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Trial registered on ANZCTR
Registration number
ACTRN12616001724460
Ethics application status
Approved
Date submitted
13/12/2016
Date registered
16/12/2016
Date last updated
19/08/2019
Date data sharing statement initially provided
19/08/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Tele-rehabilitation for the arm after stroke.
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Scientific title
A tele-rehabilitation program for the upper limb after stroke.
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Secondary ID [1]
290752
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None
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Universal Trial Number (UTN)
U1111-1190-9286
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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:
Stroke
301342
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Condition category
Condition code
Stroke
301113
301113
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0
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Haemorrhagic
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Stroke
301114
301114
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0
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Ischaemic
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Physical Medicine / Rehabilitation
301115
301115
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0
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Occupational therapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Chronic stroke survivors will be given in-home based tele-rehabilitation to actively exercise the affected upper limb for one hour, 5 days per week for 8 weeks using inexpensive, commercially available devices (AbleX or AbleM, ImAble Ltd NZ), These will enable participants to play computer games that encourage arm use.. The program will be supervised over the internet by an experienced occupational therapist who will control the level of difficulty of the games and progress them as required..
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Intervention code [1]
296657
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Rehabilitation
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Intervention code [2]
296675
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Treatment: Devices
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Comparator / control treatment
A commercially available on-line cognitive training program, Fit Brains, will be the active control intervention. Participants will undertake training for one hour, 5 days per week for 8 weeks. They will be supervised by an experienced occupational therapist who will monitor their progress on-line.
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Control group
Active
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Outcomes
Primary outcome [1]
300508
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Arm Function, assessed using the Action Research Arm Test
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Assessment method [1]
300508
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Timepoint [1]
300508
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8 weeks
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Secondary outcome [1]
330157
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Hand grip force using a Jamar dynamometer
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Assessment method [1]
330157
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Timepoint [1]
330157
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8 weeks
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Secondary outcome [2]
330158
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Pinch force using a Jamar pinch dynamometer
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Assessment method [2]
330158
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Timepoint [2]
330158
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8 weeks
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Secondary outcome [3]
330159
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Cognitive Function using the Trail Making Test
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Assessment method [3]
330159
0
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Timepoint [3]
330159
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8 weeks
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Secondary outcome [4]
330160
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Montreal Cognitive Assessment
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Assessment method [4]
330160
0
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Timepoint [4]
330160
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8 weeks
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Secondary outcome [5]
330161
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Community Integration Measure
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Assessment method [5]
330161
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Timepoint [5]
330161
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8 weeks
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Secondary outcome [6]
330162
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Modified Caregiver Strain Index
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Assessment method [6]
330162
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Timepoint [6]
330162
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8 weeks
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Secondary outcome [7]
330202
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Quality of Life using the EQ-5D-5L
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Assessment method [7]
330202
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Timepoint [7]
330202
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8 weeks
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Secondary outcome [8]
330203
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Health Utilities Index Mark III
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Assessment method [8]
330203
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Timepoint [8]
330203
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8 weeks
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Eligibility
Key inclusion criteria
1. Impaired function of the affected upper limb
2. Unilateral hemiparesis resulting from stroke affecting only one side (haemorrhage or infarct) at least 6 months prior to enrolment (lesion confirmed by CT or MRI where possible)
3. Level of cognitive function within normal limits (score above 8) on the Abbreviated Mental Test Score
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Minimum age
18
Years
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Maximum age
80
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. Severe cognitive deficits
2. Severe receptive aphasia
3. Uncontrolled epilepsy
4. Serious progressive illness
5. Currently receiving any type of formal upper limb therapy.
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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)
Central randomisation by off-site adminstrator
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation, with stratification by level of impairment (severe vs moderate or mild) and chronicity (6-12 months post-stroke vs >12 months post-stroke).
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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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
The primary outcome will be analysed using a mixed-effect multilevel linear regression model with the change in Action Research Arm Test (ARAT) score following an intervention as the dependent variable, the nature of the intervention (tele-rehabilitation vs active control) as the independent variable, baseline ARAT score, impairment level and chronicity as covariates, and patient as a random effect (level) variable.
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Recruitment
Recruitment status
Suspended
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Date of first participant enrolment
Anticipated
19/12/2016
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Actual
19/12/2016
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Date of last participant enrolment
Anticipated
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Actual
20/09/2017
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
180
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Accrual to date
9
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
7131
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Royal Melbourne Hospital - Royal Park campus - Parkville
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Recruitment postcode(s) [1]
14892
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3052 - Parkville
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Funding & Sponsors
Funding source category [1]
295178
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Hospital
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Name [1]
295178
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Royal Melbourne Hospital
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Address [1]
295178
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Grattan Street
Parkville VIC 3050
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Country [1]
295178
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Australia
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Primary sponsor type
Hospital
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Name
Royal Melbourne Hospital
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Address
Grattan Street
Parkville, VIC 3050
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Country
Australia
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Secondary sponsor category [1]
294007
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None
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Name [1]
294007
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Address [1]
294007
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Country [1]
294007
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296527
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Melbourne Health Human Research Ethics Committee
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Ethics committee address [1]
296527
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c/- Royal Melbourne Hospital Grattan Street Parkville VIC 3050
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Ethics committee country [1]
296527
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Australia
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Date submitted for ethics approval [1]
296527
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25/07/2016
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Approval date [1]
296527
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30/08/2016
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Ethics approval number [1]
296527
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HREC/16/MH/236
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Summary
Brief summary
Stroke is a major cause of disability worldwide, with 5 million people left permanently disabled. In Australia, total lifetime cost burden of first-ever stroke was estimated to be more than A$2 billion. A large contribution of these costs result from out-of-pocket expenses, informal care, and productivity losses associated with stroke. Loss of upper limb function contributes significantly to stroke-related disability and reduced independence. Functional recovery of the paretic upper limb after stroke continues to be one of the greatest challenges faced by rehabilitation staff. Yet despite a wealth of research showing that recovery of function is driven by repetitive task-specific training, rehabilitation of the arm and hand is given lower priority than retraining of walking. The major barriers include limited rehabilitation resources, difficulties with travel to rehabilitation facilities, and, for more severely impaired patients, the need for external assistance or guidance. We now propose to conduct a randomised controlled trial of in-home based tele-rehabilitation to actively exercise the affected upper limb in chronic stroke survivors using inexpensive, commercially available devices that enable participants to play computer games that encourage arm use and that can be progressed in level of difficulty. An on-line cognitive training program will be the active control intervention. We have previously shown that use of such devices in a centre-based program leads to improved arm function and quality of life. A parallel cost-effectiveness study will be conducted. If this intervention is found to be effective and cost-effective, it could be readily implemented as a practical, inexpensive, and motivating program of upper limb rehabilitation for stroke survivors in their own homes.
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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
71170
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Prof Mary Galea
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Address
71170
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Department of Medicine (Royal Melbourne Hospital)
The University of Melbourne
Parkville VIC 3010
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Country
71170
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Australia
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Phone
71170
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+61 3 8387 2017
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Fax
71170
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Email
71170
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[email protected]
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Contact person for public queries
Name
71171
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Mary Galea
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Address
71171
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Department of Medicine (Royal Melbourne Hospital)
The University of Melbourne
Parkville VIC 3010
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Country
71171
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Australia
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Phone
71171
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+61 3 8387 2017
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Fax
71171
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Email
71171
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[email protected]
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Contact person for scientific queries
Name
71172
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Mary Galea
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Address
71172
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Department of Medicine (Royal Melbourne Hospital)
The University of Melbourne
Parkville VIC 3010
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Country
71172
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Australia
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Phone
71172
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+61 3 8387 2017
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Fax
71172
0
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Email
71172
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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)?
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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
No additional documents have been identified.
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