Bilateral internal thoracic artery grafting × Ten-year overall survival after CABG — ART efficacy and sternal-harm evidence sheet

Required evidence, verification status and materials actually read
Item	AVerification status	BReading scope	CReview item	DCurrent findings	EWhy unverified	FRequired materials and conditions	GFurther research
1	Partly verified	Full text not readStored summary read	N01 · Comparative efficacyWere the selected claim and existing verdict record distinguished?Required	The selected claim is improved ten-year overall survival after CABG; the root grade D, score 34, Warning and axes E−/I2/B0/C0 are preserved. Distinguish the existing history from the current verdict record. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not turn the MAIN claim into a subclaim or introduce parent-inheritance or missing-subclaim-score explanations. Preserve the actual values, presence or absence and original verdict without a new verdict or split.	Preservation of the existing claim wording, verdict values, history and empty values	Link original materials and decisions to the actual MAIN question and root verdict record.
2	Partly verified	Full text not readStored summary read	N02 · Comparative efficacyWhat are the CABG population, baseline and eligibility, and how do they differ from other coronary questions?Required	ART is a surgical-technique trial asking whether to use bilateral internal thoracic arteries during CABG. R01 R02 R03	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not replace this with PCI-versus-CABG questions in diabetic multivessel or left-main disease. Age, eligibility, exclusions, baseline and institution-specific surgical details were not read.	Original CABG eligibility, baseline, institutions, surgical conditions and denominators	Obtain original population, eligibility, baseline, institution and surgical-condition materials.
3	Partly verified	Full text not readStored summary read	N03 · Comparative efficacyWhat are the assigned comparison and actual techniques of bilateral versus single internal thoracic artery grafting?Required	ART assigned bilateral versus single internal thoracic artery grafting; actual surgical crossover and additional radial-artery grafting in the single group occurred. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not turn the graft-number question into the effect of CABG itself, superiority of all arterial grafting, or surgical-method and selection guidance. Conduit, surgical and concurrent-management details were not read.	Original assignment, actual grafting, common CABG procedures, other conduits and concurrent treatment	Obtain original assignment, actual techniques, other conduits, concurrent management and change materials.
4	Partly verified	Full text not readStored summary read	N04 · Comparative efficacyWere the 3,102 participants distinguished from original ten-year denominators and death counts?Required	The original source records 3,102 participants and ten-year mortality of 20.3% versus 21.2%. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not calculate group allocation numbers, death counts, risk sets or new proportions and totals. Do not add multiple assessments or reports as independent people.	Assignment, group-specific analysis, follow-up, censoring, events and denominators	Obtain original group-specific assignment, analysis, follow-up, risk sets and event tables.
5	Partly verified	Full text not readStored summary read	N05 · Comparative efficacyWere the overall-survival question and actual ten-year all-cause mortality endpoint distinguished?Required	The original effect question is improved ten-year overall survival, and the original primary endpoint is all-cause death at ten years. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not convert death proportions into new survival rates or substitute cardiovascular or sternal mortality, healing or functional improvement. Original follow-up reference points and cause-specific ascertainment details were not read.	Original death definition, period, overall survival, original denominator and ascertainment	Obtain original death and survival definitions, time points, ascertainment and denominators.
6	Partly verified	Full text not readStored summary read	N06 · Comparative efficacyAre 20.3%/21.2%, HR 0.96, the 95% CI and −0.9 percentage points preserved?Required	Ten-year mortality was 20.3% with bilateral versus 21.2% with single grafting; HR 0.96 (95% CI 0.79–1.17), with an original absolute difference of −0.9 percentage points. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not fill in or calculate original P values, an absolute-difference CI, adjusted models, death counts, new survival rates or NNT.	Original group order, HR, CI, absolute difference, model and denominators	Obtain original time-to-event effects, group risk sets, models, tests and CI.
7	Partly verified	Full text not readStored summary read	N07 · Comparative efficacyWhat are the null result, CI tails allowing meaningful benefit and harm, and the original warning?Required	The original reader answer records remaining possibilities of meaningful benefit and harm, without establishing absence of benefit. The original grade D, score 34 and Warning are preserved. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not interpret an HR near the null or a null result as an exact zero effect, equivalence or exclusion of all clinical effects. No new MCID, power calculation or examples are supplied.	Original interval, precision, efficacy, harm and clinical boundaries	Obtain original clinical boundaries, precision and separate efficacy and harm interpretations.
8	Partly verified	Full text not readStored summary read	N08 · Comparative efficacyWhat are the 14% bilateral-to-single crossover and 22% additional radial-artery grafting in the single group?Required	The original record says that 14% assigned bilateral received a single graft, while 22% assigned single received a radial artery as a second arterial graft. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not add these two crossovers or convert them into causal effects of the actual surgical groups. Do not newly classify them as allocation failure or completer analysis; the degree of contrast dilution, reasons and denominators were not read.	Assignment, actual surgery, crossover, adherence, periods and original denominators	Obtain original crossover, adherence, actual techniques, reasons, denominators, effects of interest and sensitivity analyses.
9	Partly verified	Full text not readStored summary read	N09 · Comparative efficacyWere ITT, as-treated analyses, observational associations and the dilution explanation distinguished?Required	The original text preserves the ITT principle and treatment-contrast dilution, and distinguishes long-term observational benefits from randomized effects. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not conclude that crossover explains all null findings or newly derive survival superiority for actual-treatment groups. Per-protocol and as-treated model details were not read.	Assignment effect of interest, actual-treatment models, confounding and sensitivity analyses	Obtain original effects of interest, actual-treatment analyses, confounding, sensitivity analyses and denominators.
10	Partly verified	Full text not readStored summary read	N10 · Comparative efficacyIs censoring of 71 participants (2.3%) with missing ten-year vital status the same as attrition?Required	The original text records that 71 participants (2.3%) with missing ten-year vital status were censored in survival analysis and were not counted as attrition. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not subtract the 71 participants as new exclusions or a completer analysis, or certify censoring as zero missingness or complete follow-up. Censoring times, assumptions, original effects and group mapping were not read.	Original vital status, missingness, censoring times, reasons and sensitivity analyses	Obtain original group-specific censoring, times, reasons, assumptions, sensitivity analyses and risk sets.
11	Partly verified	Full text not readStored summary read	N11 · Comparative efficacyWere secure web allocation, unmasked surgery, event adjudication and the B0 history distinguished?Required	The original text records secure web randomization, inability to mask surgeons and patients, adjudication of all events including adverse events, and ITT as the historical basis for B0. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not certify event adjudication as adjudicator blinding absent from the source or as a new review establishing absence of all bias.	Allocation, concealment, surgeons and patients, assessment, adjudication and analysis	Obtain original allocation, adjudication, assessor, analyst and data-collection procedures.
12	Partly verified	Full text not readStored summary read	N12 · Comparative efficacyWhat was accessed regarding registration, prespecified ten-year mortality, subgroups and hierarchy?Required	The history of the original registration identifier ISRCTN46552265 and its consistency with prespecified ten-year all-cause mortality is preserved. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. No new registration or plan reading was performed. Do not create prespecified subgroups, α, multiplicity, changes or test P values for specific populations or actual techniques.	Original registration, protocol, SAP, prespecified endpoints, changes and multiplicity	Obtain original registration, plans, hierarchy, subgroups, interactions and changes.
13	Partly verified	Full text not readStored summary read	N13 · Supplementary harm evidenceWere sternal wounds of 3.5%/1.9%, efficacy, harm and periods distinguished?Required	The original source says that sternal wound complications increased to 3.5% with bilateral versus 1.9% with single grafting. This is a separate harm outcome from ten-year mortality. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not fill in a ten-year wound-observation period or calculate original event counts, CI, P values, RR, NNH or differences. Definitions, collection, relatedness and original denominators were not read.	Wound definition, severity and collection, people and events, periods and denominators	Obtain original wound definitions, periods, group-specific people, events, denominators, CI and tests.
14	Unverified	Full text not readStored summary read	N14 · Supplementary harm evidenceWhat are the increased wound harm and gaps concerning rare or other harms and long-term safety?Required	The original safety warning and increased sternal wounds are preserved, together with the original description of adjudication of all events. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not extend the warning to established harm of every kind or established harm to survival. Other harms, reoperations, rare events, relatedness and original exposure details were not read.	Other harms, collection, actual techniques, relatedness, periods and denominators	Obtain original overall-harm, actual-technique, collection, relatedness, period and denominator materials.
15	Partly verified	Full text not readStored summary read	N15 · Comparative efficacyWhat is the information level for MRC/BHF funding, in-kind support, affiliations and external analysis?Required	UK MRC and British Heart Foundation support and the original I2 are preserved. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not turn public funding into certification of no company in-kind support, no employees or fully independent analysis. Details of each disclosed role were not read.	Public or nonprofit funding, devices, in-kind support, affiliations, analysis and writing	Obtain original disclosures on cash, in-kind support, affiliations, design, analysis and writing.
16	Partly verified	Full text not readStored summary read	N16 · Comparative efficacyWhat are the 1822/2859 cross-citations and relationships with the same ART report and follow-up?Required	Verdict 1822 concerns CABG strategy in diabetic multivessel disease, and 2859 concerns PCI versus CABG in left-main disease; both differ from ART's graft-number question. R01 R02 R03	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Linked targets and original papers were not newly read or used as direct replication or additional participants. Do not count the same ART ten-year report or assessments as new independent trials; independent counts and total participants remain null.	Reports, related verdicts, populations, comparators, shared cohorts and independence relationships	Link new reports using original identifiers, shared cohorts and time points, and separate questions.
17	Unverified	Full text not readStored summary read	N17 · Comparative efficacyWhat are the applicability gaps for observational benefits, other techniques or populations and longer periods?Required	The original core question is ten-year overall survival under assignment to bilateral internal thoracic arteries. The source treats observational advantages separately. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not transfer effects from other conduits, selected subgroups, actual surgical groups or other CABG indications, or create guidance on surgical selection, implementation or treatment.	Original follow-up and direct efficacy and harm by population, conduit and technique	Obtain direct efficacy, harm, plans and denominators by population, technique, exposure and period.
18	Partly verified	Full text not readStored summary read	N18 · Comparative efficacyWere the summary, paper and related-verdict URLs, registration identifier and actual access distinguished?Required	The entire stored summary of the designated existing verdict was read for preparation, and the original source links and registration identifier were linked. R01 R02 R03	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. External abstracts, full texts, registrations, protocols, SAP and related-verdict targets were not read, and no separate link testing was performed. Do not create new URLs, DOI or original-study information.	Original bibliography, URLs, registration, material-specific access and cross-citations	Link user-provided original materials by material type and actual access.
19	Partly verified	Full text not readStored summary read	N19 · Comparative efficacyWere MAIN languages, dates, corrections, empty arrays, false/null, empty values and candidate history preserved?Supplementary	Preserve 2026-08-26, empty corrections/subclaims arrays, the empty deliberation string, root grade/score/safety/axes, Korean and English, false/null and empty values unchanged. R01	Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. This root record is not a case of missing subclaim scores or parent inheritance. Original verification and path checks, B0, support and safety assessments are historical, not a completed current review. Original candidate pending/eligible states are also historical.	Original root verdict, Korean and English, cut-off, corrections, history and presence or absence	Link user materials and decisions to full original preservation and separate events.

No items match your search or filter.

19 itemsWhat the statuses mean

Assessment scope

Stored-material review date: Not recorded
Original evidence cut-off: 2026-08-26
Scope actually checked: Existing review summaries and stored records of methodological application. Full papers, supplements, registrations, plans and original data were not read.
What the dates mean: This is the date the stored materials were checked, not the date of a new search of the clinical literature.
Population: ART participants undergoing CABG; original detailed eligibility and baseline information not read
Ingredient, formulation and route: Historical surgical conditions of assignment to bilateral internal thoracic artery grafting
Dose: Original details of the actual procedure, technique, devices, conduits and exposure not read; no guidance on individual implementation, selection or treatment
Comparator: Assignment to a single internal thoracic artery; distinguish the original 14% crossover and 22% additional radial-artery grafting
Measured outcome: Original ten-year overall-survival question and all-cause mortality endpoint; sternal wounds considered separately
Duration: Distinguish ten-year survival, mortality and censoring from the unverified original wound-observation window
Questions outside this scope: Converting the MAIN claim into a subclaim or a new split; Interpreting a null result or CI as an exact zero effect, equivalence or absence of all harm; Independently adding participants or reports shared across other comparative verdicts or time points; Calculating new survival rates, event counts or differences from mortality rates; Recommendations on individual procedures, surgery, devices, treatment selection or implementation

Evidence and sources

The links below lead to the sources. A link alone does not mean the original source was read or its latest publication status verified.

R01 · Taggart DP, et al. N Engl J Med. 2019;380:437-446. PMID: 30699314.

PubMed

Material type: Original RCT paper report
Materials actually read: Summary read; external materials and linked targets not read
Findings recorded in the stored summary: 20.3% versus 21.2%; HR 0.96 (95% CI 0.79–1.17); absolute difference −0.9 percentage points
Record level: Existing review summary; external papers were not compared during this preparation
Study overlap and independent replication: Family IDs link relationships and do not certify independent counts; reports, periods, events, institutions, cross-citations and participants are not independently added. F01: the same RCT, efficacy, harm and cohort shared by the designated MAIN claim. F02: an existing-verdict cross-citation concerning another population or comparator; target not read and independent replication not certified. F03: an existing-verdict cross-citation concerning another population or comparator; target not read and independent replication not certified.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Stored existing review summary	Original URL preserved	Summary read	Summary read	Report-specific summary links within the same stored summary
External abstract	Original URL preserved	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review
External full paper	No separate original URL	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review
External registration	No separate original URL	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review
External protocol and SAP	No separate original URL	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review

R02 · Chamgap 1822 CABG × Diabetic multivessel disease

Official source

Material type: Cross-citation of an existing verdict; original trial bibliography and contents not obtained
Materials actually read: Summary read; external materials and linked targets not read
Findings recorded in the stored summary: Although also concerning CABG, this asks about treatment strategy in diabetic multivessel disease.
Record level: Original cross-citation concerning another population or comparator; not direct MAIN evidence or independent replication
Study overlap and independent replication: Family IDs link relationships and do not certify independent counts; reports, periods, events, institutions, cross-citations and participants are not independently added. F01: the same RCT, efficacy, harm and cohort shared by the designated MAIN claim. F02: an existing-verdict cross-citation concerning another population or comparator; target not read and independent replication not certified. F03: an existing-verdict cross-citation concerning another population or comparator; target not read and independent replication not certified.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Stored existing review summary	Original URL preserved	Summary read	Summary read	Report-specific summary links within the same stored summary
Original related-verdict link	Original URL preserved	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review
External full paper	No separate original URL	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review
External registration	No separate original URL	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review
External protocol and SAP	No separate original URL	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review

R03 · Chamgap 2859 Stent versus CABG × Left-main disease

Official source

Material type: Cross-citation of an existing verdict; original trial bibliography and contents not obtained
Materials actually read: Summary read; external materials and linked targets not read
Findings recorded in the stored summary: PCI versus CABG is a different question from comparing numbers of graft vessels.
Record level: Original cross-citation concerning another population or comparator; not direct MAIN evidence or independent replication
Study overlap and independent replication: Family IDs link relationships and do not certify independent counts; reports, periods, events, institutions, cross-citations and participants are not independently added. F01: the same RCT, efficacy, harm and cohort shared by the designated MAIN claim. F02: an existing-verdict cross-citation concerning another population or comparator; target not read and independent replication not certified. F03: an existing-verdict cross-citation concerning another population or comparator; target not read and independent replication not certified.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Stored existing review summary	Original URL preserved	Summary read	Summary read	Report-specific summary links within the same stored summary
Original related-verdict link	Original URL preserved	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review
External full paper	No separate original URL	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review
External registration	No separate original URL	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review
External protocol and SAP	No separate original URL	Not read	Not read	External materials and related-verdict targets not read; a URL does not certify reading or review

Report counts versus independent study counts

Family IDs link relationships and do not certify independent counts; reports, periods, events, institutions, cross-citations and participants are not independently added. F01: the same RCT, efficacy, harm and cohort shared by the designated MAIN claim. F02: an existing-verdict cross-citation concerning another population or comparator; target not read and independent replication not certified. F03: an existing-verdict cross-citation concerning another population or comparator; target not read and independent replication not certified.

Review criteria

Version 1.0 · Criteria record date 2026-10-06. These are Chamgap's own application conditions, informed by the referenced methods. They do not constitute official assessment-tool certification or a new efficacy score.

N01 · Were the selected claim and existing verdict record distinguished?

Required materials and conditions: Preservation of the existing claim wording, verdict values, history and empty values
Conditions for verification: Preservation of the existing claim wording, verdict values, history and empty values
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N02 · What are the CABG population, baseline and eligibility, and how do they differ from other coronary questions?

Required materials and conditions: Original CABG eligibility, baseline, institutions, surgical conditions and denominators
Conditions for verification: Original CABG eligibility, baseline, institutions, surgical conditions and denominators
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N03 · What are the assigned comparison and actual techniques of bilateral versus single internal thoracic artery grafting?

Required materials and conditions: Original assignment, actual grafting, common CABG procedures, other conduits and concurrent treatment
Conditions for verification: Original assignment, actual grafting, common CABG procedures, other conduits and concurrent treatment
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N04 · Were the 3,102 participants distinguished from original ten-year denominators and death counts?

Required materials and conditions: Assignment, group-specific analysis, follow-up, censoring, events and denominators
Conditions for verification: Assignment, group-specific analysis, follow-up, censoring, events and denominators
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N05 · Were the overall-survival question and actual ten-year all-cause mortality endpoint distinguished?

Required materials and conditions: Original death definition, period, overall survival, original denominator and ascertainment
Conditions for verification: Original death definition, period, overall survival, original denominator and ascertainment
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N06 · Are 20.3%/21.2%, HR 0.96, the 95% CI and −0.9 percentage points preserved?

Required materials and conditions: Original group order, HR, CI, absolute difference, model and denominators
Conditions for verification: Original group order, HR, CI, absolute difference, model and denominators
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N07 · What are the null result, CI tails allowing meaningful benefit and harm, and the original warning?

Required materials and conditions: Original interval, precision, efficacy, harm and clinical boundaries
Conditions for verification: Original interval, precision, efficacy, harm and clinical boundaries
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N08 · What are the 14% bilateral-to-single crossover and 22% additional radial-artery grafting in the single group?

Required materials and conditions: Assignment, actual surgery, crossover, adherence, periods and original denominators
Conditions for verification: Assignment, actual surgery, crossover, adherence, periods and original denominators
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N09 · Were ITT, as-treated analyses, observational associations and the dilution explanation distinguished?

Required materials and conditions: Assignment effect of interest, actual-treatment models, confounding and sensitivity analyses
Conditions for verification: Assignment effect of interest, actual-treatment models, confounding and sensitivity analyses
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N10 · Is censoring of 71 participants (2.3%) with missing ten-year vital status the same as attrition?

Required materials and conditions: Original vital status, missingness, censoring times, reasons and sensitivity analyses
Conditions for verification: Original vital status, missingness, censoring times, reasons and sensitivity analyses
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N11 · Were secure web allocation, unmasked surgery, event adjudication and the B0 history distinguished?

Required materials and conditions: Allocation, concealment, surgeons and patients, assessment, adjudication and analysis
Conditions for verification: Allocation, concealment, surgeons and patients, assessment, adjudication and analysis
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N12 · What was accessed regarding registration, prespecified ten-year mortality, subgroups and hierarchy?

Required materials and conditions: Original registration, protocol, SAP, prespecified endpoints, changes and multiplicity
Conditions for verification: Original registration, protocol, SAP, prespecified endpoints, changes and multiplicity
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N13 · Were sternal wounds of 3.5%/1.9%, efficacy, harm and periods distinguished?

Required materials and conditions: Wound definition, severity and collection, people and events, periods and denominators
Conditions for verification: Wound definition, severity and collection, people and events, periods and denominators
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N14 · What are the increased wound harm and gaps concerning rare or other harms and long-term safety?

Required materials and conditions: Other harms, collection, actual techniques, relatedness, periods and denominators
Conditions for verification: Other harms, collection, actual techniques, relatedness, periods and denominators
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N15 · What is the information level for MRC/BHF funding, in-kind support, affiliations and external analysis?

Required materials and conditions: Public or nonprofit funding, devices, in-kind support, affiliations, analysis and writing
Conditions for verification: Public or nonprofit funding, devices, in-kind support, affiliations, analysis and writing
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N16 · What are the 1822/2859 cross-citations and relationships with the same ART report and follow-up?

Required materials and conditions: Reports, related verdicts, populations, comparators, shared cohorts and independence relationships
Conditions for verification: Reports, related verdicts, populations, comparators, shared cohorts and independence relationships
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N17 · What are the applicability gaps for observational benefits, other techniques or populations and longer periods?

Required materials and conditions: Original follow-up and direct efficacy and harm by population, conduit and technique
Conditions for verification: Original follow-up and direct efficacy and harm by population, conduit and technique
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N18 · Were the summary, paper and related-verdict URLs, registration identifier and actual access distinguished?

Required materials and conditions: Original bibliography, URLs, registration, material-specific access and cross-citations
Conditions for verification: Original bibliography, URLs, registration, material-specific access and cross-citations
Requirement and applicability: Required
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

N19 · Were MAIN languages, dates, corrections, empty arrays, false/null, empty values and candidate history preserved?

Required materials and conditions: Original root verdict, Korean and English, cut-off, corrections, history and presence or absence
Conditions for verification: Original root verdict, Korean and English, cut-off, corrections, history and presence or absence
Requirement and applicability: Supplementary
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Referenced methods and the sections actually reviewed

M03 · Cochrane Handbook 6.5 (2024), chapter updated 2023-08

Official methodology · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13

Referenced principle: Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.
Extent of review: Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing

M04 · Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03

Official methodology · §4.5, §4.6.1–4.6.3, MECIR C42

Referenced principle: Distinguish studies from reports and link them; do not omit a study solely because results are unreported.
Extent of review: Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing

M08 · Cochrane Handbook 6.5 (2024), chapter updated 2019-10

Official methodology · §8.1–8.2.3, Table 8.2.a

Referenced principle: Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.
Extent of review: Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing

M15 · Cochrane Handbook 6.5 (2024), chapter updated 2023-08

Official methodology · §15.2.4, §15.3.1–15.3.3

Referenced principle: Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.
Extent of review: Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing

M19 · Cochrane Handbook 6.5 (2024), chapter updated 2019-10

Official methodology · §19.1.2, §19.2.1–19.2.4

Referenced principle: Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.
Extent of review: Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing

What the statuses mean

Partly verified: Some information is present in the stored source, with detailed original materials still unverified; this does not mean review passed or clinical efficacy certified
Unverified: Detailed materials for the selected condition could not be established within the stored scope; this does not mean zero effect, zero studies or safety
Review incomplete: Awaiting user review
Met: Use only within the relevant condition's scope after user review; no automatic display in this preparation
Not reported: Distinguish only within materials actually read; do not turn unread external materials into unreported findings
Inaccessible: Not applied during this preparation because actual access was not tested
Not applicable: Use with a reason for non-applicability based on an explicit question boundary
Conflicting data: Judge after actual material comparison; review was not performed during this preparation
Insufficient evidence for the conditions: Do not use as a clinical grade encompassing currently unread materials

Change history

2026-10-10 · Public page/material version 1.0

Public pages and materials were prepared from the existing 19 items. No new clinical search, verification-status changes or scoring was performed.

The stored-material review date (Not recorded) and original evidence cut-off (2026-08-26) were retained unchanged.

Researcher downloads

These materials provide the same evidence, scope and verification status as this page.

View all item details

N01 · Were the selected claim and existing verdict record distinguished?

Current findings: The selected claim is improved ten-year overall survival after CABG; the root grade D, score 34, Warning and axes E−/I2/B0/C0 are preserved. Distinguish the existing history from the current verdict record.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not turn the MAIN claim into a subclaim or introduce parent-inheritance or missing-subclaim-score explanations. Preserve the actual values, presence or absence and original verdict without a new verdict or split.
Reason for missing information: Do not turn the MAIN claim into a subclaim or introduce parent-inheritance or missing-subclaim-score explanations. Preserve the actual values, presence or absence and original verdict without a new verdict or split.
Required materials and conditions: Preservation of the existing claim wording, verdict values, history and empty values
Materials to obtain first: Do not turn the MAIN claim into a subclaim or introduce parent-inheritance or missing-subclaim-score explanations. Preserve the actual values, presence or absence and original verdict without a new verdict or split.
Further research: Link original materials and decisions to the actual MAIN question and root verdict record.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Preservation of the existing claim wording, verdict values, history and empty values
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N02 · What are the CABG population, baseline and eligibility, and how do they differ from other coronary questions?

Current findings: ART is a surgical-technique trial asking whether to use bilateral internal thoracic arteries during CABG.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not replace this with PCI-versus-CABG questions in diabetic multivessel or left-main disease. Age, eligibility, exclusions, baseline and institution-specific surgical details were not read.
Reason for missing information: Do not replace this with PCI-versus-CABG questions in diabetic multivessel or left-main disease. Age, eligibility, exclusions, baseline and institution-specific surgical details were not read.
Required materials and conditions: Original CABG eligibility, baseline, institutions, surgical conditions and denominators
Materials to obtain first: Do not replace this with PCI-versus-CABG questions in diabetic multivessel or left-main disease. Age, eligibility, exclusions, baseline and institution-specific surgical details were not read.
Further research: Obtain original population, eligibility, baseline, institution and surgical-condition materials.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original CABG eligibility, baseline, institutions, surgical conditions and denominators
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01 R02 R03

N03 · What are the assigned comparison and actual techniques of bilateral versus single internal thoracic artery grafting?

Current findings: ART assigned bilateral versus single internal thoracic artery grafting; actual surgical crossover and additional radial-artery grafting in the single group occurred.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not turn the graft-number question into the effect of CABG itself, superiority of all arterial grafting, or surgical-method and selection guidance. Conduit, surgical and concurrent-management details were not read.
Reason for missing information: Do not turn the graft-number question into the effect of CABG itself, superiority of all arterial grafting, or surgical-method and selection guidance. Conduit, surgical and concurrent-management details were not read.
Required materials and conditions: Original assignment, actual grafting, common CABG procedures, other conduits and concurrent treatment
Materials to obtain first: Do not turn the graft-number question into the effect of CABG itself, superiority of all arterial grafting, or surgical-method and selection guidance. Conduit, surgical and concurrent-management details were not read.
Further research: Obtain original assignment, actual techniques, other conduits, concurrent management and change materials.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original assignment, actual grafting, common CABG procedures, other conduits and concurrent treatment
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N04 · Were the 3,102 participants distinguished from original ten-year denominators and death counts?

Current findings: The original source records 3,102 participants and ten-year mortality of 20.3% versus 21.2%.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not calculate group allocation numbers, death counts, risk sets or new proportions and totals. Do not add multiple assessments or reports as independent people.
Reason for missing information: Do not calculate group allocation numbers, death counts, risk sets or new proportions and totals. Do not add multiple assessments or reports as independent people.
Required materials and conditions: Assignment, group-specific analysis, follow-up, censoring, events and denominators
Materials to obtain first: Do not calculate group allocation numbers, death counts, risk sets or new proportions and totals. Do not add multiple assessments or reports as independent people.
Further research: Obtain original group-specific assignment, analysis, follow-up, risk sets and event tables.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Assignment, group-specific analysis, follow-up, censoring, events and denominators
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N05 · Were the overall-survival question and actual ten-year all-cause mortality endpoint distinguished?

Current findings: The original effect question is improved ten-year overall survival, and the original primary endpoint is all-cause death at ten years.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not convert death proportions into new survival rates or substitute cardiovascular or sternal mortality, healing or functional improvement. Original follow-up reference points and cause-specific ascertainment details were not read.
Reason for missing information: Do not convert death proportions into new survival rates or substitute cardiovascular or sternal mortality, healing or functional improvement. Original follow-up reference points and cause-specific ascertainment details were not read.
Required materials and conditions: Original death definition, period, overall survival, original denominator and ascertainment
Materials to obtain first: Do not convert death proportions into new survival rates or substitute cardiovascular or sternal mortality, healing or functional improvement. Original follow-up reference points and cause-specific ascertainment details were not read.
Further research: Obtain original death and survival definitions, time points, ascertainment and denominators.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original death definition, period, overall survival, original denominator and ascertainment
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N06 · Are 20.3%/21.2%, HR 0.96, the 95% CI and −0.9 percentage points preserved?

Current findings: Ten-year mortality was 20.3% with bilateral versus 21.2% with single grafting; HR 0.96 (95% CI 0.79–1.17), with an original absolute difference of −0.9 percentage points.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not fill in or calculate original P values, an absolute-difference CI, adjusted models, death counts, new survival rates or NNT.
Reason for missing information: Do not fill in or calculate original P values, an absolute-difference CI, adjusted models, death counts, new survival rates or NNT.
Required materials and conditions: Original group order, HR, CI, absolute difference, model and denominators
Materials to obtain first: Do not fill in or calculate original P values, an absolute-difference CI, adjusted models, death counts, new survival rates or NNT.
Further research: Obtain original time-to-event effects, group risk sets, models, tests and CI.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original group order, HR, CI, absolute difference, model and denominators
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N07 · What are the null result, CI tails allowing meaningful benefit and harm, and the original warning?

Current findings: The original reader answer records remaining possibilities of meaningful benefit and harm, without establishing absence of benefit. The original grade D, score 34 and Warning are preserved.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not interpret an HR near the null or a null result as an exact zero effect, equivalence or exclusion of all clinical effects. No new MCID, power calculation or examples are supplied.
Reason for missing information: Do not interpret an HR near the null or a null result as an exact zero effect, equivalence or exclusion of all clinical effects. No new MCID, power calculation or examples are supplied.
Required materials and conditions: Original interval, precision, efficacy, harm and clinical boundaries
Materials to obtain first: Do not interpret an HR near the null or a null result as an exact zero effect, equivalence or exclusion of all clinical effects. No new MCID, power calculation or examples are supplied.
Further research: Obtain original clinical boundaries, precision and separate efficacy and harm interpretations.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original interval, precision, efficacy, harm and clinical boundaries
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N08 · What are the 14% bilateral-to-single crossover and 22% additional radial-artery grafting in the single group?

Current findings: The original record says that 14% assigned bilateral received a single graft, while 22% assigned single received a radial artery as a second arterial graft.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not add these two crossovers or convert them into causal effects of the actual surgical groups. Do not newly classify them as allocation failure or completer analysis; the degree of contrast dilution, reasons and denominators were not read.
Reason for missing information: Do not add these two crossovers or convert them into causal effects of the actual surgical groups. Do not newly classify them as allocation failure or completer analysis; the degree of contrast dilution, reasons and denominators were not read.
Required materials and conditions: Assignment, actual surgery, crossover, adherence, periods and original denominators
Materials to obtain first: Do not add these two crossovers or convert them into causal effects of the actual surgical groups. Do not newly classify them as allocation failure or completer analysis; the degree of contrast dilution, reasons and denominators were not read.
Further research: Obtain original crossover, adherence, actual techniques, reasons, denominators, effects of interest and sensitivity analyses.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Assignment, actual surgery, crossover, adherence, periods and original denominators
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N09 · Were ITT, as-treated analyses, observational associations and the dilution explanation distinguished?

Current findings: The original text preserves the ITT principle and treatment-contrast dilution, and distinguishes long-term observational benefits from randomized effects.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not conclude that crossover explains all null findings or newly derive survival superiority for actual-treatment groups. Per-protocol and as-treated model details were not read.
Reason for missing information: Do not conclude that crossover explains all null findings or newly derive survival superiority for actual-treatment groups. Per-protocol and as-treated model details were not read.
Required materials and conditions: Assignment effect of interest, actual-treatment models, confounding and sensitivity analyses
Materials to obtain first: Do not conclude that crossover explains all null findings or newly derive survival superiority for actual-treatment groups. Per-protocol and as-treated model details were not read.
Further research: Obtain original effects of interest, actual-treatment analyses, confounding, sensitivity analyses and denominators.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Assignment effect of interest, actual-treatment models, confounding and sensitivity analyses
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N10 · Is censoring of 71 participants (2.3%) with missing ten-year vital status the same as attrition?

Current findings: The original text records that 71 participants (2.3%) with missing ten-year vital status were censored in survival analysis and were not counted as attrition.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not subtract the 71 participants as new exclusions or a completer analysis, or certify censoring as zero missingness or complete follow-up. Censoring times, assumptions, original effects and group mapping were not read.
Reason for missing information: Do not subtract the 71 participants as new exclusions or a completer analysis, or certify censoring as zero missingness or complete follow-up. Censoring times, assumptions, original effects and group mapping were not read.
Required materials and conditions: Original vital status, missingness, censoring times, reasons and sensitivity analyses
Materials to obtain first: Do not subtract the 71 participants as new exclusions or a completer analysis, or certify censoring as zero missingness or complete follow-up. Censoring times, assumptions, original effects and group mapping were not read.
Further research: Obtain original group-specific censoring, times, reasons, assumptions, sensitivity analyses and risk sets.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original vital status, missingness, censoring times, reasons and sensitivity analyses
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N11 · Were secure web allocation, unmasked surgery, event adjudication and the B0 history distinguished?

Current findings: The original text records secure web randomization, inability to mask surgeons and patients, adjudication of all events including adverse events, and ITT as the historical basis for B0.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not certify event adjudication as adjudicator blinding absent from the source or as a new review establishing absence of all bias.
Reason for missing information: Do not certify event adjudication as adjudicator blinding absent from the source or as a new review establishing absence of all bias.
Required materials and conditions: Allocation, concealment, surgeons and patients, assessment, adjudication and analysis
Materials to obtain first: Do not certify event adjudication as adjudicator blinding absent from the source or as a new review establishing absence of all bias.
Further research: Obtain original allocation, adjudication, assessor, analyst and data-collection procedures.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Allocation, concealment, surgeons and patients, assessment, adjudication and analysis
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N12 · What was accessed regarding registration, prespecified ten-year mortality, subgroups and hierarchy?

Current findings: The history of the original registration identifier ISRCTN46552265 and its consistency with prespecified ten-year all-cause mortality is preserved.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. No new registration or plan reading was performed. Do not create prespecified subgroups, α, multiplicity, changes or test P values for specific populations or actual techniques.
Reason for missing information: No new registration or plan reading was performed. Do not create prespecified subgroups, α, multiplicity, changes or test P values for specific populations or actual techniques.
Required materials and conditions: Original registration, protocol, SAP, prespecified endpoints, changes and multiplicity
Materials to obtain first: No new registration or plan reading was performed. Do not create prespecified subgroups, α, multiplicity, changes or test P values for specific populations or actual techniques.
Further research: Obtain original registration, plans, hierarchy, subgroups, interactions and changes.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original registration, protocol, SAP, prespecified endpoints, changes and multiplicity
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N13 · Were sternal wounds of 3.5%/1.9%, efficacy, harm and periods distinguished?

Current findings: The original source says that sternal wound complications increased to 3.5% with bilateral versus 1.9% with single grafting. This is a separate harm outcome from ten-year mortality.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not fill in a ten-year wound-observation period or calculate original event counts, CI, P values, RR, NNH or differences. Definitions, collection, relatedness and original denominators were not read.
Reason for missing information: Do not fill in a ten-year wound-observation period or calculate original event counts, CI, P values, RR, NNH or differences. Definitions, collection, relatedness and original denominators were not read.
Required materials and conditions: Wound definition, severity and collection, people and events, periods and denominators
Materials to obtain first: Do not fill in a ten-year wound-observation period or calculate original event counts, CI, P values, RR, NNH or differences. Definitions, collection, relatedness and original denominators were not read.
Further research: Obtain original wound definitions, periods, group-specific people, events, denominators, CI and tests.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Wound definition, severity and collection, people and events, periods and denominators
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N14 · What are the increased wound harm and gaps concerning rare or other harms and long-term safety?

Current findings: The original safety warning and increased sternal wounds are preserved, together with the original description of adjudication of all events.
Verification status: Unverified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not extend the warning to established harm of every kind or established harm to survival. Other harms, reoperations, rare events, relatedness and original exposure details were not read.
Reason for missing information: Do not extend the warning to established harm of every kind or established harm to survival. Other harms, reoperations, rare events, relatedness and original exposure details were not read.
Required materials and conditions: Other harms, collection, actual techniques, relatedness, periods and denominators
Materials to obtain first: Do not extend the warning to established harm of every kind or established harm to survival. Other harms, reoperations, rare events, relatedness and original exposure details were not read.
Further research: Obtain original overall-harm, actual-technique, collection, relatedness, period and denominator materials.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Other harms, collection, actual techniques, relatedness, periods and denominators
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N15 · What is the information level for MRC/BHF funding, in-kind support, affiliations and external analysis?

Current findings: UK MRC and British Heart Foundation support and the original I2 are preserved.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not turn public funding into certification of no company in-kind support, no employees or fully independent analysis. Details of each disclosed role were not read.
Reason for missing information: Do not turn public funding into certification of no company in-kind support, no employees or fully independent analysis. Details of each disclosed role were not read.
Required materials and conditions: Public or nonprofit funding, devices, in-kind support, affiliations, analysis and writing
Materials to obtain first: Do not turn public funding into certification of no company in-kind support, no employees or fully independent analysis. Details of each disclosed role were not read.
Further research: Obtain original disclosures on cash, in-kind support, affiliations, design, analysis and writing.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Public or nonprofit funding, devices, in-kind support, affiliations, analysis and writing
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N16 · What are the 1822/2859 cross-citations and relationships with the same ART report and follow-up?

Current findings: Verdict 1822 concerns CABG strategy in diabetic multivessel disease, and 2859 concerns PCI versus CABG in left-main disease; both differ from ART's graft-number question.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Linked targets and original papers were not newly read or used as direct replication or additional participants. Do not count the same ART ten-year report or assessments as new independent trials; independent counts and total participants remain null.
Reason for missing information: Linked targets and original papers were not newly read or used as direct replication or additional participants. Do not count the same ART ten-year report or assessments as new independent trials; independent counts and total participants remain null.
Required materials and conditions: Reports, related verdicts, populations, comparators, shared cohorts and independence relationships
Materials to obtain first: Linked targets and original papers were not newly read or used as direct replication or additional participants. Do not count the same ART ten-year report or assessments as new independent trials; independent counts and total participants remain null.
Further research: Link new reports using original identifiers, shared cohorts and time points, and separate questions.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Reports, related verdicts, populations, comparators, shared cohorts and independence relationships
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01 R02 R03

N17 · What are the applicability gaps for observational benefits, other techniques or populations and longer periods?

Current findings: The original core question is ten-year overall survival under assignment to bilateral internal thoracic arteries. The source treats observational advantages separately.
Verification status: Unverified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not transfer effects from other conduits, selected subgroups, actual surgical groups or other CABG indications, or create guidance on surgical selection, implementation or treatment.
Reason for missing information: Do not transfer effects from other conduits, selected subgroups, actual surgical groups or other CABG indications, or create guidance on surgical selection, implementation or treatment.
Required materials and conditions: Original follow-up and direct efficacy and harm by population, conduit and technique
Materials to obtain first: Do not transfer effects from other conduits, selected subgroups, actual surgical groups or other CABG indications, or create guidance on surgical selection, implementation or treatment.
Further research: Obtain direct efficacy, harm, plans and denominators by population, technique, exposure and period.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original follow-up and direct efficacy and harm by population, conduit and technique
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01

N18 · Were the summary, paper and related-verdict URLs, registration identifier and actual access distinguished?

Current findings: The entire stored summary of the designated existing verdict was read for preparation, and the original source links and registration identifier were linked.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. External abstracts, full texts, registrations, protocols, SAP and related-verdict targets were not read, and no separate link testing was performed. Do not create new URLs, DOI or original-study information.
Reason for missing information: External abstracts, full texts, registrations, protocols, SAP and related-verdict targets were not read, and no separate link testing was performed. Do not create new URLs, DOI or original-study information.
Required materials and conditions: Original bibliography, URLs, registration, material-specific access and cross-citations
Materials to obtain first: External abstracts, full texts, registrations, protocols, SAP and related-verdict targets were not read, and no separate link testing was performed. Do not create new URLs, DOI or original-study information.
Further research: Link user-provided original materials by material type and actual access.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original bibliography, URLs, registration, material-specific access and cross-citations
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01 R02 R03

N19 · Were MAIN languages, dates, corrections, empty arrays, false/null, empty values and candidate history preserved?

Current findings: Preserve 2026-08-26, empty corrections/subclaims arrays, the empty deliberation string, root grade/score/safety/axes, Korean and English, false/null and empty values unchanged.
Verification status: Partly verified
Materials actually read: Summary read; external materials and linked targets not read
Why unverified: Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. This root record is not a case of missing subclaim scores or parent inheritance. Original verification and path checks, B0, support and safety assessments are historical, not a completed current review. Original candidate pending/eligible states are also historical.
Reason for missing information: This root record is not a case of missing subclaim scores or parent inheritance. Original verification and path checks, B0, support and safety assessments are historical, not a completed current review. Original candidate pending/eligible states are also historical.
Required materials and conditions: Original root verdict, Korean and English, cut-off, corrections, history and presence or absence
Materials to obtain first: This root record is not a case of missing subclaim scores or parent inheritance. Original verification and path checks, B0, support and safety assessments are historical, not a completed current review. Original candidate pending/eligible states are also historical.
Further research: Link user materials and decisions to full original preservation and separate events.
Remaining uncertainty: Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification
Conditions for verification: Original root verdict, Korean and English, cut-off, corrections, history and presence or absence
Why this condition is needed: An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim
Application exceptions: Do not use unread materials, other questions, institutions or periods, or out-of-scope outcomes as substitutes for meeting a condition, a zero effect or safety.
Referenced methods: Selected claim: Improved ten-year overall survival after CABG

Related sources R01