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Trial registered on ANZCTR
Registration number
ACTRN12621000920897
Ethics application status
Approved
Date submitted
25/05/2021
Date registered
15/07/2021
Date last updated
20/02/2024
Date data sharing statement initially provided
15/07/2021
Date results provided
20/02/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
Prevalence, severity, and outcomes of sepsis in Australian and New Zealand children
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Scientific title
Epidemiology of paediatric community-acquired sepsis in Australia and New Zealand
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Secondary ID [1]
304307
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None
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Universal Trial Number (UTN)
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Trial acronym
SENTINEL (Sepsis in Australian and New Zealand Children)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
sepsis
322048
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Condition category
Condition code
Infection
319773
319773
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0
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Other infectious diseases
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Public Health
320082
320082
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0
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Epidemiology
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Observational study of children who present to participating Emergency Departments in Australia and New Zealand and are diagnosed with or treated for sepsis. For participants, data from medical records will be collected for study purposes. Clinical outcome data will be censored at 30 days after enrolment. Functional outcome will be ascertained by the research team 90 days after enrolment using a short questionnaire. The questionnaire will be delivered separately via telephone call, email link, or text message.
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Intervention code [1]
320651
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To describe the prevalence of sepsis in Australian and New Zealand paediatric Emergency Departments. Sepsis is defined as admission diagnosis of sepsis or treatment for sepsis in the Emergency Department (admission to hospital for IV antibiotics and one or more fluid boluses).
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Assessment method [1]
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Timepoint [1]
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The study will be conducted over a 2-year time period. During this time, all hospital admissions for sepsis will be eligible for enrolment. All patient's with an admission diagnosis of sepsis or who are treated for sepsis over this time period will be included. Patients will be identified and enrolled prospectively by their treating clinician, with data collected from the patients medical record.
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Primary outcome [2]
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A composite clinical outcome will be assessed using the medical records of enrolled patients: the Paediatric hospitalisation for Organ Support Therapy (POST30) score (days on inotropes + days on mechanical ventilation + days on renal replacement therapy + days on extra-corporeal life support + days in ICU + days in hospital censored day 30 post enrolment; death = maximum score).
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Assessment method [2]
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Timepoint [2]
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Clinical outcomes will be evaluated at hospital discharge or day 30 after enrolment, whichever comes first.
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Primary outcome [3]
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Functional outcome will be assessed using the Pediatric Overall Performance Category.
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Assessment method [3]
327960
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Timepoint [3]
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The Pediatric Overall Performance Category will be assessed 90 days after enrolment by parents of enrolled children.
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Secondary outcome [1]
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Microbiology of sepsis presenting to Australian and New Zealand Emergency Departments, including primary pathogen causing sepsis, blood culture contamination rates and bacterial resistance patterns.
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Assessment method [1]
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Timepoint [1]
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Microbiology of sepsis will be will be collected prospectively and evaluated at hospital discharge or 30 days following admission, whichever comes first.
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Secondary outcome [2]
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A composite outcome describing compliance with local sepsis guidelines assessed from the patient medical record. Aspects of care that will be evaluated include: antibiotic choice and dose, timing and route of administration; fluid bolus choice and dose, timing and route of administration; inotrope choice and dose, timing and route of administration; and concurrent therapies administered in ED (corticosteroids, IVIG, blood products).
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Assessment method [2]
396028
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Timepoint [2]
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Secondary outcomes will be will be collected prospectively and evaluated at hospital discharge or 30 days following admission, whichever comes first.
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Secondary outcome [3]
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The test characteristics of clinical scores (including SIRS, qSOFA, qPELOD-2, pSOFA, PEWS, PIM-3, and PRISM) for use in risk stratification.
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Assessment method [3]
396029
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Timepoint [3]
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Risk stratification features will be collected prospectively and evaluated at hospital discharge or 30 days following admission, whichever comes first.
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Secondary outcome [4]
398266
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The test characteristics of biomarkers (including lactate, blood cell counts, creatinine, coagulation profile) for risk stratification.
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Assessment method [4]
398266
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Timepoint [4]
398266
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Risk stratification features will be collected prospectively and evaluated at hospital discharge or 30 days following admission, whichever comes first
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Eligibility
Key inclusion criteria
Presentation to participating hospital Emergency Department
Age less than or equal to 18 years
Treatment for sepsis (IV/IM/IO antibiotics pre-hospital or in ED, fluid bolus or inotropic support pre-hospital or in ED) OR diagnosis of sepsis in the Emergency Department
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Minimum age
No limit
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Maximum age
18
Years
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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 only receive antibiotics or circulatory support following induction of anaesthetic in the operating theater.
Patients not initially seen in the Emergency Department (transferred directly to ward or admitted via clinic)
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Descriptive statistics will be used to analyse the data. Subgroups of vulnerable children, including those of Aboriginal or Torres Strait Islander or Maori heritage, neonates, immunosuppressed children, children with central venous access devices will be analysed separately.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
21/04/2021
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Date of last participant enrolment
Anticipated
21/04/2023
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Actual
31/12/2023
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Date of last data collection
Anticipated
21/07/2023
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Actual
31/12/2023
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Sample size
Target
1000
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Accrual to date
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Final
6293
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Recruitment hospital [1]
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The Royal Childrens Hospital - Parkville
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Recruitment hospital [2]
19539
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Monash Children’s Hospital - Clayton
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Recruitment hospital [3]
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Queensland Children's Hospital - South Brisbane
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Recruitment hospital [4]
19541
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Gold Coast University Hospital - Southport
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Recruitment hospital [5]
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Sydney Children's Hospital - Randwick
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Recruitment hospital [6]
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [7]
19544
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Womens and Childrens Hospital - North Adelaide
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Recruitment hospital [8]
19545
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Perth Children's Hospital - Nedlands
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Recruitment hospital [9]
19546
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Royal Darwin Hospital - Tiwi
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Recruitment postcode(s) [1]
34147
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3052 - Parkville
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Recruitment postcode(s) [2]
34148
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3168 - Clayton
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Recruitment postcode(s) [3]
34149
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4101 - South Brisbane
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Recruitment postcode(s) [4]
34150
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4215 - Southport
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Recruitment postcode(s) [5]
34151
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2031 - Randwick
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Recruitment postcode(s) [6]
34152
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2145 - Westmead
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Recruitment postcode(s) [7]
34153
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5006 - North Adelaide
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Recruitment postcode(s) [8]
34154
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6009 - Nedlands
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Recruitment postcode(s) [9]
34155
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0810 - Tiwi
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Recruitment outside Australia
Country [1]
23722
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New Zealand
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State/province [1]
23722
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Funding & Sponsors
Funding source category [1]
308682
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Self funded/Unfunded
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Name [1]
308682
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n/a
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Address [1]
308682
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n/a
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Country [1]
308682
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Primary sponsor type
Charities/Societies/Foundations
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Name
Murdoch Children's Research Institute
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Address
50 Flemington Road
Parkville, Victoria
3052
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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]
309568
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Address [1]
309568
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Country [1]
309568
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308604
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The Royal Children's Hospital Human Research Ethics Committee
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Ethics committee address [1]
308604
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52 Flemington Road Parkville, Victoria 3052
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Ethics committee country [1]
308604
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Australia
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Date submitted for ethics approval [1]
308604
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22/12/2020
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Approval date [1]
308604
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06/01/2021
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Ethics approval number [1]
308604
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68569
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Summary
Brief summary
Background: Sepsis is the leading cause of early childhood death worldwide, with an estimated 4 million children dying from this final common pathway for severe infections every year. The burden of disease in Australia and New Zealand is unknown, including mortality, duration of hospitalisation, requirement for intensive care and organ support therapies, and long-term functional outcome in sepsis survivors. Early markers of severe disease and predictors of poor outcome in childhood sepsis are unknown. Sepsis-related hospital costs are estimated at $4 billion per annum for children and $12 billion per annum for adults in the United States. The cost of hospitalisation for children with sepsis in Australia and New Zealand is unknown. Variation in guidelines for sepsis treatment in Australia and New Zealand, and adherence to such guidelines, is unknown. The microbiology and resistance patterns of bacterial pathogens in children treated for sepsis in Australia and New Zealand are unknown. Whether current empiric antibiotic recommendations are appropriate to cover bacterial pathogens causing sepsis in Australia and New Zealand is unknown. The prevalence and outcomes in subgroups of vulnerable, high risk children, including those receiving cancer chemotherapy, those self identifying as of Aboriginal or Torres Strait Islander or Maori ethnicity, those with chronic medical conditions, and infants or neonates who are treated for sepsis are unknown. Rationale: Baseline observational data is required to answer fundamental aspects of sepsis care for children in Australia and New Zealand, and to plan future interventional studies. Defining characteristics, prevalence, severity, resource utilisation, cost, variation in care, and antimicrobial stewardship are all important and unexplored components of the paediatric sepsis research landscape that will be addressed by this study. Aim: To describe the epidemiology of hospitalised children treated for sepsis in Australia and New Zealand.
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Trial website
https://www.mcri.edu.au/research/projects/sentinel
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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 Elliot Long
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Address
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Emergency Department
The Royal Children's Hospital
52 Flemington Road
Parkville, Victoria
3052
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Country
111298
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Australia
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Phone
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+61 425573585
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Fax
111298
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+61393456006
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Email
111298
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[email protected]
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Contact person for public queries
Name
111299
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Elliot Long
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Address
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Emergency Department
The Royal Children's Hospital
52 Flemington Road
Parkville, Victoria
3052
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Country
111299
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Australia
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Phone
111299
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+61 425573585
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Fax
111299
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+61393456006
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Email
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[email protected]
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Contact person for scientific queries
Name
111300
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Elliot Long
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Address
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Emergency Department
The Royal Children's Hospital
52 Flemington Road
Parkville, Victoria
3052
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Country
111300
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Australia
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Phone
111300
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+61 425573585
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Fax
111300
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+61393456006
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Email
111300
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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
De-identified data only will be collected for this study
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
11758
Study protocol
[email protected]
11759
Ethical approval
382060-(Uploaded-25-05-2021-12-54-20)-Study-related document.pdf
11760
Informed consent form
382060-(Uploaded-25-05-2021-12-55-19)-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