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Trial registered on ANZCTR
Registration number
ACTRN12617001018303
Ethics application status
Approved
Date submitted
11/07/2017
Date registered
14/07/2017
Date last updated
22/08/2022
Date data sharing statement initially provided
22/08/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
The CHAmPION Trial - A comparison of two types of regional anaesthesia for post-operative pain in patients having hepatobiliary and pancreatic surgery
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Scientific title
The effect of Continuous subcostal transversus abdominis plane block on post-operative pain in HepAtobiliary and Pancreatic surgery patients compared to Intrathecal mOrphiNe
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Secondary ID [1]
292409
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None
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Universal Trial Number (UTN)
U1111-1199-1395
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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:
Post-operative pain
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Hepatobiliary surgery
303990
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Pancreatic surgery
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Condition category
Condition code
Anaesthesiology
303329
303329
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0
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Pain management
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Surgery
303341
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Abdominal wall regional anesthesia in the form of local anaesthetic bolused via ultrasound placed subcostal transversus abdominis plane (S-TAP) catheters, after open hepatobiliary and pancreatic surgery. This will be administered immediately at completion of surgery while patient is still in the operating room.
Detailed description of technique:
Spinal with 2ml of 0.5% bupivacaine plus 0.3mL saline + Surgically placed TAP and rectus sheath catheters, each with a 30ml (to a maximum 1mL/kg) hand bolus of 0.2% ropivacaine at the end of surgery, followed by 20mL (to a maximum 0.65mL/kg) of 0.2% ropivacaine every 4 hours via a CADD®Solis pump for 72hours.
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Intervention code [1]
298578
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Treatment: Drugs
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Comparator / control treatment
The intervention will be compared with the current standard of care, which is intrathecal morphine (ITM) for post-operative pain relief for hepatobiliary and pancreatic surgery. This will be administered immediately at completion of surgery while patient is still in the operating room.
Detailed description of control technique:
Spinal anaesthetic with 2ml of 0.5% bupivacaine plus 150mcg intrathecal morphine + Surgically placed TAP and rectus sheath catheters, each with a 30mL (to a maximum 1mL/kg)) hand bolus of saline at the end of surgery, followed by 20mL (to a maximum 0.65mL/kg) of saline every 4 hours via a CADD®Solis pump for 72hours.
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Control group
Active
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Outcomes
Primary outcome [1]
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Post-operative pain intensity and interference measured by the modified pain brief inventory (mBPI) score (composite outcome)
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Assessment method [1]
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Timepoint [1]
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48 hours post-operatively, after the first abdominal catheter bolus
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Secondary outcome [1]
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mBPI intensity and interference scores (composite outcome)
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Assessment method [1]
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Timepoint [1]
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immediately post-op, 24 hours, 7 days, and 90 days after the first abdominal catheter bolus
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Secondary outcome [2]
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mBPI 'pain at its worst' score
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Assessment method [2]
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Timepoint [2]
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immediately post-op, 24 hours, 48 hours, 7 days, and 90 days after the first abdominal catheter bolus
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Secondary outcome [3]
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Total opioid requirements, referenced to total equipotent IV morphine dose collected from patient medical records.
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Assessment method [3]
336806
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Timepoint [3]
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At discharge from recovery, 24 hours, 48 hours, after the first abdominal catheter bolus
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Secondary outcome [4]
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Quality of recovery score using the Quality of Recovery-15 questionnaire
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Assessment method [4]
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Timepoint [4]
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48 hours after the first abdominal catheter bolus
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Secondary outcome [5]
336808
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Timed Up and Go test time
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Assessment method [5]
336808
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Timepoint [5]
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Within 48 to 72 hours of the first abdominal catheter bolus
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Secondary outcome [6]
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Disability free survival measured using the WHO-DAS 2.0 questionnaire score
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Assessment method [6]
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Timepoint [6]
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90 days post-opearatively
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Secondary outcome [7]
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Incidence of serious adverse drug reactions or serious adverse events through comprehensive adverse event reporting.
Serious adverse drug reaction or serious adverse event is defined by and untowards event that may be life-threatening, prolongs or requires hospitalisation, persistent or significant disability incapacity, fatal, or otherwise clinically important event determined by the investigator.
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Assessment method [7]
336810
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Timepoint [7]
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90 days post-operatively
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Eligibility
Key inclusion criteria
Patients undergoing open hepatobiliary and/or pancreatic surgery at Auckland City Hospital
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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) Contraindication to spinal block at the discretion of the treating anaesthetist, including coagulopathy (INR >/= 1.4 or platelets < 80 x 10^9/L) or abnormality precluding spinal block
2) Inability to identify with ultrasound the appropriate tissue planes for safe regional catheter placement
3) Patient refusal
4) Objection of the treating anaesthetist or surgeon for the patient to be enrolled into the study
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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 will be done by the use of sealed, opaque evelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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
Phase 3 / Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Suspended
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Date of first participant enrolment
Anticipated
1/09/2017
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Actual
30/01/2018
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Date of last participant enrolment
Anticipated
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Actual
3/04/2018
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Date of last data collection
Anticipated
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Actual
1/08/2018
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Sample size
Target
100
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Accrual to date
4
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
9045
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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A+ Trust
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Address [1]
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A+ Trust Office
Level 15
Support Building
Auckland City Hospital
Park Road
Grafton 1023
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Helen Lindsay
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Address
Department of Anaesthesia
Auckland City Hospital
2 Park Rd, Grafton
Auckland 1023
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
295966
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Address [1]
295966
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Country [1]
295966
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298165
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Southern Health and Disability Ethics Committee
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Ethics committee address [1]
298165
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
298165
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21/07/2017
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Approval date [1]
298165
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25/10/2017
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Ethics approval number [1]
298165
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17/STH/197
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Summary
Brief summary
This study aims to compare the efficacy and safety of two methods of pain relief after major abdominal surgery: intrathecal morphine (IT) standard of care verses abdominal wall regional anaesthesia. The abdominal wall regional anaesthesia is a bolus injection of local anaesthetic via ultrasound placed subcostal transversus abdominis plane (S-TAP) catheters. Although IT is the current standard practice for pain relief in this type of surgery, it has also been associated with significant complications including nausea, vomiting, respiratory depression, and hypotension. There is increasing evidence that S-TAP may be able to provide equally satisfactory pain relief and associated with fewer complications. However, no study has been conducted that comprehensively compared using multidimensional analysisto assess the pain control achieved, as well as safety, of these two techniques. This study is a randomised controlled triple blind control trial. Patients having open hepatobiliary and pancreatic (HPB) surgery at Auckland City Hospital will be randomised to receive either IT or S-TAP for pain relief after surgery. Subjects, treating physicians and investigator/outcome assessors will be blinded to the randomisation results. Patients will be followed up to assess: 1)Pain and analgesia requirement in the first 48 hours after surgery 2)Physical assessment using the Time Up and Go test at 72 hours after surgery 3) Pain assessment at 7 days after surgery 4) Change in disability free survival (WHO-DAS questionnaire)and pain assessment at 90 days after surgery The study also includes comprehensive adverse event reporting.
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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 Helen Lindsay
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Address
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Department of Anaesthesia
Level 8 Support Building
Auckland City Hospital
2 Park Rd, Grafton
Auckland, 1023
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Country
76194
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New Zealand
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Phone
76194
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+64 27 778 2061
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Fax
76194
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Email
76194
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[email protected]
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Contact person for public queries
Name
76195
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Davina McAllister
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Address
76195
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Department of Anaesthesia
Auckland City Hospital
Level 8 Support Building
2 Park Rd, Grafton
Auckland 1023
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Country
76195
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New Zealand
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Phone
76195
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+64 9 3757095
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Fax
76195
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Email
76195
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[email protected]
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Contact person for scientific queries
Name
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Helen Lindsay
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Address
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Department of Anaesthesia
Level 8 Support Building
Auckland City Hospital
2 Park Rd, Grafton
Auckland, 1023
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Country
76196
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New Zealand
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Phone
76196
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+64 27 778 2061
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Fax
76196
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Email
76196
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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
No additional documents have been identified.
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