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Trial registered on ANZCTR
Registration number
ACTRN12610000350022
Ethics application status
Approved
Date submitted
9/03/2009
Date registered
3/05/2010
Date last updated
25/11/2019
Date data sharing statement initially provided
25/11/2019
Date results provided
25/11/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of Yakult on fermentation patterns and symptoms in irritable bowel syndrome
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Scientific title
Randomised, placebo-controlled trial, followed by open-label treatment and withdrawal phases, of the effect of Yakult on fermentation patterns in patients with functional gut symptoms and an early rise of breath hydrogen after lactulose
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Secondary ID [1]
251660
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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:
Irritable bowel syndrome
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Condition category
Condition code
Alternative and Complementary Medicine
4707
4707
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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
Lactobacillus casei Shirota strain (Yakult)
65 ml once per day during the randomised placebo-controlled phase - duration 6 weeks
Upon completion, subjects will be offered 65 ml per day Yakult for 6 weeks.
During the withdrawal phase (6 weeks), no therapy is given (observation only)
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Intervention code [1]
4185
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Treatment: Other
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Comparator / control treatment
Placebo - identical to Yakult, except Lactobacillus is not added. Given 65 ml daily for 6 weeks (randomised controlled phase). No further placebo is used in the subsequent open-label and withdrawal phases.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The proportion of patients altering the time of first rise of breath hydrogen after lactulose to greater than or equal to 75 minutes and/or delaying the rise by 30 minutes from baseline at week 6.
This is assessed by hydrogen breath testing following before and every 15 minutes for 2-3 hours after the ingestion of 15 g lactulose.
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Assessment method [1]
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Timepoint [1]
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week 6
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Secondary outcome [1]
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Double-blind phase: the change in time of the first rise in breath hydrogen after lactulose.
This is assessed by hydrogen breath testing following before and every 15 minutes for 2-3 hoursafter the ingestion of 15 g lactulose.
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Assessment method [1]
9388
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Timepoint [1]
9388
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Week 6
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Secondary outcome [2]
9389
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Double-blind phase: Proportion of patients altering status of fructose breath test from that prior to entering the study.
This is assessed by hydrogen breath testing following before and every 20 minutes after the ingestion of 35 g lactulose.
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Assessment method [2]
9389
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Timepoint [2]
9389
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Week 6
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Secondary outcome [3]
9390
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double-blind phase: The change in gastric emptying time.
This is measured using C-13 acetic acid liquid gastric emptying by assessing breath C-13 every 15 minutes over 240 minutes via the Iris infrared isotope analyser and associated software. It is performed concurrently with the lactulose breath hydrogen test. 100 mg C-13 sodium acetate is added to the lactulose solution
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Assessment method [3]
9390
0
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Timepoint [3]
9390
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week 6
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Secondary outcome [4]
9391
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double-blind phase: The change in visual analogue (VAS) scores for overall and specific gut symptoms for Yakult-treated vs placebo-treated patients,
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Assessment method [4]
9391
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Timepoint [4]
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week 6
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Secondary outcome [5]
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The change in visual analogue (VAS) scores for overall and specific gut symptoms for those correcting early rise in breath hydrogen after lactulose (ERBHAL) vs those with continuing ERBHAL
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Assessment method [5]
9394
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Timepoint [5]
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week 12
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Secondary outcome [6]
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The change in visual analogue (VAS) scores for overall and specific gut symptoms for those correcting early rise in breath hydrogen after lactulose (ERBHAL) vs those with continuing ERBHAL
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Assessment method [6]
264002
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Timepoint [6]
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week 18
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Secondary outcome [7]
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Adverse events.
These will be assessed by diary entries and by direct questioning at 3 weekly visits for 18 weeks of the study; i.e., assessed by history taking and physical examination. Expected adverse events will be exacerbation of irritable bowel syndrome, nausea, and trivial events unrelated to the study medication
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Assessment method [7]
264003
0
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Timepoint [7]
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up to 18 weeks
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Secondary outcome [8]
264004
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The proportion of patients altering the time of first rise of breath hydrogen after lactulose to greater than or equal to 75 minutes and/or delaying the rise by 30 minutes from baseline at week 6.
This is assessed by hydrogen breath testing following before and every 15 minutes for 2-3 hours after the ingestion of 15 g lactulose.
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Assessment method [8]
264004
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Timepoint [8]
264004
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Week 12 and week 18
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Secondary outcome [9]
264008
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double-blind phase: The change in visual analogue (VAS) scores for overall and specific gut symptoms for those correcting early rise in breath hydrogen after lactulose (ERBHAL) vs those with continuing ERBHAL
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Assessment method [9]
264008
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Timepoint [9]
264008
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week 6
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Eligibility
Key inclusion criteria
1. ERBHAL, defined as a rise of breath hydrogen of 10 ppm or greater above baseline breath hydrogen on two consecutive 15-minute samples before 90 minutes following ingestion of lactulose;
2. Irritable bowel syndrome according to Rome III criteria;
3. On no specific medication for irritable bowel syndrome
4. On a stable diet for the four weeks prior to entering the study and during the study;
5. Able to maintain current drug therapy for functional gut symptoms without change in drugs or dose during the study;
6. Able to give written, informed consent
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Minimum age
16
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
1. treatment for greater than two weeks with any probiotic within the previous 3 months;
2. any antibiotic therapy in the previous two months;
3. excessive alcohol intake
4. clinically significant co-morbidity
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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)
Subjects identified by study staff. Allocation of treatment determined by schedule off-site
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation by using a randomization table created by a computer software
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Masking / blinding
Blinded (masking 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
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
1/06/2010
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Actual
3/08/2010
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Date of last participant enrolment
Anticipated
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Actual
6/06/2012
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Date of last data collection
Anticipated
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Actual
13/11/2019
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Sample size
Target
88
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Accrual to date
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Final
65
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
4632
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Commercial sector/Industry
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Name [1]
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Yakult Australia Pt Ltd
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Address [1]
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10 Monterey Road
Dandenong Vic 3175
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Country [1]
4632
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Australia
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Primary sponsor type
Hospital
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Name
Box Hill Hospital
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Address
5 Arnold Street,
Box Hill
Vic 3128
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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Monash University
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Address [1]
4176
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Box Hill hospital
5 Arnold Street
Box Hill
Vic 3128
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Country [1]
4176
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
6670
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Eastern Health Research & Ethics Committee
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Ethics committee address [1]
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Box Hill Hospital 5 Arnold Street Box Hill Vic 3128
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Ethics committee country [1]
6670
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Australia
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Date submitted for ethics approval [1]
6670
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Approval date [1]
6670
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13/02/2009
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Ethics approval number [1]
6670
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E61/0809
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Summary
Brief summary
Current therapy for irritable bowel syndrome is suboptimal. Recent studies have suggested that small intestinal bacterial overgrowth may be present and that its treatment may have therapeutic benefit. The primary aim is to examine whether the effect of Yakult on a breath hydrogen test feature of bacterial overgorwoth that was seen in the pilot study is reproducible and specific to the study treatment, or just a chance observation. The secondary aims were to define the effect of Yakult on the rate at which the stomach empties, to compare the effects on gut symptoms of Yakult, placebo and Yakult withdrawal, and to examine the association of change in breath test patterns with changes in gut symptoms. In addition, because bacterial overgrowth is said to be causally associated with fructose malabsorption, another aim is to examine the effect of Yakult and the changes in breath test patterns with changes in fructose absorption and malabsorption. The major study hypotheses are that Yakult corrects small intestinal bacterial overgrowth and that this correction is associated with improvement in symptoms of irritable bowel syndrome
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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 Peter Gibson
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Address
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Monash University / The Alfred Hospital
Department of Gastroenterology
Central Clinical School
Level 6, 99 Commercial Rd
Melbourne VIC 3004
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Country
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Australia
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Phone
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+613 9076 2223
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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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CK Yao
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Address
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Department of Medicine
Box Hill Hospital
Box Hill Vic 3128
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Country
12614
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Australia
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Phone
12614
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+61 3 9094 9547
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Fax
12614
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+61 3 9899 9137
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Email
12614
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[email protected]
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Contact person for scientific queries
Name
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CK Yao
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Address
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Department of Gastroenterology
Central Clinical School
Monash University & The Alfred Hospital
Melbourne VIC 3004
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Country
3542
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Australia
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Phone
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+613 99030266
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Fax
3542
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+61 3 9899 9137
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Email
3542
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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
Source
Title
Year of Publication
DOI
Embase
Poor predictive value of breath hydrogen response for probiotic effects in IBS.
2015
https://dx.doi.org/10.1111/jgh.13015
N.B. These documents automatically identified may not have been verified by the study sponsor.
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