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Trial registered on ANZCTR
Registration number
ACTRN12622000701729
Ethics application status
Approved
Date submitted
28/04/2022
Date registered
16/05/2022
Date last updated
8/09/2024
Date data sharing statement initially provided
16/05/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Better management of breathlessness in the ICU (BreatheICU):
A cross-sectional national clinician survey and consumer interview study.
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Scientific title
Better management of breathlessness in the ICU (BreatheICU):
A cross-sectional national clinician survey and consumer interview study.
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Secondary ID [1]
306991
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Nil known
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Universal Trial Number (UTN)
U1111-1277-5515
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Trial acronym
BreatheICU
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Breathlessness
326108
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Condition category
Condition code
Respiratory
323438
323438
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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
Study Part 1– Cross-sectional National Descriptive Clinician Survey.
Medical, nursing and allied health staff of Australian adult ICU’s will be invited to participate in a single survey (approximately 15mins in duration) exploring their perceptions regarding assessment and management of breathlessness. Survey questions will be based on existing published surveys used to assess attitudes toward dyspnoea assessment and management in doctors and ICU nurses. Questions include non-identifiable demographic data, and Likert-style statements inviting respondents to indicate their level of agreement concerning the importance of dyspnoea in clinical care; current assessment and management of dyspnoea; use and benefits of routine dyspnoea assessment; management of dyspnoea. In order to develop a ‘knowledge bank’, open-ended question responses will also be included, inviting responders to provide information on any strategies they have found personally useful for managing dyspnoea. We propose to reach the target population for this study through collaboration with both the Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group (CTG), and the Cardiothoracic Special Interest Group of the Australian Physiotherapy Association.
Study Part 2 - Interviews with consumers.
A purposive sample of patients admitted to the ICU with and without respiratory disease (n=20 patients) over a four-month period will be recruited. Clinical staff at The Queen Elizabeth Hospital, South Australia (TQEH) will screen ICU patients Monday to Friday meeting the inclusion criteria. The aim of the interview is to explore the experience of breathlessness in people who have been cared for within the ICU environment. A topic guide will be developed based on previous interview studies and in conjunction with local consumer representatives who are part of the study reference group. The interview will be conducted on the day of ICU discharge or as close as practical. It will be a maximum of 30 minutes duration (interview can be offered as 2 shorter sessions if appropriate) and consist of 3 to 5 key questions specific to the participants ICU experience with prompts for experiences of symptoms of breathlessness.
Post-study reference group:
At the end of the interview, participants will be provided with an option to join a post-study reference group, to consider and reflect upon the study findings. This would involve further communication by telephone and email with the study investigators on a maximum of 2 occasions (for approx. 30mins) after analysis of the data. Interested participants would be invited to collaborate with interpretation of study results and development of proposed actions and recommendations from the study findings.
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Intervention code [1]
323441
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Not applicable
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Comparator / control treatment
no control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To investigate perceptions and beliefs of Australian ICU clinicians about dyspnoea assessment and management in patients managed within the ICU setting, using a questionnaire designed for the study.
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Assessment method [1]
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Timepoint [1]
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Once off survey
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Secondary outcome [1]
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To explore, using a semi-structured interview process, the experience of dyspnoea in people who have been cared for within a local ICU environment. The interview will involve a 30min face to face interview with a senior clinician at the time of discharge from ICU.
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Assessment method [1]
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Timepoint [1]
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Assessed at the time of the patient's discharge from ICU to a ward setting.
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Eligibility
Key inclusion criteria
Survey
Medical, nursing and allied health staff of Australian adult ICU’s will be invited to participate in a single survey. With endorsement of the study by the ANZICS CTG we anticipate the survey will be able to be distributed to over 70 ANZICS CTG member ICU’s in Australia, reaching a minimum of 500 eligible clinicians on the CTG mailing list. Mailing list recipients will be encouraged to forward the survey invitation to eligible clinicians within their networks (snowballing).
Interviews
A purposive sample of patients admitted to the ICU with and without respiratory disease (n=20 patients) over a four-month period will be recruited. Clinical staff at The Queen Elizabeth Hospital, South Australia (TQEH) will screen ICU patients Monday to Friday for the following inclusion criteria:
• Aged over 18 years
• English speaking
• ICU stay of >48 hours
• Planned for discharge from the ICU to the ward
• Capacity to provide consent to participate
Patients meeting the above inclusion criteria will be asked a single screening question - “Did you ever feel breathless during your time in ICU?”. Those indicating ‘yes’ will be invited to participate in a semi-structured interview.
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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?
Yes
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Key exclusion criteria
No specific groups are to be excluded.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Survey-data:
Given the recruitment strategy planned (inclusion of snowballing), the total number of potential participants is unknown and consequently response rates will be unable to calculated. Descriptive reporting of demographic data and response rates for each survey item will be calculated (frequency, proportion). Where possible, demographic data (professional discipline, state/territory, geographic location (metropolitan/rural) will be compared to national data (ANZICS CTG membership demographics, national ICU workforce data) to estimate representativeness of the respondent’s sample. Ratings for agreement (Likert-scale items) will be reported as mean and standard deviation unless data are not normally distributed (median, interquartile range). Open ended questions will be coded for content (independently by two members of the research team) to highlight common recurring views.
Interview-data:
Demographic and clinical characteristics (comorbidities, intubation and mechanical ventilation duration/variable) will be gained from the patient medical record post-interview for subjects participating in the interview and reported descriptively. Transcript data will be analysed using reflexive thematic analysis involving five explicitly defined stages (familiarisation, initial coding, constructing, reviewing and finalising themes) each completed by two researchers to promote triangulation and credibility. Verbatim quotations from a range of participants will be included to illustrate connections between the data and themes. Study conduct and reporting will be consistent with reporting guidelines for surveys and qualitative studies (COREQ) respectively.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/05/2022
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Actual
18/10/2022
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Date of last participant enrolment
Anticipated
30/06/2023
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Actual
6/09/2023
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Date of last data collection
Anticipated
30/06/2023
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Actual
4/07/2024
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Sample size
Target
160
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Accrual to date
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Final
160
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Recruitment hospital [1]
24616
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The Queen Elizabeth Hospital - Woodville
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Recruitment postcode(s) [1]
40223
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5011 - Woodville
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Funding & Sponsors
Funding source category [1]
311303
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Charities/Societies/Foundations
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Name [1]
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Physiotherapy Research Foundation
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Address [1]
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PO Box 437 Hawthorn BC VIC 3122 Australia
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Country [1]
311303
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Australia
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Primary sponsor type
Individual
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Name
Mr Leigh Rushworth
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Address
CALHN Physiotherapy Department
28 Woodville Rd, Woodville South SA 5011
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Country
Australia
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Secondary sponsor category [1]
312666
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Individual
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Name [1]
312666
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A/Prof Kylie Johnston
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Address [1]
312666
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University of South Australia, City East Campus
Corner of North Terrace and, Frome Rd, Adelaide SA 5001
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Country [1]
312666
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Australia
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Secondary sponsor category [2]
312679
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Individual
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Name [2]
312679
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Prof Marie Williams
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Address [2]
312679
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University of South Australia, City East Campus
Corner of North Terrace and, Frome Rd, Adelaide SA 5001
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Country [2]
312679
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Australia
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Secondary sponsor category [3]
312680
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Individual
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Name [3]
312680
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Ms Patricia Williams
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Address [3]
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TQEH Department of Intensive Care Medicine
28 Woodville Rd, Woodville South SA 5011
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Country [3]
312680
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Australia
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Secondary sponsor category [4]
312681
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Individual
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Name [4]
312681
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Dr Nikki Yeo
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Address [4]
312681
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TQEH Department of Intensive Care Medicine
28 Woodville Rd, Woodville South SA 5011
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Country [4]
312681
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
310805
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CALHN Human Research Ethics Committee.
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Ethics committee address [1]
310805
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CALHN Research Services, Central Adelaide Local Health Network Inc. SA Health Level 3, Roma Mitchell Building, 136 North Terrace, Adelaide, SA 5000
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Ethics committee country [1]
310805
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Australia
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Date submitted for ethics approval [1]
310805
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11/03/2022
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Approval date [1]
310805
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07/07/2022
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Ethics approval number [1]
310805
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16181
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Ethics committee name [2]
312909
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University of South Australia Human Research Ethics Committee
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Ethics committee address [2]
312909
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University of South Australia, GPO Box 2471, Adelaide SA 5001.
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Ethics committee country [2]
312909
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Australia
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Date submitted for ethics approval [2]
312909
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18/07/2022
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Approval date [2]
312909
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19/07/2022
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Ethics approval number [2]
312909
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204869
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Summary
Brief summary
In settings of care for people who cannot breathe without support such as intensive care units (ICU), dyspnoea (the experience of difficulty breathing) is a frequent and terrifying problem. Recent reports indicate that dyspnoea in the ICU is just as commonly experienced as pain (47% report mod-severe dyspnoea vs 41% pain, n=138 ICU patients [Gentzler et al. 2019]), yet dyspnoea by comparison is poorly recognised, underassessed and under-treated. This results in increased length of ICU stay, poorer physical and long-term psychological outcomes; and occurs despite the availability of potentially suitable assessment tools and evidence-based effective interventions for dyspnoea in the ICU. Implementation of dyspnoea assessment and management in Australian ICUs is largely unexplored. This project aims to address explore this issue through two research questions: 1. What are the perceptions and beliefs of Australian ICU clinicians about dyspnoea assessment and management in patients in the ICU setting? 2. What is the experience of dyspnoea in people who have been cared for within an ICU environment? Methodology: The project will be conducted in two parts within an action research framework: 1. A cross-sectional national descriptive survey of medical, nursing and allied health clinicians working within Australian ICU’s, to explore attitudes and practices in dyspnoea assessment and management. 2. Semi-structured interviews with a purposive sample of ICU patients from a local facility, to explore the experience of breathlessness in people who have been cared for within the ICU environment. Significance: Internationally, addressing assessment and management of dyspnoea in ICU settings has been recognised as an ethical and moral imperative to lessen suffering, improve patient outcomes, and reduce health care costs associated with delayed time in the ICU and post-ICU morbidity. To date, there is no Australian data available on prevalence, assessment practices and management strategies on dyspnoea within the ICU setting. This study aims to gain an understanding of current Australian practice using a collaborative participatory action research approach to focus on patient and clinician-valued priorities and solutions. The findings from this study will provide a foundation for developing strategies to translate breathlessness science and evidence-based interventions into clinical practice in the ICU.
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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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Mr Leigh Rushworth
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Address
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CALHN Physiotherapy Department- The Queen Elizabeth Hospital
28 Woodville Rd, Woodville South, SA 5011
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Country
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Australia
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Phone
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+61 0882226621
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Fax
118934
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Email
118934
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[email protected]
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Contact person for public queries
Name
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Leigh Rushworth
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Address
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CALHN Physiotherapy Department- The Queen Elizabeth Hospital
28 Woodville Rd, Woodville South, SA 5011
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Country
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Australia
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Phone
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+61 0882226621
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Fax
118935
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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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Patricia Williams
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Address
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TQEH Department of Intensive Care Medicine,
28 Woodville Rd, Woodville South SA 5011
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Country
118936
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Australia
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Phone
118936
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+61 0882226000
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Fax
118936
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Email
118936
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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
Only summary results and verbatim quotations from a range of participants will be disseminated
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
15869
Study protocol
[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.
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