Here is the design of a clinical trial:

Official Title: Randomized Clinical Trial of a Multi-Modal Palliative Care Intervention

Included conditions:
- Depression, Anxiety
- Metastatic Cancer

Study Armgroups:
- {'label': 'Multi-Modal Acceptance and Commitment Therapy (M-ACT)', 'type': 'EXPERIMENTAL', 'description': 'M-ACT consists of five 2-hour group sessions (plus booster) that alternate with self-paced online modules and check-ins that participants complete on their own, between the group sessions. The intervention addresses distress associated with coping with metastatic cancer and supports engagement in advance care planning. The intervention is based on Acceptance and Commitment Therapy, an intervention model that aims to help people cope with life challenges and difficult thoughts/feelings in a manner that helps them to live fuller and more meaningful lives.', 'interventionNames': ['Behavioral: Multi-Modal Palliative Care Intervention']}
- {'label': 'Control: Usual Care', 'type': 'OTHER', 'description': 'Patients in the control arm will have access to usual care (UC) at the collaborating clinics, consisting of access to a clinical social worker and nurse practitioners for advance care planning and supportive visits at patient request. After completion of study procedures, including FU, the UC participants will be offered M-ACT free of cost.', 'interventionNames': ['Behavioral: Usual Care Control Condition']}

Interventions:
- {'type': 'BEHAVIORAL', 'name': 'Multi-Modal Palliative Care Intervention', 'description': 'An innovative muli-modal palliative care intervention that addresses the lack of advance care planning and unmet psychosocial needs commonly experienced by patients with metastatic cancer.', 'armGroupLabels': ['Multi-Modal Acceptance and Commitment Therapy (M-ACT)']}
- {'type': 'BEHAVIORAL', 'name': 'Usual Care Control Condition', 'description': 'The control condition includes usual care (UC) at the collaborating clinics, consisting of access to a clinical social worker and nurse practitioners for advance care planning and supportive visits at patient request.', 'armGroupLabels': ['Control: Usual Care']}

Primary Outcomes:
- {'measure': 'Change in advance care planning', 'description': "The primary outcome is defined as change in the number of steps taken toward ACP completion from baseline through 2-month follow-up. ACP steps will be assessed with a checklist adapted from the M-ACT pilot study by consulting the Hospice \\& Palliative Nurses Association online ACP resources and the study team, and refined by soliciting pilot participants' feedback on item clarity. The checklist describes each ACP step and asks patients to indicate steps taken to date.", 'timeFrame': 'Assessed four times with parallel timing in the control group: prior to the intervention (Pre), week 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 2-month follow-up (FU)'}

Please estimate the sample size based on the assumption: 
The power calculations assume a two-sided alpha of 0.05 and a minimum power of 80%. The analyses consider an intraclass correlation (ICC) ranging from 0.02 to 0.08. The expected sample size accounts for attrition, with an anticipated n = 174 out of a total n = 240 participants contributing data at the final follow-up assessment.
Power and sample size estimation
        Power calculations to evaluate group differences in outcomes over time Pre thru FU (Study Aim 1) were performed using the Optimal Design For Multilevel and Longitudinal Research Software, Version 3.01 [70], where the effect size estimates consider the number of cohorts/intervention groups, the average sample size per group, and the intraclass correlation (ICC) assessing within-cohort similiarities. Due to expected attrition, power analyses were based on an expected nâ=â174 (of total nâ=â240) participants contributing data at the final FU assessment, though this number can be considered conservative due to intent to apply modern data techniques to include patients with partial data. Though the M-ACT pilot study showed an average ICC between intervention cohort groups of less than 0.01, we conservatively estimated minimum effect sizes detectable for different power specifications for ICCs ranging from 0.02 to as high as 0.08. These ICC estimates were based on in-person intervention delivery, where cohorts would be similar by clinic and/or geographic area. Given the current switch to the online-only format due to COVID-19, within-cohort similarities are expected to be further attenuated. Power was calculated to detect treatment effects in changes over time, i.e., the condition by time interaction. Assuming two-sided alpha of 0.05 and minimum power of 80%, the proposed sample size will be sufficient to detect an effect size of Cohenâs dâ=â0.26 (or larger) of the M-ACT intervention over the UC condition on condition differences in change over time across the four time points. For the primary outcome of ACP, assuming a similar standard deviation of Â±â2.29 as observed in the M-ACT pilot trial, this power corresponds to detecting a small but clinically important increase of approximately 0.60 ACP items. If the detectable effect size increases due to higher than anticipated attrition or ICC values, increases as low as 0.80 ACP items completed will still be detectable.
        To evaluate relationships between ACP and anxiety and depression symptoms (Study Aim 2), the expected sample size will provide 80% power to detect an association of anxiety or depression symptoms with ACP as low as râ=â.25, with a multivariable regression model able to detect an R-squared of 0.08, a medium effect size. For the exploratory mediational aim, simulation [71] shows we will have â¥â80% power to detect mediated effects associated with moderate to large sized path coefficients (e.g., as low as 6-13% of variance explained), which results in an ability to detect mediated effects that are smaller than relationships observed in the M-ACT pilot trial [42].