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Authors
Ala-Kokko, Tero I.
Karhu, Jaana M.
Lehto, Pasi
Sälkiö, Sinikka
Ohtonen, Pasi
Syrjälä, Hannu
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Funding
Funding for this research was provided by:
State Funding for University level Health Research through Oulu University Hospital
University of Oulu
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Article History
Received: 7 April 2025
Accepted: 31 July 2025
First Online: 13 August 2025
Declarations
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: The authors declare that they have no competing interests.
: The study protocol was accepted by the hospital administration (1/2019, 240/2023) and the Digital and Population Data Service Agency (DVV/5100/2023-3). Under Finnish law, a medical registry study does not require ethics committee approval because it involves the use of existing, anonymized data collected for clinical purposes, rather than direct interaction with patients or intervention in their care. According to the Medical Research Act (488/1999), ethical review is required for medical research involving intervention in the integrity of a person. Since registry studies do not involve such interventions, they are exempt from this requirement.
