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Trial registered on ANZCTR
Registration number
ACTRN12619001032145p
Ethics application status
Submitted, not yet approved
Date submitted
1/05/2019
Date registered
18/07/2019
Date last updated
18/07/2019
Date data sharing statement initially provided
18/07/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of nebulised furosemide on breathlessness and cough in interstitial lung disease: a pilot study
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Scientific title
Effect of nebulised furosemide on breathlessness and cough in interstitial lung disease: a pilot study
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Secondary ID [1]
298087
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Nil
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Universal Trial Number (UTN)
U1111-1232-5016
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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:
Interstitial Lung Disease
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Condition category
Condition code
Respiratory
311108
311108
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This pilot study will seek to recruit volunteers with interstitial lung disease (ILD) experiencing significant cough and dyspnoea. These volunteers will be administered a single dose of nebulised furosemide (80mg) in the context of exercise induced dyspnoea, with a dose of nebulised normal saline of equivalent milliliters being used as a control. The order of the administration of these nebulised agents will be randomised, and both participants and researchers will be blinded to nebulised agent order. The nebulised agents will be administered by a study doctor (these are medical registrars, advanced trainees in respiratory medicine or respiratory specialists) immediately prior to exercise, i.e. exercise testing will commence immediately after completion of nebulised agent administration. This will take place in either the outpatient clinic or respiratory function testing laboratory of the John Hunter Hospital. The exercise testing referred to is the 6 minute walk test (6MWT). The 6MWT is a exercise testing tool developed by the American thoracic society, which is used both clinically and in research to assess functional exercise capacity. As the name implies, the test assesses the distance which a participant can walk over a 6 minute period.
The second nebulised agent will be given a minimum of 3 days after the first to allow a sufficient wash out period.
The response of the participants’ cough and dyspnoea to the administration of both nebulised furosemide and normal saline will be recorded and compared.
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Intervention code [1]
314317
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Treatment: Drugs
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Comparator / control treatment
Nebulised normal saline (8ml) will be used as a control
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The primary dyspnoea end point will be the area under the curve for Borg scores in the first 5 minutes after the 6 minute walk test.
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Assessment method [1]
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Timepoint [1]
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Area under the curve of Borg scores 5 minutes following walk test. Note that Borg scores will be taken every 30 seconds for the first 5 minutes after the 6 minute walk test is completed.
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Primary outcome [2]
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The primary cough end point will be the area under the curve for cough VAS scores in the 6.5 hours after the 6 minute walk test
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Assessment method [2]
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Timepoint [2]
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Area under the curve for cough VAS score in the 6.5 hours after the 6 minute walk test. Note cough VAS will be recorded immediately after completion of 6MWT, then 30 minutes after completion of the 6 minute walk test, then hourly for 6 hours.
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Secondary outcome [1]
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Area under the curve of dyspnoea visual analogue scores for a variety of time points
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Assessment method [1]
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Timepoint [1]
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Over 6.5 hours following 6 minute walk test. Note that Dyspnoea visual analogue scores will be taken every 30 seconds for the first 5 minutes after the 6 minute walk test, every 1 minute for the next 10 minutes, then every 5 minutes for the next 15 minutes. Thereafter, the visual analogue score will be recorded every 1 hour for 6 hours.
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Secondary outcome [2]
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Area under the curve of Borg scores for a variety of time points
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Assessment method [2]
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Timepoint [2]
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Over 30 minutes following the 6 minute walk test. Scores will be taken every 30 seconds for the first 5 minutes after the 6 minute walk test, every 1 minute for the next 10 minutes, then every 5 minutes for the next 15 minutes.
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Secondary outcome [3]
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Area under the curve for cough visual analogue scores for a variety of time points
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Assessment method [3]
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Timepoint [3]
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For 6.5 hours after 6 minute walk test. A cough visual analogue score is taken 30 minutes after completion of the 6 minute walk test, then every 1 hour for 6 hours.
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Secondary outcome [4]
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Cough monitor scores
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Assessment method [4]
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Timepoint [4]
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For 6.5 hours after 6 minute walk test. The cough monitor is worn and recording continuously over this 6.5 hour period to record participants' coughing. The number of times the participant coughs over this 6.5 hour period can then be counted using the recording obtained.
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Eligibility
Key inclusion criteria
Age > 18 years
Confirmed physician diagnosis of an interstitial lung disease
Medical research council dyspnoea scale of 3-5
Cough visual analogue scale >4cm
FVC >=30% predicted
DLCO >=20% predicted
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Minimum age
18
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
Current smoker
Clinical history of asthma or vocal cord dysfunction
Currently pregnant or breastfeeding
Any clinically significant cardiopulmonary abnormalities not related to ILD, including features of congestive cardiac failure on examination or history suggestive of uncontrolled ischaemic heart disease.
Any clinically significant neurological, renal, endocrine, gastrointestinal, hepatic or haematological abnormalities uncontrolled with standard treatment
History of psychiatric, medical or surgical disorders that may interfere with study
Clinical history suggestive of respiratory infection in month preceding study
Alcohol or recreational drug abuse
Inability to understand directions for study assessment, including inability to comprehend English language.
Inability to complete questionnaires required for the study, including visual analogue scales.
Inability to be contacted in case of emergency
Participation in another study at the same time or within a prior 3-month period
Regular use of short or long-acting opioids, pregabalin or gabapentin.
Inability to complete a 6 minute walk test
Allergy or significant adverse reaction to furosemide
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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 computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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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 administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Crossover
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Other design features
Note that this study is a pilot study only, therefore is only recruiting 12 participants. A sample size of 12 participants was chosen based upon the work by Julious, which demonstrates that 12 is the optimal number of participants for a pilot cross-over trial for both feasibility and for gains in precision in the mean and variance. The data from the 12 participants in the pilot study will be used to inform a formal sample size calculation for any future study.
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The primary end point and secondary end points will be evaluated as paired non parametric data for statistical analysis using the Wilcoxan signed rank test.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
5/08/2019
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Actual
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Date of last participant enrolment
Anticipated
5/08/2020
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Actual
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Date of last data collection
Anticipated
10/08/2020
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Actual
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Sample size
Target
12
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
13661
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John Hunter Hospital - New Lambton
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Recruitment postcode(s) [1]
26343
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2305 - New Lambton
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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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John Hunter Hospital Respiratory Trust Fund
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Address [1]
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John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, Australia, 2305
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Hunter New England Health
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Address
c/o Chair of Human Ethics Committee, John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, Australia, 2305
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
302530
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Country [1]
302530
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
303250
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
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c/o John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, Australia, 2305
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Ethics committee country [1]
303250
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Australia
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Date submitted for ethics approval [1]
303250
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01/05/2019
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Approval date [1]
303250
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Ethics approval number [1]
303250
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Summary
Brief summary
This pilot randomised crossover study will seek to recruit volunteers with interstitial lung disease experiencing significant cough and dyspnoea. These volunteers will be administered nebulised furosemide in the context of exercise induced dyspnoea, with nebulised normal saline being used as a control. The response of the participants’ cough and dyspnoea to the administration of these agents will be recorded and compared. It is our hypothesis that the administration of nebulised furosemide will symptomatically improve the cough and dyspnoea experienced.
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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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A/Prof Christopher Grainge
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Address
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Dept Respiratory Medicine, John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, Australia, 2305
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Country
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Australia
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Phone
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+61 2 49855043
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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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Christopher Grainge
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Address
93011
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Dept Respiratory Medicine, John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, Australia. 2305
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Country
93011
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Australia
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Phone
93011
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+61 2 49855043
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
93012
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Christopher Grainge
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Address
93012
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Dept Respiratory Medicine, John Hunter Hospital, Lookout Road, New Lambton Heights. NSW, Australia, 2305
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Country
93012
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Australia
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Phone
93012
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+61 2 49855043
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Fax
93012
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Email
93012
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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)?
Yes
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What data in particular will be shared?
Individual participant data underlying published results only, will be shared after de-identification
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When will data be available (start and end dates)?
Start date of IPD availability: 6 months after last patient visit
End date of IPD availability: No end date
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Available to whom?
only researchers who provide a methodologically sound proposal
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Available for what types of analyses?
for discussion on case by case basis
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How or where can data be obtained?
access subject to approvals by Principal Investigator, requirement to sign data access agreement
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
1971
Study protocol
377488-(Uploaded-15-07-2019-15-57-00)-Study-related document.doc
1972
Informed consent form
377488-(Uploaded-15-07-2019-15-11-10)-Study-related document.docx
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