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Trial registered on ANZCTR
Registration number
ACTRN12624000441516
Ethics application status
Approved
Date submitted
6/03/2024
Date registered
10/04/2024
Date last updated
19/07/2024
Date data sharing statement initially provided
10/04/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Preschool Outcomes of Wheeze Employing Reliable Ergonomic Digital-technology (POWERED)
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Scientific title
A multicentre RCT study to determine whether using a bundle (use of WzS with a management plan) reduces unscheduled doctor visits in preschool aged children with recurrent wheeze
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Secondary ID [1]
311257
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None
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Universal Trial Number (UTN)
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Trial acronym
POWERED
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Recurrent wheeze in pre-school children (Preschool Wheeze)
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Condition category
Condition code
Respiratory
329171
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Use of WheezeScan (WzS) with a management plan (called the 'bundle'). WzS is a portable user-friendly digital device that listens to 30sec of breathing then objectively documents wheeze using AI-informed signal processing. WzS is manufactured by Omron (Japan).
Parents will be trained by the research nurses/assistants using a standard protocol provided by the manufacturers (sse link https://www.omron-healthcare.co.uk/nebulisers/wheezescan.html). Training occcurs face-to-face and takes between 5 to 15 minutes where the parents are shown how to use the WheezeScan and then does them with the researcher watching. The video on how to use a Wheezescan is also available https://www.youtube.com/watch?app=desktop&v=DnZh-p0ZgP4
Parents are also given a cheat sheet on how to use the Wheezescan and how to complete the e-diary.
Adherence will be monitored using participant diaries recorded on-line. Wheezescan will be used at least once a day over the study period of 12 months. The management plan consists of an asthma management plan with the use of inhaled corticosteroids if there is wheeze that is reversed by using salbutamol (400 ugm via space +/-mask). The use of recommended inhaled corticosteroids (fluticasone propionate (250 micrograms) metered dose inhaler, at 2 puffs twice a day) will be intermittent at the onset of a viral infection and/or wheeze for a maximum of 10 days for each episode.
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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Treatment: Devices
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Comparator / control treatment
Usual care (as per local treating doctor). This varies between centres and not possible to describe exactly what is done but includes as necessary use of short acting beta-2 agonist (SABA) or no treatment at all.
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Control group
Active
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Outcomes
Primary outcome [1]
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Rate of unscheduled doctor visits for respiratory-related episodes
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Assessment method [1]
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As reported by care-givers and medical records
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Timepoint [1]
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12 months from randomisation
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Secondary outcome [1]
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Difference in a quality-of-life
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Assessment method [1]
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PedsQL4
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Timepoint [1]
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6 and 12 months from randomisation
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Secondary outcome [2]
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Difference in parent asthma management self-efficacy scale
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Assessment method [2]
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Parent asthma management self-efficacy scale
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Timepoint [2]
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6 and 12 months from randomisation
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Secondary outcome [3]
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Time-to-next unscheduled doctor visit
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Assessment method [3]
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As reported by care-givers and medical records
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Timepoint [3]
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Censored at 12 months from randomisation
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Secondary outcome [4]
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Proportion of children hospitalised
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Assessment method [4]
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As reported by parents/care-givers and medical records
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Timepoint [4]
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12 months from randomisation
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Secondary outcome [5]
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Adverse events (e.g. from corticosteroids - linear growth, thrush)
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Assessment method [5]
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As reported by parents/care-givers and medical records
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Timepoint [5]
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12 months from randomisation
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Secondary outcome [6]
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Cough-specific Quality-of-Life (only in subgroup with chronic cough)
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Assessment method [6]
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PC-QOL-8
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Timepoint [6]
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6 and 12 months from randomisation
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Secondary outcome [7]
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Number of wheezing episodes
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Assessment method [7]
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As reported by parents/care-givers and medical records
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Timepoint [7]
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12 months from randomisation
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Secondary outcome [8]
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Cost effectiveness
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Assessment method [8]
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Incremental cost - healthcare system perspective collected through reported health care resources reported by parents/care-givers and medical records.
This will reported as a separate paper following primary RCT analysis
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Timepoint [8]
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By 12 months from randomisation
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Eligibility
Key inclusion criteria
Children (aged 0.5 to 6 years) with recurrent wheeze (2 or more reported wheeze episodes) and/or suspected asthma (e.g. chronic (>4 weeks) cough with recurrent exertional breathlessness).
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Minimum age
6
Months
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Maximum age
6
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
(a) suspected chronic suppurative lung disease e.g. chronic wet cough,
(b) daily maintenance inhaled corticosteroids (ICS) prescribed by a paediatric respiratory specialist,
(c) previously enrolled,
(d) conditions that also cause wheeze (e.g. cystic fibrosis, tracheomalacia or
(e) unable to complete patient reported outcomes (PROs)
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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)
Central administration site via REDCap
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation (2-8 block sizes) and stratified by site (n=7) and age (<3, =>3 years)
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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
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
29/07/2024
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Actual
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Date of last participant enrolment
Anticipated
30/01/2028
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Actual
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Date of last data collection
Anticipated
30/01/2029
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Actual
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Sample size
Target
206
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,NT,QLD,WA,VIC
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Recruitment hospital [1]
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Queensland Children's Hospital - South Brisbane
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Recruitment hospital [2]
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Gold Coast University Hospital - Southport
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Recruitment hospital [3]
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [4]
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Royal Darwin Hospital - Tiwi
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Recruitment hospital [5]
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The Royal Childrens Hospital - Parkville
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Recruitment hospital [6]
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Perth Children's Hospital - Nedlands
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Recruitment postcode(s) [1]
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4101 - South Brisbane
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Recruitment postcode(s) [2]
41814
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4215 - Southport
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Recruitment postcode(s) [3]
41815
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2145 - Westmead
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Recruitment postcode(s) [4]
41816
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0810 - Tiwi
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Recruitment postcode(s) [5]
41818
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3052 - Parkville
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Recruitment postcode(s) [6]
41819
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6009 - Nedlands
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Recruitment postcode(s) [7]
42188
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4068 - Taringa
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council - MRFF
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Address [1]
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National Health and Medical Research Council GPO Box 1421 Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Queensland University of Technology
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Address
2 George St, Brisbane City QLD 4000
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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]
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Address [1]
317595
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Country [1]
317595
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Children’s Health Queensland Human Research Ethics Committee
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Ethics committee address [1]
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Level 7, Centre for Children’s Health Research 62 Graham St South Brisbane, Queensland 4101
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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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26/02/2024
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Approval date [1]
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11/04/2024
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Ethics approval number [1]
314416
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HREC Reference number: HREC/24/QCHQ/105893
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Summary
Brief summary
Preschool children with wheeze (PSW) is very common and has higher morbidity than any other asthma group. PSWs very high unmet needs are documented in international parent/end-user surveys. Although many no longer wheeze by 6y, ~40% have recurrences, require hospitalisation and it is not a benign illness. Yet, identifying wheezing is challenging for parents (>50% disagreement between doctors & parents) and many cultures (incl. Indigenous Australians) do not have a word for wheeze. This may cause under- or over-diagnosis of asthma, & lead to over- or underuse of medications, children undergoing unnecessary procedures & high parental anxiety. Giving all children asthma meds is very poor practice as there are adverse events associated with these meds and it is against parents’ wishes. Our multicentre RCT study addresses the need to manage recurrent PSW by objectively defining wheeze using as a bundle (1) an AI-developed tool (WheezeScan, WzS) and (2) a wheeze management plan. Recruiting children from hospitals and community clinics, we plan to recruit 206 children with recurrent PSW including those from our remote Indigenous clinics to determine if this intervention (WzS with management bundle) reduces unscheduled doctor visits (primary aim), and other clinically important outcomes (hospitalisation, time to next unscheduled doctor visit, quality-of life).
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Trial website
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Trial related presentations / publications
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Public notes
MRFF Scientific Title is: Improving outcomes of recurrent preschool wheeze: a multicentre randomised controlled trial (RCT) with biomarker discovery
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Contacts
Principal investigator
Name
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Prof Anne Chang
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Address
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Queensland Children's Hospital Stanley Street, South Brisbane, Qld 4101
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Country
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Australia
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Phone
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+61 7 30697283
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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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Stephanie Yerkovich
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Address
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Queensland Children's Hospital Stanley Street, South Brisbane, Qld 4101
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Country
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Australia
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Phone
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+61 7 30697283
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Fax
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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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Anne Chang
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Address
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Queensland Children's Hospital Stanley Street, South Brisbane, Qld 4101
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Country
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Australia
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Phone
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+61 7 30697283
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Fax
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Email
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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
As study involves Aboriginal and Torres Straits Islander children, specific permission is required and thus it is not possible to share the data.
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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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