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Trial registered on ANZCTR
Registration number
ACTRN12625000536460
Ethics application status
Approved
Date submitted
2/05/2025
Date registered
27/05/2025
Date last updated
27/05/2025
Date data sharing statement initially provided
27/05/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Subcutaneously anchored securement system versus a traditional sutureless securement device for the prevention of Peripherally Inserted Central Catheter dislodgement: A randomised controlled trial
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Scientific title
Subcutaneously anchored securement system versus a traditional sutureless securement device for the prevention of Peripherally Inserted Central Catheter dislodgement: A randomised controlled trial
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Secondary ID [1]
314188
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
SASS vs STAND
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Catheter Dislodgement
337120
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Condition category
Condition code
Cardiovascular
333540
333540
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients will be randomised between statlock (Standard of care) or to the SecurAcath (intervention) arm.
The SecurAcath device is a small, subcutaneous anchor securement system that is inserted in the subcutaneous layer, and held in place by small metal feet that act as anchors. The device will be inserted by trained radiology nurse and/or trained medical officer. The device will stay in place for the lifeline of the Peripherally Inserted Central Catheter (PICC) line in the patient - this could be 1 week or up to 1 year (or more in very rare cases). The SecurAcath device will only be applied the one time. If it is removed or dislodged for any reason, there is no cross-enrolment to the control arm. Strategies used to assess adherence to both arms include monthly follow up with the patient - either in person at appointments or via a phone call.
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Intervention code [1]
330827
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Prevention
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Intervention code [2]
331090
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Treatment: Devices
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Comparator / control treatment
Control arm is the use of the statlock, which secures the PICC line via a sticker on the skin, holding the catheter in place. The statlock will be applied at completion of device insertion by the inserting clinician (trained registered nurse or medical officer).
It will be affixed to the patients’ skin using a large adhesive padded footplate with plastic locking clasps, and a transparent dressing placed over the point of insertion. The statlock is changed weekly and then at device removal. It is peeled away gently from the skin and the plastic locking clips must be opened to allow for the removal of the catheter from the device.
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Control group
Active
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Outcomes
Primary outcome [1]
341303
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Dislodgement (binary): greater than 1cm movement in the catheter tip position at any point during PICC dwell; including both partial and total dislodgement.
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Assessment method [1]
341303
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Radiological confirmation of dislodgement.
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Timepoint [1]
341303
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72 hours post insertion, and then monthly until PICC line removal and/or at PICC line removal
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Secondary outcome [1]
447071
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Central Venous Access Device (CVAD)-Associated skin impairment
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Assessment method [1]
447071
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CVAD-associated skin impairment (CASI) complication assessment tool
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Timepoint [1]
447071
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In addition to throughout: 72 hours post insertion; monthly and then at PICC and/or device removal
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Secondary outcome [2]
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Catheter adverse events
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Assessment method [2]
447073
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each event defined as dislodgement, determined by review of medical records, participant and/or staff reported.
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Timepoint [2]
447073
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In addition to throughout: 72 hours post insertion; monthly and at PICC and/or device removal
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Secondary outcome [3]
447074
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Dwell time of study device
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Assessment method [3]
447074
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length of time device insitu. This will be assessed using an internal CVAD device log form, in addition to patient's medical records.
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Timepoint [3]
447074
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On device removal
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Secondary outcome [4]
447075
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Healthcare costs
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Assessment method [4]
447075
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cost and number of products used, cost of treating complications, staff time for dressing and securement replacements during dwell; continuous. The data will be collected by review of hospital records; and a staff survey.
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Timepoint [4]
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At end of last patient completing follow up
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Secondary outcome [5]
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catheter associated-thrombosis
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Assessment method [5]
448058
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confirmed via imaging
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Timepoint [5]
448058
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In addition to throughout: 72 hours post insertion; monthly and at PICC and/or device removal
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Secondary outcome [6]
448059
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extravasation
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Assessment method [6]
448059
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Checking site for redness, discharge and/or swelling.
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Timepoint [6]
448059
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In addition to throughout: 72 hours post insertion, monthly and at PICC and/or device removal
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Secondary outcome [7]
448060
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Occlusion (complete)
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Assessment method [7]
448060
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Checking upon flushing of line - the inability of any solutions to be passed through the catheter line, and not being able to aspirate blood return.
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Timepoint [7]
448060
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In addition to throughout catheter use: 72 hours post insertion, monthly and at PICC and/or device removal.
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Secondary outcome [8]
448061
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Central Line-Associated Bloodstream Infection (CLABSI)
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Assessment method [8]
448061
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Blood cultures to be collected from every lumen of PICC line, after needless-connector change.
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Timepoint [8]
448061
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Routine management - at any point that CLABSI is suspected. In addition, to 72 hours post insertion and monthly.
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Secondary outcome [9]
448062
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local infection
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Assessment method [9]
448062
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Inspect insertion site for signs of infection including redness, swelling, discharge, pain, cellulitis and/or being warm to touch. Will also include patient having fevers, chills and or rigors, determined by patient and/or staff reporting, review of medical records.
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Timepoint [9]
448062
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routine use of catheter, 72 hour post insertion follow up, monthly and at device removal.
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Eligibility
Key inclusion criteria
1. 16 years of age or older and
requiring PICC insertion in Medical Imaging, Toowoomba Hospital.
2. Informed consent given by patient or substitute decision maker
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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. Non-English speakers without an interpreter
2. Unable to consent, or without a legal guardian.
3. Patient receiving end-of-life care
4. Previous enrolment in this study
5. Patients with an indeterminate length of treatment (likely less than 2 weeks)
6. Known allergy to any of the study products (in particular nickel allergy).
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Study design
Purpose of the study
Prevention
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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)
Allocation is not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation) 1:1
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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
Safety/efficacy
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Statistical methods / analysis
Characteristics of groups at baseline will be assessed using demographic, social and clinical parameters. Means and standard deviations will be used to report normally distributed continuous data, medians and interquartile ranges will be used for interval data that could not be approximated with a normal distribution. Categorical data will be reported as frequency (percentage). Incidence rates (per 1,000 PICC days) including 95% confidence intervals will be calculated.
Primary and secondary binary outcomes will be compared between groups using logistic regression. Count outcomes will be compared using Poisson regression models, with the natural logarithm of time-at-risk included. Continuous outcomes will be compared using linear regression models. The patient is the unit of analysis. Detailed estimands will be developed to explore the effect of intercurrent events such as protocol deviations. Multivariable regression will be undertaken as a secondary analysis to explore the effect of baseline characteristics associated with the primary outcome. Missing values are expected to be minimal, random and will not be imputed, but will be reported. P values of p<0.05 will be considered statistically significant. The statistican will be masked to group allocation and a comprehensive statistical analysis plan will be developed and finalised prior to statistical analysis.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/06/2025
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Actual
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Date of last participant enrolment
Anticipated
3/06/2027
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Actual
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Date of last data collection
Anticipated
3/06/2029
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Actual
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Sample size
Target
384
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
27867
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Toowoomba Hospital - Toowoomba
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Recruitment postcode(s) [1]
44062
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4350 - Toowoomba
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Funding & Sponsors
Funding source category [1]
318706
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Government body
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Name [1]
318706
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Darling Downs Health
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Address [1]
318706
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Country [1]
318706
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Australia
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Primary sponsor type
Government body
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Name
Darling Downs Health
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Address
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Country
Australia
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Secondary sponsor category [1]
321135
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None
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Name [1]
321135
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Address [1]
321135
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Country [1]
321135
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Other collaborator category [1]
283507
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University
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Name [1]
283507
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University of Queensland
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Address [1]
283507
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Country [1]
283507
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
317312
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Darling Downs Hospital and Health Service Human Research Ethics Committee
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Ethics committee address [1]
317312
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https://www.health.qld.gov.au/darlingdowns/html/ddhhs-hrec.asp
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Ethics committee country [1]
317312
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Australia
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Date submitted for ethics approval [1]
317312
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26/11/2024
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Approval date [1]
317312
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08/01/2025
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Ethics approval number [1]
317312
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113629
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Summary
Brief summary
Approximately 240 PICCs are inserted at the Toowoomba Base Hospital (TBH) Medical Imaging department every year, with many of these patients receiving care at TBH but geographically located throughout DDH. Current migration or partial dislodgement rates are recorded locally as being as high as 60%. This is a significant proportion of patients who may be experiencing unnecessary complications requiring additional care and treatment. To our knowledge, there are no RCTs looking at the efficacy of SASS in adult patients requiring a PICC. The aim of our study is to determine if the securement of PICCs with SASS decreases the risk of catheter dislodgement (partial or total) compared to securement with SSD in adult patients. To investigate this at Darling Downs Health, the study team will undertake a randomised controlled trial in adults requiring the insertion of a PICC comparing the use of SASS compared to standard care
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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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Dr Sally Havers
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Address
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UQ Centre for Clinical Research, Herston, QLD, 4006
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Country
140662
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Australia
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Phone
140662
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+61 0433 570 585
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Fax
140662
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Email
140662
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[email protected]
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Contact person for public queries
Name
140663
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Sally Havers
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Address
140663
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UQ Centre for Clinical Research, Herston, QLD, 4006
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Country
140663
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Australia
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Phone
140663
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+61 0433 570 585
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Fax
140663
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Email
140663
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[email protected]
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Contact person for scientific queries
Name
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Sally Havers
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Address
140664
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UQ Centre for Clinical Research, Herston, QLD, 4006
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Country
140664
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Australia
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Phone
140664
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+61 0433 570 585
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Fax
140664
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Email
140664
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
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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