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Article History

Received: 28 February 2024

Accepted: 16 December 2025

First Online: 26 December 2025

Declarations

:

: This study has undergone ethical review by the Research Ethics Committee at the University of Birmingham and was granted full approval in February 2022 (ERN 21-1821).

: Not applicable.

: M. C., Birmingham Health Partners Centre for Regulatory Science and Innovation and CPROR Director and NIHR Senior Investigator. Funding, NIHR, UKRI, NIHR Birmingham BRC, NIHR ARC WM, UK SPINE, European Regional Development Fund–Demand Hub and Health Data Research UK at the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Innovate UK (part of UKRI), Macmillan Cancer Support, UCB Pharma, Janssen, GlaxoSmithKline, and Gilead. Personal fees are as follows: Astellas, Aparito, CIS Oncology, Takeda, Merck, Daiichi Sankyo, Glaukos, GlaxoSmithKline, and Patient-Centered Outcomes Research Institute. A relative owns GlaxoSmithKline shares. PA, NIHR Senior Investigator, Chair of NIHR PHR Funding Committee, Deputy Director of NIHR School for Public Health Research, Member of Wellcome Trust Early Career Advisory Group in Population and Public Health, Member of UKRI Population Health Improvement Clusters Funding panel, and member of committees related to PHR (including Programme Liaison Group, Programme Oversight Group). Grants are from NIHR (School for Public Health Research, PHIRST, NIHR156261, NIHR205249, NIHR 151295, NIHR 204247, NIHR132630, NIHR 16/137/95, NIHR 17/128/04, NIHR 17/92/39, NIHR 17/42/42, NIHR129593, NIHR135211, NIHR131396), MRC, and COLT Foundation.