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Trial registered on ANZCTR
Registration number
ACTRN12621000941864
Ethics application status
Approved
Date submitted
11/03/2021
Date registered
19/07/2021
Date last updated
19/07/2021
Date data sharing statement initially provided
19/07/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Methoxyflurane versus Nitrous Oxide: Which provides better pain relief in patients undergoing Trans-Vaginal Oocyte Retrieval (TVOR) with conscious sedation?
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Scientific title
Methoxyflurane versus Nitrous Oxide for analgesia in patients undergoing Trans-Vaginal Oocyte Retrieval (TVOR) with conscious sedation: A randomised, non blinded control trial
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Secondary ID [1]
303671
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None
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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:
Trans vaginal oocyte retrieval
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Condition category
Condition code
Reproductive Health and Childbirth
318875
318875
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0
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Fertility including in vitro fertilisation
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Anaesthesiology
318876
318876
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Assessing the effectiveness of self administered inhaled methoxyflurane 99.9% (3ml inhalation chamber device) versus Nitrous oxide 50%/ Oxygen 50% in providing procedural analgesia for patients undergoing trans vaginal oocyte retrieval. Patient will be given the allocated inhaled analgesia after identification checks have been completed, and a minimum of 1 minute prior to the start of the procedure, with inhalation ending immediately after the procedure is completed. The average time of transvaginal oocyte procedure is approximately 15-20 minutes.
Adherance to the intervention will be monitored via audit of the operation note, with study assessors asked to denote on the operation note if there have been any issues with compliance during the procedure.
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Intervention code [1]
319970
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Treatment: Drugs
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Comparator / control treatment
Nitrous oxide 50%/ oxygen 50% via a demand valve mouthpiece. Patients will be allowed to self administer as much or little of the treatment as desired for the duration of the procedure.
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Control group
Active
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Outcomes
Primary outcome [1]
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Pain measured on 100mm VAS
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Assessment method [1]
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Timepoint [1]
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Immediately post procedure and 15 minutes post procedure
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Secondary outcome [1]
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Side effects experienced will be assessed by a study specific patient questionnaire.
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Assessment method [1]
392769
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Timepoint [1]
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15 minutes Post procedure
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Secondary outcome [2]
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Oocyte number, which will be recorded on a study specific data collection sheet once the final count is determined by the embryologist.
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Assessment method [2]
392770
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Timepoint [2]
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In theatre, once the final number is determined by the embryologist, usually within 15 minutes post procedure
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Secondary outcome [3]
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Fertilization rate, which will be assessed via data linkage to patients medical records
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Assessment method [3]
392771
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Timepoint [3]
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One week post procedure
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Secondary outcome [4]
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Blastulation rate which will be assessed via data linkage to patients medical record
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Assessment method [4]
392772
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Timepoint [4]
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One week post procedure
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Secondary outcome [5]
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Clinical pregnancy rate which will be assessed via data linkage to patients medical record
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Assessment method [5]
392773
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Timepoint [5]
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6 weeks post procedure
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Secondary outcome [6]
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Length of procedure (from first puncture to scanner withdrawal) which will be recorded on a study specific data proforma
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Assessment method [6]
392774
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Timepoint [6]
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Immediately post procedure
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Eligibility
Key inclusion criteria
Women undergoing Transvaginal Oocyte Retrieval (TVOR) at The Fertility Centre Liverpool (TFCL) who have consented to partake in the study.
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Minimum age
18
Years
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Maximum age
47
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Women who have had previous adverse reaction or hypersensitivity to either agent, patients with contraindications to either medication including significant respiratory, renal or hepatic compromise, recent eye surgery using intraocular gas, patients who have taken part in the study previously and patients who request specific agents.
Of note, at TFC, as a low cost, low risk clinic our protocol dictates we do not treat patients with significant co morbidities or severe endometriosis
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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 involved contacting the holder of the computer generated allocation schedule who will be "off-site" with no clinical involvement
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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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Sample size calculation is based on a previous study by Bhattacharya et al, 1997, in which it was reported that the mean pain level scored on a visual analogue scale of 100mm during TVOR with conscious sedation was 46.1 with a standard deviation of 21.3. Assuming a difference in the mean of each treatment of zero, based on a previous study by porter et al comparing NO2 and MFO in a trauma setting and a non inferiority limit set at 15mm on the VAS, a sample size of 43 in each arm will be required to give a test significance of 0.025 and power of 0.8.
Statistical Analysis:
Continuous variables will be analysed using the Student’s t-test. Categorical variables will be analysed using the Fisher’s exact test. Data analysis will be performed using Microsoft Excel ver 16.35. Analysis of the data will included both intention to treat and as per protocol analysis.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
25/03/2021
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Date of last participant enrolment
Anticipated
1/10/2021
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Actual
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Date of last data collection
Anticipated
12/11/2021
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Actual
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Sample size
Target
86
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Accrual to date
21
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment postcode(s) [1]
33395
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2170 - Liverpool
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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The Fertility Centre Liverpool
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Address [1]
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The Fertility Centre Liverpool
Suite 301/302
Level 3/1Moore St
Liverpool
NSW 2710
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr Aine McNally Bogue
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Address
c/o The Fertility Centre Liverpool
Suite 301/302
Level 3/1 Moore St
Liverpool
NSW 2710
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Peter Leung
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Address [1]
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c/o The Fertility Centre Liverpool
Suite 301/302
Level 3/1 Moore St
Liverpool
NSW 2710
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Country [1]
308836
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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IVF Australia HREC
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Ethics committee address [1]
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Level 2/179 Pacific Highway Greenwich NSW 2065
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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19/03/2021
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Approval date [1]
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22/03/2021
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Ethics approval number [1]
308076
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Summary
Brief summary
We hypothesise that methoxyflurane (MOF) results in non inferior pain scores on a VAS compared to nitrous oxide50%/oxygen 50% (NO2) when used by patients undergoing TVOR with conscious sedation. Both agents are proven to be effective for procedural analgesia, with good safety profiles and tolerability. While comparisons of both have been made in the settings of emergency and out of hospital medicine, no studies have assessed the two for effectiveness during TVOR. While both agents are available for use in our unit, our routine protocol used for the majority of patients calls for NO2. However benefits of MOF include portability, single use inhaler device and potentially less concern regarding occupational exposure. We therefore plan an randomised control trial to test the efficacy. In fertility, it is important to consider potential effects of any medication used on lab outcomes, which will be considered in the secondary outcomes of the study.
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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 Aine McNally Bogue
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Address
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c/o The Fertility Centre Liverpool
Level 3/1 Moore St
Liverpool
NSW 2170
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Country
109446
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Australia
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Phone
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+61 0435325511
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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
109447
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Aine McNally Bogue
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Address
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c/o The Fertility Centre Liverpool
Level 3/1 Moore St
Liverpool
NSW 2170
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Country
109447
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Australia
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Phone
109447
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+61 0435325511
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Fax
109447
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Email
109447
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[email protected]
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Contact person for scientific queries
Name
109448
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Aine McNally Bogue
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Address
109448
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c/o The Fertility Centre Liverpool
Level 3/1 Moore St
Liverpool
NSW 2170
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Country
109448
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Australia
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Phone
109448
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+61 0435325511
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Fax
109448
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Email
109448
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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?
All the individual participant data collected, during the trial, after deidentification
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When will data be available (start and end dates)?
Immediately following publication. No end date
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Available to whom?
Researchers who provide a methodologically sound proposal
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Available for what types of analyses?
To achieve aims in approved proposal
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How or where can data be obtained?
Proposals to be forwarded to
[email protected]
. To gain access, applicants will be required to sign a data access form
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
10994
Study protocol
[email protected]
Request to Principal Investigator
10995
Clinical study report
[email protected]
Request to Principal Investigator
12579
Statistical analysis plan
[email protected]
Request by email to Principal Investigator
12580
Informed consent form
[email protected]
Request by email to Principal Investigator
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