Here is the design of a clinical trial:

Official Title: Development and Preliminary Evaluation of an Evidence-based Somatic Acupressure Protocol for the Self-management of Symptom Cluster of Fatigue, Insomnia and Depression in Breast Cancer Patients

Included conditions:
- Cancer

Study Armgroups:
- {'label': 'True SA (Somatic Acupressure ) group', 'type': 'EXPERIMENTAL', 'description': 'Receiving true somatic acupressure+usual care', 'interventionNames': ['Other: Somatic Acupressure', 'Other: Usual care']}
- {'label': 'Sham SA group', 'type': 'SHAM_COMPARATOR', 'description': 'Receiving sham somatic acupressure+usual care', 'interventionNames': ['Other: Sham acupressure', 'Other: Usual care']}
- {'label': 'Usual care group', 'type': 'OTHER', 'description': 'Receiving usual care only (an education booklet regarding knowledge of BC and FSD symptom cluster management advice)', 'interventionNames': ['Other: Usual care']}

Interventions:
- {'type': 'OTHER', 'name': 'Somatic Acupressure', 'description': '7-week self-acupressure plus usual care (an education booklet)', 'armGroupLabels': ['True SA (Somatic Acupressure ) group']}
- {'type': 'OTHER', 'name': 'Sham acupressure', 'description': 'Same dose as the true acupressure group but on the sham acupoints plus usual care (an education booklet)', 'armGroupLabels': ['Sham SA group']}
- {'type': 'OTHER', 'name': 'Usual care', 'description': 'Usual care only (an education booklet)', 'armGroupLabels': ['Sham SA group', 'True SA (Somatic Acupressure ) group', 'Usual care group']}

Primary Outcomes:
- {'measure': 'FEASIBILITY: Eligibility rate', 'description': 'Eligibility rate as assessed by (the number of eligible participants / number of participants screened) x 100%', 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'FEASIBILITY: Recruitment rate', 'description': 'Recruitment rate as assessed by (the number of participants who participated in the study / number of eligible participants) x 100%', 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'FEASIBILITY: Retention rate', 'description': 'Retention rate as assessed by (the number of participants who completed the study / number of participants who enrolled in) x 100%', 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'FEASIBILITY: Attrition rate', 'description': 'Attrition rate as assessed by (the number of participants who dropped out after the randomization / number of participants who enrolled in) x 100%', 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'FEASIBILITY: subject recruitment', 'description': "Feasibility of subject recruitment assessed by interviewing the participants' feedback regarding why they discontinued this study", 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'FEASIBILITY: Duration for completing the subject recruitment', 'description': 'Time period from the recruitment of first participants to the last patient: assessed by months', 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'ACCEPTABILITY: Actual days of acupressure', 'description': 'The number of days that the participants perform the SA interventions, where the scheduled sessions should be 7 weeks of daily acupressure', 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'ACCEPTABILITY: duration of each acupressure session', 'description': 'Duration of each time (minutes) of acupressure where the scheduled time per session should be around 36 minutes', 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'ACCEPTABILITY: SA protocol', 'description': "Participants' feedback and satisfaction with the SA intervention assessed by a self-designed feedback form and follow-up semi-structured interviews", 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'FEASIBILITY: Questionnaire-Item-level missing value of each questionnaire', 'description': 'Item-level missing value of each questionnaire (%) assessed by the percentage of participants who do not answer any single item', 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'FEASIBILITY: Questionnaire-Scale-level missing value of the questionnaire', 'description': 'Scale-level missing value of the questionnaire (%) assessed by the percentage of participants who do not answer at least one item in the whole questionnaire', 'timeFrame': 'Immediately after completion of the intervention (T2)'}
- {'measure': 'SAFETY: adverse events', 'description': 'Number of adverse events occur during the intervention', 'timeFrame': 'Immediately once an adverse event occurs'}

Please estimate the sample size based on the assumption: 
A completion rate of 73.4% from a previous study is used, and a possible attrition rate of 30% is considered.
Participants and sample size
        Female BC survivors who meet the following inclusion criteria will be recruited: (1) confirmed BC diagnosis from stage I to IIIa (early-stage BC survivors without any distant metastasis); (2) have experienced at least a moderate level of the FSD symptom cluster, with a score of â¥4 on a 0â10 Numeric Rating Scale (0=âno symptomâ, 10=âworst symptomâ) for all three symptoms (fatigue, sleep disturbance and depression) during the previous 1âmonth; (3) have completed adjuvant chemotherapy for at least 1âmonth and up to 3âyears (to capture persistent symptoms); (4) have no scheduled chemotherapy and radiotherapy during the study period and (5) willing to participate in this RCT with written informed consent.
        Potential participants will be excluded if they meet any of the following exclusion criteria: (1) presently taking pharmaceutical agents to treat fatigue, sleep disturbance or depression, such as antidepressant medications, psychostimulants or hypnotics; (2) extremely weak and/or have cognitive impairment that make them unable (or would make it difficult for them) to follow the study procedures and instructions; (3) have received any type of SA treatment during the previous 6âmonths and (4) presently participating in any other research projects.
        Julious30 recommended that 12 subjects per group is necessary to justify a studyâs feasibility and the precision of the mean and variance. Given that the primary objective of the proposed study is to evaluate the feasibility and acceptability of the RCTs methodological procedure, intervention protocol and questionnaires, a sample size of 12 per group will therefore be considered. According to one previous study,31 the completion rate of 6âweeks of daily self-administered acupressure to manage cancer-related fatigue in BC survivors was 73.4%. Given that the current study will consist of 7âweeks of daily self-administered acupressure to measure the FSD symptom cluster in BC survivors, a possible attrition rate of 30% will be considered. The final sample size will be 51, with 17 in each group.