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Trial registered on ANZCTR
Registration number
ACTRN12607000049471
Ethics application status
Approved
Date submitted
21/12/2006
Date registered
16/01/2007
Date last updated
19/11/2019
Date data sharing statement initially provided
19/11/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Anaesthesia Cognitive Evaluation (ACE) Study
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Scientific title
The prospective, descriptive ACE (Anaesthesia Cognitive Evaluation) Study will identify whether preoperative cognitive impairment (Mild Cognitive Impairment (MCI)) increases the risk of PostOperative Cognitive Dysfunction (POCD) in elderly patients undergoing non-cardiac surgery (elective Total Hip Replacement (THR)) compared to a concurrent control group of medically managed patients with osteoarthritis (OA).
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Secondary ID [1]
260027
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nil
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Universal Trial Number (UTN)
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Trial acronym
The ACE Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Patients with osteoarthritis which is medically managed and those requiring total hip replacement surgery.
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Condition category
Condition code
Musculoskeletal
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Osteoarthritis
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Intervention/exposure
Study type
Observational
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Patient registry
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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
To test whether MCI increases the risk of POCD following THR and to compare the change in cognitive function in patients undergoing THR for OA with a control group of patients who have OA that is managed medically. Medical management will be the use of anti-inflammatory medications as clinically indicated and prescribed by the treating physician. Patients will complete a battery of conventional and computerised neuropsychological tests preoperatively, and at 6 days, 3 months and 12 months post-operatively. The conventional battery is a set of eight paper and pencil tests (eg. trail making tests A and B, digit symbol test, Rey Auditory Verbal Learning test) and the computerised battery is a version of Cogstate®. The tests take about 1 hours to complete. Quality of Life (QoL), mood characteristics, Activities of Daily Living (ADL) and Clinical Dementia Rating (CDR) will be assessed preoperatively and 3 and 12 months post-operatively.
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Intervention code [1]
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Early detection / Screening
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Comparator / control treatment
Control group: patients who have OA that is managed medically. The control group will complete the same tests at corresponding intervals.
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Control group
Active
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Outcomes
Primary outcome [1]
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Mild Cognitive Impairment (MCI)
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Assessment method [1]
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Timepoint [1]
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Baseline
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Primary outcome [2]
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Post Operative Cognitive Dysfunction (POCD)
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Assessment method [2]
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Timepoint [2]
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At 6 days, 3 and 12 months
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Secondary outcome [1]
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Length of stay in hospital
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Assessment method [1]
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Timepoint [1]
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6 days
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Secondary outcome [2]
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Natural history of POCD
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Assessment method [2]
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Timepoint [2]
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6 days, 3 and 12 months
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Secondary outcome [3]
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Risk factors for POCD
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Assessment method [3]
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Timepoint [3]
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6 days, 3 and 12 months
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Secondary outcome [4]
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Severity of POCD
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Assessment method [4]
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Timepoint [4]
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6 days, 3 and 12 months
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Secondary outcome [5]
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Incidence of complications
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Assessment method [5]
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Timepoint [5]
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6 days, 3 and 12 months
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Eligibility
Key inclusion criteria
Scheduled for elective hip replacement surgery for osteoarthritis or control patients with medically managed osteoarthritis who: do not have neurological deficit; give informed consent; have no contraindication to neuropsychological testing. The patients must reside in accessible proximity to the hospital to enable investigators to administer baseline neuropsychological testing at home.
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Minimum age
60
Years
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Maximum age
Not stated
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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
1.Pre-existing neurological or clinically evident neurovascular disease (e.g. TIA, stroke);2.Score of less than 26 on the Mini Mental State Examination or CDR>1 (i.e. exclude dementia);3.Anticipated difficulty with neuropsychological assessment, such as English not being the prime language, blindness, deafness;4.Associated medical problems that may lead to significant complications and subsequent loss to follow-up (ASA Physical Status IV or higher);Geographical remoteness that may make it difficult to test patients at home.
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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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
1/03/2007
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Actual
3/08/2007
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Date of last participant enrolment
Anticipated
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Actual
14/01/2013
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Date of last data collection
Anticipated
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Actual
6/12/2017
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Sample size
Target
400
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Accrual to date
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Final
365
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council Project Grant # 454440
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
A/Prof Brendan Silbert
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Address
Department of Anaesthesia, St. Vincent's Hospital, PO Box 2900 Fitzroy Victoria 3065
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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A/Prof David Scott
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Address [1]
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Department of Anaesthesia, St. Vincent's Hospital, PO Box 2900 Fitzroy 3065
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Country [1]
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Australia
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Secondary sponsor category [2]
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Individual
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Name [2]
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Prof Peter Choong
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Address [2]
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Department of Orthopaedics, St. Vincent's Hospital, PO Box 2900 Fitzroy 3065
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Country [2]
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Australia
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Secondary sponsor category [3]
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Individual
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Name [3]
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Prof David Ames
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Address [3]
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St. Georges Campus, St. Vincent's Hospital, PO Box 2900 Fitzroy 3065
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Country [3]
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Australia
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Secondary sponsor category [4]
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Individual
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Name [4]
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Prof Paul Maruff
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Address [4]
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Neurosciences Department, Unitversity of Melbourne, Parkville, Victoria
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Country [4]
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Australia
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Secondary sponsor category [5]
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Individual
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Name [5]
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Prof Konrad Jamrozik
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Address [5]
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c/o St. Vincent's Hospital, PO Box 2900 Fitzroy 3065
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Country [5]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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St Vincent's Hospital HREC-A
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Ethics committee address [1]
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PO Box 2900 Fitzroy VIC 3065
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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17/01/2007
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Ethics approval number [1]
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171/06
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Summary
Brief summary
The ACE (Anaesthesia Cognitive Evaluation) Study is a prospective descriptive comparison of the prevalence of MCI (Mild Cognitive Impairment) and the incidence of POCD (Post Operative Cognitive Dysfunction) in patients undergoing THR (Total Hip Replacement) for OA (Osteoarthritis) and a control group of patients who have OA (Osteoarthritis) that is managed medically.
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Trial website
www.cognition.org.au
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Trial related presentations / publications
1) Evered LA, Silbert BS, Scott DA, Maruff P, Ames D, Choong P. Pre-existing Cognitive Impairment and Mild Cognitive Impairment in Subjects Presenting for Total Hip Joint Replacement. Anesthesiology 2011;114(6):1297-304 2) Evered LA, Scott DA, Silbert BS, Maruff P. Post Operative Cognitive Dysfunction is Independent of Type of Surgery and Anesthetic. Anesth and Analg 2011;112(5):1179-85 3) Silbert B; Evered LA; Scott DA; McMahon S; Choong P; Ames D; Maruff P; Jamrozik K. Pre-existing cognitive impairment is associated with postoperative cognitive dysfunction after non-cardiac surgery. Anesthesiology 2015; 122(6):1224-34 4) Evered LA; Silbert B; Scott DA; Ames D; Maruff P; Blennow K; Zetterberg H. Cerebrospinal fluid analysis in patients undergoing hip replacement predicts cognitive dysfunction. Anesthesiology 2016; 124:353-61. DOI: 10.1097/ALN.0000000000000953
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Brendan Silbert
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Address
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Department of Anaesthesia - St Vincent's Hospital, PO Box 2900 Fitzroy VIC 3065
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Country
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Australia
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Phone
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+61 3 9288 4253
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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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Lis Evered
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Address
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Department of Anaesthesia
St. Vincent’s Hospital
P.O. Box 2900
Fitzroy, Melbourne VIC 3065
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Country
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Australia
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Phone
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+61 3 92882251
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Fax
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+61 3 92884255
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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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Associate Professor Brendan Silbert
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Address
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Department of Anaesthesia
St. Vincent’s Hospital
P.O. Box 2900
Fitzroy, Melbourne VIC 3065
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Country
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Australia
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Phone
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+61 3 92884253
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Fax
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+61 3 92884255
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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)?
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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
Source
Title
Year of Publication
DOI
Embase
Preexisting Cognitive Impairment Is Associated with Postoperative Cognitive Dysfunction after Hip Joint Replacement Surgery.
2015
https://dx.doi.org/10.1097/ALN.0000000000000671
Embase
Cerebrospinal Fluid Biomarker for Alzheimer Disease Predicts Postoperative Cognitive Dysfunction.
2016
https://dx.doi.org/10.1097/ALN.0000000000000953
Dimensions AI
Postoperative Cognitive Dysfunction after Sevoflurane Or Propofol General Anaesthesia in Combination with Spinal Anaesthesia for Hip Arthroplasty
2018
https://doi.org/10.1177/0310057x1804600610
N.B. These documents automatically identified may not have been verified by the study sponsor.
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