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Trial registered on ANZCTR
Registration number
ACTRN12622000951752p
Ethics application status
Submitted, not yet approved
Date submitted
22/06/2022
Date registered
6/07/2022
Date last updated
6/07/2022
Date data sharing statement initially provided
6/07/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Narrative Discourse Therapy for Patients in Post-Traumatic Amnesia (PTA): A feasibility study
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Scientific title
Narrative Discourse Therapy for Patients in Post-Traumatic Amnesia (PTA): A feasibility study
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Secondary ID [1]
307411
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Nil Known
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Universal Trial Number (UTN)
Nil Known
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Trial acronym
NDT-PTA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Post-traumatic amnesia
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Narrative discourse impairment
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Cognitive-communication impairment
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Traumatic Brain Injury
326745
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Condition category
Condition code
Injuries and Accidents
323975
323975
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0
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Other injuries and accidents
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Neurological
324106
324106
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will partake in a 30-minute 1:1 therapy sessions five times a week, aimed at developing narrative discourse skills, until they are deemed out of PTA (scoring 12 for 3 consecutive days on the Westmead PTA scale) or up to 10 sessions (whichever occurs first). The intervention will be delivered face-to-face. on our Acquired Brain Injury ward.
The therapy will be conducted by a member of the speech pathology team. The speech pathology team at Epworth HealthCare is experienced in cognitive-communication therapy and brain injury but will receive additional training and support. Training will occur through use of the manual and by the two Epworth Speech Pathologists involved in the study. The manual has been designed specifically for this study. Clinicians who will be administering the intervention will participate in 1x 60 minute face-to-face training session at least 2 weeks prior to delivering the first intervention.
Each treatment session will consist of the elements described below:
Part 1: Narrative discourse task with picture prompts
The participant will be shown a narrative picture sequence and then supported by the clinician to describe all the story elements. The participant will then be asked to tell the story from start to finish without any prompting, to see if they are able to retain the narrative structure and include the story elements. Note: participants will be shown a different narrative pictures sequence during each session.
Part 2: Narrative generation task
The participant will then be asked to tell the clinician a personal anecdote describing a time where they have had a similar experience to the story they just described. The clinician will document whether the patient included the same story elements as they were supported to do in the first task.
Where the intervention has been delivered by a clinician outside of the research team, a member of the research team will check-in with the clinician to ensure all measures have been completed accurately and respond to any queries from the clinician.
In addition to formal outcome measure for monitor tolerance and participation in the intervention by tracking the duration of each session and number of sessions attended.
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Intervention code [1]
323848
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Rehabilitation
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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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Participation/ engagement using the Pittsburgh Rehabilitation Participation Scale (Lenze et al., 2004). A clinician-rated 6-point Likert-type item measuring patient participation in inpatient rehabilitation sessions.
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Assessment method [1]
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Timepoint [1]
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Measured throughout each intervention session
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Primary outcome [2]
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Agitation using the Agitated Behaviour Scale (Corrigan, 1989). A 14-item scale developed to monitor agitation during the acute phase of recovery from acquired brain injury.
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Assessment method [2]
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Timepoint [2]
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Measured during each intervention session
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Secondary outcome [1]
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Length of session assessed using a standard wall clock (record time at the start of the session and time at the end of the session to calculate duration).
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Assessment method [1]
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Timepoint [1]
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Duration of each intervention session
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Secondary outcome [2]
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Patient enjoyment of the intervention tasks- participants will be asked if they enjoyed the task (i.e. a yes/no response)
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Assessment method [2]
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Timepoint [2]
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At the end of each intervention session
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Secondary outcome [3]
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Narrative discourse skills will be assessed using the Flowerpot Story (Huber, W., and Gleber, J., 1982). This is an assessment of discourse structure which will be taken prior to treatment and then afterwards and the pre-post outcome measure. An audio recording will be taken to allow for analysis after the session.
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Assessment method [3]
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Timepoint [3]
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Assessment using the flowerpot story will be completed prior to the first intervention session (between 1 and 3 days before commencing intervention and immediately post-intervention completion.
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Secondary outcome [4]
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Task completion. Participants will be rated on how well they complete the therapy tasks on a scale of 0-2 (o = nil, 1 = partial and 2 = complete)
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Assessment method [4]
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Timepoint [4]
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At the end of each intervention session
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Secondary outcome [5]
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Number of sessions attended. Audit of session attendance checklist.
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Assessment method [5]
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Timepoint [5]
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Cumulative data will be assessed at the conclusion of the study.
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Eligibility
Key inclusion criteria
Has a next of kin who can provide consent to participate
Adequate communication to participate in structure therapy targeting narrative skills as determined by their treating speech pathologist
Ability to participate in a structured therapy session as determined by the clinician who is screening the patient
English speaking
Maximum score on The Westmead Post-Traumatic Amnesia Scale (WPTAS) <11 within 24 hours of admission
Adult (i.e. over 18 years old)
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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
Previously diagnosed dementia or conditions impacting communication
Visual impairments which cannot be compensated for to see picture stimuli
Inability to sustain alertness for sufficient period of time to participate in the intervention
Medically unstable as determined by treating medical team
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Study design
Purpose of the study
Treatment
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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
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Who is / are masked / blinded?
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Intervention assignment
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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
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
11/07/2022
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Actual
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Date of last participant enrolment
Anticipated
3/10/2022
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Actual
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Date of last data collection
Anticipated
14/10/2022
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Actual
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Sample size
Target
18
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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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Recruitment hospital [1]
22601
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Epworth Richmond - Richmond
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Recruitment postcode(s) [1]
37860
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3121 - Richmond
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Funding & Sponsors
Funding source category [1]
311687
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Charities/Societies/Foundations
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Name [1]
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Epworth Medical Foundation
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Address [1]
311687
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89 Bridge Rd, Richmond VIC 3121
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Country [1]
311687
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Australia
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Primary sponsor type
Hospital
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Name
Epworth Healthcare
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Address
89 Bridge Rd, Richmond VIC 3121
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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n/a
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Address [1]
313142
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n/a
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Country [1]
313142
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
311141
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Monash Health Ethics
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Ethics committee address [1]
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Level 2, I Block, Monash Medical Centre, 246 Clayton Road, Clayton, 3168, VIC
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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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25/05/2022
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Approval date [1]
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Ethics approval number [1]
311141
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Summary
Brief summary
Post-traumatic Amnesia (PTA) is a state of confusion after someone experiences a TBI. Speech Pathologists (SPs) currently undertake a range of practices for patients with PTA but what they do is under-reported and requires further investigation (Steel et al., 2013). It is common practice that when patients are in PTA, direct therapy is kept to a minimum in case activities lead to agitation. However recent studies have demonstrated that patients in PTA can participate in some therapies such as physiotherapy or occupational therapy. Cognitive-communication deficits are a common sequelae of Traumatic Brain Injury (TBI) with 80–100% experiencing this type of communication impairment (MacDonald & Wiseman-Hakes, 2010). Part of this cognitive-communication profile is the ability to structure verbal narration of an event or a series of events (i.e. narrative discourse). This research project aims to investigate the feasibility of conducting structured narrative discourse therapy with people in PTA in order to improve their cognitive-communication skills. It is hypothesised that patients will tolerate participating in this specialised novel therapy program without any adverse effects and we expect to see improvement in their narrative discourse skills. We also hypothesise that people in PTA will have impaired narrative discourses.
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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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Mrs Aashna Vazirani
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Address
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Epworth Healthcare, 29 Erin Street, Richmond, VIC, 3121
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Country
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Australia
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Phone
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+61 03 9426 8726
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Fax
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Email
120086
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[email protected]
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Contact person for public queries
Name
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Aashna Vazirani
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Address
120087
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Epworth Healthcare, 29 Erin Street, Richmond, VIC, 3121
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Country
120087
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Australia
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Phone
120087
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+61 03 9426 8726
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Fax
120087
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Email
120087
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[email protected]
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Contact person for scientific queries
Name
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Aashna Vazirani
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Address
120088
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Epworth Healthcare, 29 Erin Street, Richmond, VIC, 3121
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Country
120088
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Australia
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Phone
120088
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+61 03 9426 8726
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Fax
120088
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Email
120088
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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?
Individual participant data underlying published results only
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When will data be available (start and end dates)?
Data will be available in published results in Jan/ Feb 2023, no end date determined
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Available to whom?
Case-by-case basis at the discretion of Primary Sponsor,
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Available for what types of analyses?
Only to achieve the aims in the approved proposal and for IPD meta-analyses
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How or where can data be obtained?
Access subject to approvals by Principal Investigator (
[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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