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Trial registered on ANZCTR
Registration number
ACTRN12608000239369
Ethics application status
Approved
Date submitted
19/02/2008
Date registered
8/05/2008
Date last updated
11/12/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Combined therapy of electroacupuncture and cognitive behavioural therapy for tension-type headache: a randomised controlled trial
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Scientific title
Electroacupuncture and cognitive behavioural therapy for adults with tension-type headache compared with electroacupuncture or cognitive behavioural therapy alone on headache reduction
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Secondary ID [1]
285834
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
Combined therapy of EA and CBT for TTH: a randomised controlled trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Tension-type Headache
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Condition category
Condition code
Alternative and Complementary Medicine
2987
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0
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Other alternative and complementary medicine
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention of the current study is a combined therapy of electroacupuncture (EA) and cognitive behavioural therapy (CBT). EA is one form of acupuncture. It combines needle insertion and electrical stimulation, and has been widely used in clinical practice for its safety and easy operation. CBT is a type of psychological intervention. It addresses cognitive behavioural aspects of illnesses. Acupoints located in the neck, scalp, forearms and legs will be selected. EA treatments will twice per week for four weeks followed by once per week for another two weeks. Each session will last for 30 minutes. Then subjects will have weekly 50-minute CBT consultations for another six weeks. CBT will involve a number of components including relaxation training, cognitive restructuring, attention diversion and imagery techniques. Written materials and audiotapes will also be used so that subjects can develop management skills at home in their own time.
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Intervention code [1]
2583
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Other interventions
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Comparator / control treatment
Control 1: EA alone. In this EA alone group the subjects will be treated twice per week for four weeks, and then once a week for another eight weeks. Each session will last for 30 minutes. Acupoints located in the neck, scalp, forearms and legs will be selected.
Control 2: CBT alone. In the CBT alone group, the subjects will receive weekly 50-minute CBT consultation for 12 weeks.
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Control group
Active
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Outcomes
Primary outcome [1]
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number of days with headache per four weeks (with headache diaries)
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Assessment method [1]
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Timepoint [1]
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baseline, every 4 weeks during the 12 weeks treatment period, and for 4 weeks at the 3rd month during the follow-up period and for 4 weeks at the 6th month during the follow-up period
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Primary outcome [2]
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Severity of headaches recorded using IVS.
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Assessment method [2]
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Timepoint [2]
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baseline, the last 4 weeks of treatment period, and 4 weeks at the 3rd month during the follow-up period and for 4 weeks at the 6th month during the follow-up period
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Primary outcome [3]
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Duration of headache recorded using patient daily diary
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Assessment method [3]
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Timepoint [3]
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baseline, the last 4 weeks of treatment period, and 4 weeks at the 3rd month during the follow-up period and for 4 weeks at the 6th month during the follow-up period
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Secondary outcome [1]
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number of responders (50% reduction of number of days with headache)
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Assessment method [1]
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Timepoint [1]
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at the end of 6-week treatment, 12-week treatment and the six-month follow up period
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Secondary outcome [2]
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Perceived stress score
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Assessment method [2]
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Timepoint [2]
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at the end of 6-week treatment, 12-week treatment and the six-month follow up period
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Secondary outcome [3]
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analgesics consumption for tension-type headache (TTH) per four weeks by headache diaries comparison
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Assessment method [3]
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Timepoint [3]
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at the end of 6-week treatment, 12-week treatment and the six-month follow up period
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Secondary outcome [4]
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Quality of life (SF-36)
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Assessment method [4]
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Timepoint [4]
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at the end of 6-week treatment, 12-week treatment and the 3-month and 6-month follow-up period.
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Secondary outcome [5]
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Social Support Questionnaire
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Assessment method [5]
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Timepoint [5]
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at the end of 6-week treatment, 12-week treatment and the six-month follow up period
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Secondary outcome [6]
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Acupuncture Expectancy Scale
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Assessment method [6]
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Timepoint [6]
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baseline
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Eligibility
Key inclusion criteria
1) age between 18 and 65 years at entry;
2) adept at conversational and reading English;
3) TTH that are consistent with IHS criteria (codes 2.2 and 2.3); and
4) More than one day with tension-type headahce per month.
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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
1) No exclusion based on Beck Depression Inventory (BDI) score alone. But an assessment by a psychologist will be involved if deemed necessary during the study, e.g. BDI > = 30;
2) taking analgesic on more than 15 days per month (suspected of medication-overuse headache);
3) Patients with more than 4 migraine attacks (IHS code 1.1 migraine without aura) per month or Patients with any attack (IHS code 1.2 migraine with aura) per month;
4) TTH onset after 50 years old;
5) Participants refuse to maintain existing treatments of TTH, including prophylactic medications, during the trial period;
6) Whiplash or a history of significant head injury that required hospital stay;
7) Severe unstable arrhythmia or heart failure, pregnancy or intent to get pregnant, active epilepsy, brain tumour, cancer, haemophiliac or wearing cardiac pacemakers;
8) Had eight or more sessions of acupuncture or CBT treatments for TTH in the last six months;
9) with intellectual disability; or
10) being psychotic.
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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)
Potential subjects will be recruited from the community and will be assessed according to the inclusion and exclusion criteria. Once completed baseline period, each eligible subject will pick up an envelop containing one number indicating the treatment allocation. The randomisation sequence will be stored in a password protected computer and a researcher who is not involved in treatment or assessment will have the access to the allocation assignment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A computer generated random numbers will be used. The numbers will be entered into sequentially numbered, opaque sealed envelopes, one for each subject. These will be opened only when the subjects arrive for their first treatment
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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
Phase 2
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Type of endpoint/s
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
1/11/2010
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Actual
25/10/2010
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Date of last participant enrolment
Anticipated
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Actual
6/03/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
225
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
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3001
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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RMIT
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Address [1]
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Bundoora West Campus,Plenty Road,Bundoora,VIC3083,
Victoria,Australia
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Country [1]
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Australia
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Funding source category [2]
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Government body
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Name [2]
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National Health and Medical Research Council
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Address [2]
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Level 1
16 Marcus Clarke Street
Canberra ACT 2601
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Country [2]
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Australia
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Primary sponsor type
University
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Name
RMIT
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Address
Bundoora West Campus,Plenty Road,Bundoora,VIC3083,
Victoria,Australia
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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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Prof Ken Greenwood
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Address [1]
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School of Health Sciences,
Bundoora West Campus,Plenty Road,Bundoora,VIC3083,
Victoria,Australia
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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 Charlie Xue
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Address [2]
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Division of Chinese Medicine,
School of Health Sciences,
Bundoora West Campus,Plenty Road,Bundoora,VIC3083,
Victoria,Australia
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Country [2]
2999
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Australia
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Secondary sponsor category [3]
3000
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Individual
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Name [3]
3000
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Dr Zhen Zheng
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Address [3]
3000
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Division of Chinese Medicine,
School of Health Sciences,
Bundoora West Campus,Plenty Road,Bundoora,VIC3083,
Victoria,Australia
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Country [3]
3000
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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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RMIT Human Research Ethics Committee
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Ethics committee address [1]
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RMIT Human Research Ethics Committee, University Secretariat, RMIT, GPO Box 2476V, Melbourne, 3001
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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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01/11/2007
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Approval date [1]
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09/11/2007
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Ethics approval number [1]
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21/07
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Summary
Brief summary
Tension-type headache (TTH) affects up to 75% of the world population and more than 33% of Australians. There is no ideal treatment for it due to the unclear mechanism. Commonly used medications include simple pain killers and anti-depressants. They are either not effective for long-term management or not tolerated by patients due to side effects. Acupuncture has been shown to reduce the frequency and intensity of TTH within three weeks of treatment and has an excellent safety profile. Cognitive behavioural therapy (CBT) teaches patients how to cope with mental stress and correct unhelpful thoughts, belief and behaviour, and thus produces a long-term effect for TTH patients. In this current trial, we aim to assess the combined effect of electroacupuncture (EA) and CBT on TTH in short and long terms. 225 TTH patients will be recruited. After a four-week run-in period and randomisation, all subjects will have one-hour interview, and then be randomly allocated to receive either EA alone, CBT alone or EA+CBT group for a total of 12-week treatment. There will be a six-month follow-up at the end of the 12 week treatment period. Subjects will record the frequency, duration, severity and symptoms of headache and the use of headache medication during run-in, the treatment and the follow-up periods. This trial will be the first such project in the world in which acupuncture is combined with a well-received and practiced intervention in pain management for TTH, i.e., CBT. The combined therapy will be cost-effective because it will reduce the consumption of analgesics and visits to doctors, and improve effectiveness at work and quality of life as a result of reduced pain and enhanced self-management skills.
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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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Prof Ken Greenwood
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Address
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Faculty of Computing, Health and Science
Edith Cowan University
270 Joondalup Drive
JOONDALUP WA 6027
Australia
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Country
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Australia
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Phone
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+61,8,6304 5979
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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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Dr Zhen Zheng
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Address
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Level 4, Building 202, room 4.51, Plenty Road,
Bundoora West Campus, RMIT
BUNDOORA
VIC3083
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Country
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Australia
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Phone
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03 99257167
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Fax
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03 99257178
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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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Dr Zhen Zheng
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Address
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Level 4, Building 202, room 4.51, Plenty Road,
Bundoora West Campus, RMIT
BUNDOORA
VIC3083
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Country
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Australia
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Phone
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03 99257167
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Fax
2468
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03 99257178
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Email
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[email protected]
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No information has been provided regarding IPD availability
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
Identifying Chinese Medicine Patterns of Tension-Type Headache and Understanding Its Subgroups.
2021
https://dx.doi.org/10.1155/2021/5544571
N.B. These documents automatically identified may not have been verified by the study sponsor.
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