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Trial registered on ANZCTR
Registration number
ACTRN12620000474954
Ethics application status
Approved
Date submitted
10/04/2020
Date registered
15/04/2020
Date last updated
17/09/2020
Date data sharing statement initially provided
15/04/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Airway Pressure Release Ventilation for mechanically ventilated patients with COVID-19 in Western Australian Intensive Care Units: an observational study
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Scientific title
West Australian Airway Pressure Release Ventilation Study in COVID-19: evaluation of ventilation free survival days
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Secondary ID [1]
300987
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
WAVES
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
COVID-19 (SARS-CoV2)
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Condition category
Condition code
Infection
315187
315187
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0
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Other infectious diseases
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Respiratory
315188
315188
0
0
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Other respiratory disorders / diseases
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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
Airway pressure release ventilation has traditionally been used as a rescue mode of mechanical ventilation for patients with ARDS (acute respiratory distress syndrome), however it may also be beneficial early on in ARDS. It helps with recruitment (opening up) of lungs by having a continuous high level of positive pressure and timed pressure release. Spontaneous breathing is still possible.
The mode of ventilation provided to patients is chosen at the discretion of the treating clinician. Mode of mechanical ventilation received by intubated patients in ICU is being observed from intubation until extubated.
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Intervention code [1]
317309
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Not applicable
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Comparator / control treatment
The mode of mechanical ventilation provided to a patient is chosen by the treating clinician. The different modes of ventilation manipulate different parts of the breathing cycle, either focused on using pressure to deliver a breath (pressure controlled ventilation), or delivering a designated volume (spontaneous intermittent mandatory ventilation (SIMV)), or supporting a spontaneous breathing patient (pressure support),
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Control group
Active
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Outcomes
Primary outcome [1]
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Ventilation free survival days as assessed by reviewing medical records
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Assessment method [1]
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Timepoint [1]
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At 90 days after initiation of mechanical ventilation
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Secondary outcome [1]
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Change in P/F ratio after initiation of mechanical ventilation as assessed by arterial blood gas result and medical record of FiO2 delivered on ventilator
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Assessment method [1]
381965
0
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Timepoint [1]
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At 1, 3 and 7 days.
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Secondary outcome [2]
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Complications from mode of ventilation (pneumothorax) as assessed by review of radiology reports and medical records
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Assessment method [2]
381966
0
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Timepoint [2]
381966
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Any time during mechanical ventilation
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Secondary outcome [3]
381967
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ICU length of stay
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Assessment method [3]
381967
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Timepoint [3]
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Assessed up to 90 days post enrolment
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Secondary outcome [4]
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Hospital length of stay
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Assessment method [4]
381968
0
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Timepoint [4]
381968
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Assessed at 90 days post enrolment
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Secondary outcome [5]
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Mortality
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Assessment method [5]
381969
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Timepoint [5]
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Any time up to 90 days post enrolment
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Eligibility
Key inclusion criteria
Mechanically ventilated
COVID-19 positive
Admitted to Intensive Care Unit in participating Western Australian ICU
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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
None
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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
Both
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Statistical methods / analysis
The Murray Lung Injury score will be used to match patients, and compare the APRV and non-APRV groups. The primary outcome will focus on ventilation-free survival days (within 90 days) between those with and without APRV adjusted for time to initiate APRV (or death / day 90 for those without APRV) from admission to ICU. If sample size allows, further adjustment for baseline characteristics, such as the APACHE score and PaO2/FiO2 ratio, of the two groups will be conducted.
Subgroup analysis will be performed according to 1) ARDS severity 2) early initiation of APRV (within 24 hours of initiation of mechanical ventilation), versus late initiation (after 24 hours of mechanical ventilation)
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
27/04/2020
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Actual
28/04/2020
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Date of last participant enrolment
Anticipated
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Actual
29/05/2020
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Date of last data collection
Anticipated
8/03/2021
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Actual
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Sample size
Target
100
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Accrual to date
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Final
25
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment hospital [2]
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Royal Perth Hospital - Perth
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Recruitment hospital [3]
16418
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Fiona Stanley Hospital - Murdoch
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Recruitment hospital [4]
16419
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Armadale Kelmscott Memorial Hospital - Armadale
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Recruitment hospital [5]
16420
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Rockingham General Hospital - Cooloongup
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Recruitment hospital [6]
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Bunbury Hospital - Bunbury
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Recruitment hospital [7]
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St John of God Midland Public Hospital - Midland
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Recruitment hospital [8]
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Joondalup Health Campus - Joondalup
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Recruitment postcode(s) [1]
29960
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6009 - Nedlands
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Recruitment postcode(s) [2]
29961
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6000 - Perth
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Recruitment postcode(s) [3]
29962
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6150 - Murdoch
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Recruitment postcode(s) [4]
29963
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6112 - Armadale
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Recruitment postcode(s) [5]
29964
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6168 - Cooloongup
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Recruitment postcode(s) [6]
29965
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6230 - Bunbury
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Recruitment postcode(s) [7]
29966
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6056 - Midland
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Recruitment postcode(s) [8]
29967
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6027 - Joondalup
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Funding & Sponsors
Funding source category [1]
305433
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Hospital
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Name [1]
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Sir Charles Gairdner Hospital
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Address [1]
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Hospital Avenue
Nedlands 6009, Western Australia
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Country [1]
305433
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Australia
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Funding source category [2]
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Government body
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Name [2]
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WA Health
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Address [2]
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189 Royal St
East Perth 6004, Western Australia
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Country [2]
306773
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Australia
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Primary sponsor type
Hospital
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Name
Sir Charles Gairdner Hospital
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Address
Hospital Avenue
Nedlands 6009, WA
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Country
Australia
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Secondary sponsor category [1]
305827
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None
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Name [1]
305827
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Address [1]
305827
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Country [1]
305827
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305752
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Sir Charles Gairdner and Osborne Park Health Care Group Human Research Ethics Committee
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Ethics committee address [1]
305752
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A Block, Sir Charles Gairdner Hospital Hospital Avenue Nedlands, 6009, Western Australia
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Ethics committee country [1]
305752
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Australia
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Date submitted for ethics approval [1]
305752
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10/04/2020
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Approval date [1]
305752
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28/04/2020
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Ethics approval number [1]
305752
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RGS 4003
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Ethics committee name [2]
305782
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Ramsay Health Care WA|SA HREC
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Ethics committee address [2]
305782
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Joondalup Health Campus Grand Blvd &, Shenton Ave, Joondalup WA 6027
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Ethics committee country [2]
305782
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Australia
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Date submitted for ethics approval [2]
305782
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11/04/2020
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Approval date [2]
305782
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21/04/2020
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Ethics approval number [2]
305782
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2015
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Ethics committee name [3]
305783
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St John of God Health Care Human Research Ethics Committee
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Ethics committee address [3]
305783
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C/o St John of God Subiaco Hospital 12 Salvado Road Subiaco Western Australia 6008
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Ethics committee country [3]
305783
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Australia
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Date submitted for ethics approval [3]
305783
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15/04/2020
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Approval date [3]
305783
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28/04/2020
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Ethics approval number [3]
305783
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1670
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Summary
Brief summary
Prior research has suggested that in adult patients requiring mechanical ventilation for hypoxic respiratory failure, that airway pressure release ventilation (APRV) is associated with a mortality benefit and improved oxygenation when compared to conventional ventilation strategies. The Western Australian Intensive Care clinical community has extensive experience with APRV, including during the H1N1 epidemic. The aim of this observational study is to record the outcomes for mechanically ventilated patients with COVID-19, with the expectation that a significant proportion of WA intensive care clinicians will choose APRV. Analysis will compare APRV with non-APRV ventilation modes.
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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
101470
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A/Prof Matthew Anstey
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Address
101470
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c/ Intensive Care Department
G Block, 4th Floor
Hospital Avenue,
Sir Charles Gairdner Hospital
Nedlands 6009, WA
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Country
101470
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Australia
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Phone
101470
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+61 0409124876
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Fax
101470
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Email
101470
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[email protected]
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Contact person for public queries
Name
101471
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Matthew Anstey
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Address
101471
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c/ Intensive Care Department
G Block, 4th Floor
Hospital Avenue,
Sir Charles Gairdner Hospital
Nedlands 6009, WA
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Country
101471
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Australia
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Phone
101471
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+61 0409124876
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Fax
101471
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Email
101471
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[email protected]
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Contact person for scientific queries
Name
101472
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Matthew Anstey
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Address
101472
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c/ Intensive Care Department
G Block, 4th Floor
Hospital Avenue,
Sir Charles Gairdner Hospital
Nedlands 6009, WA
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Country
101472
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Australia
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Phone
101472
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+61 0409124876
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Fax
101472
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Email
101472
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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)?
Yes
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What data in particular will be shared?
The investigators will be the custodians of the final trial dataset. No-one outside the trial steering committee will be given access to the data without the permission of the trial steering committee. De-identified data (individual participant data of published results only) may be made available after request to the investigators , with approval of the site ethics departments.
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When will data be available (start and end dates)?
Available 18-24 months after publication of the results
End 5 years after publication.
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Available to whom?
Researchers who provide a methodologically sound proposal that has been approved by the study steering committee
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Available for what types of analyses?
Examples include: meta-analyses. Investigators will consider other applications.
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How or where can data be obtained?
Through a signed data sharing agreement and by emailing the principal investigator Dr Anstey.
[email protected]
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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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