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Trial registered on ANZCTR
Registration number
ACTRN12610000951055
Ethics application status
Not yet submitted
Date submitted
27/10/2010
Date registered
5/11/2010
Date last updated
18/01/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
Effectiveness of Rectal Balloon Training in Obstructive Defaecation: A Randomised Controlled Trial
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Scientific title
A Randomised controlled Trial to assess the effectiveness of rectal balloon training in Biofeedback for Obstructive defaecation patients.
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Secondary ID [1]
252968
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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:
Obstructive defecation
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Condition category
Condition code
Oral and Gastrointestinal
258664
258664
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Education sessions on the role of fluid, fibre, fitness and maintaining a correct posture during defecation plus a rectal balloon training.
For the rectal balloon trainig, the nurse will insert a deflated balloon into the rectum and inflate it with 50mL of warm water using a syringe. This provides the sensation of a full rectum and the need to defaecate. The biofeedback nurse will monitor your abdominal movements, relaxation and breathing during the attempt to expel the balloon and give you instant feedback on proper defecating technique.
The biofeedback treatment will be facilitated by a specialised biofeedback nurse. Participants will received 1 hr sessions once a month for a total of 4 months.
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Intervention code [1]
257492
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Treatment: Devices
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Intervention code [2]
257558
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Behaviour
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Intervention code [3]
257559
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Lifestyle
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Comparator / control treatment
education sessions only on the role of fluid, fibre, fitness and maintaining a correct posture during defecation.
The biofeedback treatment will be facilitated by a specialised biofeedback nurse. Participants will received 1 hr sessions once a month for a total of 4 months.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in QOL for obstructive defecation patients as determined using CR QOL (constipation related quality of life) and DQOT (Direct questioning of objectives).
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Assessment method [1]
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Timepoint [1]
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Baseline data will be collected prior to patients receiving the treatment.
The treatment involves 4 sessions with 1month interval between each sessions. Questionnaire will be administered to patients at each session.
Patients will be followed up 3,6 and 12 months post completion of treatment.
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Secondary outcome [1]
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Improved psychological sate as determined using DASS (depression, anxiety and stress scale).
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Assessment method [1]
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Timepoint [1]
266127
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Baseline data will be collected prior to patients receiving the treatment.
The treatment involves 4 sessions with 1month interval between each sessions. Questionnaire will be administered to patients at each session.
Patients will be followed up 3,6 and 12 months post completion of treatment.
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Secondary outcome [2]
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Improved symptoms as determined using CSI (constipation severity instrument)
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Assessment method [2]
266230
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Timepoint [2]
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Baseline data will be collected prior to patients receiving the treatment.
The treatment involves 4 sessions with 1month interval between each sessions. Questionnaire will be administered to patients at each session.
Patients will be followed up 3,6 and 12 months post completion of treatment.
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Eligibility
Key inclusion criteria
1) prior assessment by a doctor, nurse specialist or physiotherapist;
2) fulfill the ROME criteria of obstructive defecation
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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
1) structural causes such as colorectal malignancy, full thickness rectal prolapse or a non-emptying rectocoele;
2) previous treatment with biofeedback;
3) poor command of English;
4) an underlying organic brain lesion that may limit a patient’s ability to understand or follow instructions for biofeedback;
5) unable to consent for other reasons.
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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)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation by using a randomization table created by a computer software (i.e., computerised sequence generation)
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Masking / blinding
Blinded (masking 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
1/12/2010
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Actual
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Date of last participant enrolment
Anticipated
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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
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
3400
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2050
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Colorectal Research Department
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Address [1]
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Level 9 East, Ambulatory Care,
Royal Prince Alfred Hospital
Missenden Road,
Camperdown 2050 NSW
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
A/Prof Christopher Young
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Address
Suite 415, RPAH Medical Centre, 100 Carillon Ave, Newtown, NSW 2042
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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 Cherry Koh
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Address [1]
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Source, PO Box M157, Missenden Road, Camperdown, NSW 2050
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Country [1]
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Australia
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Secondary sponsor category [2]
257133
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Individual
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Name [2]
257133
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Professor Michael Solomon
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Address [2]
257133
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Suite 415, RPAH Medical Centre, 100 Carillon Ave, Newtown, NSW 2042
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Country [2]
257133
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Australia
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Secondary sponsor category [3]
257134
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Individual
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Name [3]
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Dr Christopher Byrne
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Address [3]
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Suite 415, RPAH Medical Centre, 100 Carillon Ave, Newtown, NSW 2042
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Country [3]
257134
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Australia
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Secondary sponsor category [4]
257135
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Individual
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Name [4]
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Prof Anthony Eyers
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Address [4]
257135
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Suite 202, RPAH Medical Centre, 100 Carillon Ave, Newtown, NSW 2042
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Country [4]
257135
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Australia
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Secondary sponsor category [5]
257136
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Individual
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Name [5]
257136
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Dr Peter Lee
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Address [5]
257136
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Suite 415, RPAH Medical Centre, 100 Carillon Ave, Newtown, NSW 2042
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Country [5]
257136
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Australia
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Secondary sponsor category [6]
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Individual
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Name [6]
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Dr Caroline Wright
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Address [6]
257137
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Suite 415, RPAH Medical Centre, 100 Carillon Ave, Newtown, NSW 2042
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Country [6]
257137
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Australia
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
259950
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SSWAHS Ethics Review Committee (RPAH Zone)
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Ethics committee address [1]
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c/- Research Development Office Level 3, Building 92 Royal Prince Alfred Hospital Missenden Road CAMPERDOWN NSW 2050
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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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29/09/2010
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Approval date [1]
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Ethics approval number [1]
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HREC/10/RPAH/506
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Summary
Brief summary
Obstructive defaecation (OD) is a challenging clinical problem not uncommonly encountered in colorectal practice. OD is associated with depression, anxiety and impaired quality of life (QOL).1 Unfortunately, because the underlying anatomic and pathophysiology of OD is poorly understood, large number of medical, surgical and behavioural treatment have been described with no panacea. A recent meta-analysis suggests that biofeedback is effective in the treatment of OD, although only a handful of randomized trials, each with different biofeedback regime have been completed to date.2 Most trials have also focused on symptomatic improvement with relative neglect of impact of treatment on QOL or psychological state.2 In amongst the seemingly vast literature surrounding OD and its treatment, some fundamental questions remain unanswered: 1) is it the counselling and support that makes biofeedback effective; 2) is balloon retraining effective as a biofeedback modality; 3) does treatment improve QOL or psychological state. The biofeedback protocol at Royal Prince Alfred Hospital (RPAH) for OD is a comprehensive program entailing education, counselling (conservative management) and balloon retraining. Balloon retraining has only been evaluated in 1 randomised trial in 1995 (Koutsoumanis et al)3 and although improved treatment success have been noted since it was introduced at RPAH, whether or not this represents a biased observation remains unclear. A randomized controlled trial (RCT) is proposed to: 1) determine if biofeedback improves QOL and psychological state of patients with OD; 2) to determine if balloon retraining as a biofeedback modality is effective; 3) to determine if balloon retraining confers any additional benefit to patient receiving conservative management.
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Trial website
None
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Trial related presentations / publications
None
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Public notes
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Contacts
Principal investigator
Name
31838
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Address
31838
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Country
31838
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Emily Chew
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Address
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Colorectal Research Department
Level 9 East Ambulatory Care,
Royal Prince Alfred Hospital
Missenden Road, Camperdown 2050 NSW
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Country
15085
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Australia
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Phone
15085
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+61 2 9515 3209
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Fax
15085
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+61 2 9515 3222
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Email
15085
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[email protected]
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Contact person for scientific queries
Name
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Dr Cherry Koh
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Address
6013
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Colorectal Research Department
Level 9 East Ambulatory Care,
Royal Prince Alfred Hospital
Missenden Road, Camperdown 2050 NSW
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Country
6013
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Australia
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Phone
6013
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+61 2 9515 6111
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
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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