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NCT01401907 · STUDY IN CONTEXT

Early Palliative Care in Advanced Lung and Gastrointestinal Malignancies

Draft scope assessment: narrower. Linked by condition-string match at the cancer-entity level. The study's eligibility - stage, biomarker, treatment line and prior therapy - has not been reconciled against this page's definition, so its population is narrower than this page in ways not yet recorded. The condition was transformed or resolved through the terminology hierarchy to reach this cancer type, so the link itself is a candidate a reviewer must confirm. Found by searching ClinicalTrials.gov for this cancer type, restricted to studies that have posted results to the registry. No FDA notice, FDA label or NCI summary held by this site cites this study. Because the search asked for posted results, studies without posted results were never looked for, so their absence from this page means nothing.

Read the full study record and all posted results →

Linked outcomes

Measures are not ranked. Open each original source section for treatment groups, denominators, units and results.

primary · POSTED

The Functional Assessment of Cancer Therapy - General is a quality of life measure with higher scores indicating better quality of life (range 0-108). We are examining the adjusted mean difference from baseline to 12 weeks in this study

Source null

→

secondary · POSTED

The Functional Assessment of Cancer Therapy - General is a quality of life measure with higher scores indicating better quality of life (range 0-108). We are examining the adjusted mean difference from baseline to 24 weeks.

The analysis focuses on participants who completed week-24 questionnaires (N = 118 in the early palliative care arm, and N = 124 in the standard of care arm)

→

secondary · POSTED

The hospital anxiety and depression scale examines symptoms of depression and anxiety. We compared rates of clinically significant depression symptoms (using a cut off of 8 on the depression subscale score) between study arms at week-12 and week-24.

The two rows examine outcomes at two different time points week-12 and week-24. Please note the number of participants included in week-12 and week-24 analyses reflect the participants who completed the hospital anxiety and depression scale at these time points (study completers), which explains the discrepancy with the flow chart.

→

secondary · POSTED

We used the response to an item on Perception of Treatment and Prognosis Questionnaire to compare rates of accurate prognostic understanding between study arms. Participants reported their primary goal of their current cancer treatment: 1) to cure my cancer; 2) to lesson my suffering as much as possible; 3) for me and/or my family to be able to keep hoping; 4) to make sure I have done everything; 5) to extend my life as long as possible; 6) to help cancer research. Participants' responses were dichotomized as 1) to cure my cancer vs. all other.

The different rows reflect analyses at week-12 and week-24. Please note the number of participants included in week-12 and week-24 analyses reflect the participants who completed the Perception of Treatment and Prognosis Questionnaire at these time points (study completers), which explains the discrepancy with the flow chart.

→

secondary · POSTED

The Medical Health Outcomes Survey- Short Form (SF-36) is a measure of QOL. The SF-36 measures eight domains of health-related quality of life: physical functioning, role limitation due to physical health, bodily pain, general health perceptions, vitality, social functioning, role limitation due to emotional health, and mental health. The response choices are scored and summed to yield two physical (PCS) and mental (MCS) component summary measures with ranges from 0-100. Higher scores indicate better quality of life. We compared family caregiver PCS and MCS scores between the two study arms at week-12 and week-24 adjusting for baseline scores.

Adjusted Means controlling for baseline scores. The different rows reflect Week-12 and Week-24 outcomes on SF-36 PCS and MCS domains. The number of participants included in week-12 and week-24 analyses reflect the participants who completed the SF-36 at these time points, which explains the discrepancy with the flow chart.

→

secondary · POSTED

We used the Hospital Anxiety and Depression scale to measure overall psychological distress in family caregivers. The Hospital Anxiety and Depression Scale contains two subscales measuring depression and anxiety respectively. When examined continuously, this scale reflects degree of psychological distress with higher scores indicating more psychological distress (range 0-42). We compared overall psychological distress (HADS-total) among family caregivers between the two study arms

Looking at the HADS-total score at week-12 and week-24. Please note the number of participants included in week-12 and week-24 analyses reflect the participants who completed the hospital anxiety and depression scale at these time points (study completers), which explains the discrepancy with the flow chart.

→

Reported safety

Serious events are not the same as severe events. Compare the original safety groups and their at-risk populations.

Open the study safety table →

Quality of life and patient-reported measures

Unnamed quality-of-life measure · Functional Assessment of Cancer Therapy (Quality of Life Measure)

Score direction: Higher is better, according to the source. Direction is never inferred from an instrument name.

release id
clinical-indications-draft-1
disease state id
ds-liver-neoplasm
nct id
NCT01401907
qol key
qol-0000
source section id
NCT01401907-om-0000
source outcome index
0
instrument
Unnamed quality-of-life measure
instrument basis
matched 'quality of life' in the study's own wording
scale title
Functional Assessment of Cancer Therapy (Quality of Life Measure)
measure definition
The Functional Assessment of Cancer Therapy - General is a quality of life measure with higher scores indicating better quality of life (range 0-108). We are examining the adjusted mean difference from baseline to 12 weeks in this study
time frame
12 weeks
analysis role
primary
reporting status
POSTED
higher is better
1
direction quote
higher scores indicating better
population note
Source null
curation status
draft
reviewed by
Source null
reviewed at
Source null
created at
2026-09-10T00:00:00Z
Open the exact result →
Unnamed quality-of-life measure · Functional Assessment of Cancer Therapy (Quality of Life Measure)

Score direction: Higher is better, according to the source. Direction is never inferred from an instrument name.

release id
clinical-indications-draft-1
disease state id
ds-liver-neoplasm
nct id
NCT01401907
qol key
qol-0001
source section id
NCT01401907-om-0001
source outcome index
1
instrument
Unnamed quality-of-life measure
instrument basis
matched 'quality of life' in the study's own wording
scale title
Functional Assessment of Cancer Therapy (Quality of Life Measure)
measure definition
The Functional Assessment of Cancer Therapy - General is a quality of life measure with higher scores indicating better quality of life (range 0-108). We are examining the adjusted mean difference from baseline to 24 weeks.
time frame
24 weeks
analysis role
secondary
reporting status
POSTED
higher is better
1
direction quote
higher scores indicating better
population note
The analysis focuses on participants who completed week-24 questionnaires (N = 118 in the early palliative care arm, and N = 124 in the standard of care arm)
curation status
draft
reviewed by
Source null
reviewed at
Source null
created at
2026-09-10T00:00:00Z
Open the exact result →
SF-36 / SF-12 · Family Caregiver Quality of Life as Measured by the SF-36

Score direction: Higher is better, according to the source. Direction is never inferred from an instrument name.

release id
clinical-indications-draft-1
disease state id
ds-liver-neoplasm
nct id
NCT01401907
qol key
qol-0004
source section id
NCT01401907-om-0004
source outcome index
4
instrument
SF-36 / SF-12
instrument basis
matched 'sf-36' in the study's own wording
scale title
Family Caregiver Quality of Life as Measured by the SF-36
measure definition
The Medical Health Outcomes Survey- Short Form (SF-36) is a measure of QOL. The SF-36 measures eight domains of health-related quality of life: physical functioning, role limitation due to physical health, bodily pain, general health perceptions, vitality, social functioning, role limitation due to emotional health, and mental health. The response choices are scored and summed to yield two physical (PCS) and mental (MCS) component summary measures with ranges from 0-100. Higher scores indicate better quality of life. We compared family caregiver PCS and MCS scores between the two study arms at week-12 and week-24 adjusting for baseline scores.
time frame
Week-12 and Week-24
analysis role
secondary
reporting status
POSTED
higher is better
1
direction quote
Higher scores indicate better
population note
Adjusted Means controlling for baseline scores. The different rows reflect Week-12 and Week-24 outcomes on SF-36 PCS and MCS domains. The number of participants included in week-12 and week-24 analyses reflect the participants who completed the SF-36 at these time points, which explains the discrepancy with the flow chart.
curation status
draft
reviewed by
Source null
reviewed at
Source null
created at
2026-09-10T00:00:00Z
Open the exact result →
Full draft applicability and source-link record
trial
release id
clinical-indications-draft-1
disease state id
ds-liver-neoplasm
nct id
NCT01401907
trial label
Early Palliative Care in Advanced Lung and Gastrointestinal Malignancies
applicability
narrower
applicability note
Linked by condition-string match at the cancer-entity level. The study's eligibility - stage, biomarker, treatment line and prior therapy - has not been reconciled against this page's definition, so its population is narrower than this page in ways not yet recorded. The condition was transformed or resolved through the terminology hierarchy to reach this cancer type, so the link itself is a candidate a reviewer must confirm.
curation status
draft
reviewed by
Source null
reviewed at
Source null
created at
2026-09-10T00:00:00Z
provenance class
registry-condition-search
discovery note
Found by searching ClinicalTrials.gov for this cancer type, restricted to studies that have posted results to the registry. No FDA notice, FDA label or NCI summary held by this site cites this study. Because the search asked for posted results, studies without posted results were never looked for, so their absence from this page means nothing.
outcome Count
6
harms Count
2
qol Count
3
outcomes
  1. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0000
    source section id
    NCT01401907-om-0000
    source outcome index
    0
    endpoint
    Functional Assessment of Cancer Therapy (Quality of Life Measure)
    endpoint definition
    The Functional Assessment of Cancer Therapy - General is a quality of life measure with higher scores indicating better quality of life (range 0-108). We are examining the adjusted mean difference from baseline to 12 weeks in this study
    time origin
    12 weeks
    analysis role
    primary
    reporting status
    POSTED
    data cutoff
    Source null
    population note
    Source null
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
  2. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0001
    source section id
    NCT01401907-om-0001
    source outcome index
    1
    endpoint
    Functional Assessment of Cancer Therapy (Quality of Life Measure)
    endpoint definition
    The Functional Assessment of Cancer Therapy - General is a quality of life measure with higher scores indicating better quality of life (range 0-108). We are examining the adjusted mean difference from baseline to 24 weeks.
    time origin
    24 weeks
    analysis role
    secondary
    reporting status
    POSTED
    data cutoff
    Source null
    population note
    The analysis focuses on participants who completed week-24 questionnaires (N = 118 in the early palliative care arm, and N = 124 in the standard of care arm)
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
  3. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0002
    source section id
    NCT01401907-om-0002
    source outcome index
    2
    endpoint
    Rate of Clinically Significant Depression Symptoms Based on Hospital Anxiety and Depression Scale
    endpoint definition
    The hospital anxiety and depression scale examines symptoms of depression and anxiety. We compared rates of clinically significant depression symptoms (using a cut off of 8 on the depression subscale score) between study arms at week-12 and week-24.
    time origin
    Week-12 and Week-24
    analysis role
    secondary
    reporting status
    POSTED
    data cutoff
    Source null
    population note
    The two rows examine outcomes at two different time points week-12 and week-24. Please note the number of participants included in week-12 and week-24 analyses reflect the participants who completed the hospital anxiety and depression scale at these time points (study completers), which explains the discrepancy with the flow chart.
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
  4. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0003
    source section id
    NCT01401907-om-0003
    source outcome index
    3
    endpoint
    Number and Percentage of Participants Who Reported Goal of Their Cancer Treatment is to Cure Their Cancer
    endpoint definition
    We used the response to an item on Perception of Treatment and Prognosis Questionnaire to compare rates of accurate prognostic understanding between study arms. Participants reported their primary goal of their current cancer treatment: 1) to cure my cancer; 2) to lesson my suffering as much as possible; 3) for me and/or my family to be able to keep hoping; 4) to make sure I have done everything; 5) to extend my life as long as possible; 6) to help cancer research. Participants' responses were dichotomized as 1) to cure my cancer vs. all other.
    time origin
    Week12 and Week 24
    analysis role
    secondary
    reporting status
    POSTED
    data cutoff
    Source null
    population note
    The different rows reflect analyses at week-12 and week-24. Please note the number of participants included in week-12 and week-24 analyses reflect the participants who completed the Perception of Treatment and Prognosis Questionnaire at these time points (study completers), which explains the discrepancy with the flow chart.
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
  5. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0004
    source section id
    NCT01401907-om-0004
    source outcome index
    4
    endpoint
    Family Caregiver Quality of Life as Measured by the SF-36
    endpoint definition
    The Medical Health Outcomes Survey- Short Form (SF-36) is a measure of QOL. The SF-36 measures eight domains of health-related quality of life: physical functioning, role limitation due to physical health, bodily pain, general health perceptions, vitality, social functioning, role limitation due to emotional health, and mental health. The response choices are scored and summed to yield two physical (PCS) and mental (MCS) component summary measures with ranges from 0-100. Higher scores indicate better quality of life. We compared family caregiver PCS and MCS scores between the two study arms at week-12 and week-24 adjusting for baseline scores.
    time origin
    Week-12 and Week-24
    analysis role
    secondary
    reporting status
    POSTED
    data cutoff
    Source null
    population note
    Adjusted Means controlling for baseline scores. The different rows reflect Week-12 and Week-24 outcomes on SF-36 PCS and MCS domains. The number of participants included in week-12 and week-24 analyses reflect the participants who completed the SF-36 at these time points, which explains the discrepancy with the flow chart.
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
  6. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0005
    source section id
    NCT01401907-om-0005
    source outcome index
    5
    endpoint
    Family Caregiver Psychological Distress (Based on the Hospital Anxiety and Depression Scale)
    endpoint definition
    We used the Hospital Anxiety and Depression scale to measure overall psychological distress in family caregivers. The Hospital Anxiety and Depression Scale contains two subscales measuring depression and anxiety respectively. When examined continuously, this scale reflects degree of psychological distress with higher scores indicating more psychological distress (range 0-42). We compared overall psychological distress (HADS-total) among family caregivers between the two study arms
    time origin
    Week 12 and Week 24
    analysis role
    secondary
    reporting status
    POSTED
    data cutoff
    Source null
    population note
    Looking at the HADS-total score at week-12 and week-24. Please note the number of participants included in week-12 and week-24 analyses reflect the participants who completed the hospital anxiety and depression scale at these time points (study completers), which explains the discrepancy with the flow chart.
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
arms
  1. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0000
    arm key
    OG000
    arm label
    Early Palliative Care
    regimen
    Subjects receive standard of care with early palliative care. early palliative care: patient assigned to the intervention will receive early palliative care along with standard oncology care.
    analyzed count
    148
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0000#groups/OG000
  2. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0000
    arm key
    OG001
    arm label
    Standard of Care
    regimen
    Subjects receives standard of care
    analyzed count
    153
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0000#groups/OG001
  3. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0001
    arm key
    OG000
    arm label
    Early Palliative Care
    regimen
    Subjects receive standard of care with early palliative care. early palliative care: patient assigned to the intervention will receive early palliative care along with standard oncology care.
    analyzed count
    118
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0001#groups/OG000
  4. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0001
    arm key
    OG001
    arm label
    Standard of Care
    regimen
    Subjects receives standard of care
    analyzed count
    124
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0001#groups/OG001
  5. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0002
    arm key
    OG000
    arm label
    Early Palliative Care
    regimen
    Early Palliative Care
    analyzed count
    138
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0002#groups/OG000
  6. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0002
    arm key
    OG001
    arm label
    Standard Oncology Care
    regimen
    Standard Oncology Care
    analyzed count
    141
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0002#groups/OG001
  7. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0003
    arm key
    OG000
    arm label
    Early Palliative Care
    regimen
    Early Palliative Care
    analyzed count
    143
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0003#groups/OG000
  8. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0003
    arm key
    OG001
    arm label
    Standard Oncology Care
    regimen
    Standard Oncology Care
    analyzed count
    145
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0003#groups/OG001
  9. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0004
    arm key
    OG000
    arm label
    Early Palliative Care
    regimen
    Early Palliative Care
    analyzed count
    110
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0004#groups/OG000
  10. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0004
    arm key
    OG001
    arm label
    Standard Oncology Care
    regimen
    Standard Oncology Care
    analyzed count
    119
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0004#groups/OG001
  11. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0005
    arm key
    OG000
    arm label
    Early Palliative Care
    regimen
    Early Palliative Care
    analyzed count
    110
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0005#groups/OG000
  12. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    outcome key
    om-0005
    arm key
    OG001
    arm label
    Standard Oncology Care
    regimen
    Standard Oncology Care
    analyzed count
    119
    analyzed unit
    Participants
    is comparator
    Source null
    source pointer
    NCT01401907-om-0005#groups/OG001
harms
  1. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    harm key
    EG000
    source section id
    NCT01401907-ae
    event group key
    EG000
    event group label
    Early Palliative Care
    serious affected
    0
    serious at risk
    175
    other affected
    0
    other at risk
    175
    frequency threshold
    5
    collection period
    6 months
    event definition
    no AE from this non-medication/treatment study
    undenominated note
    Source null
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
  2. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    harm key
    EG001
    source section id
    NCT01401907-ae
    event group key
    EG001
    event group label
    Standard of Care
    serious affected
    0
    serious at risk
    175
    other affected
    0
    other at risk
    175
    frequency threshold
    5
    collection period
    6 months
    event definition
    no AE from this non-medication/treatment study
    undenominated note
    Source null
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
quality of life
  1. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    qol key
    qol-0000
    source section id
    NCT01401907-om-0000
    source outcome index
    0
    instrument
    Unnamed quality-of-life measure
    instrument basis
    matched 'quality of life' in the study's own wording
    scale title
    Functional Assessment of Cancer Therapy (Quality of Life Measure)
    measure definition
    The Functional Assessment of Cancer Therapy - General is a quality of life measure with higher scores indicating better quality of life (range 0-108). We are examining the adjusted mean difference from baseline to 12 weeks in this study
    time frame
    12 weeks
    analysis role
    primary
    reporting status
    POSTED
    higher is better
    1
    direction quote
    higher scores indicating better
    population note
    Source null
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
  2. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    qol key
    qol-0001
    source section id
    NCT01401907-om-0001
    source outcome index
    1
    instrument
    Unnamed quality-of-life measure
    instrument basis
    matched 'quality of life' in the study's own wording
    scale title
    Functional Assessment of Cancer Therapy (Quality of Life Measure)
    measure definition
    The Functional Assessment of Cancer Therapy - General is a quality of life measure with higher scores indicating better quality of life (range 0-108). We are examining the adjusted mean difference from baseline to 24 weeks.
    time frame
    24 weeks
    analysis role
    secondary
    reporting status
    POSTED
    higher is better
    1
    direction quote
    higher scores indicating better
    population note
    The analysis focuses on participants who completed week-24 questionnaires (N = 118 in the early palliative care arm, and N = 124 in the standard of care arm)
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
  3. release id
    clinical-indications-draft-1
    disease state id
    ds-liver-neoplasm
    nct id
    NCT01401907
    qol key
    qol-0004
    source section id
    NCT01401907-om-0004
    source outcome index
    4
    instrument
    SF-36 / SF-12
    instrument basis
    matched 'sf-36' in the study's own wording
    scale title
    Family Caregiver Quality of Life as Measured by the SF-36
    measure definition
    The Medical Health Outcomes Survey- Short Form (SF-36) is a measure of QOL. The SF-36 measures eight domains of health-related quality of life: physical functioning, role limitation due to physical health, bodily pain, general health perceptions, vitality, social functioning, role limitation due to emotional health, and mental health. The response choices are scored and summed to yield two physical (PCS) and mental (MCS) component summary measures with ranges from 0-100. Higher scores indicate better quality of life. We compared family caregiver PCS and MCS scores between the two study arms at week-12 and week-24 adjusting for baseline scores.
    time frame
    Week-12 and Week-24
    analysis role
    secondary
    reporting status
    POSTED
    higher is better
    1
    direction quote
    Higher scores indicate better
    population note
    Adjusted Means controlling for baseline scores. The different rows reflect Week-12 and Week-24 outcomes on SF-36 PCS and MCS domains. The number of participants included in week-12 and week-24 analyses reflect the participants who completed the SF-36 at these time points, which explains the discrepancy with the flow chart.
    curation status
    draft
    reviewed by
    Source null
    reviewed at
    Source null
    created at
    2026-09-10T00:00:00Z
setting source links

    Preserved source evidence · Not medical advice