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Article History

Received: 10 May 2023

Accepted: 6 June 2023

First Online: 16 June 2023

Declarations

:

: The study has been approved by Medical Ethics Committee of Inner Mongolia Medical University (YKD202201082) and Biomedical Ethics Committee of Southern Medical University (NYLS [2022] No.21). We have obtained ethical approvals for a waiver of informed consent from the service providers or clinicians, including getting secret audio recordings from them. This is due to the fact that the USP study meets the ethical standards by conducting only de-identified and aggregated analysis only (not violating clinician privacy), using only non-emergency settings only (not wasting scare resource), and employing the “deception” of the USP to prevent “priming” the research subject. As previously stated, the optical services will be unaware of their participation in this study in order to avoid opt-in bias, making the visit unannounced. And the recordings are being used as fidelity checks of the USPs and their interactions with the OSPs, and that the USPs and their companions are aware of these recordings. However, electronic informed consent will still be obtained from the USPs and potential harms have been explained.

: Not applicable. This manuscript does not contain individual personal data from participants.

: The authors declare no competing interests.