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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01552031
Registration number
NCT01552031
Ethics application status
Date submitted
6/03/2012
Date registered
13/03/2012
Date last updated
6/03/2017
Titles & IDs
Public title
Monitoring Chronic Obstructive Pulmonary Disease Patients at Home by a Forced Oscillation Technique Device
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Scientific title
Monitoring COPD Patients at Home by a Forced Oscillation Technique Device
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Secondary ID [1]
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COPD-FOT-MON1
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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:
COPD
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Condition category
Condition code
Intervention/exposure
Study type
Observational
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Patient registry
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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
Observational group -
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Day-by-day changes of lung mechanical impedance
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Assessment method [1]
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Changes in within-breath total respiratory input impedance (Zrs), resistance (Rrs) and Reactance (Xrs) measured day-by-day by the RESMONPRO device
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Timepoint [1]
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Every day for 8 months
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Primary outcome [2]
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Day-by-day changes of patient's symptom
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Assessment method [2]
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Changes of perceived symptoms as reported by the patients no the RESMONPRO device
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Timepoint [2]
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Every day for 8 months
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Primary outcome [3]
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Day-by-day changes of patient activity
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Assessment method [3]
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level of activity of the patient as recorded by the Actiwatch.
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Timepoint [3]
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Every day for 8 months
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Primary outcome [4]
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Number of exacerbation
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Assessment method [4]
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On the basis of the presence of the following events an exacerbation will be detected and classified as:
Mild exacerbation: changes in current treatment or prescription of a short acting bronchodilator Intermediate exacerbation: prescription of a steroids per os Severe exacerbation: prescription of systemic antibiotic Very severe exacerbation: hospital admission
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Timepoint [4]
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8 months
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Primary outcome [5]
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Day-by-day changes of breathing pattern
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Assessment method [5]
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Changes in breathing pattern measured while performing FOT by RESMONPRO device
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Timepoint [5]
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Every day for 8 months
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Eligibility
Key inclusion criteria
* COPD at stage 3 and 4 of GOLD classification(spirometric values after bronchodilator: FEV1/VC < 95th percentile of predicted and FEV1 < 50% of predicted)
* patients who reported more than two exacerbations in the past year OR
* patients who required more than two hospital admission in the last year OR
* patients with ER admission in the last year due to acute respiratory failure
better if:
* depressive phenotype
* worsening of dyspnea during walk (measured by MRC-Medical Research Council score)
* malnutrition or obesity (BMI < 19 or > 25)
* patient lives alone
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Minimum age
40
Years
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Maximum age
80
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
* Other respiratory diseases
* Alpha-1antitrypsin deficiency
* Significant inflammatory diseases other than COPD
* Organ or systemic diseases that may impair the ventilatory function (any restrictive pulmonary disease, cystic fibrosis and so on)
* Prior lung surgery
* Concomitant enrollment in other trials
* Any major non-COPD disease or condition, such as uncontrolled malignancy, end-stage heart disease, liver or renal insufficiency (that requires current evaluation for liver or renal transplantation or dialysis), amyotrophic lateral sclerosis, or severe stroke, or other as deemed appropriate by investigator as determined by review of medical history and / or patient reported medical history
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Study design
Purpose
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Duration
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Selection
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
UNKNOWN
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/11/2011
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/07/2018
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Actual
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Sample size
Target
80
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Woolcock Institute of Medical Research - Glebe
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Recruitment postcode(s) [1]
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2037 - Glebe
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Recruitment outside Australia
Country [1]
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Italy
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State/province [1]
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BS
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Country [2]
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Italy
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State/province [2]
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Torino
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Italy
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State/province [3]
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Pavia
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Country [4]
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Italy
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State/province [4]
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Varese
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Funding & Sponsors
Primary sponsor type
Other
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Name
Raffaele Dellaca
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Address
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Country
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Restech Srl
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Politecnico di Milano
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Address [2]
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Country [2]
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Other collaborator category [3]
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Other
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Name [3]
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Fondazione Salvatore Maugeri
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Address [3]
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Other collaborator category [4]
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Other
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Name [4]
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Azienda Ospedaliera S. Luigi, Orbassano (TO)
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Address [4]
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Other collaborator category [5]
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Other
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Name [5]
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Baylor College of Medicine
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Address [5]
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Other collaborator category [6]
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Other
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Name [6]
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Ospedale di Circolo e Fondazione Macchi, Varese
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Address [6]
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Other collaborator category [7]
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Other
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Name [7]
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Woolcock Institute of Medical Research
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Address [7]
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Country [7]
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Ethics approval
Ethics application status
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Summary
Brief summary
Chronic obstructive pulmonary disease (COPD) is a pathological condition whose progression is characterized by stable periods broken up by intermittent acute exacerbations of the symptoms, during which a severe inflammatory process occurs often requiring hospitalization. During exacerbations the risk of death is very high making the social and economical impact of such events important. The need of rationalize the utilization of health care resources together with the optimization of patient's care has prompted the development of models of assistance based on home monitoring. At the present time most of the suggested models were based on the utilization of diaries for symptoms perceived by the patients. Even if positive results are reported in terms of reduction of in hospitalization many COPD patients tend to underestimate the severity of their condition and their compliance in recording their symptoms rapidly decreases with time. Attempts of using more objective measurements such as home spirometers have been done but poor results were reported mainly due to the difficulties in performing a spirometric test without medical supervision. A more suitable approach to get objective information on the function of the respiratory system is the Forced Oscillation Technique (FOT). Such methodology is based on the analysis of the response of the system to small pressure stimuli over-imposed to the normal breathing of the patients. The measurements require minimal cooperation and can be performed without medical supervision. The purpose of this study is to measure daily variability of FOT data measured at home of a group of COPD patients in order to identify possible correlations between symptoms change, breathing pattern, lung mechanical impedance and occurrence of exacerbation.
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Trial website
https://clinicaltrials.gov/study/NCT01552031
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Trial related presentations / publications
United Nations Population Division, World Population Ageing: 1950-2050 2002. Connors AF Jr, Dawson NV, Thomas C, Harrell FE Jr, Desbiens N, Fulkerson WJ, Kussin P, Bellamy P, Goldman L, Knaus WA. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med. 1996 Oct;154(4 Pt 1):959-67. doi: 10.1164/ajrccm.154.4.8887592. Erratum In: Am J Respir Crit Care Med 1997 Jan;155(1):386. Soler-Cataluna JJ, Martinez-Garcia MA, Roman Sanchez P, Salcedo E, Navarro M, Ochando R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005 Nov;60(11):925-31. doi: 10.1136/thx.2005.040527. Epub 2005 Jul 29. Anzueto A, Leimer I, Kesten S. Impact of frequency of COPD exacerbations on pulmonary function, health status and clinical outcomes. Int J Chron Obstruct Pulmon Dis. 2009;4:245-51. doi: 10.2147/copd.s4862. Epub 2009 Jul 20. Donaldson GC, Seemungal TA, Bhowmik A, Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax. 2002 Oct;57(10):847-52. doi: 10.1136/thorax.57.10.847. Erratum In: Thorax. 2008 Aug;63(8):753. Dal Negro R. Optimizing economic outcomes in the management of COPD. Int J Chron Obstruct Pulmon Dis. 2008;3(1):1-10. doi: 10.2147/copd.s671. Vitacca M, Bianchi L, Guerra A, Fracchia C, Spanevello A, Balbi B, Scalvini S. Tele-assistance in chronic respiratory failure patients: a randomised clinical trial. Eur Respir J. 2009 Feb;33(2):411-8. doi: 10.1183/09031936.00005608. Epub 2008 Sep 17. Rennard S, Decramer M, Calverley PM, Pride NB, Soriano JB, Vermeire PA, Vestbo J. Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey. Eur Respir J. 2002 Oct;20(4):799-805. doi: 10.1183/09031936.02.03242002. Cote J, Cartier A, Malo JL, Rouleau M, Boulet LP. Compliance with peak expiratory flow monitoring in home management of asthma. Chest. 1998 Apr;113(4):968-72. doi: 10.1378/chest.113.4.968. Ram FS, Wedzicha JA, Wright J, Greenstone M. Hospital at home for patients with acute exacerbations of chronic obstructive pulmonary disease: systematic review of evidence. BMJ. 2004 Aug 7;329(7461):315. doi: 10.1136/bmj.38159.650347.55. Epub 2004 Jul 8. Erratum In: BMJ. 2004 Oct 2;329(7469):773. Bolton CE, Waters CS, Peirce S, Elwyn G; EPSRC and MRC Grand Challenge Team. Insufficient evidence of benefit: a systematic review of home telemonitoring for COPD. J Eval Clin Pract. 2011 Dec;17(6):1216-22. doi: 10.1111/j.1365-2753.2010.01536.x. Epub 2010 Sep 16. Gold PM. The 2007 GOLD Guidelines: a comprehensive care framework. Respir Care. 2009 Aug;54(8):1040-9. Erratum In: Respir Care. 2009 Nov;54(11):1501. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J; ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005 Aug;26(2):319-38. doi: 10.1183/09031936.05.00034805. No abstract available. Brouwer AF, Visser CA, Duiverman EJ, Roorda RJ, Brand PL. Is home spirometry useful in diagnosing asthma in children with nonspecific respiratory symptoms? Pediatr Pulmonol. 2010 Apr;45(4):326-32. doi: 10.1002/ppul.21183. Dellaca RL, Santus P, Aliverti A, Stevenson N, Centanni S, Macklem PT, Pedotti A, Calverley PM. Detection of expiratory flow limitation in COPD using the forced oscillation technique. Eur Respir J. 2004 Feb;23(2):232-40. doi: 10.1183/09031936.04.00046804. Dellaca RL, Pompilio PP, Walker PP, Duffy N, Pedotti A, Calverley PM. Effect of bronchodilation on expiratory flow limitation and resting lung mechanics in COPD. Eur Respir J. 2009 Jun;33(6):1329-37. doi: 10.1183/09031936.00139608. Epub 2009 Jan 22. Zimmermann SC, Huvanandana J, Nguyen CD, Bertolin A, Watts JC, Gobbi A, Farah CS, Peters MJ, Dellaca RL, King GG, Thamrin C. Day-to-day variability of forced oscillatory mechanics for early detection of acute exacerbations in COPD. Eur Respir J. 2020 Sep 10;56(3):1901739. doi: 10.1183/13993003.01739-2019. Print 2020 Sep.
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Public notes
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Contacts
Principal investigator
Name
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Raffaele L Dellaca', PhD
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Address
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Politecnico di Milano, Italy
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Raffaele L Dellaca', PhD
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Address
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Country
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Phone
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+393804799108
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Fax
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Email
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[email protected]
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT01552031
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