{
  "schema_version": "chamgap-public-evidence-check-1.0",
  "public_id": "v2918-main",
  "verdict_number": "2918",
  "title": "Routine thrombus aspiration added × Thirty-day all-cause mortality in STEMI — TASTE evidence sheet",
  "view_version": "1.0",
  "view_created_date": "2026-10-10",
  "criteria_version": "1.0",
  "criteria_date": "2026-10-06",
  "review_date": null,
  "legacy_evidence_date": "2026-08-26",
  "review_scope": {
    "materials_read": "Existing review summaries and stored records of methodological application",
    "clinical_papers_directly_read": false,
    "new_clinical_search": false,
    "limitation": "The entire designated existing review summary was read for preparation. No new access to external abstracts, full texts, registrations, plans or linked verdicts, or separate link testing, was performed.",
    "date_meaning": "This is the date the stored materials were checked, not the date of a new search of the clinical literature."
  },
  "claim_context": {
    "population": "STEMI participants undergoing primary PCI; original detailed eligibility and baseline information not read",
    "intervention": "Historical conditions of adding routine manual thrombus aspiration before primary PCI",
    "dose": "Original details of the actual procedure, technique, devices, conduits and exposure not read; no guidance on individual implementation, selection or treatment",
    "comparator": "Comparator without routine aspiration added to primary PCI; detailed actual and rescue exposure not read",
    "endpoint": "Original thirty-day all-cause mortality; neurological harm at discharge considered separately",
    "duration": "Distinguish thirty-day mortality from neurological complications at discharge",
    "excluded_extensions": [
      "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"
    ]
  },
  "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: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "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.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The selected claim is reduced thirty-day all-cause mortality in STEMI; the root grade D, score 34, Good safety label and axes E0/I1/B0/C0 are preserved. Distinguish the existing history from the current verdict record.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "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.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "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."
    },
    {
      "item_id": "N02",
      "question_type": "Comparative efficacy",
      "question": "What are the actual population, eligibility and baseline for primary PCI in STEMI?",
      "needed": "Original STEMI, entry time, PCI, eligibility, institutions 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 STEMI, entry time, PCI, eligibility, institutions and denominators",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original population, diagnosis, eligibility, time points, institutions, baseline and denominator materials.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "TASTE asks about adding routine manual thrombus aspiration to primary PCI in ST-elevation myocardial infarction.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Detailed diagnosis, onset and treatment times, shock and thrombus risks, eligibility, exclusions and institution-specific characteristics are not detailed in the summary.",
      "missingness": "Detailed diagnosis, onset and treatment times, shock and thrombus risks, eligibility, exclusions and institution-specific characteristics are not detailed in the summary.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Detailed diagnosis, onset and treatment times, shock and thrombus risks, eligibility, exclusions and institution-specific characteristics are not detailed in the summary."
    },
    {
      "item_id": "N03",
      "question_type": "Comparative efficacy",
      "question": "Do routine aspiration added, PCI itself and selective aspiration involve the same comparison?",
      "needed": "Original additional procedure, comparator, common PCI, actual exposure 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 additional procedure, comparator, common PCI, actual exposure and concurrent treatment",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original aspiration, comparator, actual implementation, rescue, crossover and common-treatment materials.",
      "current_reports": [
        "R01",
        "R02"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The original question is adding routine manual thrombus aspiration before primary PCI. Verdict 1791 is a different comparison concerning PCI itself.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not transfer the finding to selective or rescue aspiration, other devices or PCI-versus-thrombolysis effects. Device, actual-use, antithrombotic and concurrent-treatment details were not read; no procedural-method or selection instructions are supplied.",
      "missingness": "Do not transfer the finding to selective or rescue aspiration, other devices or PCI-versus-thrombolysis effects. Device, actual-use, antithrombotic and concurrent-treatment details were not read; no procedural-method or selection instructions are supplied.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Do not transfer the finding to selective or rescue aspiration, other devices or PCI-versus-thrombolysis effects. Device, actual-use, antithrombotic and concurrent-treatment details were not read; no procedural-method or selection instructions are supplied."
    },
    {
      "item_id": "N04",
      "question_type": "Comparative efficacy",
      "question": "Are SWEDEHEART registry randomization and observational associations distinguished?",
      "needed": "Original recruitment, randomization, registry follow-up, analysis and institutions",
      "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 recruitment, randomization, registry follow-up, analysis and institutions",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original registry recruitment, allocation, follow-up, ascertainment and denominators.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The source records a SWEDEHEART-based registry RCT that made recruitment, randomization and follow-up more efficient.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not turn registry use into an observational design or use routine-care efficiency as certification of every effect or of safety. Detailed data collection and institutional scope were not read.",
      "missingness": "Do not turn registry use into an observational design or use routine-care efficiency as certification of every effect or of safety. Detailed data collection and institutional scope were not read.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Do not turn registry use into an observational design or use routine-care efficiency as certification of every effect or of safety. Detailed data collection and institutional scope were not read."
    },
    {
      "item_id": "N05",
      "question_type": "Comparative efficacy",
      "question": "Were the 7,244 participants and each group's mortality denominators preserved in their original form?",
      "needed": "Original allocation, groups, deaths, analysis and follow-up 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 allocation, groups, deaths, analysis and follow-up denominators",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original allocation, analysis, group denominators, events and follow-up tables.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The original source records 7,244 participants: aspiration 103/3621 (2.8%) versus control 110/3623 (3.0%).",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not independently add people, repeated events, institutions or related verdicts. No new death or participant totals, proportions, NNT or follow-up rates are calculated.",
      "missingness": "Do not independently add people, repeated events, institutions or related verdicts. No new death or participant totals, proportions, NNT or follow-up rates are calculated.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Do not independently add people, repeated events, institutions or related verdicts. No new death or participant totals, proportions, NNT or follow-up rates are calculated."
    },
    {
      "item_id": "N06",
      "question_type": "Comparative efficacy",
      "question": "What are the thirty-day all-cause mortality definition and national-registry ascertainment?",
      "needed": "Death definition, reference point, thirty-day window, registry and external events",
      "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": "Death definition, reference point, thirty-day window, registry and external events",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original death definitions, time points, ascertainment, registry linkage and denominators.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The original primary endpoint is thirty-day all-cause mortality; national death-registry follow-up is recorded as the original basis for a hard endpoint.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not replace this with cause-specific effects, cardiovascular mortality, long-term survival or a periprocedural period. Detailed reference points, events outside the country and ascertainment procedures were not read.",
      "missingness": "Do not replace this with cause-specific effects, cardiovascular mortality, long-term survival or a periprocedural period. Detailed reference points, events outside the country and ascertainment procedures were not read.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Do not replace this with cause-specific effects, cardiovascular mortality, long-term survival or a periprocedural period. Detailed reference points, events outside the country and ascertainment procedures were not read."
    },
    {
      "item_id": "N07",
      "question_type": "Comparative efficacy",
      "question": "Are HR 0.94, the 95% CI of 0.72–1.22 and the original −0.2 percentage points preserved?",
      "needed": "Original time-to-event effect, comparison direction, interval, absolute difference and model",
      "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 time-to-event effect, comparison direction, interval, absolute difference and model",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original effect direction, models, tests, CI and denominators.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The original thirty-day mortality HR is 0.94 (95% CI 0.72–1.22), with an absolute difference of −0.2 percentage points.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not turn this into an RR, an individual protection rate or a reverse-direction effect. Do not fill in absent original P values, an absolute-difference CI or adjusted models; no new calculations are performed.",
      "missingness": "Do not turn this into an RR, an individual protection rate or a reverse-direction effect. Do not fill in absent original P values, an absolute-difference CI or adjusted models; no new calculations are performed.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Do not turn this into an RR, an individual protection rate or a reverse-direction effect. Do not fill in absent original P values, an absolute-difference CI or adjusted models; no new calculations are performed."
    },
    {
      "item_id": "N08",
      "question_type": "Comparative efficacy",
      "question": "Were the null result and CI tails allowing benefit and harm distinguished?",
      "needed": "Original interval, clinical boundaries, precision and interpretation",
      "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, clinical boundaries, precision and interpretation",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original clinical boundaries, precision, denominators and assumptions.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The source describes remaining possibilities of substantial benefit and harm, without establishing absence of benefit; the CI lower bound of 0.72 leaves room for a reduction.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not interpret a null result as an exact zero effect, equivalence or absence of all risk. No new MCID, power calculation, margin or hypothetical numbers are supplied.",
      "missingness": "Do not interpret a null result as an exact zero effect, equivalence or absence of all risk. No new MCID, power calculation, margin or hypothetical numbers are supplied.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Do not interpret a null result as an exact zero effect, equivalence or absence of all risk. No new MCID, power calculation, margin or hypothetical numbers are supplied."
    },
    {
      "item_id": "N09",
      "question_type": "Comparative efficacy",
      "question": "Were the roles of online allocation, unmasked procedures, objective mortality and ITT distinguished?",
      "needed": "Allocation, concealment, blinding, event ascertainment, analysis and missingness",
      "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, blinding, event ascertainment, analysis and missingness",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original allocation, ascertainment, actual procedures, analysis and missing-data materials.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The original text records online registry randomization before PCI, unmasked procedures, the national death registry, ITT and complete thirty-day vital-status follow-up as the historical basis for B0.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. This is not a new original-paper review, a finding of no bias or certification of complete follow-up for every outcome. Operator, analyst, institutional and intervention-crossover details were not read.",
      "missingness": "This is not a new original-paper review, a finding of no bias or certification of complete follow-up for every outcome. Operator, analyst, institutional and intervention-crossover details were not read.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "This is not a new original-paper review, a finding of no bias or certification of complete follow-up for every outcome. Operator, analyst, institutional and intervention-crossover details were not read."
    },
    {
      "item_id": "N10",
      "question_type": "Comparative efficacy",
      "question": "What are the access gaps for registration, prespecified thirty-day mortality, hierarchy and subgroups?",
      "needed": "Registration, protocol, SAP, hierarchy, changes and models",
      "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": "Registration, protocol, SAP, hierarchy, changes and models",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "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, changes and models.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The historical consistency of the original registration identifier NCT01093404 with the prespecified primary endpoint of thirty-day all-cause mortality is preserved.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Registration and plans were not newly read; multiplicity, test P values, prespecified risk subgroups and analysis changes were not newly established.",
      "missingness": "Registration and plans were not newly read; multiplicity, test P values, prespecified risk subgroups and analysis changes were not newly established.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Registration and plans were not newly read; multiplicity, test P values, prespecified risk subgroups and analysis changes were not newly established."
    },
    {
      "item_id": "N11",
      "question_type": "Comparative efficacy",
      "question": "Was the finding extended to longer periods, specific patients, rescue aspiration or procedural mechanisms?",
      "needed": "Periods, populations, selective exposure and direct clinical outcomes",
      "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": "Periods, populations, selective exposure and direct clinical outcomes",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original direct subgroup and period-specific outcomes, interactions and actual exposure.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The original core outcome is thirty-day all-cause mortality with routine aspiration added; the original explanation says that performing thrombus removal does not imply a survival benefit.",
      "condition_status": "Unverified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not create effects or suitability findings for other periods, specific thrombus groups, rescue procedures or all aspiration. No implementation or treatment instructions are supplied.",
      "missingness": "Do not create effects or suitability findings for other periods, specific thrombus groups, rescue procedures or all aspiration. No implementation or treatment instructions are supplied.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Do not create effects or suitability findings for other periods, specific thrombus groups, rescue procedures or all aspiration. No implementation or treatment instructions are supplied."
    },
    {
      "item_id": "N12",
      "question_type": "Comparative efficacy",
      "question": "What are the 1791 cross-citation, trial question and relationships within the same report?",
      "needed": "Original bibliography, related verdict, additional-procedure question and cohort 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": "Original bibliography, related verdict, additional-procedure question and cohort relationships",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Link new reports by original identifier, cohort and question.",
      "current_reports": [
        "R01",
        "R02"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The original 1791 link is a cross-citation distinguishing the effect of primary PCI itself from adding aspiration. The original outcomes of one TASTE report are preserved.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Verdict 1791's target and original papers were not newly read or used as direct replication of the same question or added participants. Independent counts and total participants remain null.",
      "missingness": "Verdict 1791's target and original papers were not newly read or used as direct replication of the same question or added participants. Independent counts and total participants remain null.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Verdict 1791's target and original papers were not newly read or used as direct replication of the same question or added participants. Independent counts and total participants remain null."
    },
    {
      "item_id": "N13",
      "question_type": "Comparative efficacy",
      "question": "Were public and regional support distinguished from unrestricted grants from three companies?",
      "needed": "Cash, devices, in-kind support, affiliations, external analysis and research roles",
      "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": "Cash, devices, in-kind support, affiliations, external analysis and research roles",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original funding, devices, in-kind support, affiliation, design, analysis and writing disclosures.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "Swedish Research Council and local or regional association support, and unrestricted research grants from Terumo, Medtronic and Vascular Solutions, are preserved with the original I1.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Public support alone does not certify absence of company involvement, complete independence or absence of device provision. Employee authors, in-kind support and design, analysis and writing roles were separately not read.",
      "missingness": "Public support alone does not certify absence of company involvement, complete independence or absence of device provision. Employee authors, in-kind support and design, analysis and writing roles were separately not read.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Public support alone does not certify absence of company involvement, complete independence or absence of device provision. Employee authors, in-kind support and design, analysis and writing roles were separately not read."
    },
    {
      "item_id": "N14",
      "question_type": "Supplementary harm evidence",
      "question": "What is the window for stroke or neurological complications of 0.5% and P=.87 at discharge?",
      "needed": "Harm definitions, observation window, people and events, original denominators and tests",
      "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": "Harm definitions, observation window, people and events, original denominators and tests",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original harm definitions, people, events, periods, denominators, CI and tests.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The original values for stroke or neurological complications at discharge are 0.5% versus 0.5%, P=.87.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not transfer the discharge window to thirty-day or long-term events or create original participant counts, CI, relatedness or equivalence. Composite type, denominators and original ascertainment procedures were not read.",
      "missingness": "Do not transfer the discharge window to thirty-day or long-term events or create original participant counts, CI, relatedness or equivalence. Composite type, denominators and original ascertainment procedures were not read.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Do not transfer the discharge window to thirty-day or long-term events or create original participant counts, CI, relatedness or equivalence. Composite type, denominators and original ascertainment procedures were not read."
    },
    {
      "item_id": "N15",
      "question_type": "Supplementary harm evidence",
      "question": "What are the original Good safety label, no-increase finding and gaps in rare or long-term harms?",
      "needed": "Other harms, relatedness, actual exposure, collection and long-term follow-up",
      "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, relatedness, actual exposure, collection and long-term follow-up",
      "basis": "Selected claim: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "condition_origin": "Individual preparation condition; completed review or automatic fulfillment of a common definition is not implied",
      "proposed_research": "Obtain original overall-harm, exposure, relatedness, discontinuation, denominator and rare or long-term materials.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The original Good safety label and description of neurological events at discharge are preserved as history.",
      "condition_status": "Unverified",
      "status_reason": "Only the relevant stored-summary information is recorded; detailed original materials and user review remain outstanding. Do not extend equal proportions or P values, or no increase, to absence of all harm, long-term safety or effects of every device. Other harms, discontinuation, crossover and safety-population details were not read.",
      "missingness": "Do not extend equal proportions or P values, or no increase, to absence of all harm, long-term safety or effects of every device. Other harms, discontinuation, crossover and safety-population details were not read.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Do not extend equal proportions or P values, or no increase, to absence of all harm, long-term safety or effects of every device. Other harms, discontinuation, crossover and safety-population details were not read."
    },
    {
      "item_id": "N16",
      "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: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "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.",
      "current_reports": [
        "R01",
        "R02"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "The entire stored summary of the designated existing verdict was read for preparation, and the original source links and registration identifier were linked.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "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.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "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."
    },
    {
      "item_id": "N17",
      "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: Reduced thirty-day all-cause mortality in ST-elevation myocardial infarction",
      "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.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "observation": "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.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "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.",
      "uncertainty": "Unread or unverified does not mean a zero effect, zero events, safety or new clinical certification",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "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."
    }
  ],
  "reports": [
    {
      "report_id": "R01",
      "title": "Fröbert O, et al. N Engl J Med. 2013. PMID: 23991656.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/23991656/",
      "report_type": "Original RCT paper report",
      "existence": "Citation and evidence information in the existing review summary",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "study_family": "F01",
      "independent_replication": false,
      "observed_result": "2.8% versus 3.0%; HR 0.94 (95% CI 0.72–1.22); absolute difference −0.2 percentage points",
      "result_level": "Existing review summary; external papers were not compared during this preparation",
      "materials": [
        {
          "material_type": "Stored existing review summary",
          "public_status": "Original URL preserved",
          "access_status": "Summary read",
          "acquired": true,
          "actually_read": "Summary read",
          "as_of": "2026-08-26",
          "qualification": "Report-specific summary links within the same stored summary"
        },
        {
          "material_type": "External abstract",
          "public_status": "Original URL preserved",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External materials and related-verdict targets not read; a URL does not certify reading or review"
        },
        {
          "material_type": "External full paper",
          "public_status": "No separate original URL",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External materials and related-verdict targets not read; a URL does not certify reading or review"
        },
        {
          "material_type": "External registration",
          "public_status": "No separate original URL",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External materials and related-verdict targets not read; a URL does not certify reading or review"
        },
        {
          "material_type": "External protocol and SAP",
          "public_status": "No separate original URL",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External materials and related-verdict targets not read; a URL does not certify reading or review"
        }
      ],
      "links": [
        {
          "label": "PubMed",
          "url": "https://pubmed.ncbi.nlm.nih.gov/23991656/"
        }
      ]
    },
    {
      "report_id": "R02",
      "title": "Chamgap 1791 Primary PCI × STEMI",
      "url": "https://chamgap.com/verdicts/heart/primary-pci-stemi-versus-fibrinolysis/",
      "report_type": "Cross-citation of an existing verdict; original trial bibliography and contents not obtained",
      "existence": "Only an original cross-citation is present; linked target not read",
      "acquired_read": "Summary read; external materials and linked targets not read",
      "study_family": "F02",
      "independent_replication": false,
      "observed_result": "Distinguish the effect of PCI itself from the null result for aspiration added.",
      "result_level": "Original cross-citation concerning another population or comparator; not direct MAIN evidence or independent replication",
      "materials": [
        {
          "material_type": "Stored existing review summary",
          "public_status": "Original URL preserved",
          "access_status": "Summary read",
          "acquired": true,
          "actually_read": "Summary read",
          "as_of": "2026-08-26",
          "qualification": "Report-specific summary links within the same stored summary"
        },
        {
          "material_type": "Original related-verdict link",
          "public_status": "Original URL preserved",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External materials and related-verdict targets not read; a URL does not certify reading or review"
        },
        {
          "material_type": "External full paper",
          "public_status": "No separate original URL",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External materials and related-verdict targets not read; a URL does not certify reading or review"
        },
        {
          "material_type": "External registration",
          "public_status": "No separate original URL",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External materials and related-verdict targets not read; a URL does not certify reading or review"
        },
        {
          "material_type": "External protocol and SAP",
          "public_status": "No separate original URL",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External materials and related-verdict targets not read; a URL does not certify reading or review"
        }
      ],
      "links": [
        {
          "label": "Official source",
          "url": "https://chamgap.com/verdicts/heart/primary-pci-stemi-versus-fibrinolysis/"
        }
      ]
    }
  ],
  "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"
  },
  "study_overlap": {
    "state": "Unverified",
    "unique_trial_count": null,
    "unique_participant_count": null,
    "reason": "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."
  },
  "history": [
    {
      "date": "2026-10-10",
      "kind": "Separation of public-facing pages and materials",
      "view_version": "1.0",
      "change": "Public pages and materials were prepared from the existing 17 items. No new clinical search, verification-status changes or scoring was performed."
    }
  ],
  "language": "en",
  "translation_date": "2026-10-10"
}