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Trial Review
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
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Trial registered on ANZCTR
Registration number
ACTRN12624001444572
Ethics application status
Approved
Date submitted
4/11/2024
Date registered
11/12/2024
Date last updated
5/09/2025
Date data sharing statement initially provided
11/12/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Prevalence of Quadriceps and Hamstring Strength Deficits among Anterior Cruciate Ligament Reconstruction Patients
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Scientific title
Prevalence of Quadriceps and Hamstring Strength Deficits among Anterior Cruciate Ligament Reconstruction Patients: A Retrospective Longitudinal Study
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Secondary ID [1]
313285
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None
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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:
Anterior cruciate ligament
335621
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Condition category
Condition code
Physical Medicine / Rehabilitation
332180
332180
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0
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Physiotherapy
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Musculoskeletal
332536
332536
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0
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Other muscular and skeletal disorders
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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
This study will employ a retrospective, longitudinal design using secondary data. The data will be collected from the medical records of patients who underwent anterior cruciate ligament reconstruction (ACLR) at the Hospital Canselor Tuanku Muhriz (HCTM) over a four-year period from January 2020 to December 2023. The study population will consist of all adult patients over 18 years old who underwent ACLR at the hospital and have documented preoperative and postoperative assessments of knee muscle strength and physical function at the Orthopaedic ward/clinic and Physiotherapy Unit of HCTM.
The primary outcomes of this study are 1) the percentage of quadriceps and hamstring strength between operated and non-operated knees and 2) the functional performance (single-leg hop test).
The secondary and exploratory outcomes measure patient-reported outcomes on symptoms, function, and sports activity based on the International Knee Documentation Committee (IKDC) questionnaire score and the level of patient adherence to rehabilitation sessions.
All the outcome measures will be obtained from the patient's medical record, as evaluated by the physiotherapist and physician in the HCTM between preoperative, 3-month, and 6-month postoperative ACLR.
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Intervention code [1]
329861
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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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Quadriceps strength
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Assessment method [1]
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The limb symmetry index (LSI) of the quadriceps maximum voluntary isometric contraction (MVIC) will be calculated using the formula: (MVIC peak force of the affected limb / MVIC peak force of the unaffected limb) × 100
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Timepoint [1]
339776
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preoperative, 3-month, and 6-month post-ACLR.
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Primary outcome [2]
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Hamstring strength
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Assessment method [2]
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The limb symmetry index (LSI) of the hamstring maximum voluntary isometric contraction (MVIC) will be calculated using the formula: (MVIC peak force of the affected limb / MVIC peak force of the unaffected limb) × 100
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Timepoint [2]
340053
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preoperative, 3-month, and 6-month post-ACLR.
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Primary outcome [3]
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Physical function
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Assessment method [3]
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Single-Leg Hop Test performance between operated and non-operated knee.
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Timepoint [3]
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Preoperative and 6-month post-ACLR.
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Secondary outcome [1]
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The patient-reported outcomes on symptoms, function, and sports activity will be assessed collectively as a composite outcome.
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Assessment method [1]
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The International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form.
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Timepoint [1]
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Preoperative, 3-month, and 6-month post-ACLR.
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Secondary outcome [2]
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Patient adherence to rehabilitation programs
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Assessment method [2]
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The number of sessions attended and exercises completed by patients, categorized into low, medium, and high levels of adherence, will be collected through attendance logs and exercise tracking records maintained at the rehabilitation centre.
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Timepoint [2]
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Preoperative, 3-month, and 6-month post-ACLR.
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Eligibility
Key inclusion criteria
1) Patients who have completed at least 6 months of follow-up post-ACLR surgery.
2) Patients with complete and accessible medical records, including preoperative, intraoperative, and postoperative data.
3) Patients who have undergone standardized assessments of knee muscle strength, physical function, or related evaluations at specified intervals post-surgery (e.g., pre-operatively, 3 and 6 months).
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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
1) Patients with missing or incomplete data related to key variables of interest in the study.
2) Female patients who were pregnant at the time of follow-up assessments, as pregnancy may affect physical function and muscle strength.
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
Descriptive statistics will be employed to concisely summarise the characteristics of the participants and the prevalence of impairments in knee muscle and physical function. The analysis will use Chi-square tests to estimate the frequency of the study population's demographic characteristics and categorical variables (type of graft, concomitant bone/chondral lesion and level of adherence), as well as linear regression analysis to identify influence factors and predictors of ACLR outcome. Furthermore, the Pearson correlation test will be employed for continuous variables and normally distributed data, or the Spearman correlation for ordinal or non-normally distributed data. The Bonferroni post-hoc test will be performed to identify differences in the relevant analysis. The significance level is set at P <0.05. Additionally, the odds ratio (OR), 95% confidence interval (CI), or Z-score will be included.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
17/12/2024
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Actual
19/12/2024
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Date of last participant enrolment
Anticipated
31/05/2025
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Actual
9/06/2025
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Date of last data collection
Anticipated
30/06/2025
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Actual
1/07/2025
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Sample size
Target
108
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Accrual to date
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Final
104
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Recruitment outside Australia
Country [1]
26667
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Malaysia
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State/province [1]
26667
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Kuala Lumpur
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Funding & Sponsors
Funding source category [1]
317736
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Hospital
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Name [1]
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Hospital Canselor Tuanku Muhriz UKM
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Address [1]
317736
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Country [1]
317736
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Malaysia
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Primary sponsor type
Hospital
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Name
Hospital Canselor Tuanku Muhriz UKM
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Address
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Country
Malaysia
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Secondary sponsor category [1]
320049
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None
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Name [1]
320049
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Address [1]
320049
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Country [1]
320049
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316424
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UKM Research Ethic Committee (RECUKM)
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Ethics committee address [1]
316424
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sepukm@ukm.edu.my
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Ethics committee country [1]
316424
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Malaysia
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Date submitted for ethics approval [1]
316424
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24/09/2024
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Approval date [1]
316424
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18/11/2024
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Ethics approval number [1]
316424
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JEP-2024-849
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Summary
Brief summary
This study investigates the frequency of quadriceps, hamstring, and physical function deficits among anterior cruciate ligament reconstruction (ACLR) patients at Hospital Canselor Tuanku Muhriz, Malaysia, between 2020 and 2023. A retrospective longitudinal study design will be employed, analysing patient data from medical records at preoperative, 3-, and 6-month follow-up periods. The primary outcome is the prevalence of quadriceps and hamstring strength deficits between the operated and non-operated limbs. Secondary outcomes included the impact of graft types and sociodemographic factors on strength recovery. Statistical analysis will assess the association between strength deficits and demographic, surgical, and rehabilitation factors. Understanding these deficits may help guide the development of targeted rehabilitation strategies to address specific impairments and optimise functional recovery following ACL reconstruction.
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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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A/Prof Badrul Akmal Hisham Bin Md. Yusoff
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Address
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Hospital Canselor Tuanku Muhriz, UKM, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Wilayah Persekutuan Kuala Lumpur
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Country
137846
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Malaysia
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Phone
137846
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+60125196119
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Fax
137846
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Email
137846
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[email protected]
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Contact person for public queries
Name
137847
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Efri Noor Bin Muhamad Hendri
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Address
137847
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Hospital Canselor Tuanku Muhriz, UKM, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Wilayah Persekutuan Kuala Lumpur
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Country
137847
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Malaysia
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Phone
137847
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+60132117407
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Fax
137847
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Email
137847
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[email protected]
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Contact person for scientific queries
Name
137848
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Mohamad Shariff Bin A Hamid
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Address
137848
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Jabatan Perubatan Kesukanan, Tingkat 5, Menara Selatan, Pusat Perubatan Universiti Malaya, Lembah Pantai, 59100 Kuala Lumpur
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Country
137848
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Malaysia
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Phone
137848
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+60122065452
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Fax
137848
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Email
137848
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
Yes
Will there be any conditions when requesting access to individual participant data?
Persons/groups eligible to request access:
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Researchers
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Journal editors, peer reviewers (for manuscript evaluation), and qualified researchers with a sound proposal and ethics approval
Conditions for requesting access:
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Yes, conditions apply:
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Requires review on a case-by-case basis by the trial custodian, sponsor or data sharing committee
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Requires a scientifically sound proposal or protocol
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Requires approval by an ethics committee
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Requires a data sharing agreement between data requester and trial custodian or sponsor
What individual participant data might be shared?
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De-identified individual participant data:
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Published results
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Primary outcome(s)
What types of analyses could be done with individual participant data?
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Any type of analysis (i.e. no restrictions on data re-use)
When can requests for individual participant data be made (start and end dates)?
From:
After publication of main results
To:
Not yet decided
Where can requests to access individual participant data be made, or data be obtained directly?
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Email of trial custodian, sponsor or committee:
[email protected]
Are there extra considerations when requesting access to individual participant data?
No
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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