ClinicalTrials.gg
RecruitingNCT03675087Updated Mar 10, 2025

Assessment of Exercise Response in Chronic Fatigue Syndrome / Myalgic Encephalomyelitis.

An observational study in Fatigue Syndrome, Chronic, sponsored by Escuela Universitaria de Fisioterapia de la Once. Recruiting at 1 site in Spain. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2025-03-10.

Sponsored by Escuela Universitaria de Fisioterapia de la Once · Observational

From the registry’s dates

  • Primary completion was expected by Jul 2025, 1 year 4 months ago, but the record still lists the study as recruiting.
  • Started Feb 2019; still recruiting 7 years 8 months later.
Study type
Observational
Model
Case-only
Time perspective
Cross-sectional
Enrollment
22
Ages
18 Years to 65 Years
Sex
All
01

Study summary

This study evaluates the correlation between the 6-min walking test (6MWT) with gases measurement, and the peak cardiopulmonary exercise testing (CPET) using incremental cycling with gases and workload measurement, in order to determine if the 6MWT detects impairment in exercise tolerance and if it avoids the post-exertional malaise that the peak CPET causes on decreasing levels of physical activity, in participants affected by chronic fatigue syndrome/ myalgic encephalomyelitis (CFS/ME).

Physical activity level at baseline (usual activity, the parcipant will not be given any directions) will be recorded during 7 days, 24 hours/day. Afterwards, the 6MWT will be performed. After this test, the physical activity level will be collected again during 7 days, 24 hours/day. Peak CPET will be carried out 14 days after 6MWT to make sure that the basal levels are recovered, and finally, physical activity level will be collected again during 7 days, 24 hours/day.

Read the detailed description

Chronic fatigue syndrome/ myalgic encephalomyelitis presents with a significant deterioration of functional capacity, which seriously affects the quality of life. The peak or maximal incremental CPET is considered valid for the evaluation of exercise tolerance of those affected by CFS/ME, but its performance causes worsening of its symptomatology, decreasing its physical activity level after the test. It has not been verified whether the 6MWT (submaximal exercise test) with gases measurement is able to assess the exercise tolerance of those affected by SFC/EM without increasing their symptoms. So far, only the correlation between another submaximal test and a peak CPET in two different groups of participants have been analyzed and proven, which it makes necessary to check adequately whether there is a correlation by performing both tests on the same participants. In addition, it is necessary to compare the degree of worsening in physical activity level that both tests produce in participants, because they have not been objectively evaluated in any previous study. It could be useful to have a more innocuous and simple test for the assessment of exercise tolerance in CFS/ME in clinical practice, in order to evaluate the benefits of treatments like rehabilitation programs. 6MWT could respond to these characteristics because it reaches an identical value in peak VO2 than in the peak CPET in other pathologies and it generates less physical stress.

This research will be developed with the utmost respect for individual human rights, according to the postulates accepted internationally by the United Nations and the European Commission (Helsinki Act of 1964 and the Oviedo Convention of 1997) and Regulation (EU) 2016/679 of the European Parliament and the Council of April 27, 2016 on Data Protection (RGPD).

Participation in this study is entirely voluntary and does not imply any risk to health. Participants are entitled to refuse to participate or to leave the study at any time they choose.

All information will be treated confidentially. If it is decided to publish the results of the study, in these publications will not include individual data or the names of the participants, only information considered globally will be included.

This study has been approved in August 2018 by the Ethics and Research Committee of the La Paz University Hospital in Madrid (HULP Code: PI-3320).

The sample sizes were calculated in order to find the significance of the Pearson linear correlation coefficient between two variables, for a unilateral hypothesis test according to the formula: n = [Z1-α + Z1- β / ½ ln (1 + r / 1-r)]\^2 + 3 and the largest has been chosen, which involve studying 22 participants.

Taking into account the data of a previous study with participants of similar characteristics, a correlation of the parameters that set up the primary outcome, peak VO2 of r = 0.7 is assumed.

An expected drop out in rate of 0.474 has been estimated from the data obtained in another related study.

Accepting an alpha risk of 0.05 and a beta risk of 0.20 in a unilateral contrast, 22 participants are required to detect a positive correlation between the variables of the exercise tests, equal to or greater than those found in the study used as reference.

This size will guarantee sufficient power to detect correlation in the purpose of the study. To guarantee this power, and since there is not enough information about the previous values, an intermediate analysis of the data, will be carried out in the middle of the study to recalculate the size of the final sample.

The incidental sampling will be carried out according to a non-probabilistic system of consecutive cases of people diagnosed with CFS/ME.

Data analysis / Statistical methods:

  1. Descriptive: Descriptive analysis of all variables collected will be carried out. For quantitative data, centralization and dispersion measures will be calculated according to the distribution of each variable, such as mean, standard deviation, minimum and maximum median. The qualitative data will be described by absolute frequency and percentage. It will be checked if the variables are distributed normally by means of the Kolmogórov-Smirnov test for a single sample.
  2. Correlation: A bivariate analysis will be performed to observe the association between the variables obtained in the 6MWT with gases measurement and those of the peak incremental CPET; between peak VO2 in the peak CPET and the distance achieved during the 6MWT; between peak VO2 and physical activity level at baseline and after each test; and between distance achieved in the 6MWT and physical activity level at baseline and after each test. In case of normality, the Pearson product-moment correlation coefficient will be used, and if any variable is not distributed normally, the Spearman correlation analysis will be used.
  3. Linear regression: If some variables of the 6MWT are strongly correlated with the corresponding variables of the peak incremental CPET, a linear regression analysis will be performed to construct a regression equation for the prediction of the peak test performance. If necessary, a multiple linear regression analysis will be carried out to control the possible confounding variables: medication intake, time of disease evolution, quality of life, multidimensional fatigue, physical activity level at baseline, age, sex, profession, weight, height and body mass index.
  4. Comparison: a comparative analysis of physical activity level at baseline and physical activity levels after each of the tests and between physical activity levels after each of the tests to compare decrease in physical activity level that generate both tests; using repeated measures ANOVA for related samples, if they meet the normal distribution or, if not, the Friedman test.

In case of drop out, the data collected will be taken into account for the analysis.

The analysis will assume a confidence level (1 - α) of 0.95 (significance level α = 0.05). The program SPSS® Statistics version 20.0 (SPSS Incorporation, Chicago, USA) will be used.

02

Conditions studied

  • Fatigue Syndrome, Chronic

Keywords

  • Work Capacity Evaluation
  • Fatigue Syndrome,Chronic
  • Exercise Tests
03

In context

Fatigue Syndrome, Chronic

263 studies on the registry are indexed under Fatigue Syndrome, Chronic; 61 are open to participants now.

This study's planned enrollment of 22 is below the median of 150 across 77 observational studies indexed under Fatigue Syndrome, Chronic.

Browse Fatigue Syndrome, Chronic studies →

Lead sponsor

Escuela Universitaria de Fisioterapia de la Once is the lead sponsor of 2 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis affected and derived by their specialist in internal medicine from Hospital Universitario La Paz or by the Asociación de Afectados por el Síndrome de Fatiga Crónica y el Síndrome de Sensibilidad Química Múltiple de la Comunidad de Madrid, to the Escuela Universitaria de Fisioterapia de la ONCE and to the Department of Functional Tests of the Pneumology Service of the Hospital Universitario La Paz, Madrid (Spain) from October 1st, 2018 to July 1st, 2025 and that fulfill the inclusion criteria and do not present any exclusion criteria.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • To be diagnosed by a medical specialist in internal medicine with experience in this disease. For this, the participant must fulfill with the diagnostic criteria of CFS/ME, following the recommended criteria for the diagnosis of 2015.
  • Prior signing of the .

Exclusion criteria

Exclusion Criteria:

  • Present any of the diagnoses considered excluding of the CFS/ME, according to the international criteria recommended for clinical diagnosis and the selection of subjects for research:

    • Primary psychiatric disorders
    • Somatoform disorders
    • or Substance abuse
  • Present any of the absolute or relative , to perform exercise tests, described in previous investigations:

    • Decompensated heart failure
    • Acute myocardial infarction (less than 3 days)
    • Syncope
    • Unstable angina
    • Cardiac arrhythmia poorly controlled
    • Endocarditis, myocarditis or acute pericarditis
    • Acute pulmonary edema
    • Moderate or severe cardiac valvular stenosis
    • Suspected dissection or dissecting aortic aneurysm
    • O2 saturation at rest less than 85%
    • Acute renal failure
    • Untreated thyrotoxicosis
    • Acute infection
    • Uncontrolled hypertension (greater than 200-120 mmHg)
    • Hypertrophic obstructive cardiomyopathy
    • High-grade atrioventricular block
    • Significant pulmonary arterial hypertension
    • Advanced or risky pregnancy
    • Significant diselectrolithmia
    • Severe symptomatic aortic stenosis
    • Severe anemia
    • Pulmonary embolism
    • Acute thrombophlebitis
    • Traumatologic, orthopedic or neurological pathology that does not allow to walk or cycling.
    • Psychic incapacity to understand the instructions of the tests.
    • Present comorbidity of Multiple Chemical Sensitivity Syndrome.
    • Have performed the peak incremental CPET in the last 3 years.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Observational model
Case-only
Time perspective
Cross-sectional
Enrollment
22 participants (estimated)
Patient registry
No
06

What researchers measure

Primary outcomes

  1. Mean Value of the Peak VO2 in both Exercise Tests (6MWT and Peak CPET) in Milillitres/ Minute.

    The portable spirometer Oxycon Mobile CPET from JaegerTM during 6MWT or the fixed spirometer Mijnhart Oxycon during peak CPET will be used for its measuring. Those instruments are validated. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

Secondary outcomes

  1. Mean Age of Participants in Years.

    It will be measured with the date of birth, collected by data collection sheet. Mean and standard deviation will be calculated.

    Time frame: 5 minutes.

  2. Percentage of Males and Females.

    It will be collected by data collection sheet. The percentage by gender will be calculated.

    Time frame: 5 minutes.

  3. Percentage of Participants´ Professions.

    Profession is an open field, works, with or without salary. It will be collected by data collection sheet. The percentage by profession will be calculated.

    Time frame: 5 minutes.

  4. Mean of Time of Evolution of the Disease in Years.

    It will be measured from the date of medical diagnosis. It will be collected by data collection sheet. Mean and standard deviation will be calculated.

    Time frame: 5 minutes.

  5. Percentage of Participants with Autonomic Dysfunction.

    Options yes or not, presence of orthostatic postural tachycardias and/or alterations in the Heart Rate Variability. It will be collected by data collection sheet. Percentage of participants with or without autonomic dysfunction will be calculated.

    Time frame: 5 minutes.

  6. Percentage of Medications Intake.

    The type of medications consumed is an open field. It will be collected by data collection sheet. Percentage by name of medication will be calculated.

    Time frame: 10 minutes.

  7. Mean of Weight in Kilograms.

    It will be measured with the Pesperson precision scale. Range 200 grams-160 kilograms. Sensitivity 100 grams. Mean and standard deviation will be calculated.

    Time frame: 5 minutes.

  8. Mean of Height in Meters.

    It will be measured with the Pesperson tape height meter, range 82-200cm. Sensitivity 1mm. Mean and standard deviation will be calculated.

    Time frame: 5 minutes.

  9. Mean of Body Mass Index in Kilograms/ Meters^2.

    It is calculated by dividing the weight by the square of the height with the data obtained by the two previous outcomes. Mean and standard deviation will be calculated.

    Time frame: 5 minutes.

  10. Mean of Physical Activity Level at Baseline on ActivPAL 4 Micro.

    The time that participant spends lying, sitting, standing or walking is measured 7 days, 24 hours/day before both exercise tests. It will be registered with the activity meter ActivPAL4 micro, which is validated as an instrument for detecting the activity and as a tool for estimating energy expenditure, and whose data are reproducible. Mean and standard deviation will be calculated.

    Time frame: 7 days.

  11. Mean Forced Vital Capacity (FVC) on Forced Spirometry in Milillitres.

    It will be performed according to the American Thoracic Society protocol with three forced spirometries The portable spirometer Oxycon Mobile CPET from JaegerTM will be used for its measuring. Mean and standard deviation will be calculated.

    Time frame: 15 minutes.

  12. Mean Forced Expiratory Volume in the First Second (FEV1) on Forced Spirometry in Milillitres.

    It will be performed according to the American Thoracic Society protocol with three forced spirometries. The portable spirometer Oxycon Mobile CPET from JaegerTM will be used for its measuring. Mean and standard deviation of FEV1 will be calculated.

    Time frame: 15 minutes.

  13. Mean Tiffeneau Index (FEV1 / FVC) on Forced Spirometry in Percentage.

    It is calculated with the data provided by the two previous outcomes. Mean and standard deviation will be calculated.

    Time frame: 15 minutes.

  14. Mean Change from Baseline in Medications Dosage at After Both Exercise Tests (6MWT and Peak CPET).

    Open field, daily medications dosage consumed before and after both tests. It will be collected by data collection sheet. Mean and standard deviation of the differences in the dose intake by type of medication will be calculated.

    Time frame: 10 minutes on day and 10 minutes another day.

  15. Mean Change from Baseline in Quality of Life Related to Health on SF-36v2 at After Both Exercise Tests.

    It is measured from 0 to 100 points by the SF-36v2 (internal consistency value α of Cronbach of 0.94). This instrument provides a profile of health status, it is usually used in studies of research in the international field in the SFC/EM and a validated version is available in Spanish. Mean and standard deviation of the differences in the total questionnaire score and in the subscales of the questionnaire will be calculated.

    Time frame: 20 minutes one day and 20 minutes another day.

  16. Mean Change from Baseline in Multidimensional Fatigue on MIF:S at After Both Exercise Tests.

    It is measured from 4 to 20 points with the Multidimensional Inventory of Fatigue in Spanish (MIF: S) (internal consistency value α of Cronbach of 0.91). Mean and standard deviation of the differences will be calculated.

    Time frame: 10 minutes one day and 10 minutes another day.

  17. Mean Change from Baseline in Physical Activity Level on ActivPAL 4 Micro at After each of the Exercise Tests.

    The mean change in values of the time that participant spends lying, sitting, standing or walking is measured 7 days, 24 hours/day before both exercise tests and 7 days, 24 hours/day after the 6MWT and after the peak CPET. It will be registered with the activity meter ActivPAL4 micro, which is validated as an instrument for detecting the activity and as a tool for estimating energy expenditure, and whose data are reproducible.

    Time frame: 21 days, in 3 periods of 7 days.

  18. Mean Value of the Peak VO2 Body Weight Adjusted in 6MWT and in Peak CPET in Milillitres/ Kilograms/ Minute.

    The portable spirometer Oxycon Mobile CPET from JaegerTM during 6MWT or the fixed spirometer Mijnhart Oxycon during peak CPET will be used for its measuring. Those instruments are validated. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  19. Percentage of Exercise Tolerance.

    Class 1, 2, 3 or 4, classification of the impairment in exercise tolerance of the American Medical Association that is based on the values of percentage of peak VO2 body weight adjusted achieved during the exercise tests in accordance with the values of overall population. Percentage of participants in each class will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  20. Mean Distance on the 6MWT in Metres.

    It will be obtained by the 6MWT with the American Thoracic Society protocol. Mean and standard deviation will be calculated.

    Time frame: 3 hours.

  21. Mean Peak Work Load on the Peak CPET in Watts.

    It is measured through the Jaeger 900 cycle ergometer during the peak CPET with Snell CR. et al protocol. Mean and standard deviation of participants´ peak work load will be calculated.

    Time frame: 2 hours.

  22. Mean Change from Baseline in O2 Saturation on Spirometer at After each of the Exercise Tests.

    It is measured in percentage with a portable spirometer Oxycon Mobile CPET of JaegerTM in the 6MWT or with a fixed spirometer Mijnhart Oxycon in the peak CPET. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  23. Mean Change from Baseline in Heart Rate on Pulsiometer or Electrocardiogram at Maximum Hearth Rate in both Exercise Tests.

    It is measured in beats per minute with the heart rate sensor of the Polar TM31 band in 6MWT or with the 12-lead JaegerTM ECG in the peak CPET. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  24. Mean Change from Baseline in Heart Rate on Pulsiometer or Elecrocardiogram at After each of the Exercise Tests.

    It is measured in beats per minute with the heart rate sensor of the Polar TM31 band in the 6MWT or with the 12-lead JaegerTM ECG in the peak CPET. Mean and standard deviation of the differences in hearth rate between baseline and after the 6MWT or peak CPET will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  25. Mean Change from Baseline in Blood Pressure on Tensiometer at After each of the Exercise Tests.

    It is measured in mmHg with Suntech Oscar 2 tensionmeter in the 6MWT or Riester tensionmeter in the peak CPET. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  26. Mean Change from Baseline in Total Heart Rate Variability on Pulsiometer or Electrocardiogram at After each of the Exercise Tests.

    It will be measured in milliseconds, standard deviation of all the variations in the time interval between heartbeats measured with the heart rate sensor of the TM31 Polar band in the 6MWT or with the 12-lead JaegerTM ECG in the peak CPET. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  27. Mean of the Maximum Heart Rate in Percentage.

    It will be calculated with the value of the maximum heart rate reached and the maximum theoretical heart rate (220-patient's age) in the 6MWT and in the peak CPET. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  28. Mean Change from Baseline in VO2 on Spirometer at the Peak VO2 of the 6MWT and the Peak CPET.

    It is measured in millilitres/ minute with a portable spirometer Oxycon Mobile CPET of JaegerTM in the 6MWT or with a fixed spirometer Mijnhart Oxycon in the peak CPET. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  29. Mean Change from Baseline in VO2 Body Weight Adjusted on Spirometer at the Peak VO2 of both Exercise Tests.

    It is measured in millilitres/ minute /kilograms with a portable spirometer Oxycon Mobile CPET of JaegerTM in the 6MWT or with a fixed spirometer Mijnhart Oxycon in the peak CPET. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  30. Mean Change from Baseline in Oxygen Pulse on Spirometer at the Peak VO2 of both Exercise Tests.

    It will be measured in millilitre/ cycle with a portable spirometer Oxycon Mobile CPET of JaegerTM in the 6MWT or with a fixed spirometer Mijnhart Oxycon in the peak CPET. Mean and standard deviation in differences in oxygen pulse at baseline and at peak VO2 in both exercise tests will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  31. Mean Change from Baseline in CO2 Production on Spirometer at the Peak VO2 of both Exercise Tests.

    It will be measured in millilitre/ min with a portable spirometer Oxycon Mobile CPET of JaegerTM in the 6MWT or with a fixed spirometer Mijnhart Oxycon in the peak CPET. Mean and standard deviation in differences in CO2 production between baseline and peak VO2 in both exercise tests will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  32. Mean Change from Baseline in Respiratory Exchange Ratio (RER) at the Peak VO2 of both Exercise Tests.

    It will be measured in millilitres/ minute, is calculated with the values of O2 consumption and CO2 production before tests and at peak VO2 of both exercise tests. Mean and standard deviation will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

  33. Mean Change from Baseline in Minute Ventilation at the Peak VO2 of both Exercise Tests.

    It will be measured in litres/ minute with a portable spirometer Oxycon Mobile CPET of JaegerTM in the 6MWT or with a fixed spirometer Mijnhart Oxycon in the peak CPET. Mean and standard deviation of differences between baseline and at peak VO2 of both exercise tests will be calculated.

    Time frame: 3 hours one day and 2 hours another day.

07

Study locations

1 of 1 sites recruiting
  • Escuela Universitaria de Fisioterapia de la ONCE
    Madrid, 28034, Spain
    Recruiting
    • Susana García-Juez, Lecturer · Contactsgj@once.es · +0034915894500
    • Irene Rodríguez-Andonaegui, Lecturer · Contactirra@once.es · +0034915894500
08

References and documents

Publications

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  • Schafer C, Evans M, Jason LA, So S, Brown A. Measuring substantial reductions in activity. J Prev Interv Community. 2015;43(1):5-19. doi: 10.1080/10852352.2014.973242. PubMed 25584524 ↗
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Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Feb 2019 (actual). Primary completion is estimated for Jul 2025, 77 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 2, 2018
First posted
Sep 18, 2018
StartActual
Feb 27, 2019
Primary completionEst.
Jul 2025
CompletionEst.
Dec 2025
Last update
Mar 10, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 10, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03675087
Lead sponsor
Escuela Universitaria de Fisioterapia de la Once
Collaborators
Hospital Universitario La Paz
Responsible party
Susana García Juez (PhD candidate. Master´s degree in physiotherapy. Postgraduate and degree lecturer of Escuela Universitaria de Fisioterapia de la ONCE. Physioterapist practice in a private clinic., Escuela Universitaria de Fisioterapia de la Once) — Principal investigator
First posted
Sep 18, 2018
Start date
Feb 27, 2019
Primary completion
Jul 2025 (estimated)
Completion
Dec 2025 (estimated)
Last update
Mar 10, 2025

Study contacts

Susana García-Juez, Lecturer
Contact
sgj@once.es
915894500 ext. 4496
Irene Rodríguez-Andonaegui, Lecturer
Contact
irra@once.es
915894500 ext. 4389
Ana B Varas-de-la-Fuente, Chair
study chair · Escuela Universitaria de Fisioterapia de la Once
Susana García-Juez
principal investigator · Escuela Universitaria de Fisioterapia de la Once

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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