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Trial registered on ANZCTR
Registration number
ACTRN12619000942156
Ethics application status
Approved
Date submitted
14/05/2019
Date registered
5/07/2019
Date last updated
5/07/2019
Date data sharing statement initially provided
5/07/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
The feasibility of Enteral Nutrition (EN) support in Allogeneic Haematopoietic Stem Cell Transplantation.
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Scientific title
The feasibility of enteral nutrition support in patients undergoing Allogeneic Haematopoietic Stem Cell Transplantation.
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Secondary ID [1]
298168
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None
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Universal Trial Number (UTN)
U1111-1233-3418
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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:
Hematologic Neoplasms
312733
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Enteral Nutrition
312817
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Condition category
Condition code
Cancer
311315
311315
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0
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Leukaemia - Acute leukaemia
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Cancer
311316
311316
0
0
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Leukaemia - Chronic leukaemia
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Cancer
311317
311317
0
0
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study aims to determine whether enteral feeding is tolerated post allogeneic stem cell transplant. Patients will be recruited to the study during a pre-transplant appointment with the Transplant CNC and eligible participants will be consented and randomised into the intervention or control group.
The control group will receive standard nutrition practice throughout their admission, i.e. exclusive oral intake unless unable to tolerate and then Parenteral Nutrition will be considered.
The intervention group will receive continuous nasogastric enteral feeds in addition to standard nutrition practice. A fine-bore nasogastric feeding tube will be inserted on Day 0 of the transplant by a medical officer or accredited nurse. A standard polymeric feed formula (Isosource Protein Fibre, 1.3kcal/mL) will be administered by an enteral feeding pump that is set up by nursing staff. Enteral feeds will commence on Day +1 of the transplant at a rate of 20mL/hr for 24 hours continuously. If the feeds are tolerated, the rate will be increased by 10mL/day to a goal rate of 40mL/hr. The amount of enteral feed administered will be recorded by nursing staff within the electronic fluid balance chart and this will be monitored by the primary investigator to determine adherence to the intervention. Enteral feeds will remain at this rate throughout the patient’s admission and will be ceased once engraftment has occurred and the patient is meeting 60-75% of their nutrition requirements via oral intake.
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Intervention code [1]
314455
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Treatment: Other
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Comparator / control treatment
The control group will receive standard nutrition practice throughout their admission, i.e. exclusive oral intake unless unable to tolerate and then Parenteral Nutrition will be considered.
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Control group
Active
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Outcomes
Primary outcome [1]
320047
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The severity of gastrointestinal symptoms measured using the Memorial Symptom Assessment Scale, a paper-based questionnaire to be completed by the patient.
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Assessment method [1]
320047
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Timepoint [1]
320047
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Assessed at baseline (Day 0 transplant), Day 7, Day 14, Day 21 and Day 28
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Primary outcome [2]
320600
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The percentage of total possible amount of enteral feeds delivered, assessed by referring to the electronic fluid balance chart completed by nursing staff within the patient's medical record.
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Assessment method [2]
320600
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Timepoint [2]
320600
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Assessed on discharge.
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Secondary outcome [1]
370365
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Oral intake, determined by speaking with the patient and completing a food chart to capture 24 hours of oral intake
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Assessment method [1]
370365
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Timepoint [1]
370365
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Will be assessed at baseline (Day 0 transplant), Day 7, Day 14, Day 21 and Day 28.
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Secondary outcome [2]
371172
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Neutrophil and platelet engraftment; determined by liaising with the medical/transplant team and consulting biochemical markers (including neutrophil and platelet count, measured daily within routine blood tests)
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Assessment method [2]
371172
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Timepoint [2]
371172
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Will be assessed on discharge
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Secondary outcome [3]
371173
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Post transplant complications (including Graft Versus Host Disease); determined by liaising with the medical/transplant team
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Assessment method [3]
371173
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Timepoint [3]
371173
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Will be assessed on discharge
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Secondary outcome [4]
371174
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Length of hospital stay
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Assessment method [4]
371174
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Timepoint [4]
371174
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Will be assessed on discharge by determining the duration of inpatient hospital stay with the day of transplant considered as day 0 until the day of discharge, using data linkage to medical records.
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Secondary outcome [5]
371175
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Prescence of mucositis; according to the World Health Organisation levels of mucositis
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Assessment method [5]
371175
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Timepoint [5]
371175
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Will be assessed at baseline (Day 0 transplant), Day 7, Day 14, Day 21 and Day 28.
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Secondary outcome [6]
371176
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Nutritional Status; determined using the Patient Generated Subjective Global Assessment (PGSGA)
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Assessment method [6]
371176
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Timepoint [6]
371176
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Will be assessed at baseline (Day 0 transplant), Day 7, Day 14, Day 21 and Day 28.
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Secondary outcome [7]
371248
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Quality of life; determined by using the SF-36 quesitonnaire
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Assessment method [7]
371248
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Timepoint [7]
371248
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Will be assessed at baseline (Day 0 transplant), Day 7, Day 14, Day 21 and Day 28.
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Eligibility
Key inclusion criteria
Patients undergoing an initial MAC or RIC allogeneic stem cell transplant for a Haematological Malignancy
Patients >18 years old
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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
Patients who have previously received a MAC or RIC allogeneic stem cell transplant
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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)
Randomization will be conducted through adhering to the allocation concealment and permuted block randomization method.
5 cards labeled ‘intervention’ and 5 cards labeled ‘control’ will be placed in opaque envelopes. Envelopes will then undergo block randomization and positioned in a box. The Chief Investigator will open an envelope after consenting a participant and assign the participant to the relevant group.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
29/05/2019
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Date of last participant enrolment
Anticipated
16/05/2020
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Actual
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Date of last data collection
Anticipated
16/06/2020
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Actual
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Sample size
Target
10
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Accrual to date
1
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment postcode(s) [1]
26479
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2050 - Camperdown
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Funding & Sponsors
Funding source category [1]
302703
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Hospital
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Name [1]
302703
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Sydney Local Health District (specifially Royal Prince Alfred Hospital; Nutrition & Dietetics Department) will be providing the enteral feeds and funding staff time as part of their standard practice
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Address [1]
302703
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Royal Prince Alfred Hospital, Nutrition & Dietetics Department - Building 12, Corner of Missenden Road & Grose Street, CAMPERDOWN NSW 2050
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Country [1]
302703
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Australia
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Primary sponsor type
Individual
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Name
Shannon Petrovic
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Address
Royal Prince Alfred Hospital,Nutrition & Dietetics Department, Building 12, Corner of Missenden Road & Grose Street, CAMPERDOWN NSW 2050
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Country
Australia
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Secondary sponsor category [1]
302701
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None
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Name [1]
302701
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Address [1]
302701
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Country [1]
302701
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
303313
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Sydney Local Health District Ethics Review Committee (RPAH Zone)
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Ethics committee address [1]
303313
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RESEARCH ETHICS AND GOVERNANCE OFFICE ROYAL PRINCE ALFRED HOSPITAL CAMPERDOWN NSW 2050
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Ethics committee country [1]
303313
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Australia
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Date submitted for ethics approval [1]
303313
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Approval date [1]
303313
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02/05/2019
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Ethics approval number [1]
303313
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Summary
Brief summary
The purpose of this study is to determine whether enteral feeding (via a tube through the mouth to the stomach) is tolerated post allogeneic Haematopoietic stem cell transplant. Who is it for? Patients 18 and over that have been diagnosed with a haematological malignancy and are planned for an initial allogeneic haematopoietic stem cell transplant. Study details: Patients will be recruited to the study during a pre-transplant appointment with the Transplant clinical nurse consultant (CNC) and eligible patients will be consented and randomly allocated (by chance) to the intervention or control group. The study will examine the feasibility of using enteral feeding post transplant. Following transplantation, both groups will continue with standard nutrition practice, by eating and drinking orally as tolerated. If patients are unable to tolerate oral intake, Parenteral Nutrition may be considered. One group (the intervention group) will also have a nasogastric tube inserted on the day of the transplant and will receive enteral feeds throughout the patient's admission. The rate of feed will start at 20mL/hr for 24 hours continuously and will be increased by 10mL/day to a goal rate of 40mL/hr. Enteral feeds will cease once the patient is meeting 60-75% of their nutrition requirements via their oral intake and they have engrafted. It is hoped that this study will assist in better addressing the optimal use of nutrition support to improve outcomes post transplant.
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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
93234
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Miss Shannon Petrovic
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Address
93234
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Royal Prince Alfred Hospital, Nutrition & Dietetics Department, Building 12, Corner of Missenden Road & Grose Street, CAMPERDOWN NSW 2050
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Country
93234
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Australia
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Phone
93234
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+61 2 9515 8053
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Fax
93234
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Email
93234
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[email protected]
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Contact person for public queries
Name
93235
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Shannon Petrovic
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Address
93235
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Royal Prince Alfred Hospital, Nutrition & Dietetics Department, Building 12, Corner of Missenden Road & Grose Street, CAMPERDOWN NSW 2050
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Country
93235
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Australia
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Phone
93235
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+61 2 9515 8053
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Fax
93235
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Email
93235
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[email protected]
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Contact person for scientific queries
Name
93236
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Shannon Petrovic
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Address
93236
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Royal Prince Alfred Hospital, Nutrition & Dietetics Department, Building 12, Corner of Missenden Road & Grose Street, CAMPERDOWN NSW 2050
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Country
93236
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Australia
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Phone
93236
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+61 2 9515 8053
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Fax
93236
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Email
93236
0
[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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