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Trial registered on ANZCTR
Registration number
ACTRN12608000362392
Ethics application status
Approved
Date submitted
9/07/2008
Date registered
25/07/2008
Date last updated
22/08/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
The second intensive Blood Pressure reduction in acute cerebral haemorrhage trial.
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Scientific title
An international randomised controlled trial to establish the effects of early intensive blood pressure lowering in patients with intracerebral haemorrhage
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Secondary ID [1]
281146
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NCT00716079
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Universal Trial Number (UTN)
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Trial acronym
INTERACT 2
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
intracerebral haemorrhage
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Condition category
Condition code
Stroke
3339
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0
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Haemorrhagic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients will be randomised to either intensive blood pressure lowering or current guideline based management. As the trial is an assessment of Blood pressure (BP) management policies, there is some flexibility in the use of particular BP lowering agents to achieve BP targets. Intravenous treatment protocols, based on available medications, are provided. Only licensed drugs are used such as labetolol hydrochloride, metoprolol tartrate, hydralazine hydrochloride, glyceral trinitrate and phentoloamine. Intensive therapy is given via an intravenous drip for 24 hours. The target is to reach a systolic BP <140mmHg within 1 hour and to maintain this pressure during hospitalisation and for 3 months post hospitalisation. Oral or nasogastric treatment should be commenced within 24 hours. Control group therapy will include less intensive management of BP using similar choice of route and agents if systolic blood pressure rises above 180mmHg. The target of control therapy is to manage blood pressure according to guidelines, which state blood pressure should be <180mmHg. Follow up is 3 months for both groups.
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Intervention code [1]
2911
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Treatment: Drugs
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Comparator / control treatment
Usual care - standard Blood Pressure lowering based on the American Heart Association (AHA)
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Control group
Active
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Outcomes
Primary outcome [1]
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A composite of death or dependency, with dependency being defined by a score of 3 to 5 on the modified Rankin Score (mRS).
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Assessment method [1]
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Timepoint [1]
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90 days
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Secondary outcome [1]
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A composite of death or dependency in a subgroup of patients who receive treatment within 4 hours of Intracerebral Haemorrhage (ICH) onset.
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Assessment method [1]
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Timepoint [1]
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28 days and 90 days
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Secondary outcome [2]
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Mortality
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Assessment method [2]
7563
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Timepoint [2]
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28 days and 90 days
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Secondary outcome [3]
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Dependency (measured by modified Rankin Score (mRS)).
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Assessment method [3]
7564
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Timepoint [3]
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28 days and 90 days
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Secondary outcome [4]
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Health related quality of life (measured by the EuroQuol 5D)
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Assessment method [4]
7565
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Timepoint [4]
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28 days and 90 days
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Secondary outcome [5]
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Recurrent stroke defined as an acute disturbance of focal neurological function with symptoms lasting more than 24 hours due to new onset ICH or cerebral ischaemia, confirmed by neuro-imaging (or necropsy), that has occurred after an unequivocal period of neurological stability after 24 hours of the initial ICH
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Assessment method [5]
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Timepoint [5]
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90 days
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Secondary outcome [6]
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Acute myocardial infarction (or sudden death) from a cardiovascular cause
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Assessment method [6]
7567
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Timepoint [6]
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28 days and 90 days
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Secondary outcome [7]
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Need for permanent residential care (eg hostel or nursing home)
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Assessment method [7]
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Timepoint [7]
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90 days
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Secondary outcome [8]
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Duration of initial hospital stay
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Assessment method [8]
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Timepoint [8]
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End of hospital stay
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Eligibility
Key inclusion criteria
Patients with computerised tomography (CT)-confirmed spontaneous Intracerebral Haemorrhage (ICH) and elevated systolic blood pressure (>150mmHg and <220mmHg), capacity to commence randomly assigned treatment within 6 hours of onset of ICH.
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Minimum age
18
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
Clear indication or contraindication to intensive BP lowering. Evidence ICH secondary to a structural abnormality, or use of thrombolytic agent, an ischaemic stroke within 30 days, a score of 3-5 on the Glasgow Coma Scale (indicating deep coma), significant pre-stroke disability or medical illness, planned early neurological intervention and participation in another clinical trial.
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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)
Randomisation is performed through the centralised web-based system and the treatment group is concealed until assigned.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Assignment to a treatment group is determined by a computerised algorithm which runs on the central database and uses the minimisation method. The stratification factors are country, site and time since onset.
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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
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Type of endpoint/s
Safety/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
1/09/2008
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Actual
13/10/2008
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Date of last participant enrolment
Anticipated
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Actual
30/08/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
2800
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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]
988
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2050
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Recruitment outside Australia
Country [1]
980
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China
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State/province [1]
980
0
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Country [2]
981
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France
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State/province [2]
981
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Country [3]
982
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New Zealand
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State/province [3]
982
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Country [4]
983
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Germany
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State/province [4]
983
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Country [5]
984
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Spain
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State/province [5]
984
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Country [6]
985
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United Kingdom
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State/province [6]
985
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Country [7]
986
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Belgium
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State/province [7]
986
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Country [8]
987
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Netherlands
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State/province [8]
987
0
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Country [9]
988
0
Switzerland
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State/province [9]
988
0
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Country [10]
989
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Austria
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State/province [10]
989
0
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Country [11]
990
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Austria
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State/province [11]
990
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Funding & Sponsors
Funding source category [1]
3414
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Government body
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Name [1]
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National Health and Medical Research Council (NHMRC)
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Address [1]
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GPO Box 1421 Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Other
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Name
The George Institute for International Health
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Address
PO Box M201 Missenden Road,
Camperdown
NSW 2050
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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]
3058
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Country [1]
3058
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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SSWAHS RPAH zone
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Ethics committee address [1]
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Research Development Office Level 8, building 14 RPAH Camperdown NSW 2050
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Ethics committee country [1]
5610
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Date submitted for ethics approval [1]
5610
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11/06/2008
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Approval date [1]
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26/06/2008
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Ethics approval number [1]
5610
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08/RPAH/273
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Summary
Brief summary
The main phase of an academic lead and conducted, international, multi-centre, open label, blinded endpoint, randomised controlled trial to establish the balance of benefits and risks of a treatment strategy of early intensive lowering of blood pressure (BP) compared to a conservative BP lowering policy in patients with acute primary intracerebral haemorrhage (ICH) and co-existing elevated BP without any definite indication or contraindication to treatment.
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Trial website
http://www.thegeorgeinstitute.org/
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Trial related presentations / publications
Anderson CS, Heeley E, Huang Y, Wang J, Stapf C, Delcourt C, Lindley R, Robinson T, Lavados P, Neal B, Hata J, Arima H, Parsons M, Li Y, Wang J, Heritier S, Li Q, Woodward M, Simes J, Davis S, and Chalmers J, for the INTERACT2 Investigators. “Rapid blood pressure lowering in acute intracerebral hemorrhage: the INTERACT2 trial”.New England Journal of Medicine. 2013; 368(25):2355-65
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Public notes
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Contacts
Principal investigator
Name
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Prof Craig Anderson
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Address
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The George Institute for Global Health, Level 10 King George V Building Missenden Road Camperdown NSW 2050
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Country
28608
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Australia
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Phone
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+61 2 99934500
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Fax
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Email
28608
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[email protected]
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Contact person for public queries
Name
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Emma Heeley
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Address
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The George Institute Royal Prince ALfred Hospital Level 10 King George V Building Missenden Road Camperdown NSW 2050
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Country
11765
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Australia
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Phone
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+61 2 99934561
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Fax
11765
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+61 2 99934502
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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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Craig Anderson
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Address
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The George Institute Royal Prince ALfred Hospital Level 10 King George V Building Missenden Road Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 99934590
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Fax
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+61 2 99934502
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Email
2693
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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
No additional documents have been identified.
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