# New Cannabinoid Clinical Trials: CBD Titration in Adult LGS, Cancer Use Tracking, and Stress in Cannabis Use Disorder

> **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637)
> **Publisher:** CED Clinic (https://cedclinic.com)
> **Canonical URL:** https://cedclinic.com/new-cannabinoid-clinical-trials-lgs-cancer-cud/
> **Published:** 2026-10-22T13:33:33-04:00 | **Last Modified / Clinically Audited:** 2026-10-22T13:38:28-04:00
> **Clinical Summary:** Three cannabinoid clinical trials to watch: CBD titration in adults with LGS, cannabis use tracking in cancer care, and stress in cannabis use disorder.

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CED Clinical Relevance #65 Verified Overview Curated multi-source overview preserving 3 verified developments.

Clinical Insight | CED Clinic
Clinicians often face a vacuum of data when managing patients who use cannabis for symptom relief. Moving toward structured titration protocols, as seen in the LGS study, provides a template for reducing the unpredictability of [cannabinoid therapy](https://cedclinic.com/cannabis-alzheimer-treatment-research-2025/). In oncology, the shift toward app-based tracking acknowledges that patients are already using these products, and formalizing their reporting is the first step toward safety. Understanding the biological drivers of stress-induced use helps us move away from viewing dependency as a moral failing and toward treating it as a physiological response that requires targeted intervention.

DigestCannabis NewsRegulationPublic Health[Clinical Practice](https://cedclinic.com/shifting-public-attitudes-toward-cannabis/)

AudiencePatients, clinicians, healthcare professionals, regulators, and industry researchers.
Primary TopicThree cannabinoid clinical trials: LGS, cancer care, and [cannabis use disorder](https://cedclinic.com/cannabis-youth-psychosis-risk-study-insights/) .
Source[Read the full source](https://clinicaltrials.gov/study/NCT07089225)

New Cannabinoid Clinical Trials: CBD Titration in Adult LGS, Cancer Use Tracking, and Stress in [Cannabis Use](https://cedclinic.com/cannabis-use-patterns-young-adults-social-health/) Disorder

Evidence level: registered trial protocols without posted results (not yet gradable on the Oxford CEBM scale)Direct Clinical Answer

Three cannabinoid studies registered on ClinicalTrials.gov are worth watching: an open-label trial of gradual prescription CBD titration in 40 adults with Lennox-Gastaut syndrome, an app-based cannabis journal study in cancer care, and a stress-hormone study in cannabis use disorder. None has posted results yet, so patients should not change treatment based on these registrations.

**Trials covered:** NCT07728097, NCT07089225, NCT06430580**Results posted:** None as of October 22, 2026**Strongest design:** Double-blind crossover (stress study)**Clinical perspective:** Benjamin Caplan, MD, board-certified family physician (ABFM)

A physician-led look at three cannabinoid studies on ClinicalTrials.gov: a CBD titration trial in adults with Lennox-Gastaut syndrome, an app-based cannabis journal study in cancer care, and a laboratory study of stress hormones and cannabis craving.

What This Study Teaches Us
The oncology study (NCT07089225) employs a mobile application to gather real-world data from cancer patients on their cannabis use habits. A Phase 4 trial by Jazz Pharmaceuticals (NCT07728097) evaluates the efficacy of CBD-OS as an add-on therapy for adults with [Lennox-Gastaut Syndrome](/clinically-meaningful-cannabidiol-reduction-lennox-gastaut/) using a gradual titration model. An Early Phase 1 study (NCT06430580) at Florida State University uses pharmacological stress induction to measure changes in cannabis use motivation among those with Cannabis Use Disorder.Three cannabinoid trials comparedFeatureEpiGOAL (NCT07728097)COSMIC-Releaf (NCT07089225)COBRAS (NCT06430580)DesignOpen-label interventional, Phase 3b/4Observational pilot cohortRandomized, placebo-controlled, double-blind crossover, Early Phase 1Enrollment40 planned45 planned38 enrolledPopulationAdults with Lennox-Gastaut syndrome taking 1 to 3 antiseizure medicationsAdults with cancer who obtain cannabis from licensed storesAdults 18 to 50 with moderate-to-severe cannabis use disorderPrimary outcome50% or greater reduction in major motor seizures at week 24Pattern of cannabis use over 6 monthsEEG response to cannabis cues and cannabis demand measuresStatusNot yet recruiting (planned start Nov. 18, 2026)RecruitingCompleted (Aug. 2026)Results postedNoNoNoSponsorJazz PharmaceuticalsScot Remick, MD (MaineHealth Cancer Care), with the National Cancer InstituteFlorida State University, with the National Institute on Drug Abuse

Source: ClinicalTrials.gov records accessed October 22, 2026.

Why This Matters
Standardizing titration protocols helps clinicians minimize adverse effects while maximizing seizure control in complex epilepsy cases. Real-world tracking in oncology provides the necessary data to bridge the gap between patient self-administration and evidence-based medical guidance.

Study SnapshotPost TypeCannabis News & Regulatory Digest using canonical CED layoutItems Reviewed3 verified updatesPrimary DatesOctober 22, 2026Related Reading3 verified live CED Clinic internal linksUpdate 1A Study in Patients Reporting (Scot Remick Trial Registration)Update 2A Study to Investigate the (Jazz Pharmaceuticals Trial Registration)Update 3Cannabinoids and Biological Reactivity to (Florida State University Trial Registration)

Clinical Bottom Line
This clinical and regulatory overview preserves key signals across 3 updates without overstatement, offering grounded guidance for patients and practitioners.

Context Across These 3 Updates

This curated cannabis news & regulatory digest brings together 3 key developments in cannabinoid clinical research. Reviewing these distinct updates side by side clarifies emerging patterns while preserving the specific clinical context of each report.

Examining these developments concurrently helps clinicians, patients, and families trace the broader trajectory of the field while grounding practical decisions in verified primary data.

Update 1: A Study in Patients Reporting Cannabis Use Followed

**Title & Source:** [Clinical Trial: A Study in Patients Reporting Cannabis Use Followed With an Application-Based Cannabis Journal](https://clinicaltrials.gov/study/NCT07089225) (*Scot Remick*, 2026-10-22)

**Lead Authors & Identifiers:** Scot Remick. Content lane: **Protocol Watch**.

**Study Design:** This observational study uses a mobile application to collect real-world data from [cancer patients who use cannabis](/ced-what-canpan-suggests-about-thc-dose-2026-09-22/). The researchers aim to fill a significant gap in clinical knowledge regarding how this population uses cannabinoids for symptom management.

**What It Measures:** The study focuses on the feasibility of app-based reporting and the diversity of cannabis products used by oncology patients. Its primary outcome is the pattern of cannabis use over six months, including frequency, dose, product type, route, and THC and CBD content, with patient-reported helpful and adverse effects as secondary outcomes. The pilot plans to enroll 45 patients at MaineHealth Cancer Care, with National Cancer Institute collaboration.

Illustration with example values. The COSMIC-Releaf pilot asks participants to log cannabis use in an app for six months.

**Clinical Relevance:** Encourage patients to use digital tools to record their usage patterns and symptom changes. This data is invaluable for identifying which products provide the most relief with the fewest side effects.

**Practical Boundaries:** The study relies on self-reported data, which can be inconsistent or influenced by patient expectations.

Update 2: A Study to Investigate the Effect of Gradual

**Title & Source:** [Clinical Trial: A Study to Investigate the Effect of Gradual Titration to Optimize Cannabidiol Treatment in Adults With LGS](https://clinicaltrials.gov/study/NCT07728097) (*Jazz Pharmaceuticals*, 2026-10-22)

**Lead Authors & Identifiers:** Jazz Pharmaceuticals. Content lane: **Protocol Watch**.

**Study Design:** This open-label Phase 3b/4 trial (EpiGOAL), planned for 40 adults and not yet recruiting as of October 2026, investigates the optimization of CBD-OS as an add-on therapy for adults with Lennox-Gastaut Syndrome. The study specifically evaluates the impact of a gradual titration schedule on patient outcomes and safety.

**What It Measures:** Its primary outcome is the share of participants with at least a 50% reduction in major motor seizures by week 24. Secondary outcomes track treatment retention, seizure-free days, caregiver-rated severity, laboratory abnormalities, and adverse events leading to discontinuation.

Planned schedule from ClinicalTrials.gov record NCT07728097. Dates may change.

**Clinical Relevance:** Follow a strict, slow titration schedule when introducing high-dose CBD to minimize the risk of gastrointestinal or hepatic issues. Gradual increases allow for better assessment of the minimum effective dose.

**Practical Boundaries:** The findings are specific to a pharmaceutical CBD formulation and may not apply to over-the-counter products.

Update 3: Cannabinoids and Biological Reactivity to Stress

**Title & Source:** [Clinical Trial: Cannabinoids and Biological Reactivity to Stress](https://clinicaltrials.gov/study/NCT06430580) (*Florida State University*, 2026-10-22)

**Lead Authors & Identifiers:** Florida State University. Content lane: **Clinical Evidence Update**.

**Study Design:** This Early Phase 1 study examines the relationship between pharmacological stress induction and the motivation to use cannabis. In a randomized, placebo-controlled, double-blind crossover design, 38 adults with [moderate-to-severe cannabis use disorder](/progesterone-cannabis-use-disorder-stress-trial-post/) received hydrocortisone, yohimbine, both, or placebo across four lab visits.

**What It Measures:** Researchers measured brain responses to cannabis images by EEG and cannabis demand on a purchase task, with blood endocannabinoid levels as an exploratory outcome. The study was completed in August 2026, but results had not been posted to ClinicalTrials.gov as of October 22, 2026, so no conclusions about stress and craving can be drawn yet.

Design described in ClinicalTrials.gov record NCT06430580. Results not yet posted.

**Clinical Relevance:** Help patients identify their specific [stress triggers](/videos/cannabis-anxiety-ptsd/) to develop alternative coping strategies. Understanding the biological drive behind the urge to use can reduce patient guilt and improve treatment adherence.

**Practical Boundaries:** The small sample size and laboratory setting may not reflect the complexity of real-world stress.

How Strong Is This Evidence?
The LGS study is an open-label Phase 3b/4 trial with 40 planned participants; it can show how well a gradual titration schedule is tolerated, but without a placebo group it cannot establish efficacy on its own. The oncology study is observational and relies on self-reported data, which offers high ecological validity but lower experimental control. The stress reactivity study is an Early Phase 1 trial with a small, specific cohort designed for mechanistic insight rather than broad clinical application.

Where This Paper Deserves Skepticism
Self-reported data in the oncology journal study may be subject to recall bias or inconsistent entry habits. The LGS titration study is sponsored by the manufacturer, which necessitates careful review of the final data for objective outcomes. Pharmacological stress induction in a lab setting may not perfectly replicate the complex, chronic stressors patients face in daily life.

What This Paper Does Not Show
These studies do not establish a universal dosing standard for all cancer-related symptoms or all forms of epilepsy. They also do not prove that stress is the sole driver of cannabis use disorder in the general population.

How This Fits With the Broader Clinical Conversation

The current clinical environment is shifting from general observation to granular data collection. By integrating digital health tools like mobile journals into oncology care, researchers are finally capturing the nuances of how patients use various chemotypes and delivery methods. This move toward real-world evidence complements the rigorous, phase-controlled trials conducted by pharmaceutical companies.

Simultaneously, the focus on titration protocols reflects a maturing understanding of cannabinoid pharmacokinetics. We are moving past the era of ‘start low and go slow’ as a vague suggestion and toward specific, data-driven schedules that aim to reach therapeutic windows more efficiently. This precision is vital for patients with severe conditions like LGS where the margin for error is narrow.

Editorial Commentary

*I see many patients who feel lost in the trial-and-error phase of cannabis use. They often arrive with a bag of products but no clear record of what worked or why it failed. The introduction of app-based journaling in a clinical trial setting validates what I have encouraged for years: the patient is the most important data source. When we formalize this process, we turn anecdotal experience into a clinical tool that can inform future treatment plans.*

*The emphasis on titration in the LGS study is particularly relevant. In my experience, many side effects that lead patients to discontinue therapy are actually the result of rushing the dose. A structured, gradual approach allows the [endocannabinoid system](https://cedclinic.com/adolescent-cannabis-use-psychotic-disorders-risk/) to adapt, which often preserves the therapeutic benefit while keeping the patient comfortable. This is a lesson that applies far beyond epilepsy.*

*Finally, the research into stress and use motivation reminds us that cannabis use is often a functional behavior. Patients are frequently trying to solve a physiological problem, such as a heightened stress response. By identifying these triggers, we can better support patients in finding the right balance between therapeutic use and dependency.*

What a Careful Reader Should Take Away
Patients should maintain detailed logs of their cannabis use and prioritize gradual dose increases to identify their specific therapeutic window. Clinical outcomes improve when patients and providers use structured data to guide treatment decisions.

[https://cedclinic.com/ask/](https://cedclinic.com/ask/)Ask about this study:[🧠Anxiety and Mood](https://cedclinic.com/ask/)[🎗️Oncology](https://cedclinic.com/ask/)[🧬Epilepsy](https://cedclinic.com/ask/)[🔎This study's limits](https://cedclinic.com/ask/)

Evidence Interpretation Guide

Table of Contents

- [How to Interpret This Cannabis News & Regulatory Digest](#How_to_Interpret_This_Cannabis_News_Regulatory_Digest)[Three Rules for Critical Reading](#Three_Rules_for_Critical_Reading)
- [CED Perspective Lens: Eight Viewpoints on These Updates](#CED_Perspective_Lens_Eight_Viewpoints_on_These_Updates)[Empowering Your Treatment with Data](#Empowering_Your_Treatment_with_Data)
- [Standardizing Cannabinoid Protocols](#Standardizing_Cannabinoid_Protocols)
- [Minimizing Risks Through Gradual Dosing](#Minimizing_Risks_Through_Gradual_Dosing)
- [The Role of Real-World Evidence](#The_Role_of_Real-World_Evidence)
- [Advancing Digital Health in Cannabis](#Advancing_Digital_Health_in_Cannabis)
- [Evaluating Data Quality and Bias](#Evaluating_Data_Quality_and_Bias)
- [Supporting Patient Stability](#Supporting_Patient_Stability)
- [The Future of Precision Medicine](#The_Future_of_Precision_Medicine)
- [Frequently Asked Questions](#Frequently_Asked_Questions)[Cite This Article (AMA Style)](#Cite_This_Article_AMA_Style)
- [Related](#Related)

## How to Interpret This Cannabis News & Regulatory Digest

These studies represent the evolution of cannabinoid medicine from anecdotal reports to structured clinical protocols and behavioral analysis.

### Three Rules for Critical Reading

**Distinguish Between Observational and Interventional Data**The oncology study tracks what patients are already doing, while the LGS study tests a specific, controlled intervention.

**Look for Specific Titration Schedules**Effective cannabinoid therapy relies on the rate of dose escalation, which directly impacts both safety and efficacy.

**Consider the Source of Stress**Behavioral studies using pharmacological triggers provide insight into the biology of use but may differ from psychological stress.

Key Evaluation Question
How do the titration protocols in these trials compare to the informal methods currently used by patients in the community?

The Patient Question
Can you help me set up a structured titration schedule and a way to track my symptoms so we can find the most effective dose?

The Bottom Line
Precision in tracking and dosing is the most reliable path to safe and effective cannabis therapy.

CED Perspective Lens

## CED Perspective Lens: Eight Viewpoints on These Updates

Why these developments matter across clinical, patient, safety, and policy perspectives

Lens OverviewEight distinct clinical and regulatory perspectives on Clinical Trial: Cannabinoids and Biological R.

#### Empowering Your Treatment with Data

You might find it helpful to know that researchers are finally looking at how you use cannabis in your daily life. By using apps to track your symptoms and doses, you contribute to a larger body of knowledge that helps other patients.

This shift toward better tracking means your doctor can give you more specific advice. Instead of guessing, you can use your own data to find the products that work best for your needs. In clinical practice, evaluating patient factors requires assessing individual tolerance, baseline functional capacity, and verifiable product testing rather than generalizing from preliminary reports alone.

Lens takeawayStart keeping a detailed journal of your cannabis use to share with your doctor.

#### Standardizing Cannabinoid Protocols

These studies highlight the importance of moving toward structured titration and formal data collection in your practice. The LGS trial provides a model for how we can manage complex patients by prioritizing a slow, methodical approach to dosing.

Integrating digital tracking tools can help you bridge the communication gap with patients who use cannabis. This objective data allows for more precise adjustments to their treatment plans and better safety monitoring. In clinical practice, evaluating clinician factors requires assessing individual tolerance, baseline functional capacity, and verifiable product testing rather than generalizing from preliminary reports alone.

Lens takeawayImplement structured titration protocols and symptom tracking for all patients using cannabinoids.

#### Minimizing Risks Through Gradual Dosing

Safety in cannabinoid medicine is closely tied to the rate of dose escalation and the consistency of the product. The focus on gradual titration in recent trials is a positive step toward reducing avoidable adverse reactions.

Monitoring for stress-induced use patterns can also help identify patients at risk for developing dependency. By addressing the underlying triggers, we can promote a more sustainable and safer relationship with the medicine. In clinical practice, evaluating safety factors requires assessing individual tolerance, baseline functional capacity, and verifiable product testing rather than generalizing from preliminary reports alone.

Lens takeawayPrioritize slow titration and monitor for behavioral triggers to enhance patient safety.

#### The Role of Real-World Evidence

Regulatory bodies are increasingly looking for real-world evidence to inform policy decisions regarding cannabis. Studies that use mobile journals to capture patient data provide the kind of large-scale information that regulators need.

Standardizing titration and dosing protocols through clinical trials also helps establish a framework for product labeling and medical guidelines. This move toward pharmaceutical-grade rigor is essential for the long-term integration of cannabis into healthcare. In clinical practice, evaluating policy factors requires assessing individual tolerance, baseline functional capacity, and verifiable product testing rather than generalizing from preliminary reports alone.

Lens takeawaySupport policies that encourage the collection of real-world evidence and standardized dosing.

#### Advancing Digital Health in Cannabis

The use of digital health platforms in oncology research represents a significant advancement in how we study cannabis. This approach allows for the collection of high-volume data without the constraints of traditional clinical settings.

Investigating the biological mechanisms of stress and use motivation provides a foundation for developing targeted therapies for Cannabis Use Disorder. These early-phase studies are necessary for identifying the pathways that drive patient behavior. In clinical practice, evaluating research factors requires assessing individual tolerance, baseline functional capacity, and verifiable product testing rather than generalizing from preliminary reports alone.

Lens takeawayFocus future research on integrating real-world data with mechanistic biological studies.

#### Evaluating Data Quality and Bias

It is important to remain cautious about self-reported data, as patients may not record their use accurately in their journals. We must also consider how manufacturer-sponsored trials might influence the presentation of titration benefits.

While laboratory stress tests are useful, they may not capture the full experience of a patient’s life. We need to see if these findings hold up in broader, more diverse populations over longer periods. In clinical practice, evaluating skeptic factors requires assessing individual tolerance, baseline functional capacity, and verifiable product testing rather than generalizing from preliminary reports alone.

Lens takeawayCritically evaluate the source of data and the potential for bias in clinical trials.

#### Supporting Patient Stability

For those caring for patients with complex conditions like LGS, the emphasis on slow titration is a helpful guide. It suggests that patience in the dosing process is key to finding the right balance for your loved one.

Helping the patient maintain a simple log of their symptoms and doses can make a big difference in their care. This information helps the medical team make better decisions and ensures the patient stays comfortable. In clinical practice, evaluating caregiver factors requires assessing individual tolerance, baseline functional capacity, and verifiable product testing rather than generalizing from preliminary reports alone.

Lens takeawaySupport the patient in following a slow titration schedule and keeping a daily log.

#### The Future of Precision Medicine

The common thread across these updates is the move toward precision and better data. Whether it is through app-based journals or formal titration trials, the goal is to make cannabis therapy more predictable.

By focusing on the details of how and why patients use cannabis, we can move away from generalities and toward personalized medicine. This approach benefits everyone from the patient to the researcher. In clinical practice, evaluating takeaway factors requires assessing individual tolerance, baseline functional capacity, and verifiable product testing rather than generalizing from preliminary reports alone.

Lens takeawayPrecision dosing and detailed tracking are the future of effective cannabis medicine.

Join the Conversation

Have a question about how this applies to your situation? [Ask Dr. Caplan](https://benjamincaplan.com/ask-dr-caplan)

Want to discuss this topic with other patients and caregivers? [Join the forum discussion](https://cedclinic.com/interact/discussion-forums/forum/cannabis-industry/)

 

 
 
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Source: [Primary Sources: Scot Remick, Jazz Pharmaceuticals, Florida State University](https://clinicaltrials.gov/study/NCT07089225)

Related Reading at CED ClinicContinue exploring the evidence[Cannabis Use Disorder Is Rising Among US Adults](https://cedclinic.com/cannabis-use-disorder-rising-us-adults-2026/)

More on this topic: Epidemiological evaluation of diagnostic trends, screening tools, and evidence-based patient counseling.

[More on this topic: CUD trends & screening](https://cedclinic.com/cannabis-use-disorder-rising-us-adults-2026/)[Pancreatic Cancer Cannabis Trial Finds Modest THC Dose Signals for Anxiety and Sleep](https://cedclinic.com/ced-pancreatic-cancer-cannabis-trial-fi-2026-09-22/)

More on this topic: Physician appraisal of adjunctive cannabinoid therapies in oncology, symptom management, and anxiety.

[More on this topic: Cannabinoids in oncology](https://cedclinic.com/ced-pancreatic-cancer-cannabis-trial-fi-2026-09-22/)[CBD or THC: Sorting the Claimed Advantages by What Randomized Trials Have Shown](https://cedclinic.com/cbd-vs-thc-benefits-what-trials-show/)

More on this topic: Direct comparison of THC and CBD analgesic pathways and evidence-supported clinical indications.

[More on this topic: CBD vs THC for pain](https://cedclinic.com/cbd-vs-thc-benefits-what-trials-show/)

## Frequently Asked Questions

What is the EpiGOAL trial of cannabidiol in adults with Lennox-Gastaut syndrome?

EpiGOAL (NCT07728097) is an open-label Phase 3b/4 study sponsored by Jazz Pharmaceuticals that plans to enroll 40 adults with Lennox-Gastaut syndrome already taking one to three antiseizure medications. It tests a gradual titration schedule for prescription cannabidiol oral solution, and its primary outcome is a 50% or greater reduction in major motor seizures by week 24.

Why does the titration schedule for prescription CBD matter?

Prescription cannabidiol commonly causes sleepiness, reduced appetite, and diarrhea, and its FDA labeling notes that [liver enzyme elevations](/consumer-range-cbd-liver-enzyme-elevations-fda-study-2025/) are more frequent when it is combined with valproate. A slower schedule may improve tolerability and help patients stay on treatment, which is why EpiGOAL tracks retention and adverse events alongside seizure counts.

What did the Florida State University stress and cannabis study test?

The COBRAS study (NCT06430580) gave 38 adults with moderate-to-severe cannabis use disorder hydrocortisone, yohimbine, both, or placebo in a double-blind crossover design, then measured EEG responses to cannabis cues and cannabis demand. It finished in August 2026, but results had not been posted as of October 22, 2026.

Why would a cancer study ask patients to log cannabis use in an app?

Many people with cancer use cannabis without structured follow-up. The COSMIC-Releaf pilot (NCT07089225) plans to follow 45 patients at MaineHealth Cancer Care for six months, recording product types, doses, routes, and THC and CBD content along with patient-reported helpful and adverse effects.

Do newly registered trials show that cannabinoids work?

No. A registry entry describes what researchers plan to measure, not what they found. None of these three studies had posted results as of October 22, 2026, and the LGS and cancer studies have no placebo comparison, so their eventual findings will need careful interpretation.

### Cite This Article (AMA Style)

Caplan B. New Cannabinoid Clinical Trials: CBD Titration in Adult LGS, Cancer Use Tracking, and Stress in Cannabis Use Disorder. *CED Clinic*. Accessed October 22, 2026. https://cedclinic.com/new-cannabinoid-clinical-trials-lgs-cancer-cud/

 

### Related

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### Verification & Medical Governance

- **Lead Clinical Author:** Benjamin Caplan, MD
- **Credentials:** Board Certified in Family Medicine (ABFM), Former CMO Canna Care Docs (250,000+ patients supervised), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House).
- **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`).
- **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/).
- **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637).
- **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).
