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Article History

Received: 20 November 2024

Accepted: 1 September 2025

First Online: 18 September 2025

Declarations

:

: The study was registered with the German Clinical Trials Register (DRKS00024604). The study was approved by the Ethics Committee of Goethe University Frankfurt (No. 20-1023, 18.01.2021), and written informed consent was obtained from all participants.

: Not applicable.

: The institutions of S.H., S.M.K., P.J.C., N.D., L.N. and B.S.M received funding for this study from the German Federal Ministry of Education and Research, BMBF, grant number 01KX2021. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. P.J.C. is an employee at OncologyInformationService. N.D. has received the CSL Behring award “Translational Research on Extracellular Vesicles in COPD”. SK is founder and managing partner of MED.digital GmbH. He is member several committees of the German Medical Association (“Digitalization of health care“ and “Medical Education and University Medicine”). B.S.M. has received personal honoraria for scientific consultancy to health insurance fund “Die Techniker”. The remaining authors declare no conflict of interest.