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Randomized block urn design is a clinical trial design that is increasingly being used as a means of treatment allocation to balance the treatment allocation. With repeated measures or multi-centre trials though, the corresponding complex structures of dependency invalidate the standard asymptotic approximations, even in small to moderate samples. In this paper, a high-accuracy saddlepoint approximation model of a linear rank test is established with the dual conditions of cluster sampling and adaptive urn randomization. We obtained the joint cumulant generating function of the test statistic conditional in the realized block allocation counts, and the accurate calculation of mid-
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