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Trial registered on ANZCTR
Registration number
ACTRN12613000266763
Ethics application status
Approved
Date submitted
5/03/2013
Date registered
6/03/2013
Date last updated
12/03/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
Can death from chronic life-limiting illnesses be predicted in Australian general practice? A study exploring the feasibility and acceptability of a case finding approach to care planning of patients nearing the end-of-life.
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Scientific title
The study of Australian general practitioners using a systematic death prediction tool versus clinical intuition on the accuracy of prediction of patient death.
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Secondary ID [1]
282060
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Nil known
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Universal Trial Number (UTN)
U1111-1140-1414
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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:
Cancer
288540
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Frailty
288541
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Heart failure
288542
0
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Degenerative neurological conditions
288543
0
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End stage renal failure
288544
0
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End stage liver disease
288545
0
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End stage respiratory disease
288546
0
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Dementia
288547
0
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Condition category
Condition code
Cancer
288874
288874
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0
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Any cancer
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Public Health
288901
288901
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0
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Health service research
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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
Systematic clinical prediction tool, (modified version of the SPICT tool developed in the UK), used to help the GP in identifying patients at risk of dying in the next 12 months. The tool comprises of three elements: (i) 'surprise' question, (ii) general indicators of health, (iii) specific indicators around advanced conditions.
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Intervention code [1]
286658
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Early detection / Screening
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Comparator / control treatment
Clinical intuition that the GP normally uses to determine which of their patients are likely to die over the next 12 months.
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Control group
Active
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Outcomes
Primary outcome [1]
289001
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% of predicted patients who have actually died. Patient deaths will be identified through interrogation of the practice database.
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Assessment method [1]
289001
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Timepoint [1]
289001
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6 months after the GP has applied the systematic prediction tool or used their clinical intuition to identify patients who are at risk of dying
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Secondary outcome [1]
301542
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Positive predictive value and negative predictive value of prediction of death at 6 months. Patient deaths will be identified through interrogation of the practice database.
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Assessment method [1]
301542
0
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Timepoint [1]
301542
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6 months after the GP has applied the systematic prediction tool or used their clinical intuition to identify patients who are at risk of dying
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Secondary outcome [2]
301543
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% patients predicted to die who have received or would have benefited from end-of-life care planning during study period. This will be collected through a questionnaire completed by the GP.
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Assessment method [2]
301543
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Timepoint [2]
301543
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6 months after the GP has applied the systematic prediction tool or used their clinical intuition to identify patients who are at risk of dying
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Secondary outcome [3]
301544
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Place of death. This will be collected through a questionnaire completed by the GP.
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Assessment method [3]
301544
0
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Timepoint [3]
301544
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6 months after the GP has applied the systematic prediction tool or used their clinical intuition to identify patients who are at risk of dying
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Secondary outcome [4]
301545
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Unplanned admissions to Emergency Department or hospital. This will be collected through a questionnaire completed by the GP.
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Assessment method [4]
301545
0
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Timepoint [4]
301545
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6 months after the GP has applied the systematic prediction tool or used their clinical intuition to identify patients who are at risk of dying
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Secondary outcome [5]
301546
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Use of palliative care specialist services. This will be collected through a questionnaire completed by the GP.
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Assessment method [5]
301546
0
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Timepoint [5]
301546
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6 months after the GP has applied the systematic prediction tool or used their clinical intuition to identify patients who are at risk of dying
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Secondary outcome [6]
301547
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% non malignant deaths and nursing home deaths correctly identified. The place of death and the cause of death will be collected through a questionnaire completed by the GP. Patient deaths will be collected through an interrogation of the practice database.
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Assessment method [6]
301547
0
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Timepoint [6]
301547
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6 months after the GP has applied the systematic prediction tool or used their clinical intuition to identify patients who are at risk of dying
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Secondary outcome [7]
301548
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Respondent burden. This will be collected through a questionnaire completed by the GP.
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Assessment method [7]
301548
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Timepoint [7]
301548
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Immediately after the GP has applied the systematic prediction tool or used their clinical intuition to identify patients who are at risk of dying
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Secondary outcome [8]
307264
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Proportion of deaths correctly identified in the practice records when compared to state-based official death registries
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Assessment method [8]
307264
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Timepoint [8]
307264
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6 months after the GP has applied the systematic prediction tool or used their clinical intuition to identify patients who are at risk of dying.
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Eligibility
Key inclusion criteria
Inclusion criteria for GPs:
1. Working in active clinical general practice.
2. Working in Sydney or Brisbane.
Inclusion criteria for patients:
1. Patients of participating GPs
2. Greater than or equal to 70 years of age or patients under 70 years of age who have been identified as the GP as being at risk of dying in the next 12 months
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Minimum age
70
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
Exclusion criteria for GPs: 1. Not seeing patients >70 years of age. 2. Not having computerised practice database. 3. Having worked <12 months in the practice.
Exclusion criteria for patients: 1. Patients under 70 years of age unless they have been identified by the participating GP as being at risk of dying in the next 12 months.
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Study design
Purpose
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Duration
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Selection
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Timing
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
5/12/2012
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Actual
5/12/2012
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Date of last participant enrolment
Anticipated
15/05/2013
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Actual
16/08/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD
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Funding & Sponsors
Funding source category [1]
286834
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Charities/Societies/Foundations
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Name [1]
286834
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The Primary Care Collaborative Cancer Clinical Trials Group (PC4) / RACGP research grant.
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Address [1]
286834
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The RACGP Foundation
1 Palmerston Cr, South Melbourne, Victoria 3205 Australia
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Country [1]
286834
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Australia
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Primary sponsor type
University
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Name
The University of New South Wales
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Address
UNSW Sydney NSW 2052
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Country
Australia
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Secondary sponsor category [1]
285624
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University
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Name [1]
285624
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The University of Queensland
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Address [1]
285624
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The University of Queensland
Brisbane QLD 4072 Australia
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Country [1]
285624
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Australia
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Other collaborator category [1]
277315
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Hospital
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Name [1]
277315
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HammondCare Palliative & Supportive Care Services
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Address [1]
277315
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Greenwich Hospital, Pallister House
PO Box 5084
Greenwich NSW 2065
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Country [1]
277315
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288900
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The University of New South Wales Human Research Ethics Committee
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Ethics committee address [1]
288900
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The University of New South Wales UNSW Sydney NSW 2052
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Ethics committee country [1]
288900
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Australia
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Date submitted for ethics approval [1]
288900
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Approval date [1]
288900
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30/10/2012
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Ethics approval number [1]
288900
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HC12553
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Ethics committee name [2]
288901
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The University of Queensland Medical Research Ethics Committee
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Ethics committee address [2]
288901
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The University of Queensland Brisbane QLD 4072 Australia
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Ethics committee country [2]
288901
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Australia
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Date submitted for ethics approval [2]
288901
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Approval date [2]
288901
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20/11/2012
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Ethics approval number [2]
288901
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2012001275
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Summary
Brief summary
General Practitioners (GP) have a key role to play in the care of dying patients. General practice is defined by the continuity of care and trusting long-term doctor-patient relationships. This means that general practitioners are well placed to provide quality end of life care to patients. This research explores the feasibility and acceptability of a general practice based case-finding approach to care planning of patients nearing the end of life. General practices will be recruited to test the accuracy of GPs clinical acumen in predicting which of their patients will die in the next 6 months. A number of practices will make use of a clinical prediction tool in addition to the GPs clinical acumen to see whether this improves the accuracy of prognostication. The findings of the project will help to determine the best way of identifying patients who are in need of end of life care planning. Our aim is to use the data gathered from this study as a springboard into developing a solid evidence-based intervention that could be used in general practice to identify and plan the care of patients who are nearing the end of life.
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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
38270
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Dr Joel Rhee
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Address
38270
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School of Public Health and Community Medicine
The University of New South Wales
UNSW Sydney, NSW 2052
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Country
38270
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Australia
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Phone
38270
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+61 2 9385 3502
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Fax
38270
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Email
38270
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[email protected]
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Contact person for public queries
Name
38271
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Joel Rhee
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Address
38271
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School of Public Health and Community Medicine
The University of New South Wales
UNSW Sydney, NSW 2052
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Country
38271
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Australia
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Phone
38271
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+61 2 9385 3502
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Fax
38271
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Email
38271
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[email protected]
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Contact person for scientific queries
Name
38272
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Joel Rhee
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Address
38272
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School of Public Health and Community Medicine
The University of New South Wales
UNSW Sydney, NSW 2052
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Country
38272
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Australia
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Phone
38272
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+61 2 9385 3502
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Fax
38272
0
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Email
38272
0
[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.
Download to PDF