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Trial registered on ANZCTR
Registration number
ACTRN12620001365954
Ethics application status
Approved
Date submitted
28/08/2020
Date registered
18/12/2020
Date last updated
18/12/2020
Date data sharing statement initially provided
18/12/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
A high-fat meal challenge study exposing non-traditional risk factors for Type 2 Diabetes for Chinese Australians
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Scientific title
High-fat meal challenge to assess lipid metabolism in Chinese Australians at risk of Type 2 Diabetes Mellitus: A non-randomised crossover trial
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Secondary ID [1]
301912
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NIL
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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:
Type 2 Diabetes Mellitus
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Cardiovascular Diseases
318706
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Condition category
Condition code
Diet and Nutrition
316435
316435
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0
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Other diet and nutrition disorders
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Metabolic and Endocrine
317555
317555
0
0
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Diabetes
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Cardiovascular
317556
317556
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This will be a 2-armed crossover intervention trial. The aim of the intervention is to challenge the postprandial lipid metabolism participants to determine if there is a difference between Chinese and Caucasian participants.
Participants will be given two separate meal challenges.
The first will be a high-fat meal challenge (with approximately 53% fat, 40% carb, 6% protein) and the second (on a separate study visit) will be a high-carbohydrate meal challenge (70% carb, 24% fat and 6% protein) .
Each meal challenge will include 2 meals per study visit (one at 0 hours and another at 4 hours). The second meal at each visit will reflect a standard fat and carbohydrate composition. Participants will be asked to fast for 12 hours prior to each visit and consume a standard low-fat meal the evening prior to the visit.
The intervention will be delivered by a trained researcher accompanied by a trained nurse with expertise in cannula blood draws.
Both interventions will be delivered face-to-face on two separate occasions over 7 hours. The intervention will take place at our lab facility with a minimum 1 week washout period between the two intervention sessions.
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Intervention code [1]
318198
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Early detection / Screening
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Comparator / control treatment
The control group will Caucasian participants matched based on age and waist circumference who will receive the same intervention meals as the Chinese participants.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary outcome will be the difference in the postprandial triglycerides incremental area under the curve (iAUC) between the two groups. This will be assessed based on plasma blood samples taken over the 6 hours postprandial for each participant.
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Assessment method [1]
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Timepoint [1]
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The entire 6 hours period after ingestion of the first test meal for each study visit
Twelve blood samples will be taken at baseline, 15, 30, 45, 60, 90. 120. 180, 240, 270, 300, and 360 minutes post ingestion..
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Secondary outcome [1]
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Differences in postprandial and/or fasting glucose between testing groups and test meals.
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Assessment method [1]
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Timepoint [1]
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Twelve blood samples will be taken at baseline, 15, 30, 45, 60, 90. 120. 180, 240, 270, 300, and 360 minutes post ingestion..
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Secondary outcome [2]
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Fecal microbiota composition
Bacterial diversity profiling: gDNA extracted from stool samples will be amplified by PCR using validated fusion primers for the 16SrRNA: 341F - 806R region. Bar-coded amplicons will then be pooled and sequenced on the MiSeq platform utilising Illumina’s Paired End Chemistry.
Bioinformatics: Demultiplexed paired-end reads will be received from the sequencing centre in FastQ format and imported into QIIME2 (version 2019.7). Overall run quality will be assessed with FastQC (version 0.11.5). Paired end reads will be denoised, filtered and trimmed using the dada2 plugin. Amplicon sequence variants (ASVs) will be classified using the greengenes (version 13_8) database. De novo phylogenetic trees will be created using the align-to-tree-mafft-fastree plugin in QIIME2. Taxa barplots, heatmaps, alpha and beta diversity analyses will be completed in QIIME2 using rarefied counts. Beta-diversity will be visualised with principal coordinates analysis (PCoA) generated within QIIME2 using the EMPeror graphics package.
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Assessment method [2]
386248
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Timepoint [2]
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The day before the second testing visit.
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Secondary outcome [3]
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The time course kinetics of total cholesterol will also be examined. Lipidomics will provide a descriptive overview of lipid profiles in both groups. This will aim to identify novel biomarkers.
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Assessment method [3]
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Timepoint [3]
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Twelve blood samples will be taken at baseline, 15, 30, 45, 60, 90. 120. 180, 240, 270, 300, and 360 minutes post ingestion..
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Secondary outcome [4]
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Differences in postprandial and/or fasting insulin between testing groups and test meals.
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Assessment method [4]
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Timepoint [4]
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Twelve blood samples will be taken at baseline, 15, 30, 45, 60, 90. 120. 180, 240, 270, 300, and 360 minutes post ingestion..
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Secondary outcome [5]
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The time course kinetics of HDL will also be examined. Lipidomics will provide a descriptive overview of lipid profiles in both groups. This will aim to identify novel biomarkers.
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Assessment method [5]
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Timepoint [5]
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Twelve blood samples will be taken at baseline, 15, 30, 45, 60, 90. 120. 180, 240, 270, 300, and 360 minutes post ingestion..
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Secondary outcome [6]
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The time course kinetics of LDL cholesterol, will also be examined. Lipidomics will provide a descriptive overview of lipid profiles in both groups. This will aim to identify novel biomarkers.
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Assessment method [6]
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Timepoint [6]
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Twelve blood samples will be taken at baseline, 15, 30, 45, 60, 90. 120. 180, 240, 270, 300, and 360 minutes post ingestion..
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Secondary outcome [7]
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The time course kinetics of chylomicron particles will also be examined.
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Assessment method [7]
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Timepoint [7]
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Twelve blood samples will be taken at baseline, 15, 30, 45, 60, 90. 120. 180, 240, 270, 300, and 360 minutes post ingestion..
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Eligibility
Key inclusion criteria
Group 1: Adult migrants of Chinese ethnicity who screen at high risk of T2D according to the AUSDRISK tool.
Group 2:Adult Caucasians who screen at high risk of T2D according to the AUSDRISK tool
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Minimum age
35
Years
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Maximum age
54
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 confirmed diagnosis of T2D or a diagnosis of lipid-related disorder (e.g hypercholesterolemia, fatty liver); anyone on lipid lowering medication or other medications and smokers known to interfere with normal lipid metabolism.
Participants with abnormal fasting triglycerides and fasting glucose above 7mmol/L(this is indicative of diabetes)
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving 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
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Statistical methods / analysis
As this is a pilot study, sample size calculations were not completed.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
15/01/2021
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Actual
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Date of last participant enrolment
Anticipated
30/04/2021
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Actual
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Date of last data collection
Anticipated
31/05/2021
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
306327
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Charities/Societies/Foundations
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Name [1]
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Diabetes Australia
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Address [1]
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Level 1, 101 Northbourne Ave, Turner ACT 2612
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Catherine Huggins
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Address
BASE Facility, Monash University
Level 1, 264 Ferntree Gully Rd
Notting Hill, VIC, 3168
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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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Sarah Lee
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Address [1]
306823
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BASE Facility, Monash University
Level 1, 264 Ferntree Gully Rd
Notting Hill, VIC, 3168
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Country [1]
306823
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Australia
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Secondary sponsor category [2]
306833
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Individual
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Name [2]
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Nicole Kellow
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Address [2]
306833
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BASE Facility, Monash University
Level 1, 264 Ferntree Gully Rd
Notting Hill, VIC, 3168
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Country [2]
306833
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Australia
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Secondary sponsor category [3]
306834
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Individual
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Name [3]
306834
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Tammie Choi
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Address [3]
306834
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BASE Facility, Monash University
Level 1, 264 Ferntree Gully Rd
Notting Hill, VIC, 3168
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Country [3]
306834
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306538
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Monash University Human Research Ethics Committee
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Ethics committee address [1]
306538
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Monash University Human Research Ethics Committee (MUHREC) Room 111, Chancellery Building D, 26 Sports Walk, Clayton Campus Research Office Monash University VIC 3800
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Ethics committee country [1]
306538
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Australia
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Date submitted for ethics approval [1]
306538
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24/02/2020
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Approval date [1]
306538
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25/02/2020
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Ethics approval number [1]
306538
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22948
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Summary
Brief summary
We do not fully understand why Type 2 Diabetes (T2D) risk is, disproportionately higher in people from culturally and linguistically diverse backgrounds. Because of this knowledge gap, opportunities for early intervention are reduced and more lives will be lost. This study will identify if impaired non-fasting lipid metabolism is an early feature of T2D risk in Chinese immigrants in Australia. The metabolic phenotype of Chinese immigrants at risk of T2D is distinct from other ethnic groups. People from China develop T2D at a lower body mass index (BMI) and younger age than Caucasians. Traditional Western-based screening measures may not adequately capture the risk factors for T2D in this population. Chinese immigrants are Australia’s largest group of non-English speaking migrants. Recent evidence supports assessment of lipid profiles in T2D risk assessment in Chinese populations. We propose this mechanistic study as the first step in addressing the knowledge gap. We will conduct an acute high fat meal challenge to assess post-prandial lipid metabolism in Chinese adult participants. A group of age-matched Caucasian participants will be recruited as a comparison and we will employ a cross-over design. Each participant will attend two testing days, the first where they will be given a high-fat meal challenge and then second where they will be given a high-carbohydrate meal challenge. Aim: To demonstrate that Chinese-immigrants at risk for T2D have (a) an exaggerated lipid response to a high fat meal challenge and (b) a unique lipid phenotype compared with Caucasians. Hypothesis: Chinese-immigrants will exhibit a different post-prandial lipid profile compared with age and weight-matched Caucasian controls.
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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 Catherine Huggins
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Address
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BASE Facility, Monash University
Level 1, 264 Ferntree Gully Rd.
Notting Hill, VIC, 3168
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Country
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Australia
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Phone
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+61 3 99024269
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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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Catherine Huggins
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Address
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BASE Facility, Monash University
Level 1, 264 Ferntree Gully Rd.
Notting Hill, VIC, 3168
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Country
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Australia
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Phone
104211
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+61 3 99024269
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Fax
104211
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Email
104211
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[email protected]
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Contact person for scientific queries
Name
104212
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Catherine Huggins
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Address
104212
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BASE Facility, Monash University
Level 1, 264 Ferntree Gully Rd.
Notting Hill, VIC, 3168
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Country
104212
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Australia
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Phone
104212
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+61 3 99024269
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Fax
104212
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Email
104212
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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?
All of the individual participant data collected during the trial, after de-identification
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When will data be available (start and end dates)?
After publication of results, no end date.
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Available to whom?
Researchers who have an ethically approved project proposal.
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Available for what types of analyses?
Only to achieve the aims in the approved proposal.
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How or where can data be obtained?
Access subject to approvals by Principal Investigator who can be contacted at:
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
8647
Ethical approval
[email protected]
380288-(Uploaded-21-08-2020-11-06-56)-Study-related document.pdf
8983
Statistical analysis plan
[email protected]
8984
Clinical study report
[email protected]
8985
Analytic code
[email protected]
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.
Download to PDF