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Trial registered on ANZCTR
Registration number
ACTRN12620000443998p
Ethics application status
Submitted, not yet approved
Date submitted
31/03/2020
Date registered
6/04/2020
Date last updated
6/04/2020
Date data sharing statement initially provided
6/04/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Home rehabilitation for people with COVID-19: Implementing telehealth approaches to care
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Scientific title
Home telerehabilitation for people with COVID-19: Implementing telehealth approaches to care and its effect on reintegration into the community
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Secondary ID [1]
300885
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Nil known
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Universal Trial Number (UTN)
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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:
COVID-19
316820
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Requiring home rehabilitation service
316912
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Condition category
Condition code
Public Health
315028
315028
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0
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Health service research
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Physical Medicine / Rehabilitation
315039
315039
0
0
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Other physical medicine / rehabilitation
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Infection
315087
315087
0
0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The primary aim of this study is to evaluate the efficacy and efficiency of two telerehabilitation interventions. The intervention consists of a rehabilitation intervention which focuses more on participation in usual activities and is offered via a coaching model to a virtual group of people. The intervention components are: identifying patient goals with therapist (1:1); and participation in virtual groups (up to 4 participants per session) with physiotherapist and occupational therapists which focus on increasing participation in life roles and usual activities.
The 1:1 session will last for approximately 45 minutes and will be followed by commencement of group sessions within 5 days.
Groups adopt a coaching model where the therapist talks about common challenges, facilitates discussion and sharing of experiences and ideas and the group brainstorm and plan next steps together. The group sessions will last approximately 45 minutes and will be delivered 3 times per week for up to 4 weeks.
Adherence will be measured using attendance logs.
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Intervention code [1]
317211
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Rehabilitation
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Intervention code [2]
317246
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Treatment: Other
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Comparator / control treatment
The control/ usual care group consists of a traditional model which is predominantly focused on improving physical function and is offered as usual care by the home rehabilitation service. The intervention components are: patient goals identified with therapist (1:1); input as required from physiotherapist, occupational therapist and allied health assistants; telehealth consultations focused on improving physical function through exercise and modifying activities of daily living to enhance independence.
The 1:1 session will last for approximately 45 minutes and will be followed by commencement of therapy sessions within 5 days.
The therapy sessions will last approximately 45 minutes and will be delivered 3 times per week for up to 4 weeks. The sessions will consist of low to moderate intensity exercises (such as functional activities, or sit-to stand exercises) and are monitored by physiotherapist, No group sessions are planned for participants in the standard care arm.
Adherence will be measured using attendance logs.
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Control group
Active
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Outcomes
Primary outcome [1]
323334
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Integration to community as measured on the Reintegration to Normal Living Index (RNLI) - A 11-item questionnaire-based instrument that measures the degree to which individuals achieve reintegration into normal social activities (such as recreation, movement in the community, and interaction in family or other relationships).
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Assessment method [1]
323334
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Timepoint [1]
323334
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Baseline,
Three (3) months following baseline assessment.
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Secondary outcome [1]
381599
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Level of frailty as identified on the FRAIL scale - A five-question test that can increase the identification of frailty without a face-to-face examination.
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Assessment method [1]
381599
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Timepoint [1]
381599
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Baseline,
Three (3) months following baseline assessment.
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Secondary outcome [2]
381600
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Quality of life as measures on the EQ-5D – a five-dimensional questionnaire used for measuring health-related quality of life for the estimation of quality-adjusted life years within economic evaluations.
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Assessment method [2]
381600
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Timepoint [2]
381600
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Baseline,
Three (3) months following baseline assessment.
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Secondary outcome [3]
381601
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Functional Independence Measure
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Assessment method [3]
381601
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Timepoint [3]
381601
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Baseline,
Three (3) months following baseline assessment.
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Secondary outcome [4]
381603
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Average cost of services/intervention delivered per participant, calculated based on the purchase price of telehealth hardware and therapist time for each client (including set up time).
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Assessment method [4]
381603
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Timepoint [4]
381603
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Baseline,
Three (3) months following baseline assessment.
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Secondary outcome [5]
381605
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Adverse events such as falls assessed by observation during therapy session or self-reports.
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Assessment method [5]
381605
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Timepoint [5]
381605
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Three (3) months from baseline.
twelve (12) months from baseline.
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Secondary outcome [6]
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Re-admissions as assessed by checking of participant medical records.
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Assessment method [6]
381724
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Timepoint [6]
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Three (3) months from baseline.
twelve (12) months from baseline.
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Eligibility
Key inclusion criteria
Any person aged 18 or older, confirmed with COVID-19 referred to home rehabilitation services delivered at Flinders medical Centre through the division of rehabilitation, aged and palliative care.
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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
Prospective participants are excluded from the study if they decline the offer to participate in the study experimental arm.
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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)
Allocation concealment will be done by using sequentially numbered opaque, sealed envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The randomisation sequence will be generated using an online computer randomisation software program.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
N/A
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Based on the Australian study published by Fairhall et al. (2011) which reported data on 181 frail older people who completed the Reintegration to Normal Living Index it was calculated that a sample size of 52 participants (26 per group) would be required. This is based on a mean of 22.2 and standard deviation of 4.31 in recently discharged frail older adults with alpha 0.05 and power at 80%. This study will allow for 10% drop out and therefore recruit 58 participants.
Standard descriptive statistics such as mean and SD or median and range for continuous variables and proportions for categorical variables will be reported, as well as a comparison of means and proportions using t-tests, chi-square tests or fishers exact test as appropriate . Regression analyses where the independent variable will be the allocated condition, and the dependent variable will be the outcomes following intervention (such as FIM score) will be used.
Recruitment data will be reported descriptively. Attendance (in rehabilitation sessions) data will be analysed descriptively in order to explore the number of sessions attended by participants. Characteristics of participants will be presented in a table. Process information (such as intervention processes), information about the telehealth equipment used and the need for technical support) will be presented narratively.
Costs will be calculated based on the costs of telehealth hardware for each person and the costs of providing the intervention for each participant. Staff time based on the time spent with each client and costs and hourly therapist wages will also be calculated. This information is not intended to provide a definitive cost of providing the intervention but will inform the larger planned study.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/05/2020
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Actual
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Date of last participant enrolment
Anticipated
31/12/2020
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
58
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
16180
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Flinders Medical Centre - Bedford Park
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Recruitment postcode(s) [1]
29723
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5042 - Bedford Park
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Funding & Sponsors
Funding source category [1]
305338
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University
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Name [1]
305338
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Flinders University
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Address [1]
305338
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College of Medicine and Public Health
Division of Rehabilitation, Aged and Palliative Care
Flinders Drive
Bedford park, SA, 5042
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Country [1]
305338
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Australia
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Primary sponsor type
Hospital
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Name
Flinders Medical Centre
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Address
Division of Rehabilitation, Aged and Palliative Care
Flinders Drive
Bedford park, SA, 5042
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Country
Australia
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Secondary sponsor category [1]
305705
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None
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Name [1]
305705
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Address [1]
305705
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Country [1]
305705
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
305671
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Southern Adelaide Clinical Human Research Ethics Committee
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Ethics committee address [1]
305671
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Ward 6C, Room 6A219 Flinders Medical Centre Flinders Drive, Bedford Park SA 5042
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Ethics committee country [1]
305671
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Australia
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Date submitted for ethics approval [1]
305671
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02/04/2020
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Approval date [1]
305671
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Ethics approval number [1]
305671
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Summary
Brief summary
The aim of this study is to evaluate the efficacy and efficiency of two telerehabilitation interventions: 1) traditional model which is predominantly focuses on improving physical function and is currently offered as usual care by the home rehabilitation service: 2) a rehabilitation intervention which focuses more on participation in usual activities and is offered via a coaching model to a virtual group of people. Both interventions are provided in a telehealth format as a response to the global pandemic, COVID-19. The purpose is to determine whether the novel intervention is more effective as well as if it is more efficient (as it is offered in a virtual group format). We plan to recruit 58 participants who have been confirmed with COVID-19 and referred to home rehabilitation services at Flinders Medical Centre Division of Rehabilitation Aged and Palliative care. At the completion of the study, we expect to be able to describe the functional and social impacts of a telerehabilitation interventions for individuals confirmed with COVID-19 receiving home rehabilitation services.
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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
101170
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Prof Maria Crotty
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Address
101170
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Division of Rehabilitation, Aged and Palliative Care; Flinders Medical Centre,
Flinders Dr,
Bedford Park SA 5042
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Country
101170
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Australia
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Phone
101170
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+61 8 8404 2232
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Fax
101170
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Email
101170
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[email protected]
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Contact person for public queries
Name
101171
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Kate Laver
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Address
101171
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Division of Rehabilitation, Aged and Palliative Care; Flinders Medical Centre,
Flinders Dr,
Bedford Park SA 5042
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Country
101171
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Australia
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Phone
101171
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+61 8 7221 8335
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Fax
101171
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Email
101171
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[email protected]
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Contact person for scientific queries
Name
101172
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Maria Crotty
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Address
101172
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Division of Rehabilitation, Aged and Palliative Care; Flinders Medical Centre,
Flinders Dr,
Bedford Park SA 5042
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Country
101172
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Australia
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Phone
101172
0
+61 8 8404 2232
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Fax
101172
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Email
101172
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
in order to maintain the confidentiality of the participants, personal identifying information will not be available at data analysis and only group level results will be published/ disseminated.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
7466
Study protocol
[email protected]
379528-(Uploaded-30-03-2020-14-27-09)-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