{
  "schema_version": "chamgap-public-criteria-1.0",
  "title": "Bilateral internal thoracic artery grafting × Ten-year overall survival after CABG — ART efficacy and sternal-harm evidence sheet",
  "language": "en",
  "translation_date": "2026-10-10",
  "criteria_version": "1.0",
  "criteria_date": "2026-10-06",
  "condition_origin": "Chamgap's own application conditions",
  "method_sources": [
    {
      "id": "M03",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03",
      "section": "§3.1, §3.2.1–3.2.3, MECIR C5/C7/C13",
      "official_principle": "Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.",
      "review_level": "Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing"
    },
    {
      "id": "M04",
      "version": "Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04",
      "section": "§4.5, §4.6.1–4.6.3, MECIR C42",
      "official_principle": "Distinguish studies from reports and link them; do not omit a study solely because results are unreported.",
      "review_level": "Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing"
    },
    {
      "id": "M08",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08",
      "section": "§8.1–8.2.3, Table 8.2.a",
      "official_principle": "Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.",
      "review_level": "Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing"
    },
    {
      "id": "M15",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15",
      "section": "§15.2.4, §15.3.1–15.3.3",
      "official_principle": "Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.",
      "review_level": "Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing"
    },
    {
      "id": "M19",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19",
      "section": "§19.1.2, §19.2.1–19.2.4",
      "official_principle": "Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.",
      "review_level": "Existing stored methodological links reused for preparation; no current review, reassessment of methodological content or external-link testing"
    }
  ],
  "status_dictionary": {
    "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"
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Comparative efficacy",
      "question": "Were the selected claim and existing verdict record distinguished?",
      "needed": "Preservation of the existing claim wording, verdict values, history and empty values",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Preservation of the existing claim wording, verdict values, history and empty values",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Link original materials and decisions to the actual MAIN question and root verdict record."
    },
    {
      "item_id": "N02",
      "question_type": "Comparative efficacy",
      "question": "What are the CABG population, baseline and eligibility, and how do they differ from other coronary questions?",
      "needed": "Original CABG eligibility, baseline, institutions, surgical conditions and denominators",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original CABG eligibility, baseline, institutions, surgical conditions and denominators",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original population, eligibility, baseline, institution and surgical-condition materials."
    },
    {
      "item_id": "N03",
      "question_type": "Comparative efficacy",
      "question": "What are the assigned comparison and actual techniques of bilateral versus single internal thoracic artery grafting?",
      "needed": "Original assignment, actual grafting, common CABG procedures, other conduits and concurrent treatment",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original assignment, actual grafting, common CABG procedures, other conduits and concurrent treatment",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original assignment, actual techniques, other conduits, concurrent management and change materials."
    },
    {
      "item_id": "N04",
      "question_type": "Comparative efficacy",
      "question": "Were the 3,102 participants distinguished from original ten-year denominators and death counts?",
      "needed": "Assignment, group-specific analysis, follow-up, censoring, events and denominators",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Assignment, group-specific analysis, follow-up, censoring, events and denominators",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original group-specific assignment, analysis, follow-up, risk sets and event tables."
    },
    {
      "item_id": "N05",
      "question_type": "Comparative efficacy",
      "question": "Were the overall-survival question and actual ten-year all-cause mortality endpoint distinguished?",
      "needed": "Original death definition, period, overall survival, original denominator and ascertainment",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original death definition, period, overall survival, original denominator and ascertainment",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original death and survival definitions, time points, ascertainment and denominators."
    },
    {
      "item_id": "N06",
      "question_type": "Comparative efficacy",
      "question": "Are 20.3%/21.2%, HR 0.96, the 95% CI and −0.9 percentage points preserved?",
      "needed": "Original group order, HR, CI, absolute difference, model and denominators",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original group order, HR, CI, absolute difference, model and denominators",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original time-to-event effects, group risk sets, models, tests and CI."
    },
    {
      "item_id": "N07",
      "question_type": "Comparative efficacy",
      "question": "What are the null result, CI tails allowing meaningful benefit and harm, and the original warning?",
      "needed": "Original interval, precision, efficacy, harm and clinical boundaries",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original interval, precision, efficacy, harm and clinical boundaries",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original clinical boundaries, precision and separate efficacy and harm interpretations."
    },
    {
      "item_id": "N08",
      "question_type": "Comparative efficacy",
      "question": "What are the 14% bilateral-to-single crossover and 22% additional radial-artery grafting in the single group?",
      "needed": "Assignment, actual surgery, crossover, adherence, periods and original denominators",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Assignment, actual surgery, crossover, adherence, periods and original denominators",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original crossover, adherence, actual techniques, reasons, denominators, effects of interest and sensitivity analyses."
    },
    {
      "item_id": "N09",
      "question_type": "Comparative efficacy",
      "question": "Were ITT, as-treated analyses, observational associations and the dilution explanation distinguished?",
      "needed": "Assignment effect of interest, actual-treatment models, confounding and sensitivity analyses",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Assignment effect of interest, actual-treatment models, confounding and sensitivity analyses",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original effects of interest, actual-treatment analyses, confounding, sensitivity analyses and denominators."
    },
    {
      "item_id": "N10",
      "question_type": "Comparative efficacy",
      "question": "Is censoring of 71 participants (2.3%) with missing ten-year vital status the same as attrition?",
      "needed": "Original vital status, missingness, censoring times, reasons and sensitivity analyses",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original vital status, missingness, censoring times, reasons and sensitivity analyses",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original group-specific censoring, times, reasons, assumptions, sensitivity analyses and risk sets."
    },
    {
      "item_id": "N11",
      "question_type": "Comparative efficacy",
      "question": "Were secure web allocation, unmasked surgery, event adjudication and the B0 history distinguished?",
      "needed": "Allocation, concealment, surgeons and patients, assessment, adjudication and analysis",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Allocation, concealment, surgeons and patients, assessment, adjudication and analysis",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original allocation, adjudication, assessor, analyst and data-collection procedures."
    },
    {
      "item_id": "N12",
      "question_type": "Comparative efficacy",
      "question": "What was accessed regarding registration, prespecified ten-year mortality, subgroups and hierarchy?",
      "needed": "Original registration, protocol, SAP, prespecified endpoints, changes and multiplicity",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original registration, protocol, SAP, prespecified endpoints, changes and multiplicity",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original registration, plans, hierarchy, subgroups, interactions and changes."
    },
    {
      "item_id": "N13",
      "question_type": "Supplementary harm evidence",
      "question": "Were sternal wounds of 3.5%/1.9%, efficacy, harm and periods distinguished?",
      "needed": "Wound definition, severity and collection, people and events, periods and denominators",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Wound definition, severity and collection, people and events, periods and denominators",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original wound definitions, periods, group-specific people, events, denominators, CI and tests."
    },
    {
      "item_id": "N14",
      "question_type": "Supplementary harm evidence",
      "question": "What are the increased wound harm and gaps concerning rare or other harms and long-term safety?",
      "needed": "Other harms, collection, actual techniques, relatedness, periods and denominators",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Other harms, collection, actual techniques, relatedness, periods and denominators",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original overall-harm, actual-technique, collection, relatedness, period and denominator materials."
    },
    {
      "item_id": "N15",
      "question_type": "Comparative efficacy",
      "question": "What is the information level for MRC/BHF funding, in-kind support, affiliations and external analysis?",
      "needed": "Public or nonprofit funding, devices, in-kind support, affiliations, analysis and writing",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Public or nonprofit funding, devices, in-kind support, affiliations, analysis and writing",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original disclosures on cash, in-kind support, affiliations, design, analysis and writing."
    },
    {
      "item_id": "N16",
      "question_type": "Comparative efficacy",
      "question": "What are the 1822/2859 cross-citations and relationships with the same ART report and follow-up?",
      "needed": "Reports, related verdicts, populations, comparators, shared cohorts and independence relationships",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Reports, related verdicts, populations, comparators, shared cohorts and independence relationships",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Link new reports using original identifiers, shared cohorts and time points, and separate questions."
    },
    {
      "item_id": "N17",
      "question_type": "Comparative efficacy",
      "question": "What are the applicability gaps for observational benefits, other techniques or populations and longer periods?",
      "needed": "Original follow-up and direct efficacy and harm by population, conduit and technique",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original follow-up and direct efficacy and harm by population, conduit and technique",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain direct efficacy, harm, plans and denominators by population, technique, exposure and period."
    },
    {
      "item_id": "N18",
      "question_type": "Comparative efficacy",
      "question": "Were the summary, paper and related-verdict URLs, registration identifier and actual access distinguished?",
      "needed": "Original bibliography, URLs, registration, material-specific access and cross-citations",
      "role": "Required",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original bibliography, URLs, registration, material-specific access and cross-citations",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Link user-provided original materials by material type and actual access."
    },
    {
      "item_id": "N19",
      "question_type": "Comparative efficacy",
      "question": "Were MAIN languages, dates, corrections, empty arrays, false/null, empty values and candidate history preserved?",
      "needed": "Original root verdict, Korean and English, cut-off, corrections, history and presence or absence",
      "role": "Supplementary",
      "role_reason": "An individual preparation condition recording the population, endpoint, denominator, period, efficacy, harm and report relationships of the existing native MAIN claim",
      "application_exception": "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.",
      "criterion": "Original root verdict, Korean and English, cut-off, corrections, history and presence or absence",
      "basis": "Selected claim: Improved ten-year overall survival after CABG",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Link user materials and decisions to full original preservation and separate events."
    }
  ]
}