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Trial registered on ANZCTR
Registration number
ACTRN12624000292572
Ethics application status
Approved
Date submitted
14/02/2024
Date registered
20/03/2024
Date last updated
20/03/2024
Date data sharing statement initially provided
20/03/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
Reliability of lung ultrasound interpretation by physiotherapists in premature infants
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Scientific title
Investigating inter-rater reliability for the use of lung ultrasound by physiotherapists in premature infants with Respiratory Distress Syndrome
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Secondary ID [1]
307449
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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:
respiratory distress syndrome
326823
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premature infant
326824
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Condition category
Condition code
Respiratory
324039
324039
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0
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Other respiratory disorders / diseases
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Reproductive Health and Childbirth
329837
329837
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0
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Complications of newborn
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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
This study is a retrospective analysis of Lung Ultrasound (LUS) scans collected from preterm infants as part of a non-randomised, exploratory proof of concept study (Mater HREC Project 56566) investigating the effect of nebulised surfactant (AeroFact) on lung aeration and regional ventilation distribution (Electrical impedance tomography, thoracic breath sensor and LUS measurements of neonates with respiratory distress syndrome during surfactant administration: Mater HREC Project 56566). LUS scans being analysed were originally collected commencing in March 2021 and recruitment is ongoing. The study setting is Mater Mother’s Hospital Neonatal Critical Care Unit (NCCU) and Physiotherapy Department, South Brisbane, Queensland Australia. Anticipated completion on data collection is December 2023.. Scans previously collected by a neonatologist in the Aerofact study will have been de-identified with the infant’s study identification at the time of collection. Two LUS scans will have been collected, prior to and within 4 hours following, administration of nebulised surfactant. The LUS will be independently assessed by three novice physiotherapist assessors who have been trained in analysing LUS and are blinded to the history of the infants from whom the scans were taken. The assessors will all be currently working in the neonatal nursery and scans will have been previously deidentified and saved securely on the ultrasound machine. Interpretation will be undertaken by all assessors using a pre-determined standardised LUS scoring tool. based on previous studies (Brat et al, 2015). Each LUS scan will consist of 6 separate regional lung images that will be scored individually and independently on a dedicated score sheet by each assessor. A score between 0-3 will be given for each regional lung image depending on the specific signs identified in the following order: 0 = normal lung aeration (presence of A lines only), 1 = interstitial lung pathology (multiple, well-spaced B lines), 2 = alveolar patterning (crowded or coalescent B lines, with or without consolidation adjacent to the pleura) or 3 = extensive consolidation (Brat et al, 2015). Additionally, any other pathology identified (pleural effusion or pneumothorax) will also be documented. Total scores will also be calculated for each LUS scan by adding each of the separate regional lung scores together, with total scores ranging from 0-18.
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Intervention code [1]
323902
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Diagnosis / Prognosis
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Comparator / control treatment
LUS scans will be accessed and scored independently by a neonatologist trained in the delivery and interpretation of LUS using the same standardised scoring system. The neonatologist will represent the experienced assessor and reference standard for this study against which three physiotherapists assessors’ interpretation will be correlated.
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Control group
Active
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Outcomes
Primary outcome [1]
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Intra-class correlations will be undertaken for total LUS scores to determine level of agreement between 3 physiotherapists, and 1 neonatologist
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Assessment method [1]
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Timepoint [1]
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Following independent scoring of retrospectively-accessed LUS scans by 3 physiotherapist assessors and 1 neonatologist assessor.
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Primary outcome [2]
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Intra-class correlations for Right upper anterior lung region LUS scores to determine level of agreement between 3 physiotherapists, and 1 neonatologist
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Assessment method [2]
337400
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Timepoint [2]
337400
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Following independent scoring of retrospectively-accessed LUS scans by 3 physiotherapist assessors and 1 neonatologist assessor.
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Primary outcome [3]
337605
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Intra-class correlations for Right lateral lung region LUS scores to determine level of agreement between 3 physiotherapists, and 1 neonatologist
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Assessment method [3]
337605
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Timepoint [3]
337605
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Following independent scoring of retrospectively-accessed LUS scans by 3 physiotherapist assessors and 1 neonatologist assessor.
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Secondary outcome [1]
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Intra-class correlations for R lower anterior lung region LUS scores to determine level of agreement between 3 physiotherapists, and 1 neonatologist
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Assessment method [1]
431680
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Timepoint [1]
431680
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Following independent scoring of retrospectively-accessed LUS scans by 3 physiotherapist assessors and 1 neonatologist assessor.
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Secondary outcome [2]
432494
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Intra-class correlations for Left upper anterior lung region LUS scores to determine level of agreement between 3 physiotherapists, and 1 neonatologist
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Assessment method [2]
432494
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Timepoint [2]
432494
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Following independent scoring of retrospectively-accessed LUS scans by 3 physiotherapist assessors and 1 neonatologist assessor.
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Secondary outcome [3]
432495
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Intra-class correlations for Left lateral lung region LUS scores to determine level of agreement between 3 physiotherapists, and 1 neonatologist
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Assessment method [3]
432495
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Timepoint [3]
432495
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Following independent scoring of retrospectively-accessed LUS scans by 3 physiotherapist assessors and 1 neonatologist assessor.
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Secondary outcome [4]
432497
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Intra-class correlations for Left lower anterior lung region LUS scores to determine level of agreement between 3 physiotherapists, and 1 neonatologist
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Assessment method [4]
432497
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Timepoint [4]
432497
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Following independent scoring of retrospectively-accessed LUS scans by 3 physiotherapist assessors and 1 neonatologist assessor.
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Eligibility
Key inclusion criteria
A neonatologist experienced in delivery and interpretation of LUS images in neonates and preterm infants and physiotherapy staff who have undergone LUS training and who work in the Mater NCCU.
This is a retrospective analysis of previously collected LUS scans and no direct patient contact will be undertaken as part of this study
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Minimum age
30
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?
Yes
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Key exclusion criteria
Physiotherapy staff previously not trained in the interpretation of LUS
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Study design
Purpose
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Duration
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Selection
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Timing
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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
1/07/2023
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Date of last participant enrolment
Anticipated
30/12/2024
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Actual
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Date of last data collection
Anticipated
30/12/2024
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Actual
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Sample size
Target
30
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Accrual to date
7
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
26181
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Mater Mother's Hospital - South Brisbane
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Recruitment postcode(s) [1]
42053
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4101 - South Brisbane
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Mater Mother's Hospital
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Address [1]
311718
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Country [1]
311718
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Australia
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Funding source category [2]
315838
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Hospital
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Name [2]
315838
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Betty McGrath Mater Hospital Foundation
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Address [2]
315838
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Country [2]
315838
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Australia
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Primary sponsor type
Hospital
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Name
Mater Mother's Hospital
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Address
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Country
Australia
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Secondary sponsor category [1]
313178
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None
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Name [1]
313178
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Address [1]
313178
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Country [1]
313178
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
311169
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Mater Misericordiae Ltd Human Research Ethics Committee
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Ethics committee address [1]
311169
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http://www.materresearch.org.au/about-us/human-research-ethics-and-governance/human-research-ethics
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Ethics committee country [1]
311169
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Australia
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Date submitted for ethics approval [1]
311169
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16/12/2021
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Approval date [1]
311169
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19/07/2022
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Ethics approval number [1]
311169
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Summary
Brief summary
This research study aims to look at whether physiotherapists working in the Neonatal Intensive Care Unit (NICU) can identify changes in babies’ lungs to the same level as a neonatologist using Lung Ultrasound (LUS) scans. Physiotherapists working in the NICU may provide chest physiotherapy (CPT) to preterm babies to help treat certain respiratory pathologies. Not all preterm babies require CPT and currently physiotherapists use multiple assessment tools to identify appropriate babies in lieu of a single existing Gold Standard measurement tool. Current assessment tools have inherent challenges and are not considered clinimetrically robust. LUS has been suggested as a new physiotherapy assessment tool because of its high level of valid, reliable and feasible lung imaging, that can be performed in real-time by the bedside, without exposing babies to radiation. This project will investigate whether neonatal physiotherapists can reliably interpret LUS scans compared to an experienced neonatologist. Results may allow physiotherapists to use LUS as an assessment tool in the future to help more safely and correctly identify babies who may benefit from chest physiotherapy.
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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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Ms Bronagh McAlinden
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Address
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Mater Hospital Brisbane, Raymond Terrace, South Brisbane QLD 4101
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Country
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Australia
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Phone
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+61 0403652991
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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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Bronagh McAlinden
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Address
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Mater Hospital Brisbane, Raymond Terrace, South Brisbane QLD 4101
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Country
120195
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Australia
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Phone
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+61 0403652991
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Fax
120195
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Email
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[email protected]
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Contact person for scientific queries
Name
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Bronagh McAlinden
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Address
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Mater Hospital Brisbane, Raymond Terrace, South Brisbane QLD 4101
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Country
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Australia
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Phone
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+61 0403652991
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Fax
120196
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Email
120196
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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
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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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