137271
0
Australia
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Phone
137271
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+61 02 49647000
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Fax
137271
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Email
137271
0
[email protected]
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Contact person for scientific queries
Name
137272
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Irosh Fernando
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Address
137272
0
Greater Newcastle Mental Health Service 72 Watt St, Newcastle, NSW, 2300
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Country
137272
0
Australia
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Phone
137272
0
+61 02 49647000
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Fax
137272
0
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Email
137272
0
[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?
Deidentified data of call duration (assessment time) for each participant and satisfaction survey results.
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When will data be available (start and end dates)?
Immediately following publication, no end date
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Available to whom?
Only researchers who provide a methodologically sound proposal and case-by-case basis at the discretion of Primary Sponsor.
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Available for what types of analyses?
Only to achieve the aims in the approved proposal
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How or where can data be obtained?
Access subject to approvals by Principal Investigator, Irosh Fernando.
Email:
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
24230
Study protocol
388553-(Uploaded-16-10-2024-15-09-06)-2018_ETH00546 - Psychiatry Triaging Study Protocol.docx
24231
Informed consent form
388553-(Uploaded-09-10-2024-14-55-40)-2018_ETH00546 - Consent - online form-2-22-JAN-2020.docx
24232
Other
Information for participants
388553-(Uploaded-02-10-2024-12-08-54)-2018_ETH00546 - Attachment 6. Participant Information Statement version 2 (29_11_18)-3-22-JAN-2020.doc
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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