Dry Eyes Thesis Topics for MS Ophthalmology/DNB Ophthalmology
This page brings together dry eye disease thesis topics for MS Ophthalmology covering clinical assessment, tear-film tests, digital-device exposure, environmental and systemic risk factors, meibomian gland dysfunction, ocular surface disease and short-term treatment outcomes. The topics are intended for MS Ophthalmology residents and are framed around designs that can usually be completed within one thesis period using routine outpatient patients, symptom questionnaires, slit-lamp examination and tear-film investigations already available in most ophthalmology departments. The strongest dry eye disease research topics for MS Ophthalmology define how symptoms and signs are measured, standardise the order of testing and avoid assuming that one abnormal test represents the whole disease. Once a topic is shortlisted, the MS Ophthalmology dry eye protocol and MS Ophthalmology dry eye synopsis should specify the diagnostic definition, exposure measurement, primary outcome, test sequence and feasible statistical plan.
Last reviewed and updated: September 2026 · 2026–27 admissions
Clinical Assessment and Diagnostic Tests
Correlation of Ocular Surface Disease Index score with tear film breakup time and corneal fluorescein staining in adults with symptomatic dry eye disease: a cross-sectional study.
Correlation of Schirmer test values with tear film breakup time in adults with clinically diagnosed aqueous-deficient dry eye disease: a cross-sectional study.
Diagnostic accuracy of Ocular Surface Disease Index for detecting dry eye disease using objective tear film abnormalities as the reference standard: a diagnostic accuracy study.
Agreement between tear film breakup time and corneal fluorescein staining for grading severity in adults with dry eye disease: an agreement study.
Correlation of tear meniscus height on slit-lamp examination with Schirmer test values in patients with suspected aqueous-deficient dry eye disease: a cross-sectional study.
Association of corneal fluorescein staining severity with best corrected visual acuity in patients with moderate-to-severe dry eye disease: a cross-sectional study.
Correlation of conjunctival staining with Ocular Surface Disease Index score in adults with symptomatic dry eye disease: a cross-sectional study.
Agreement between two consecutive tear film breakup time measurements in patients with symptomatic dry eye disease: an intra-observer reliability study.
Inter-observer agreement for corneal fluorescein staining grading between ophthalmology residents and cornea specialists in patients with dry eye disease: an agreement study.
Inter-observer agreement for tear film breakup time measurement between ophthalmology residents in adults with suspected dry eye disease: an agreement study.
Correlation of dry eye symptom severity with blink rate during sustained near work in young adults with digital screen exposure: a cross-sectional study.
Association of reduced tear film breakup time with fluctuating vision in adults with symptomatic dry eye disease: a cross-sectional study.
Correlation of Schirmer test values with corneal epithelial staining in adults with aqueous-deficient dry eye disease: a cross-sectional study.
Diagnostic accuracy of reduced tear film breakup time for identifying clinically significant dry eye disease using combined symptom and staining criteria: a diagnostic accuracy study.
Association of tear film instability with refractive measurement variability in adults undergoing routine ophthalmic evaluation: a cross-sectional study.
Correlation of dry eye severity with contrast sensitivity in adults with moderate-to-severe symptomatic dry eye disease: a cross-sectional study.
Agreement between symptom-based and sign-based dry eye severity grading in adults attending a tertiary ophthalmology clinic: an agreement study.
Correlation of ocular surface staining with duration of symptoms in patients with newly diagnosed dry eye disease: a cross-sectional study.
Association of dry eye severity with reduced quality of vision despite normal best corrected visual acuity: a cross-sectional study.
Clinical profile of patients with discordance between severe dry eye symptoms and minimal objective ocular surface signs: a cross-sectional analytical study.
Digital Devices, Environment and Lifestyle Factors
Association of daily smartphone use duration with Ocular Surface Disease Index score and tear film breakup time among medical students: a cross-sectional study.
Association of prolonged computer use with tear film instability and corneal staining among office workers with dry eye symptoms: a cross-sectional study.
Comparative dry eye severity in medical students with high and low daily digital screen exposure: a comparative cross-sectional study.
Association of continuous screen viewing without breaks with tear film breakup time among young adults using digital devices for more than four hours daily: a cross-sectional study.
Association of reduced blink frequency during smartphone use with dry eye symptoms and corneal staining among young adults: a cross-sectional study.
Association of late-night digital device use with dry eye symptoms and tear film instability among college students: a cross-sectional study.
Association of daily screen exposure with dry eye severity among school-going adolescents using smartphones for educational and recreational purposes: a cross-sectional study.
Association of poor sleep quality with dry eye symptoms and tear film breakup time among young adults: a cross-sectional study.
Association of sleep duration with Schirmer test values and ocular surface symptoms among adults with dry eye disease: a cross-sectional study.
Comparative dry eye parameters among habitual motorcycle riders and predominantly indoor workers exposed to lower levels of traffic pollution: a comparative cross-sectional study.
Association of outdoor dust exposure with dry eye symptoms and corneal fluorescein staining among construction workers: a cross-sectional study.
Association of agricultural dust exposure with tear film instability and ocular surface staining among farm workers: a cross-sectional study.
Comparative dry eye severity among traffic police personnel and office-based government employees: a comparative cross-sectional study.
Association of household biomass fuel exposure with dry eye symptoms and tear film abnormalities among adult women: a cross-sectional study.
Comparative dry eye parameters among women using biomass cooking fuel and women using cleaner household fuels: a comparative cross-sectional study.
Association of air-conditioned workplace exposure with tear film breakup time and dry eye symptoms among office workers: a cross-sectional study.
Association of daily outdoor working hours with dry eye severity among street vendors and other outdoor workers: a cross-sectional study.
Seasonal variation in dry eye symptoms, tear film breakup time, and corneal staining among patients attending a tertiary ophthalmology clinic: a repeated cross-sectional study.
Association of smoking exposure with dry eye symptoms and tear film instability among adults attending an ophthalmology outpatient department: a cross-sectional study.
Association of habitual eye rubbing with corneal staining and dry eye symptom severity among young adults: a cross-sectional study.
Systemic Diseases, Medications and Hormonal Factors
Comparative dry eye severity in adults with diabetes mellitus and age-matched adults without diabetes mellitus: a comparative cross-sectional study.
Association of diabetes mellitus duration with Schirmer test values, tear film breakup time, and corneal staining: a cross-sectional study.
Association of glycaemic control with dry eye symptom severity and tear film abnormalities among adults with diabetes mellitus: a cross-sectional study.
Comparative dry eye parameters in patients with diabetic retinopathy and patients with diabetes mellitus without retinopathy: a comparative cross-sectional study.
Association of diabetic peripheral neuropathy with dry eye symptoms and reduced corneal sensitivity among adults with diabetes mellitus: a cross-sectional study.
Comparative dry eye severity in postmenopausal and premenopausal women without systemic autoimmune disease: a comparative cross-sectional study.
Association of years since menopause with Ocular Surface Disease Index score and tear film breakup time among postmenopausal women: a cross-sectional study.
Association of thyroid dysfunction with dry eye symptoms and tear film abnormalities among adults attending a tertiary hospital: a cross-sectional study.
Comparative dry eye parameters in patients with hypothyroidism and age-matched adults with normal thyroid function: a comparative cross-sectional study.
Association of rheumatoid arthritis duration with dry eye severity among patients without previous ocular surface surgery: a cross-sectional study.
Comparative dry eye severity in patients with rheumatoid arthritis and age-matched controls without autoimmune disease: a comparative cross-sectional study.
Association of systemic antihistamine use with tear film breakup time and dry eye symptoms among patients receiving treatment for allergic disorders: a cross-sectional study.
Association of long-term oral antidepressant use with dry eye symptoms and Schirmer test values among adults attending a tertiary hospital: a cross-sectional study.
Association of systemic antihypertensive medication use with dry eye symptoms and tear film abnormalities among older adults: a cross-sectional study.
Comparative dry eye severity in patients receiving multiple systemic medications and age-matched adults receiving no regular medication: a comparative cross-sectional study.
Association of chronic kidney disease with dry eye symptoms, tear film breakup time, and corneal staining: a cross-sectional study.
Comparative dry eye parameters in patients receiving haemodialysis and patients with chronic kidney disease not receiving haemodialysis: a comparative cross-sectional study.
Association of vitamin D deficiency with dry eye symptom severity and tear film abnormalities among adults attending a teaching hospital: a cross-sectional study.
Comparative dry eye severity in patients with autoimmune thyroid disease and patients with non-autoimmune hypothyroidism: a comparative cross-sectional study.
Association of anaemia severity with dry eye symptoms and tear film breakup time among adult women: a cross-sectional study.
Meibomian Gland Dysfunction and Ocular Surface Disorders
Correlation of meibomian gland dysfunction severity with tear film breakup time and Ocular Surface Disease Index score in adults with evaporative dry eye disease: a cross-sectional study.
Association of meibomian gland expressibility with corneal fluorescein staining in patients with evaporative dry eye disease: a cross-sectional study.
Correlation of meibum quality with dry eye symptom severity among adults with clinically diagnosed meibomian gland dysfunction: a cross-sectional study.
Comparative tear film parameters in patients with meibomian gland dysfunction and patients with aqueous-deficient dry eye disease: a comparative cross-sectional study.
Association of blepharitis severity with tear film instability and corneal epithelial staining among adults with symptomatic dry eye disease: a cross-sectional study.
Comparative dry eye severity in patients with anterior blepharitis and patients with meibomian gland dysfunction: a comparative cross-sectional study.
Association of lid margin abnormalities with dry eye symptom severity among elderly adults attending an ophthalmology outpatient department: a cross-sectional study.
Correlation of meibomian gland orifice obstruction with tear film breakup time among patients with evaporative dry eye disease: a cross-sectional study.
Association of pterygium size with tear film breakup time and dry eye symptoms among adults with primary pterygium: a cross-sectional study.
Comparative dry eye parameters in eyes with unilateral pterygium and clinically unaffected fellow eyes: a paired comparative cross-sectional study.
Association of chronic allergic conjunctivitis with tear film instability and corneal staining among adults with recurrent ocular allergy: a cross-sectional study.
Comparative dry eye severity in patients with allergic conjunctivitis and age-matched individuals without ocular allergy: a comparative cross-sectional study.
Association of vernal keratoconjunctivitis severity with tear film breakup time and corneal epithelial staining among adolescents: a cross-sectional study.
Association of frequent eye rubbing with tear film instability in patients with chronic ocular allergy: a cross-sectional study.
Comparative dry eye parameters in patients with primary open angle glaucoma receiving topical medication and treatment-naive patients: a comparative cross-sectional study.
Association of number of topical antiglaucoma medications with Ocular Surface Disease Index score and corneal staining: a cross-sectional study.
Association of duration of topical antiglaucoma treatment with tear film breakup time and dry eye severity: a cross-sectional study.
Comparative ocular surface status in patients using preserved and preservative-free topical antiglaucoma medications: a comparative cross-sectional study.
Association of contact lens wearing duration with tear film instability and corneal staining among habitual soft contact lens users: a cross-sectional study.
Comparative dry eye severity in habitual soft contact lens users and age-matched spectacle users: a comparative cross-sectional study.
Treatment, Surgery and Short-Term Outcomes
Change in Ocular Surface Disease Index score and tear film breakup time four weeks after routine lubricating therapy in newly diagnosed dry eye disease: a prospective observational study.
Change in Schirmer test values and corneal staining six weeks after routine treatment of aqueous-deficient dry eye disease: a prospective observational study.
Change in tear film breakup time and dry eye symptoms after four weeks of warm compresses and lid hygiene in meibomian gland dysfunction: a prospective observational study.
Association of baseline meibomian gland dysfunction severity with improvement in dry eye symptoms after six weeks of routine lid hygiene: a prospective observational study.
Comparative short-term improvement in dry eye symptoms with gel-forming and conventional lubricating eye drops in patients receiving routine clinical treatment: a comparative observational study.
Association of baseline corneal staining severity with symptom improvement after six weeks of routine lubricating therapy in dry eye disease: a prospective observational study.
Change in tear film parameters before and six weeks after pterygium excision with conjunctival autografting in patients with primary pterygium: a prospective observational study.
Change in dry eye symptoms and tear film breakup time before and six weeks after uncomplicated cataract surgery: a prospective observational study.
Comparative dry eye severity before and six weeks after phacoemulsification and manual small incision cataract surgery: a comparative prospective observational study.
Association of preoperative dry eye disease with postoperative ocular discomfort at one and six weeks after uncomplicated cataract surgery: a prospective observational study.
Association of cataract surgery incision type with tear film breakup time and corneal staining at six weeks after surgery: a prospective observational study.
Comparative postoperative dry eye parameters in patients with diabetes mellitus and patients without diabetes mellitus six weeks after uncomplicated cataract surgery: a comparative observational study.
Association of preoperative meibomian gland dysfunction with dry eye symptom severity six weeks after uncomplicated cataract surgery: a prospective observational study.
Change in ocular surface symptoms after switching from preserved to preservative-free topical glaucoma medication over six weeks: a prospective observational study.
Change in dry eye parameters after four weeks of structured digital screen breaks among symptomatic young adults with prolonged screen exposure: a prospective observational study.
Association of adherence to the twenty-twenty-twenty screen break rule with improvement in dry eye symptoms after four weeks among digital device users: a prospective observational study.
Change in tear film breakup time and corneal staining after six weeks of reduced contact lens wearing duration in symptomatic soft contact lens users: a prospective observational study.
Association of correct lubricant instillation technique with symptom improvement after four weeks in patients receiving treatment for dry eye disease: a prospective observational study.
Change in dry eye symptoms and tear film parameters after six weeks of treatment for associated blepharitis in patients with evaporative dry eye disease: a prospective observational study.
Predictors of poor symptomatic improvement after six weeks of routine dry eye treatment, assessing baseline severity, meibomian gland dysfunction, digital exposure, and treatment adherence: a prospective observational study.
Not the ophthalmology subspeciality you need? Dry eye disease is one section of our full ophthalmology collection — the hub page lists every subspeciality, each with its own free topic list. Updated September 2026.
📌 Updated for 2026–2027 MS Ophthalmology Dry Eye Disease admissions
The list was reviewed for feasibility in departments where dry eye research depends mainly on routine symptom assessment, slit-lamp examination and simple tear-film testing.
Most topics can be completed with Ocular Surface Disease Index scoring, tear film breakup time, Schirmer testing, fluorescein staining and routine lid-margin examination; advanced tear osmolarity or meibography is not essential for many projects.
Cross-sectional, comparative, agreement, reliability and short prospective follow-up designs are usually more practical than long-duration treatment trials.
Publication potential is strongest when symptom scores and objective signs are analysed separately, test order is standardised and exposure variables such as screen time, medication burden or environmental exposure are measured consistently.
Generate a protocol from any topic above
Select Generate Protocol → beside any title in the list above and receive a submission-ready document built around that topic, containing all eighteen components:
Introduction / Synopsis
Research Question
Aim of the Study
Primary Objective
Secondary Objectives
Materials and Methods
Inclusion Criteria
Exclusion Criteria
Sample Size Calculation
Methodology
Statistical Analysis
Ethical Considerations
Review of Literature
References
Gantt Chart / Study Timeline
Patient Information Sheet
Consent Form
Data Collection Form
Already have your thesis title?
Generate the full dry eye disease protocol directly — objectives, methodology, sample size, statistics, timeline, references and annexures.
Alongside dry eye disease protocols and synopses, support is also available for departmental presentations, journal club presentations, ethics committee presentations, and posters and oral presentations for medical conferences — for postgraduate residents, board trainees and research scholars across India and the GCC. Prepared by a practising doctor with long experience in medical publishing and thesis supervision.
The topics above work as research questions anywhere — what changes is the document the institution expects, and who approves it before data collection begins. The Gulf equivalent of an Indian synopsis is the dry eye disease research proposal submitted to an institutional review board, and it ordinarily carries three sections an Indian synopsis does not: a Gantt chart, a budget and resources section, and a Declaration of Helsinki statement.
Board and residency programmes — country by country
Saudi Arabia — SCFHS and the Saudi Board. Residency and fellowship training under the Saudi Commission for Health Specialties includes a research project with a set timeline, and the dry eye disease research proposal is the document prepared at the outset and cleared by the institutional review board before recruitment starts.
United Arab Emirates — DHA, DOH Abu Dhabi and MOHAP. Residents training in Dubai, Abu Dhabi and the northern emirates prepare a dry eye disease research protocol for their programme and submit it for institutional review board approval before any data are collected.
Qatar — DHP (formerly QCHP) and Hamad Medical Corporation. A dry eye disease IRB proposal is reviewed before recruitment, with the ethics section written to the institution's own template rather than a generic one.
Bahrain — NHRA. Trainees turning dry eye disease research topics into a project need the proposal cleared by their institutional research and ethics committee before fieldwork begins.
Oman — OMSB. Residency programmes under the Oman Medical Specialty Board include a research component, and the dry eye disease research proposal is the document assessed at the start of it.
Kuwait — KIMS. A dry eye disease study protocol goes to the institutional committee for approval before the project begins.
Arab Board programmes across the region. The Arab Board carries its own research requirement irrespective of the host country, and the dry eye disease proposal follows the same structure throughout.
Postgraduate degrees — Malaysia, the Gulf and beyond
Malaysia — MMed, the National Medical Research Register and MREC. A dry eye disease dissertation proposal for a Master of Medicine programme carried out in a Ministry of Health facility must be registered on the NMRR and approved by the Medical Research and Ethics Committee before the study begins, and the guidance asks for submission four to six months ahead of data collection. Every investigator on the study team registers on the NMRR as well, so the methodology, ethics and team sections are written in far more detail than an Indian synopsis requires.
PhD and Master's candidates elsewhere. University programmes generally require a full dry eye disease research proposal of roughly 6,000 to 10,000 words, with an extended literature review, a theoretical framework and a detailed methodology chapter.
PhD and MMed proposals are written individually by a medical doctor and revised until the supervisor accepts them. They are not produced by the automated protocol generator.
🔥 Trending research areas in Dry Eye Disease for 2026–27
Dry eye research is increasingly focused on exposure-related disease, ocular-surface phenotyping and reproducibility of commonly used clinical tests.
Digital-device related dry eye: screen duration, reduced blink frequency, late-night device use and structured screen breaks are practical areas because exposure is common and measurable in younger populations.
Meibomian gland dysfunction and evaporative dry eye: lid-margin findings, meibum quality, gland expressibility and tear-film instability allow clinically meaningful phenotyping without expensive equipment.
Medication-related ocular surface disease: topical antiglaucoma treatment, preservative exposure and systemic medications are useful because treatment burden may influence both symptoms and objective surface damage.
Symptom-sign discordance: patients may report severe discomfort despite limited staining or relatively preserved tear-production tests, creating useful research questions around agreement, visual quality and treatment response.
Protocol and synopsis guidance
What a Dry Eye Disease protocol must contain
Define dry eye disease operationally. State whether diagnosis requires symptoms, tear-film instability, ocular-surface staining, reduced tear production or a predefined combination. Ocular Surface Disease Index score, tear film breakup time, Schirmer value and staining grade should remain separate variables even when they contribute to a composite diagnosis.
Standardise the sequence of testing. Tear-film investigations are not independent of the examination itself. Fluorescein, repeated blinking, topical drops and Schirmer strips can alter subsequent measurements, so the protocol should fix the test order, interval between tests, examiner and number of readings.
Measure exposures reproducibly. Screen time, sleep duration, outdoor work, dust exposure, medication use and contact-lens wear should be defined in measurable units rather than vague categories. If exposure is self-reported, specify the recall period and how categories are formed.
Fix the analysis unit and timing. Most symptom scores are patient-level while staining and tear-film measurements are eye-level. State whether one eye, both eyes or a prespecified worse eye will be analysed, and define whether measurements are made at baseline, after treatment or at a fixed postoperative interval.
Dry Eye Disease synopsis versus Dry Eye Disease protocol
The synopsis gives the compact study plan. It should identify the target population, dry eye definition, main exposure or comparison, primary tear-film or symptom outcome, study design and planned analysis.
The protocol provides reproducibility. It should state the Ocular Surface Disease Index version, cut-off or scoring method, tear film breakup time technique, Schirmer method, staining scale, order of tests, number of repeated measurements, observer training and how bilateral eyes will be handled.
Dry eye studies can look similar but measure different constructs. A symptom questionnaire measures patient experience, tear film breakup time measures stability, Schirmer testing measures aqueous production and fluorescein staining measures surface damage. The protocol must define which measure is primary rather than treating them as interchangeable markers of one severity scale.
Sample size and statistical analysis
Calculate sample size from the primary objective. Correlation studies use the expected correlation coefficient, comparative studies use the anticipated difference between groups, prevalence studies use an expected proportion and precision, and diagnostic-accuracy studies require expected sensitivity or specificity together with disease prevalence.
Match the analysis to the question. Correlation between Ocular Surface Disease Index and tear film breakup time is not agreement. Agreement studies need an appropriate agreement statistic, observer grading may require kappa or an intraclass correlation coefficient, and repeated same-visit measurements require repeatability analysis.
Avoid pseudo-replication. Two eyes from one participant are correlated, while symptom scores are usually recorded once per participant. A protocol should prespecify a study-eye rule, paired analysis or a method that accounts for within-person clustering. For prospective treatment studies, change from baseline should be analysed against the planned follow-up point rather than mixing visits.
1. How do I choose a feasible Dry Eye Disease thesis topic?
For 2026–2027 admissions, choose a population that is easy to recruit and an outcome that can be measured consistently. Medical students, office workers, patients with diabetes mellitus, glaucoma patients using topical medication, patients with meibomian gland dysfunction and adults attending routine ophthalmology clinics are generally practical groups. Prefer a topic with one principal exposure and one primary outcome rather than several loosely related tear-film variables.
2. Which study designs are commonly accepted for Dry Eye Disease thesis work?
Common designs include cross-sectional analytical studies, comparative cross-sectional studies, correlation studies, diagnostic-accuracy studies, observer-agreement studies, repeatability studies and short prospective observational follow-up studies. Intervention trials should be considered only when treatment allocation, follow-up and ethical approval can be managed properly.
3. What should I settle with my guide before finalising a Dry Eye Disease topic?
Settle the operational definition of dry eye disease, the primary outcome, test sequence, number of readings, staining scale, symptom questionnaire, study-eye rule and whether the exposure can be measured reliably. For screen-related studies, agree on the recall period and screen-time categories. For treatment studies, agree on the exact follow-up point before recruitment begins.
4. How should I handle symptom and sign measurements in Dry Eye Disease research?
Keep them as separate domains unless a validated diagnostic rule explicitly combines them. A high symptom score with a normal Schirmer value is not necessarily contradictory because aqueous production, tear-film stability, surface staining and patient-reported discomfort measure different aspects of disease. Prespecify which measure is primary and which are secondary outcomes.
5. What is the difference between a Dry Eye Disease synopsis and a Dry Eye Disease protocol?
The synopsis summarises the research question, rationale, objectives, design, principal tests and analysis. The protocol gives the full operating method, including questionnaire scoring, tear film breakup time technique, Schirmer method, staining scale, order of examination, examiner roles, repeated-measurement rules, exposure definitions, study-eye selection and handling of missing measurements.
6. What ethical issues are important in Dry Eye Disease research?
Prospective studies require informed consent, and studies involving children require guardian consent with age-appropriate assent from about seven years where feasible. Record-based work may seek a waiver of consent when permitted by the ethics committee. Research should not add unnecessary corneal staining, topical medication, contact-lens interruption or other procedures beyond what is justified by the protocol. Separate consent should be obtained for identifiable ocular photographs or video. Any stored images or device exports should be anonymised. The protocol should also state how clinically important findings such as severe keratitis, marked epithelial damage, suspected autoimmune ocular surface disease or significant medication-related toxicity will be referred for treatment.
7. Can severe dry eye symptoms occur despite nearly normal objective tests?
Yes. Symptom severity and objective tear-film or staining abnormalities may be discordant because they represent different dimensions of ocular surface disease. A participant with severe discomfort may have limited staining or preserved Schirmer values, while another patient may show objective abnormalities with relatively few symptoms. The protocol should therefore avoid defining severity from a single test unless that rule is specified in advance, and it should analyse symptom and sign outcomes separately when appropriate.
8. Can a Dry Eye Disease thesis also support PhD or Gulf board research pathways?
Yes, but the expected scope differs. A PhD proposal usually needs a broader research gap, stronger methodological justification and a larger programme of work than an MS dissertation. An MS synopsis is usually centred on one feasible dissertation question. SCFHS and Saudi Board trainees may also complete a mandatory board research project, while Arab Board of Health Specializations and DHP, DHA, DOH or MOHAP-linked programmes may have separate research-proposal, ethics and submission requirements. The scientific topic may overlap, but the document should be written for the intended training pathway.
9. When should I register my Dry Eye Disease thesis topic?
Register after confirming access to the target population, availability of the required tear-film tests, a standardised examination sequence and guide agreement on the primary outcome and analysis. Prospective recruitment or collection of research-specific measurements should begin only after the institutional requirements and ethics pathway have been completed.
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