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re raised by our data and these should be addressed in future research using randomised controlled trial designs. Our methodological recommendations-including recruiting non-cancer diagnoses, and earlier in the treatment trajectory-likely apply more broadly to the delivery of psychological intervention in the palliative care setting. This study was pre-registered on the Open Science Framework (Ref 46,033) and retrospectively registered on the ISRCTN registry (Ref ISRCTN12084782). The study investigated a putative association between ear
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