<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03834116</url>
  </required_header>
  <id_info>
    <org_study_id>HSEARS20180509003</org_study_id>
    <nct_id>NCT03834116</nct_id>
  </id_info>
  <brief_title>Resistance Inspiratory Muscle Training for Patients With Thoracic Malignancies</brief_title>
  <official_title>The Effect of Resistance Inspiratory Muscle Training in the Management of Breathlessness in Patients With Thoracic Malignancies: A Randomized Controlled Trial</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>The Hong Kong Polytechnic University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>The Affiliated Hospital Of Southwest Medical University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>The Hong Kong Polytechnic University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      A small-scale pilot randomized controlled trial conducted by the investigators demonstrated&#xD;
      some preliminary evidence that inspiratory muscle training (IMT) could be a promising&#xD;
      self-management method for alleviating breathlessness. Hence, the aim of this study is to&#xD;
      assess the effectiveness of IMT in patients with thoracic malignancies on dyspnea.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      The hypothesis of this study is that inspiratory muscle training (IMT) for a three-month&#xD;
      treatment will improve dyspnea in lung cancer patients with stable disease experiencing&#xD;
      breathlessness.&#xD;
&#xD;
      Plan of Investigation Subjects The sample will be a heterogeneous group of outpatients cared&#xD;
      for in a large university medical center in China (Southwest Medical University Hospital).&#xD;
&#xD;
      Methods The trial will be a two-arm, non-blinded, randomized controlled study. Patients will&#xD;
      be randomly assigned through a computer program to IMT or a control group by an independent&#xD;
      statistician. The IMT group will receive standard care and additionally the IMT intervention.&#xD;
      The control group will receive standard treatment.&#xD;
&#xD;
      Study Design Intervention: A pressure threshold device will be used to deliver IMT, which is&#xD;
      commercially available by Phillips Respironics. When patients inhale through the IMT device,&#xD;
      the valve blocks air flow until the patient generates sufficient inspiratory pressure to&#xD;
      overcome the resistance provided by the spring-loaded valve. The patient must generate the&#xD;
      inspiratory pressure, in order for the valve to open and allow inhalation of air. The IMT&#xD;
      protocol will have five sessions weekly for 12 weeks for 30 mins/day, divided over two&#xD;
      sessions.&#xD;
&#xD;
      Procedures Participants will be recruited at the outpatients' clinic of Southwest Medical&#xD;
      University Hospital or referred to the research team by the clinicians. Patients allocated to&#xD;
      the experimental arm will have training in the IMT use and the trainer (device) will be&#xD;
      adjusted to a level which is comfortable to each patient. In the control arm, patients will&#xD;
      be visited for completing the study assessments at the same times as in the experimental arm&#xD;
      (months 2 &amp; 3).&#xD;
&#xD;
      Sample Size The investigators have used the mBorg score change [primary outcome] in baseline&#xD;
      to month three assessment of 0.80 obtained in the pilot study and the established minimally&#xD;
      important difference of 1 for the mBorg to calculate sample size requirements, adding a 25%&#xD;
      attrition observed in the pilot study. This corresponds to a sample size of 196 subjects.&#xD;
&#xD;
      Data Processing and Analysis The statistical software package IBM SPSS version 23.0 will be&#xD;
      used. Descriptive statistics will summarize the sample characteristics. Generalized&#xD;
      estimating equations (GEE) models will be used to compare differential changes in the&#xD;
      outcomes between the two study arms across multiple time points (baseline-month 2 and month 3&#xD;
      assessment). A p-value of &lt;0.05 was considered statistically significance. Intention-to-treat&#xD;
      analysis will be carried out.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">November 23, 2019</start_date>
  <completion_date type="Actual">September 15, 2021</completion_date>
  <primary_completion_date type="Actual">September 15, 2021</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Modified Borg Scale (mBorg)</measure>
    <time_frame>week 8</time_frame>
    <description>It is a vertical 0-10 scale, with corresponding verbal expressions of progressively increased intensity from &quot;nothing at all&quot; to ''maximal.&quot;</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>6-minute walk test (6MWT)</measure>
    <time_frame>week 8</time_frame>
    <description>6-minute walk test (6MWT) on a level surface, which is easy for patients, well-validated, and correlates well with lung function</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>6-minute walk test (6MWT)</measure>
    <time_frame>week 12</time_frame>
    <description>6-minute walk test (6MWT) on a level surface, which is easy for patients, well-validated, and correlates well with lung function</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Dyspnea Symptoms and Its Impact on Patients' Functional Status (Dyspnea-12 Questionnaire).</measure>
    <time_frame>Week 8</time_frame>
    <description>D-12 questionnaire uses 12 items, higher scores indicate more impact of dyspnea on functional status</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Dyspnea Symptoms and Its Impact on Patients' Functional Status (Dyspnea-12 Questionnaire).</measure>
    <time_frame>Week 12</time_frame>
    <description>D-12 questionnaire uses 12 items.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Perceived Severity of Breathlessness</measure>
    <time_frame>week 8</time_frame>
    <description>Will be measured on a 0-10 numerical rating scale (NRS)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Perceived Severity of Breathlessness</measure>
    <time_frame>week 12</time_frame>
    <description>Will be measured on a 0-10 numerical rating scale (NRS)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>St George's Respiratory Questionnaire</measure>
    <time_frame>week 8</time_frame>
    <description>The St George's Respiratory Questionnaire will be used. It measures impact on overall health, daily life, and perceived well-being in patients with dyspnea. Scores range from 0 to 100, with higher scores indicating more limitations.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>St George's Respiratory Questionnaire</measure>
    <time_frame>week 12</time_frame>
    <description>The St George's Respiratory Questionnaire will be used. It measures impact on overall health, daily life, and perceived well-being in patients with dyspnea. Scores range from 0 to 100, with higher scores indicating more limitations.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Anxiety and depression</measure>
    <time_frame>week 8</time_frame>
    <description>The Hospital Anxiety &amp; Depression Scale will be used. It has 14 items, 7 measuring anxiety and 7 measuring depression, with higher scores indicating more anxiety or depression. For each subscale, scores more than 10 indicate clinical signs of anxiety or depression.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Anxiety and depression</measure>
    <time_frame>week 12</time_frame>
    <description>The Hospital Anxiety &amp; Depression Scale will be used. It has 14 items, 7 measuring anxiety and 7 measuring depression, with higher scores indicating more anxiety or depression. For each subscale, scores more than 10 indicate clinical signs of anxiety or depression.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Modified Borg scale</measure>
    <time_frame>week 12.</time_frame>
    <description>It is a vertical 0-10 scale, with corresponding verbal expressions of progressively increased intensity from &quot;nothing at all&quot; to ''maximal.&quot;</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Patients Compliance to IMT Protocol</measure>
    <time_frame>Week 12.</time_frame>
    <description>Each patient in the experimental arm will be given a training diary to record IMT home practice sessions.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">196</enrollment>
  <condition>Lung Neoplasm Malignant</condition>
  <arm_group>
    <arm_group_label>Inspiratory muscle training group</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>A pressure threshold device will be used to deliver IMT, which is commercially available by Phillips Respironics.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Control group</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>The control group will receive standard treatment in a fast-track design.</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Inspiratory muscle training</intervention_name>
    <description>A pressure threshold device will be used to deliver IMT, which is commercially available by Phillips Respironics.</description>
    <arm_group_label>Inspiratory muscle training group</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  adults with histological diagnosis of primary LC or mesothelioma;&#xD;
&#xD;
          -  refractory dyspnea not responding to current treatment for the past 2 weeks;&#xD;
&#xD;
          -  expected prognosis of &gt;3 months as judged by the clinicians,&#xD;
&#xD;
          -  oxygen saturation above 85% at rest.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Those with unstable COPD with frequent or acute exacerbations,&#xD;
&#xD;
          -  rapidly worsening dyspnea requiring urgent medical intervention,&#xD;
&#xD;
          -  treatment with palliative radiotherapy to the chest received within 4 weeks or&#xD;
             chemotherapy within 2 weeks;&#xD;
&#xD;
          -  experiencing intractable cough, and those having unstable angina or clinically&#xD;
             significant pleural effusion needing drainage&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>N/A</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Alex Molassiotis</last_name>
    <role>Study Chair</role>
    <affiliation>The Hong Kong Polytechnic University</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Southwest Medical University Hospital</name>
      <address>
        <city>Luzhou</city>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>China</country>
  </location_countries>
  <reference>
    <citation>Barton R, English A, Nabb S, Rigby AS, Johnson MJ. A randomised trial of high vs low intensity training in breathing techniques for breathless patients with malignant lung disease: a feasibility study. Lung Cancer. 2010 Dec;70(3):313-9. doi: 10.1016/j.lungcan.2010.03.007. Epub 2010 Apr 14.</citation>
    <PMID>20392515</PMID>
  </reference>
  <reference>
    <citation>Molassiotis A, Charalambous A, Taylor P, Stamataki Z, Summers Y. The effect of resistance inspiratory muscle training in the management of breathlessness in patients with thoracic malignancies: a feasibility randomised trial. Support Care Cancer. 2015 Jun;23(6):1637-45. doi: 10.1007/s00520-014-2511-x. Epub 2014 Nov 23.</citation>
    <PMID>25417042</PMID>
  </reference>
  <reference>
    <citation>Farquhar MC, Higginson IJ, Fagan P, Booth S. The feasibility of a single-blinded fast-track pragmatic randomised controlled trial of a complex intervention for breathlessness in advanced disease. BMC Palliat Care. 2009 Jul 7;8:9. doi: 10.1186/1472-684X-8-9.</citation>
    <PMID>19583857</PMID>
  </reference>
  <reference>
    <citation>Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM. Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed). 1982 May 29;284(6329):1607-8. doi: 10.1136/bmj.284.6329.1607. No abstract available.</citation>
    <PMID>6805625</PMID>
  </reference>
  <reference>
    <citation>Tan JY, Yorke J, Harle A, Smith J, Blackhall F, Pilling M, Molassiotis A. Assessment of Breathlessness in Lung Cancer: Psychometric Properties of the Dyspnea-12 Questionnaire. J Pain Symptom Manage. 2017 Feb;53(2):208-215. doi: 10.1016/j.jpainsymman.2016.08.009. Epub 2016 Oct 5.</citation>
    <PMID>27720789</PMID>
  </reference>
  <reference>
    <citation>Wilcock A, Crosby V, Clarke D, Tattersfield A. Repeatability of breathlessness measurements in cancer patients. Thorax. 1999 Apr;54(4):375. doi: 10.1136/thx.54.4.374b. No abstract available.</citation>
    <PMID>10400541</PMID>
  </reference>
  <reference>
    <citation>Xu W, Collet JP, Shapiro S, Lin Y, Yang T, Wang C, Bourbeau J. Validation and clinical interpretation of the St George's Respiratory Questionnaire among COPD patients, China. Int J Tuberc Lung Dis. 2009 Feb;13(2):181-9.</citation>
    <PMID>19146745</PMID>
  </reference>
  <reference>
    <citation>Walker J, Postma K, McHugh GS, Rush R, Coyle B, Strong V, Sharpe M. Performance of the Hospital Anxiety and Depression Scale as a screening tool for major depressive disorder in cancer patients. J Psychosom Res. 2007 Jul;63(1):83-91. doi: 10.1016/j.jpsychores.2007.01.009.</citation>
    <PMID>17586341</PMID>
  </reference>
  <verification_date>August 2022</verification_date>
  <study_first_submitted>February 1, 2019</study_first_submitted>
  <study_first_submitted_qc>February 6, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">February 7, 2019</study_first_posted>
  <last_update_submitted>August 22, 2022</last_update_submitted>
  <last_update_submitted_qc>August 22, 2022</last_update_submitted_qc>
  <last_update_posted type="Actual">August 23, 2022</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>The Hong Kong Polytechnic University</investigator_affiliation>
    <investigator_full_name>Professor Alex MOLASIOTIS</investigator_full_name>
    <investigator_title>Chair Professor of Nursing and Head</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Neoplasms</mesh_term>
    <mesh_term>Lung Neoplasms</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03834116
org study id: HSEARS20180509003
nct id: NCT03834116
lead sponsor: 
collaborator: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
A small-scale pilot randomized controlled trial conducted by the investigators demonstrated
      some preliminary evidence that inspiratory muscle training (IMT) could be a promising
      self-management method for alleviating breathlessness. Hence, the aim of this study is to
      assess the effectiveness of IMT in patients with thoracic malignancies on dyspnea.
The hypothesis of this study is that inspiratory muscle training (IMT) for a three-month
      treatment will improve dyspnea in lung cancer patients with stable disease experiencing
      breathlessness.

      Plan of Investigation Subjects The sample will be a heterogeneous group of outpatients cared
      for in a large university medical center in China (Southwest Medical University Hospital).

      Methods The trial will be a two-arm, non-blinded, randomized controlled study. Patients will
      be randomly assigned through a computer program to IMT or a control group by an independent
      statistician. The IMT group will receive standard care and additionally the IMT intervention.
      The control group will receive standard treatment.

      Study Design Intervention: A pressure threshold device will be used to deliver IMT, which is
      commercially available by Phillips Respironics. When patients inhale through the IMT device,
      the valve blocks air flow until the patient generates sufficient inspiratory pressure to
      overcome the resistance provided by the spring-loaded valve. The patient must generate the
      inspiratory pressure, in order for the valve to open and allow inhalation of air. The IMT
      protocol will have five sessions weekly for 12 weeks for 30 mins/day, divided over two
      sessions.

      Procedures Participants will be recruited at the outpatients' clinic of Southwest Medical
      University Hospital or referred to the research team by the clinicians. Patients allocated to
      the experimental arm will have training in the IMT use and the trainer (device) will be
      adjusted to a level which is comfortable to each patient. In the control arm, patients will
      be visited for completing the study assessments at the same times as in the experimental arm
      (months 2 & 3).

      Sample Size The investigators have used the mBorg score change [primary outcome] in baseline
      to month three assessment of 0.80 obtained in the pilot study and the established minimally
      important difference of 1 for the mBorg to calculate sample size requirements, adding a 25%
      attrition observed in the pilot study. This corresponds to a sample size of 196 subjects.

      Data Processing and Analysis The statistical software package IBM SPSS version 23.0 will be
      used. Descriptive statistics will summarize the sample characteristics. Generalized
      estimating equations (GEE) models will be used to compare differential changes in the
      outcomes between the two study arms across multiple time points (baseline-month 2 and month 3
      assessment). A p-value of <0.05 was considered statistically significance. Intention-to-treat
      analysis will be carried out.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Single (Outcomes Assessor)
measure: Modified Borg Scale (mBorg)
time frame: week 8
description: It is a vertical 0-10 scale, with corresponding verbal expressions of progressively increased intensity from "nothing at all" to ''maximal."
measure: 6-minute walk test (6MWT)
time frame: week 8
description: 6-minute walk test (6MWT) on a level surface, which is easy for patients, well-validated, and correlates well with lung function
measure: 6-minute walk test (6MWT)
time frame: week 12
description: 6-minute walk test (6MWT) on a level surface, which is easy for patients, well-validated, and correlates well with lung function
measure: Dyspnea Symptoms and Its Impact on Patients' Functional Status (Dyspnea-12 Questionnaire).
time frame: Week 8
description: D-12 questionnaire uses 12 items, higher scores indicate more impact of dyspnea on functional status
measure: Dyspnea Symptoms and Its Impact on Patients' Functional Status (Dyspnea-12 Questionnaire).
time frame: Week 12
description: D-12 questionnaire uses 12 items.
measure: Perceived Severity of Breathlessness
time frame: week 8
description: Will be measured on a 0-10 numerical rating scale (NRS)
measure: Perceived Severity of Breathlessness
time frame: week 12
description: Will be measured on a 0-10 numerical rating scale (NRS)
measure: St George's Respiratory Questionnaire
time frame: week 8
description: The St George's Respiratory Questionnaire will be used. It measures impact on overall health, daily life, and perceived well-being in patients with dyspnea. Scores range from 0 to 100, with higher scores indicating more limitations.
measure: St George's Respiratory Questionnaire
time frame: week 12
description: The St George's Respiratory Questionnaire will be used. It measures impact on overall health, daily life, and perceived well-being in patients with dyspnea. Scores range from 0 to 100, with higher scores indicating more limitations.
measure: Anxiety and depression
time frame: week 8
description: The Hospital Anxiety & Depression Scale will be used. It has 14 items, 7 measuring anxiety and 7 measuring depression, with higher scores indicating more anxiety or depression. For each subscale, scores more than 10 indicate clinical signs of anxiety or depression.
measure: Anxiety and depression
time frame: week 12
description: The Hospital Anxiety & Depression Scale will be used. It has 14 items, 7 measuring anxiety and 7 measuring depression, with higher scores indicating more anxiety or depression. For each subscale, scores more than 10 indicate clinical signs of anxiety or depression.
measure: Modified Borg scale
time frame: week 12.
description: It is a vertical 0-10 scale, with corresponding verbal expressions of progressively increased intensity from "nothing at all" to ''maximal."
measure: Patients Compliance to IMT Protocol
time frame: Week 12.
description: Each patient in the experimental arm will be given a training diary to record IMT home practice sessions.
arm group label: Inspiratory muscle training group
arm group type: Experimental
description: A pressure threshold device will be used to deliver IMT, which is commercially available by Phillips Respironics.
arm group label: Control group
arm group type: No Intervention
description: The control group will receive standard treatment in a fast-track design.
intervention type: Device
intervention name: Inspiratory muscle training
description: A pressure threshold device will be used to deliver IMT, which is commercially available by Phillips Respironics.
arm group label: Inspiratory muscle training group
criteria: 
gender: All
minimum age: N/A
maximum age: N/A
healthy volunteers: No
last name: Alex Molassiotis
role: Study Chair
affiliation: The Hong Kong Polytechnic University
facility: 
country: China
citation: Barton R, English A, Nabb S, Rigby AS, Johnson MJ. A randomised trial of high vs low intensity training in breathing techniques for breathless patients with malignant lung disease: a feasibility study. Lung Cancer. 2010 Dec;70(3):313-9. doi: 10.1016/j.lungcan.2010.03.007. Epub 2010 Apr 14.
PMID: 20392515
citation: Molassiotis A, Charalambous A, Taylor P, Stamataki Z, Summers Y. The effect of resistance inspiratory muscle training in the management of breathlessness in patients with thoracic malignancies: a feasibility randomised trial. Support Care Cancer. 2015 Jun;23(6):1637-45. doi: 10.1007/s00520-014-2511-x. Epub 2014 Nov 23.
PMID: 25417042
citation: Farquhar MC, Higginson IJ, Fagan P, Booth S. The feasibility of a single-blinded fast-track pragmatic randomised controlled trial of a complex intervention for breathlessness in advanced disease. BMC Palliat Care. 2009 Jul 7;8:9. doi: 10.1186/1472-684X-8-9.
PMID: 19583857
citation: Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM. Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed). 1982 May 29;284(6329):1607-8. doi: 10.1136/bmj.284.6329.1607. No abstract available.
PMID: 6805625
citation: Tan JY, Yorke J, Harle A, Smith J, Blackhall F, Pilling M, Molassiotis A. Assessment of Breathlessness in Lung Cancer: Psychometric Properties of the Dyspnea-12 Questionnaire. J Pain Symptom Manage. 2017 Feb;53(2):208-215. doi: 10.1016/j.jpainsymman.2016.08.009. Epub 2016 Oct 5.
PMID: 27720789
citation: Wilcock A, Crosby V, Clarke D, Tattersfield A. Repeatability of breathlessness measurements in cancer patients. Thorax. 1999 Apr;54(4):375. doi: 10.1136/thx.54.4.374b. No abstract available.
PMID: 10400541
citation: Xu W, Collet JP, Shapiro S, Lin Y, Yang T, Wang C, Bourbeau J. Validation and clinical interpretation of the St George's Respiratory Questionnaire among COPD patients, China. Int J Tuberc Lung Dis. 2009 Feb;13(2):181-9.
PMID: 19146745
citation: Walker J, Postma K, McHugh GS, Rush R, Coyle B, Strong V, Sharpe M. Performance of the Hospital Anxiety and Depression Scale as a screening tool for major depressive disorder in cancer patients. J Psychosom Res. 2007 Jul;63(1):83-91. doi: 10.1016/j.jpsychores.2007.01.009.
PMID: 17586341
responsible party type: Principal Investigator
investigator affiliation: The Hong Kong Polytechnic University
investigator full name: Professor Alex MOLASIOTIS
investigator title: Chair Professor of Nursing and Head
mesh term: Neoplasms
mesh term: Lung Neoplasms
sharing ipd: Undecided