{
  "schema_version": "chamgap-public-evidence-check-1.0",
  "public_id": "v2941-s0",
  "verdict_number": "2941",
  "title": "Two-year caloric restriction × slower DunedinPACE: a post hoc DNA-surrogate evidence checklist",
  "view_version": "1.0",
  "view_created_date": "2026-10-11",
  "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 complete existing review summary was read for production, linking existing URLs and identifiers. External abstracts, full texts, registration, protocols and SAP were not newly read or checked.",
    "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": "Healthy non-obese adults in CALERIE; three US sites; detailed eligibility not read",
    "intervention": "Historical two-year caloric-restriction study intervention; not personal calorie, diet or weight-loss instructions",
    "dose": "Original target of 25% and achieved average of about 12% preserved separately; individual and time-specific exposure details not read",
    "comparator": "Parent randomized control group; specific control diet, support and concurrent management not read",
    "endpoint": "Selected slower-DunedinPACE question; the two PC measures and clinical outcomes kept separate",
    "duration": "Two-year study intervention; details of DunedinPACE at 12 and 24 months and time-specific PC outcomes unverified; post-intervention follow-up unverified",
    "excluded_extensions": [
      "Recasting a DNA measure as clinical rejuvenation, aging in general, disease, disability, death, lifespan or independent living",
      "Treating target exposure and the achieved average as identical",
      "Summing time points, measures, the 197-person DNA denominator or sibling sheets as new independent evidence",
      "Personal calorie, dietary, weight-loss or treatment instructions"
    ]
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Comparative efficacy",
      "question": "Are the original DunedinPACE subclaim assessment and the parent pace-of-aging context kept separate?",
      "needed": "Separate records of the original claim, grade, note and parent values",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Separate records of the original claim, grade, note and parent values",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "If additional original material is provided, connect the selected measure separately from the parent context.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The subclaim concerns 'Slower DunedinPACE', with original grade C and a note of a roughly 2~3% slowing signal. The parent surrogate assessment is C, 54 points and Unknown safety.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The subclaim has no score, status or axes; parent values are not used to fill them. This is not a new clinical assessment.",
      "missingness": "The subclaim has no score, status or axes; parent values are not used to fill them. This is not a new clinical assessment.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The subclaim has no score, status or axes; parent values are not used to fill them. This is not a new clinical assessment."
    },
    {
      "item_id": "N02",
      "question_type": "Comparative efficacy",
      "question": "What population and applicability limits concern healthy non-obese adults?",
      "needed": "Age, baseline condition, obesity status, eligibility and population-specific denominators",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Age, baseline condition, obesity status, eligibility and population-specific denominators",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original eligibility, baseline characteristics and recruitment denominators.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original population was healthy non-obese adults, and CALERIE took place at three US sites.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Detailed age, BMI, disease and eligibility criteria are absent from this summary. Findings are not automatically applied to aging or disease effects in other populations.",
      "missingness": "Detailed age, BMI, disease and eligibility criteria are absent from this summary. Findings are not automatically applied to aging or disease effects in other populations.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Detailed age, BMI, disease and eligibility criteria are absent from this summary. Findings are not automatically applied to aging or disease effects in other populations."
    },
    {
      "item_id": "N03",
      "question_type": "Comparative efficacy",
      "question": "Are the target caloric restriction and achieved average exposure distinguished?",
      "needed": "Study records of the original target, achieved exposure, measurement, adherence and duration",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Study records of the original target, achieved exposure, measurement, adherence and duration",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original exposure measurements, adherence, support and change records.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The historical study target was 25% restriction, whereas the original account reports average achieved restriction of about 12%.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The target and achieved exposure are not treated as identical or presented as personal dietary, calorie or weight-loss targets. Individual exposure, estimation and changes over time have not been read.",
      "missingness": "The target and achieved exposure are not treated as identical or presented as personal dietary, calorie or weight-loss targets. Individual exposure, estimation and changes over time have not been read.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The target and achieved exposure are not treated as identical or presented as personal dietary, calorie or weight-loss targets. Individual exposure, estimation and changes over time have not been read."
    },
    {
      "item_id": "N04",
      "question_type": "Comparative efficacy",
      "question": "Can the intervention and control diets, support and concurrent exposures over two years be verified?",
      "needed": "Actual intervention and control diets, support, contact and concurrent management",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Actual intervention and control diets, support, contact and concurrent management",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Connect protocol records of the control, support, achieved exposure and concurrent management.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original intervention was two-year caloric restriction, and the positive finding is recorded as a randomized comparison with a control group.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Specific control diets, contact, support and concurrent management are absent from this summary. Equivalent calorie, nutrient or attention conditions are not newly confirmed.",
      "missingness": "Specific control diets, contact, support and concurrent management are absent from this summary. Equivalent calorie, nutrient or attention conditions are not newly confirmed.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Specific control diets, contact, support and concurrent management are absent from this summary. Equivalent calorie, nutrient or attention conditions are not newly confirmed."
    },
    {
      "item_id": "N05",
      "question_type": "Comparative efficacy",
      "question": "Do 220 randomized participants, 2:1 allocation and the 197-person DNA sample share a denominator?",
      "needed": "Randomization, sample acquisition, measure-specific analyses and time-specific denominators",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Randomization, sample acquisition, measure-specific analyses and time-specific denominators",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original tables tracing allocation, DNA samples and analyses by time and measure.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "CALERIE randomized 220 participants in a 2:1 ratio. DNA data were analyzed for 197 participants with baseline and at least one follow-up sample.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Group sizes are not newly calculated from the allocation ratio. The 197 participants are not assumed to be the denominator for every measure at both 12 and 24 months.",
      "missingness": "Group sizes are not newly calculated from the allocation ratio. The 197 participants are not assumed to be the denominator for every measure at both 12 and 24 months.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Group sizes are not newly calculated from the allocation ratio. The 197 participants are not assumed to be the denominator for every measure at both 12 and 24 months."
    },
    {
      "item_id": "N06",
      "question_type": "Comparative efficacy",
      "question": "Do gaps remain concerning DNA sample selection, follow-up, missingness and the effect of interest?",
      "needed": "Sample selection, missingness by group, analysis populations, sensitivity analyses and original models",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Sample selection, missingness by group, analysis populations, sensitivity analyses and original models",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original sample-selection, group-specific missingness, analysis-population and sensitivity plans.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original DNA analysis requirement of baseline and at least one follow-up sample is preserved.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Reasons for DNA exclusions, missingness by time, ITT status and sample-selection effects have not been read. Attrition rates or missing counts are not newly calculated.",
      "missingness": "Reasons for DNA exclusions, missingness by time, ITT status and sample-selection effects have not been read. Attrition rates or missing counts are not newly calculated.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Reasons for DNA exclusions, missingness by time, ITT status and sample-selection effects have not been read. Attrition rates or missing counts are not newly calculated."
    },
    {
      "item_id": "N07",
      "question_type": "Comparative efficacy",
      "question": "Is DunedinPACE a pace measure distinct from clinical events?",
      "needed": "DNA measure definitions, measurement units, validation and measurement procedures",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "DNA measure definitions, measurement units, validation and measurement procedures",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original measure definitions, validation, measurement, units and clinical-linkage material.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original account describes DunedinPACE as a DNA-methylation measure of the pace of aging and a surrogate rather than a clinical event.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The result is not converted into clinical aging itself, reduced disease, rejuvenation or years of life. Details of the formula, units and clinical calibration have not been read.",
      "missingness": "The result is not converted into clinical aging itself, reduced disease, rejuvenation or years of life. Details of the formula, units and clinical calibration have not been read.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The result is not converted into clinical aging itself, reduced disease, rejuvenation or years of life. Details of the formula, units and clinical calibration have not been read."
    },
    {
      "item_id": "N08",
      "question_type": "Comparative efficacy",
      "question": "Are details of DNA measurement, batches, normalization and measure calculation available?",
      "needed": "Original methods for samples, DNA measurement, batches, normalization and algorithms",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Original methods for samples, DNA measurement, batches, normalization and algorithms",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original laboratory, measure-calculation and quality-processing methods.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The post hoc DNA-methylation design and analyst blinding are preserved.",
      "condition_status": "Unverified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Sample types, laboratory platforms, batches, normalization and algorithm details are not inferred, and measures are not newly calculated.",
      "missingness": "Sample types, laboratory platforms, batches, normalization and algorithm details are not inferred, and measures are not newly calculated.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Sample types, laboratory platforms, batches, normalization and algorithm details are not inferred, and measures are not newly calculated."
    },
    {
      "item_id": "N09",
      "question_type": "Comparative efficacy",
      "question": "Are the original 12-month DunedinPACE effect and CI preserved?",
      "needed": "Original effects, units, CIs, models and denominators by time",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Original effects, units, CIs, models and denominators by time",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain the original 12-month model, adjustments, denominators, effect and CI.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original account records the 12-month effect as d=−0.29 (95% CI −0.45 to −0.13).",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The standardized effect d is not recalculated into years of aging, percentages or clinical-event effects. Time-specific group denominators and model details have not been read.",
      "missingness": "The standardized effect d is not recalculated into years of aging, percentages or clinical-event effects. Time-specific group denominators and model details have not been read.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The standardized effect d is not recalculated into years of aging, percentages or clinical-event effects. Time-specific group denominators and model details have not been read."
    },
    {
      "item_id": "N10",
      "question_type": "Comparative efficacy",
      "question": "Is the 24-month DunedinPACE effect and interval preserved as a separate time-specific value?",
      "needed": "Original effects, original intervals, models and denominators by time",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Original effects, original intervals, models and denominators by time",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain the original 24-month effect, interval level, model and time-specific denominators.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original wording d=−0.25 (−0.41 to −0.09) at 24 months is preserved.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The 12-month 95% label is not added to the 24-month interval without separate verification in the original paper. A mean of the two time points or a persistence rate is not calculated.",
      "missingness": "The 12-month 95% label is not added to the 24-month interval without separate verification in the original paper. A mean of the two time points or a persistence rate is not calculated.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The 12-month 95% label is not added to the 24-month interval without separate verification in the original paper. A mean of the two time points or a persistence rate is not calculated."
    },
    {
      "item_id": "N11",
      "question_type": "Comparative efficacy",
      "question": "What is the scope of P<0.003 and the roughly 2~3% wording?",
      "needed": "Links between time-specific tests, effect transformations and original estimates",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Links between time-specific tests, effect transformations and original estimates",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain the original definitions and models for time-specific tests and percentage wording.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original rationale presents the DunedinPACE values at 12 and 24 months together with P<0.003. The reader answer and note describe roughly 2~3% slowing.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The P threshold is not turned into separate exact values for each time point, and 2~3% is not newly calculated from d. It is not converted into a rate of longer healthy life.",
      "missingness": "The P threshold is not turned into separate exact values for each time point, and 2~3% is not newly calculated from d. It is not converted into a rate of longer healthy life.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The P threshold is not turned into separate exact values for each time point, and 2~3% is not newly calculated from d. It is not converted into a rate of longer healthy life."
    },
    {
      "item_id": "N12",
      "question_type": "Comparative efficacy",
      "question": "Are the null PC PhenoAge and PC GrimAge findings preserved together?",
      "needed": "Original effects, intervals and tests by distinct measure and time",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Original effects, intervals and tests by distinct measure and time",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain effects, CIs, P values and denominators separately for each PC measure and time.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original account describes the other two measures as null, with d −0.04 to 0.05 and P>0.15.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The range endpoints are not assigned separately to individual measures or time points. The finding is not extended to slowing of all DNA clocks.",
      "missingness": "The range endpoints are not assigned separately to individual measures or time points. The finding is not extended to slowing of all DNA clocks.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The range endpoints are not assigned separately to individual measures or time points. The finding is not extended to slowing of all DNA clocks."
    },
    {
      "item_id": "N13",
      "question_type": "Comparative efficacy",
      "question": "Do the pace measure and the two PC clocks use the same units and address the same question?",
      "needed": "Definitions, reference standards, units and interpretation limits for each measure",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Definitions, reference standards, units and interpretation limits for each measure",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original definitions, validation, units and applicability material for each measure.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original account distinguishes a result in which only one of three DNA-methylation measures changed.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The pace-measure effect is not copied as an effect or value for PC biological age. Exact differences in units and validation have not been read.",
      "missingness": "The pace-measure effect is not copied as an effect or value for PC biological age. Exact differences in units and validation have not been read.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The pace-measure effect is not copied as an effect or value for PC biological age. Exact differences in units and validation have not been read."
    },
    {
      "item_id": "N14",
      "question_type": "Comparative efficacy",
      "question": "Are the post hoc analysis and the parent's prespecified clinical primary endpoint distinguished?",
      "needed": "Original registration, protocol, SAP, analysis timing and outcome hierarchy",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Original registration, protocol, SAP, analysis timing and outcome hierarchy",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original registration, protocol and SAP, and records of post hoc analysis selection and changes.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The paper explicitly identifies the analysis as post hoc. The original account states that the DNA outcomes were not the parent trial's prespecified clinical primary endpoint.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The DNA analysis is not recast as a prespecified confirmatory primary analysis merely because its parent trial was randomized.",
      "missingness": "The DNA analysis is not recast as a prespecified confirmatory primary analysis merely because its parent trial was randomized.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The DNA analysis is not recast as a prespecified confirmatory primary analysis merely because its parent trial was randomized."
    },
    {
      "item_id": "N15",
      "question_type": "Comparative efficacy",
      "question": "Are the split findings across three measures and the multiple-outcome analysis plan preserved?",
      "needed": "Original plans for three measures, time points, models, tests and multiplicity handling",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Original plans for three measures, time points, models, tests and multiplicity handling",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain the DNA analysis's original outcome list, time points, tests, adjustments and selective-reporting plan.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original account assesses only one of three measures as positive and the key measures as split; the parent split-key-measures flag remains true.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The parent's split-results wording is not turned into a new claim that all three measures were the parent's clinical coprimary endpoints. Multiplicity-adjustment details have not been read.",
      "missingness": "The parent's split-results wording is not turned into a new claim that all three measures were the parent's clinical coprimary endpoints. Multiplicity-adjustment details have not been read.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The parent's split-results wording is not turned into a new claim that all three measures were the parent's clinical coprimary endpoints. Multiplicity-adjustment details have not been read."
    },
    {
      "item_id": "N16",
      "question_type": "Comparative efficacy",
      "question": "Is the absence of a clinical minimum-effect threshold and prespecified success boundary preserved?",
      "needed": "Clinical validation, minimum-effect thresholds and plans for each measure",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Clinical validation, minimum-effect thresholds and plans for each measure",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Connect clinical validation, prespecified thresholds and plans for each measure if provided.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original account records no clinical minimum-effect threshold or prespecified success boundary and describes the effects as small.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Statistical positivity is not converted into certification of general clinical importance, calorie targets or health effects.",
      "missingness": "Statistical positivity is not converted into certification of general clinical importance, calorie targets or health effects.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Statistical positivity is not converted into certification of general clinical importance, calorie targets or health effects."
    },
    {
      "item_id": "N17",
      "question_type": "Comparative efficacy",
      "question": "What is the original scope of allocation and analyst blinding?",
      "needed": "Parent allocation, blinding of DNA laboratory staff or analysts, and analysis procedures",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Parent allocation, blinding of DNA laboratory staff or analysts, and analysis procedures",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original allocation, laboratory and measure-analysis methods and blinding roles.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The Korean account says that analysts did not know allocation; the English account specifies 'laboratory analysts blinded'. The parent's 2:1 randomized design is also preserved.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Blinding of all analysts, participants or intervention providers is not newly certified. Allocation concealment and measure-specific model procedures have not been read.",
      "missingness": "Blinding of all analysts, participants or intervention providers is not newly certified. Allocation concealment and measure-specific model procedures have not been read.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Blinding of all analysts, participants or intervention providers is not newly certified. Allocation concealment and measure-specific model procedures have not been read."
    },
    {
      "item_id": "N18",
      "question_type": "Comparative efficacy",
      "question": "Is the relationship between achieved restriction, adherence, weight changes and measure effects directly verified?",
      "needed": "Original achieved exposure, adherence, concurrent changes and effects of interest",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Original achieved exposure, adherence, concurrent changes and effects of interest",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain achieved exposure, adherence, concurrent changes and prespecified mediation or effect-of-interest material.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The 25% target and average achieved restriction of about 12% are preserved as historical study conditions.",
      "condition_status": "Unverified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Effects of individual achieved restriction, time-specific adherence and weight or nutrient mediation are not newly calculated or confirmed as causal mechanisms.",
      "missingness": "Effects of individual achieved restriction, time-specific adherence and weight or nutrient mediation are not newly calculated or confirmed as causal mechanisms.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Effects of individual achieved restriction, time-specific adherence and weight or nutrient mediation are not newly calculated or confirmed as causal mechanisms."
    },
    {
      "item_id": "N19",
      "question_type": "Comparative efficacy",
      "question": "Do gaps remain concerning persistence after 12 or 24 months, mechanisms and other aging measures?",
      "needed": "Follow-up measures, duration, denominators, original effects and direct mechanism evidence",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Follow-up measures, duration, denominators, original effects and direct mechanism evidence",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain direct post-intervention follow-up and original measurements, denominators and effects separately by measure.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original DNA effects are presented at 12 and 24 months, and the intervention lasted two years.",
      "condition_status": "Unverified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Persistence after the intervention or effects on all aging mechanisms and later measures are not newly filled in.",
      "missingness": "Persistence after the intervention or effects on all aging mechanisms and later measures are not newly filled in.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Persistence after the intervention or effects on all aging mechanisms and later measures are not newly filled in."
    },
    {
      "item_id": "N20",
      "question_type": "Comparative efficacy",
      "question": "Has the result been kept separate from disease, disability, death, lifespan and independent-living outcomes?",
      "needed": "Direct clinical endpoints, adequate follow-up, events, denominators and effects",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Direct clinical endpoints, adequate follow-up, events, denominators and effects",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Direct definitions, long-term follow-up, denominators and effect data are needed for each clinical outcome.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original account explicitly states that reduced disease, disability or death was not measured and longer healthy life was not answered.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The slowing signal is not turned into proof of clinical rejuvenation, added years of life or maintained independent living.",
      "missingness": "The slowing signal is not turned into proof of clinical rejuvenation, added years of life or maintained independent living.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The slowing signal is not turned into proof of clinical rejuvenation, added years of life or maintained independent living."
    },
    {
      "item_id": "N21",
      "question_type": "Comparative efficacy",
      "question": "Are the two sibling sheets, two time points and one post hoc report kept from being independently summed?",
      "needed": "Relationships among the parent trial, post hoc report, same participants, measures and time points",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Relationships among the parent trial, post hoc report, same participants, measures and time points",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Link additional reports through original trial identifiers while retaining relationships to the same population.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "Both sheets share the same CALERIE post hoc report and the 220-person and 197-person context.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Reports, measures and time points are not summed as new independent trials or participant totals. Unique trial and participant totals and the final independent count remain unrecorded.",
      "missingness": "Reports, measures and time points are not summed as new independent trials or participant totals. Unique trial and participant totals and the final independent count remain unrecorded.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Reports, measures and time points are not summed as new independent trials or participant totals. Unique trial and participant totals and the final independent count remain unrecorded."
    },
    {
      "item_id": "N22",
      "question_type": "Comparative efficacy",
      "question": "Are funding and DunedinPACE invention and commercial-licensing interests distinguished?",
      "needed": "Funding, authors, invention, licensing, provision and analysis roles",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Funding, authors, invention, licensing, provision and analysis roles",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain original funding, licensing, affiliations, product or service provision, analysis and manuscript roles separately.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "Support from NIA, American Brain Foundation, CIHR and others, authorship by inventors D.L. Corcoran and D.W. Belsky, and commercial licensing are preserved.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Inventors are not newly classified as company employees or financial beneficiaries. Details of cash funding, provision, affiliations and outside analysis have not been read.",
      "missingness": "Inventors are not newly classified as company employees or financial beneficiaries. Details of cash funding, provision, affiliations and outside analysis have not been read.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Inventors are not newly classified as company employees or financial beneficiaries. Details of cash funding, provision, affiliations and outside analysis have not been read."
    },
    {
      "item_id": "N23",
      "question_type": "Supplementary harm evidence",
      "question": "Does absent safety reporting establish that the parent trial had no harms?",
      "needed": "Harm plans, events by group and exposure denominators for this analysis and the parent trial",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Harm plans, events by group and exposure denominators for this analysis and the parent trial",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain the parent trial's original harm plans, events by group, exposure, discontinuation and denominators separately.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "This post hoc analysis did not report safety as an endpoint, and the parent's safety assessment is Unknown.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Absent reporting in the post hoc report is not extended to zero adverse events or established safety across CALERIE.",
      "missingness": "Absent reporting in the post hoc report is not extended to zero adverse events or established safety across CALERIE.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Absent reporting in the post hoc report is not extended to zero adverse events or established safety across CALERIE."
    },
    {
      "item_id": "N24",
      "question_type": "Supplementary harm evidence",
      "question": "Do gaps remain concerning long-term or rare harms under two-year achieved exposure?",
      "needed": "Direct harm data by achieved exposure, discontinuation, severity and duration",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Direct harm data by achieved exposure, discontinuation, severity and duration",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Obtain group-specific harms, discontinuation, rare events and long-term data from the parent trial and follow-up reports.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The original safety account states that this analysis cannot determine harms of long-term caloric restriction.",
      "condition_status": "Unverified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Duration alone does not establish safety, and new harm counts, rates, CIs or nutritional problems are not invented.",
      "missingness": "Duration alone does not establish safety, and new harm counts, rates, CIs or nutritional problems are not invented.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Duration alone does not establish safety, and new harm counts, rates, CIs or nutritional problems are not invented."
    },
    {
      "item_id": "N25",
      "question_type": "Supplementary harm evidence",
      "question": "Are harm replication, applicability to other populations or exposures, and dietary instructions distinguished?",
      "needed": "Direct effects, harms, exposures and same-population relationships by population",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Direct effects, harms, exposures and same-population relationships by population",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Connect direct comparisons and harm evidence for new populations or exposures separately.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The current population is healthy non-obese adults, and the historical exposure is a two-year study with differing target and achieved average restriction.",
      "condition_status": "Unverified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Effects or harms in other populations or dietary-restriction methods are not newly confirmed, and personal calorie, diet or weight-loss instructions are not created.",
      "missingness": "Effects or harms in other populations or dietary-restriction methods are not newly confirmed, and personal calorie, diet or weight-loss instructions are not created.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Effects or harms in other populations or dietary-restriction methods are not newly confirmed, and personal calorie, diet or weight-loss instructions are not created."
    },
    {
      "item_id": "N26",
      "question_type": "Comparative efficacy",
      "question": "Are the stored summary, PubMed link and registration identifier distinguished from materials actually read?",
      "needed": "Separate access records for the summary, abstract, full text, registration, protocol and SAP",
      "role": "Required",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Separate access records for the summary, abstract, full text, registration, protocol and SAP",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Connect additional provided material with its individual access status.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The whole parent summary was read for production, and the original PubMed link and NCT00427193 identifier were connected.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. A new registration URL is not constructed from the identifier; all external materials remain unread. Links and original full text were not compared or tested.",
      "missingness": "A new registration URL is not constructed from the identifier; all external materials remain unread. Links and original full text were not compared or tested.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "A new registration URL is not constructed from the identifier; all external materials remain unread. Links and original full text were not compared or tested."
    },
    {
      "item_id": "N27",
      "question_type": "Comparative efficacy",
      "question": "Are original dates, Korean and English text, empty values, subclaim and parent values, and review status preserved?",
      "needed": "Distinction among the complete original, selected assessment record, history and current production status",
      "role": "Supplementary",
      "role_reason": "An individual condition for recording the selected measure, time, original values and applicability limits",
      "application_exception": "Unread external materials, other measures or out-of-scope outcomes do not establish that a condition is met, an effect is zero or safety is established.",
      "criterion": "Distinction among the complete original, selected assessment record, history and current production status",
      "basis": "Slower DunedinPACE",
      "condition_origin": "Question-specific application conditions; existing content review remains incomplete and common definitions are not automatically fulfilled",
      "proposed_research": "Proposal: Reflect additional materials and decisions through preservation of original wording and separate events.",
      "current_reports": [
        "R01"
      ],
      "existence": "Material information recorded in the preserved summary",
      "acquired_read": "Summary read; external materials not read",
      "observation": "The 2026-08-26 reference date, empty correction and deliberation values, Korean and English text, C54, original axes and subclaim C are preserved. Original pending and production-eligible markers are historical; content review at that time remained incomplete.",
      "condition_status": "Partly verified",
      "status_reason": "Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. The missing subclaim score and unrecorded precision are not filled in. Original model, content and scope review activation and completion remain false; added assessment units are 0 and the final independent count is unrecorded.",
      "missingness": "The missing subclaim score and unrecorded precision are not filled in. Original model, content and scope review activation and completion remain false; added assessment units are 0 and the final independent count is unrecorded.",
      "uncertainty": "Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The missing subclaim score and unrecorded precision are not filled in. Original model, content and scope review activation and completion remain false; added assessment units are 0 and the final independent count is unrecorded."
    }
  ],
  "reports": [
    {
      "report_id": "R01",
      "title": "Waziry R, Ryan CP, Corcoran DL, et al. Effect of long-term caloric restriction on DNA methylation measures of biological aging in healthy adults from the CALERIE trial. Nat Aging. 2023;3:248-257. PMID: 37118425.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/37118425/",
      "report_type": "Post hoc DNA-analysis report from the parent randomized trial",
      "existence": "Materials preserved in original citation and evidence lists",
      "acquired_read": "Summary read; external materials not read",
      "study_family": "F01",
      "independent_replication": false,
      "observed_result": "Only DunedinPACE changed: d=−0.29 at 12 months and d=−0.25 at 24 months; the other two clocks were null",
      "result_level": "Stored evidence-list and narrative summaries; not direct reading of the original paper or registration",
      "source_evidence_date": "2026-08-26",
      "materials": [
        {
          "material_type": "local_summary",
          "public_status": "Original source link preserved",
          "access_status": "Summary read",
          "acquired": true,
          "actually_read": "Summary read",
          "as_of": "2026-08-26",
          "qualification": "Preserved parent verdict summary"
        },
        {
          "material_type": "abstract",
          "public_status": "Original source link preserved",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External material unread; a URL does not mean acquisition, reading or completed review"
        },
        {
          "material_type": "fulltext",
          "public_status": "No separate URL in the original material",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External material unread; a URL does not mean acquisition, reading or completed review"
        },
        {
          "material_type": "registration",
          "public_status": "No separate URL in the original material",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External material unread; a URL does not mean acquisition, reading or completed review"
        },
        {
          "material_type": "protocol_sap",
          "public_status": "No separate URL in the original material",
          "access_status": "Not read",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-08-26",
          "qualification": "External material unread; a URL does not mean acquisition, reading or completed review"
        }
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      "links": [
        {
          "label": "PubMed",
          "url": "https://pubmed.ncbi.nlm.nih.gov/37118425/"
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      "review_level": "Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed."
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      "review_level": "Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed."
    },
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      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
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      "review_level": "Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed."
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      "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": "Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed."
    }
  ],
  "status_dictionary": {
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    "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": "Review of existing content incomplete",
    "Met": "Use only within the relevant conditions after existing content review; no automatic designation 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"
  },
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    "unique_participant_count": null,
    "reason": "Post hoc DNA analysis of the CALERIE parent randomized trial; the two subclaim sheets, measures and time points are shared, rather than separate new trials. Family IDs connect relationships and do not certify unique trial counts; reports, time points, measures, sibling sheets and the same participants are not newly summed as independent evidence."
  },
  "history": [
    {
      "date": "2026-10-11",
      "kind": "Separation of public-facing pages and materials",
      "view_version": "1.0",
      "change": "Public pages and materials were prepared from the existing 27 items. No new clinical search, verification-status change or scoring was performed."
    }
  ],
  "language": "en",
  "translation_date": "2026-10-11"
}