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Trial registered on ANZCTR
Registration number
ACTRN12619000011189
Ethics application status
Approved
Date submitted
19/12/2018
Date registered
8/01/2019
Date last updated
14/02/2020
Date data sharing statement initially provided
8/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Does the use of Bariboard(TM) improve adequacy of chest compressions in morbid obesity?
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Scientific title
Does the use of Bariboard(TM) improve adequacy of chest compressions in morbid obesity?
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Secondary ID [1]
296890
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None
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Universal Trial Number (UTN)
U1111-1225-6682
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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:
Obesity
310829
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Cardiac Arrest
310830
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Condition category
Condition code
Diet and Nutrition
309504
309504
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0
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Obesity
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Cardiovascular
309505
309505
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0
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Other cardiovascular diseases
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Emergency medicine
309561
309561
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0
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Resuscitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Randomised, blinded cross over design
The intervention arm will be asked to perform two minutes of uninterrupted CPR on a mannequin that has been encased in a suit containing pig fat in a vacuum sealed bag to a depth that mimics a BMI of 40kg/m2, with the Bariboard(TM) device in use. The Bariboard(TM) is a piece of equipment that is placed under the supine bariatric patient during CPR, which has been designed to better support the the spine and torso as it is contoured with the larger patient in mind. The additional support to the spine and thorax aims to decrease patient's posterior surface area and change force distribution during CPR, increasing the effectiveness of chest compressions delivered by the rescuer. CPR will be uninterrupted compressions, at participants discretion (i.e. without prompting from examiners), although revision of the elements of adequate compressions as per standard Australian BLS guidelines (ANZCOR) with the participants will occur just prior to completing the station.
Blinding will occur by concealing the device within the sheeting of the bed on which the mannequin lies.
There will be a washout period between each arm of 5 minutes to allow participant recovery.
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Intervention code [1]
313185
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Treatment: Devices
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Comparator / control treatment
The control arm will comprise of the same participants performing CPR on a mannequin that has been encased in a suit containing pig fat in a vacuum sealed bag to a depth that mimics a BMI of 40kg/m2.
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Control group
Active
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Outcomes
Primary outcome [1]
308482
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Quality of CPR (composite endpoint comprising of rate of compressions, depth of compressions, and adequate chest recoil for >90% of compressions) assessed by data generated through electronic monitoring of chest wall movement (accelerometer) produced from specialised software.
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Assessment method [1]
308482
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Timepoint [1]
308482
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For the duration of 2 minutes of uninterrupted CPR
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Secondary outcome [1]
355117
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Rate of CPR lies between 100 and 120 bpm for >90% of compressions, assessed by data generated through electronic monitoring of chest wall movement (accelerometer) produced from specialised software.
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Assessment method [1]
355117
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Timepoint [1]
355117
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For the duration of 2 minutes of uninterrupted CPR
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Secondary outcome [2]
355118
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Depth of CPR lies between 1/3 and 1/2 of the antero-posterior diameter of the thorax for >90% of compressions, using data generated through electronic monitoring of chest wall movement (accelerometer connected to a ZOLL defibrillator).
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Assessment method [2]
355118
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Timepoint [2]
355118
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For the duration of 2 minutes of uninterrupted CPR
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Secondary outcome [3]
355119
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Adequate thoracic cage recoil (full recoil for >90% of compressions), using data generated through electronic monitoring of chest wall movement (accelerometer connected to a ZOLL defibrillator)
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Assessment method [3]
355119
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Timepoint [3]
355119
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For the duration of 2 minutes of uninterrupted CPR
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Secondary outcome [4]
355120
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Time taken to fatigue (inability to delivier high quality CPR i.e. insufficient rate of compressions, insufficient depth of compressions or inadequate time for chest wall recoil); determined using data generated for each of these values for each candidate by a ZOLL defibrillator attached to the mannequin.
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Assessment method [4]
355120
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Timepoint [4]
355120
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For the duration of 2 minutes of uninterrupted CPR
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Secondary outcome [5]
355121
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Perceived effectiveness of cardiac compressions as measured by a questionnaire using a visual analogue scale (VAS). The VAS questionnaire was designed for this study and is not validated.
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Assessment method [5]
355121
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Timepoint [5]
355121
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At the completion of 2 minutes of uninterrupted CPR
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Secondary outcome [6]
365377
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Participant discomfort/pain experienced whilst performing CPR assessed by completion of a visual analogue scale from 1 (no discomfort/pain) to 10 (worst pain imaginable).
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Assessment method [6]
365377
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Timepoint [6]
365377
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At the completion of 2 minutes of uninterrupted CPR
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Eligibility
Key inclusion criteria
Health care staff who have previously undergone BLS training and would be expected to provide CPR during cardiopulmonary arrest.
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Minimum age
18
Years
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Maximum age
65
Years
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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
Untrained in BLS
Unable to undertake 2 minutes of CPR
Currently undergoing a managed return to work program
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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 is not concealed. Participants will be recruited based on convenience (released from clinical duties), and randomised by coin toss following informed consent.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will only occur following recruitment of particpants with a coin toss determining the order which they complete the CPR workstations.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people administering the treatment/s
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Intervention assignment
Crossover
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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
Randomised controlled crossover trial
On the basis of our previous research, in which 4% of rescuers could provide adequate chest compressions, in order to demonstrate a clinically significant improvement (10% of rescuers acheiving "adequate compressions", or a 150% improvement) with an alpha of 0.05 and a beta of 0.8, 113 participants would be required.
Results will be analysed using STATA(TM). Non-parametric data will be analysed using the Chi squared statistic (efficacy of CPR, rate, adequate depth, adequate recoil for >90% of compressions, difference between perceived and actual effectiveness).
Parametric data will be analysed using the students t-test (time taken to fatigue, level of discomfort/pain).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/02/2019
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Actual
13/02/2019
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Date of last participant enrolment
Anticipated
28/02/2019
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Actual
21/08/2019
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Date of last data collection
Anticipated
28/02/2019
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Actual
21/08/2019
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Sample size
Target
120
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Accrual to date
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Final
205
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Recruitment in Australia
Recruitment state(s)
NT
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Recruitment hospital [1]
12773
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Alice Springs Hospital - Alice Springs
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Recruitment postcode(s) [1]
25234
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0870 - Alice Springs
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Funding & Sponsors
Funding source category [1]
301462
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Hospital
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Name [1]
301462
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Alice Springs Hospital
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Address [1]
301462
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Gap Road,
Alice Springs NT 0870
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Country [1]
301462
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Australia
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Funding source category [2]
301505
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Commercial sector/Industry
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Name [2]
301505
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Iron Duck
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Address [2]
301505
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20 Veterans Drive
Chicopee, MA 01022
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Country [2]
301505
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United States of America
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Funding source category [3]
301506
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Commercial sector/Industry
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Name [3]
301506
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ZOLL Medical Australia Pty Ltd
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Address [3]
301506
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Unit 10, 39 Herbert Street
St Leonards NSW 2065
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Country [3]
301506
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Australia
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Primary sponsor type
Hospital
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Name
Alice Springs Hospital
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Address
Gap Road
Alice Springs NT 0870
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Country
Australia
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Secondary sponsor category [1]
301203
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None
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Name [1]
301203
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Address [1]
301203
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Country [1]
301203
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302196
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CENTRAL AUSTRALIAN HUMAN RESEARCH ETHICS COMMITEE (CAHREC)
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Ethics committee address [1]
302196
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CAHREC PO BOX 4066 Alice Springs, NT 0870
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Ethics committee country [1]
302196
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Australia
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Date submitted for ethics approval [1]
302196
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09/11/2018
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Approval date [1]
302196
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12/12/2018
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Ethics approval number [1]
302196
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CA-18-3273
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Summary
Brief summary
There is little research regarding the efficacy of CPR in obese patients. Using a simulation model we have previously demonstrated that the adequacy of chest compressions in morbidly obese mannequins is compromised, predominantly in the domains of achieving adequate compression depth and allowing sufficient time for chest wall recoil during CPR. The Bariboard(TM) is a device that purports to aid in the redistribution of forces applied to the anterior chest wall in order to improve the adequacy of chest compression. There have been no empirical trials using this device. Aim of Study: The primary aim of this study will be to explore whether the adequacy of chest compressions can be improved using a mechanical device (Bariboard(TM)) to better distribute the mechanical forces applied to the anterior thorax during CPR. Primary outcome: * To measure the efficacy of chest compressions using a previously described model of morbid obesity with and without a mechanical device that raises the thoracic cage. This will use the digital mannequins to record the quality and adequacy of chest compressions over a period of 2 minutes of uninterrupted CPR. Effective CPR will be defined as a composite measure of adequate depth of compression, adequate time for recoil at an adequate rate for >90% of compressions delivered. Secondary outcomes: * Adequacy of each component of CPR (namely rate, depth of compressions and adequate recoil). * Time taken for participants to fatigue when performing CPR on a morbidly obese mannequin. It is known that the maximum amount of time a member of staff can perform effective CPR is 2 minutes in a normal scenario. * Participant discomfort/pain experienced during CPR. * The association between staffs' perceived effectiveness and the recorded adequacy of chest compressions.
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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 Kate Goulding
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Address
89442
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c/o Intensive Care Unit
Alice Springs Hospital
6 Gap Road
Alice Springs NT 0870
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Country
89442
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Australia
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Phone
89442
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+61 428306130
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Fax
89442
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Email
89442
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[email protected]
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Contact person for public queries
Name
89443
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Paul Secombe
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Address
89443
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c/o Intensive Care Unit
Alice Springs Hospital
6 Gap Road
Alice Springs NT 0870
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Country
89443
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Australia
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Phone
89443
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+61 8 8951 7777
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Fax
89443
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+61 8 8951 6936
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Email
89443
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[email protected]
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Contact person for scientific queries
Name
89444
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Paul Secombe
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Address
89444
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c/o Intensive Care Unit
Alice Springs Hospital
6 Gap Road
Alice Springs NT 0870
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Country
89444
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Australia
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Phone
89444
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+61 8 8951 7777
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Fax
89444
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+61 8 8951 6936
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Email
89444
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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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