# Non-obligatory postcards × people with any repetition: an evidence sheet distinguishing repeat-event counts Verdict 2943 · Evidence Check Stored-material review date: Not recorded Original evidence cut-off: 2026-08-26 Review-criteria version: 1.0 Public page/material preparation date: 2026-10-11 Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect. ## Assessment scope - Population: Participants aged 16 or older after hospital treatment in Newcastle, Australia; detailed eligibility and baseline characteristics have not been read - Ingredient, formulation and route: Historical study exposure to eight non-obligatory postcards over 12 months; detailed existing treatment and actual receipt remain unverified - Dose: Only original study exposure is preserved; no mailing schedule, wording, support actions or treatment implementation guidance is generated - Comparator: Usual care in the original trial; detailed existing treatment and concomitant care have not been read - Measured outcome: Selected endpoint: people with any repetition; the coprimary repeat-event count and mortality are separate - Duration: 12 months in the original trial; detailed review periods and follow-up denominators have not been read - Questions outside this scope: Repurposing repeat-event counts as fewer people with repetition; Establishing reductions in repetition or mortality, effects across all contacts, or widespread implementation; Personal support actions or treatment instructions; Descriptions of methods of repeating the behavior ## Checklist items ### N01 · Are the selected reduction in people with any repetition and the parent repeat-event result distinguished? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The selected original question is ‘Fewer people with any repetition’, with original grade D and a note describing 15.1% versus 17.3% and a CI including zero. The parent verdict concerns fewer repeat events, grade C, 56 points and unknown safety. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Missing subclaim score, status and axes are not filled with the parent score. No new verdict is made. - Reason for missing information: Missing subclaim score, status and axes are not filled with the parent score. No new verdict is made. - Required materials and conditions: Separate records of the original subclaim, grade, note and parent results - Materials to obtain first: Missing subclaim score, status and axes are not filled with the parent score. No new verdict is made. - Further research: Additional materials are linked separately to the selected any-repetition endpoint and the repeat-event endpoint. - Conditions for verification: Separate records of the original subclaim, grade, note and parent results - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N02 · Who was recruited after hospital treatment and what is the scope of application? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The recorded study population comprises 772 participants aged 16 or older after hospital treatment in Newcastle, Australia. - Why unverified: 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 results are not automatically applied to other locations, ages, prior treatments or episode types. Detailed eligibility, baseline characteristics and histories of previous repetition have not been read. - Reason for missing information: The results are not automatically applied to other locations, ages, prior treatments or episode types. Detailed eligibility, baseline characteristics and histories of previous repetition have not been read. - Required materials and conditions: Prior episodes, age, location, eligibility, baseline characteristics and denominators - Materials to obtain first: The results are not automatically applied to other locations, ages, prior treatments or episode types. Detailed eligibility, baseline characteristics and histories of previous repetition have not been read. - Further research: Obtain original eligibility, baseline characteristics, individual histories of repetition and treatment records. - Conditions for verification: Prior episodes, age, location, eligibility, baseline characteristics and denominators - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N03 · Are non-obligatory postcard exposure and the existing-treatment comparator distinguished? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original intervention consisted of 8 postcards requiring no reply over 12 months; the comparator was usual care. - Why unverified: 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 mailing times, wording, actual receipt, existing treatment and additional care have not been read. No personal support actions, treatment or implementation instructions are created. - Reason for missing information: Detailed mailing times, wording, actual receipt, existing treatment and additional care have not been read. No personal support actions, treatment or implementation instructions are created. - Required materials and conditions: Records of historical study exposure, usual care and concomitant care by group - Materials to obtain first: Detailed mailing times, wording, actual receipt, existing treatment and additional care have not been read. No personal support actions, treatment or implementation instructions are created. - Further research: Obtain original intervention, actual exposure, usual-care and concomitant-care materials. - Conditions for verification: Records of historical study exposure, usual care and concomitant care by group - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N04 · Are the units of randomized people, people with repetition and repeat events preserved separately? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: Among 772 participants, 378 were assigned to postcards and 394 to usual care. People with any repetition and total events are different units. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Events are not converted into people, and people with repetition are not added as new participants. The same participants in sibling sheets are not added together. - Reason for missing information: Events are not converted into people, and people with repetition are not added as new participants. The same participants in sibling sheets are not added together. - Required materials and conditions: Distinguishing randomized denominators, individual repetition and event counts - Materials to obtain first: Events are not converted into people, and people with repetition are not added as new participants. The same participants in sibling sheets are not added together. - Further research: Obtain original mappings of person-level and event-level analyses and follow-up denominators. - Conditions for verification: Distinguishing randomized denominators, individual repetition and event counts - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N05 · What are the definition, follow-up period and ascertainment scope for people with any repetition? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The preserved record states that the trial counted hospital-treated episodes through an administrative database over 12 months. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Episodes outside hospital, episodes at other institutions, self-reports and deaths are not assigned the same repetition definition. Detailed capture scope and linkage omissions have not been read. - Reason for missing information: Episodes outside hospital, episodes at other institutions, self-reports and deaths are not assigned the same repetition definition. Detailed capture scope and linkage omissions have not been read. - Required materials and conditions: Episode definition, hospital treatment, follow-up period and administrative-data scope - Materials to obtain first: Episodes outside hospital, episodes at other institutions, self-reports and deaths are not assigned the same repetition definition. Detailed capture scope and linkage omissions have not been read. - Further research: Obtain original episode definitions, database, linkage, observation-period and missing-data materials. - Conditions for verification: Episode definition, hospital treatment, follow-up period and administrative-data scope - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N06 · Are 57/378 versus 68/394 and the proportions preserved as originally recorded? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: People with any repetition numbered 57/378 (15.1%) in the postcard group versus 68/394 (17.3%) with usual care. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Proportions are not recalculated, and new person counts, missing denominators or repetition rates are not created. - Reason for missing information: Proportions are not recalculated, and new person counts, missing denominators or repetition rates are not created. - Required materials and conditions: People with repetition by group, original denominators, proportions and analysis populations - Materials to obtain first: Proportions are not recalculated, and new person counts, missing denominators or repetition rates are not created. - Further research: Obtain original person-level episode tables, group denominators, follow-up completeness and analysis populations. - Conditions for verification: People with repetition by group, original denominators, proportions and analysis populations - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N07 · Are the difference in repeater proportions, its interval and the missing P value preserved? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The stored summary records a difference of −2 percentage points (95% CI −7 to 3) and judges the repeater result null. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. P values, RR, OR, NNT or new risk differences absent from the original record are not calculated. An interval including zero does not certify every effect as zero or establish equivalence. - Reason for missing information: P values, RR, OR, NNT or new risk differences absent from the original record are not calculated. An interval including zero does not certify every effect as zero or establish equivalence. - Required materials and conditions: Original between-group difference, interval, test, denominators and model - Materials to obtain first: P values, RR, OR, NNT or new risk differences absent from the original record are not calculated. An interval including zero does not certify every effect as zero or establish equivalence. - Further research: Link original tests, models, intervals, prespecified importance thresholds and denominator materials. - Conditions for verification: Original between-group difference, interval, test, denominators and model - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N08 · Do 101 versus 192 repeat events and the IRR describe the selected effect on people with repetition? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: Total repeat events fell to 101 versus 192, IRR 0.55 (95% CI 0.35–0.87). - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Fewer events are not repurposed as fewer people with repetition or confirmed prevention. Person-level distributions, exposure time and models have not been read. - Reason for missing information: Fewer events are not repurposed as fewer people with repetition or confirmed prevention. Person-level distributions, exposure time and models have not been read. - Required materials and conditions: Separate records of event counts, person counts, exposure time and incidence rate ratio - Materials to obtain first: Fewer events are not repurposed as fewer people with repetition or confirmed prevention. Person-level distributions, exposure time and models have not been read. - Further research: Obtain individual repetition distributions, original event tables, exposure and incidence-rate analysis plans. - Conditions for verification: Separate records of event counts, person counts, exposure time and incidence rate ratio - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N09 · Are total events, repeat events per person and the contribution of a small group of repeaters distinguished? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original text explains that only repeated episodes among a small group declined; the recorded endpoints include repeat events per person. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Mean event counts, high-frequency subgroup sizes, distributions and sample-specific effects are not newly calculated. The original explanation is not relabelled as a completed subgroup test. - Reason for missing information: Mean event counts, high-frequency subgroup sizes, distributions and sample-specific effects are not newly calculated. The original explanation is not relabelled as a completed subgroup test. - Required materials and conditions: Original data on event distributions, individual repetition, observation time and models - Materials to obtain first: Mean event counts, high-frequency subgroup sizes, distributions and sample-specific effects are not newly calculated. The original explanation is not relabelled as a completed subgroup test. - Further research: Obtain original person-level distributions, repeated-event models, subgroup plans and denominators. - Conditions for verification: Original data on event distributions, individual repetition, observation time and models - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N10 · Are the split coprimary outcomes and selected subclaim grade D displayed together? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original materials record repeater proportion and repeat-event count as coprimary outcomes, with only one succeeding. The original axis flag for split coprimary outcomes is preserved as true. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Success on event count is not retained while failure on repeater proportion is omitted, and parent grade C is not transferred to the selected endpoint. Detailed testing and adjustment plans have not been read. - Reason for missing information: Success on event count is not retained while failure on repeater proportion is omitted, and parent grade C is not transferred to the selected endpoint. Detailed testing and adjustment plans have not been read. - Required materials and conditions: Coprimary designation, individual effects, tests and multiplicity plans - Materials to obtain first: Success on event count is not retained while failure on repeater proportion is omitted, and parent grade C is not transferred to the selected endpoint. Detailed testing and adjustment plans have not been read. - Further research: Obtain original protocols, SAP, coprimary endpoint hierarchy, multiplicity plans and individual original tables. - Conditions for verification: Coprimary designation, individual effects, tests and multiplicity plans - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N11 · What is the recorded information on randomization, concealment, blinding and administrative measurement? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The stored summary describes a randomized usual-care-controlled trial with unavoidable participant unblinding, while hospital administrative data were used to count episodes. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Using administrative data does not certify that all measurement, capture or selection bias was resolved. Allocation-concealment and analyst procedures have not been read. - Reason for missing information: Using administrative data does not certify that all measurement, capture or selection bias was resolved. Allocation-concealment and analyst procedures have not been read. - Required materials and conditions: Allocation, concealment, participant/outcome measurement and analyst procedures - Materials to obtain first: Using administrative data does not certify that all measurement, capture or selection bias was resolved. Allocation-concealment and analyst procedures have not been read. - Further research: Obtain original methods, administrative linkage, allocation, concealment, measurement and analysis procedures. - Conditions for verification: Allocation, concealment, participant/outcome measurement and analyst procedures - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N12 · Do gaps remain in 12-month follow-up, missing data, deaths, relocation and analysis populations? Verification status: Unverified Reading scope: Summary read; external materials not read - Current findings: Randomized denominators, the 12-month period and administrative counting are preserved. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Reporting denominators does not establish complete follow-up for everyone. Detailed handling of withdrawals, relocation and deaths, and ITT procedures, have not been read. - Reason for missing information: Reporting denominators does not establish complete follow-up for everyone. Detailed handling of withdrawals, relocation and deaths, and ITT procedures, have not been read. - Required materials and conditions: Follow-up by group, reasons for missing data, competing events, analysis populations and sensitivity analyses - Materials to obtain first: Reporting denominators does not establish complete follow-up for everyone. Detailed handling of withdrawals, relocation and deaths, and ITT procedures, have not been read. - Further research: Obtain original follow-up flows, administrative capture, analysis populations and missing-data/competing-event plans. - Conditions for verification: Follow-up by group, reasons for missing data, competing events, analysis populations and sensitivity analyses - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N13 · Can actual postcard receipt, replies, existing treatment exposure and adherence be verified? Verification status: Unverified Reading scope: Summary read; external materials not read - Current findings: Historical exposure to postcards requiring no reply and the usual-care comparator are recorded. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Not requiring replies does not mean receipt, contact or treatment use was equal. Numbers received, discontinuation, treatment changes and effect mappings have not been read. - Reason for missing information: Not requiring replies does not mean receipt, contact or treatment use was equal. Numbers received, discontinuation, treatment changes and effect mappings have not been read. - Required materials and conditions: Actual study exposure, receipt, discontinuation, treatment use and concomitant treatment records - Materials to obtain first: Not requiring replies does not mean receipt, contact or treatment use was equal. Numbers received, discontinuation, treatment changes and effect mappings have not been read. - Further research: Obtain actual exposure, receipt, existing treatment, discontinuation and prespecified effects of interest. - Conditions for verification: Actual study exposure, receipt, discontinuation, treatment use and concomitant treatment records - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N14 · Are prespecified plans and the registration identifier distinguished from actual reading of the registration? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original recorded registration string is ACTRN012605000050651. Coprimary designation is preserved in the parent text. - Why unverified: 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 identifier is not arbitrarily corrected and no new URL is constructed. External registration, protocol and SAP have not been read. - Reason for missing information: The identifier is not arbitrarily corrected and no new URL is constructed. External registration, protocol and SAP have not been read. - Required materials and conditions: Original registration, protocol, SAP, amendments and prespecification records - Materials to obtain first: The identifier is not arbitrarily corrected and no new URL is constructed. External registration, protocol and SAP have not been read. - Further research: When original registration and planning materials are provided, link their original form and amendment history separately. - Conditions for verification: Original registration, protocol, SAP, amendments and prespecification records - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N15 · Is the specific postcard study equivalent to a review of several brief-contact interventions? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The Milner 2015 review synthesizes 14 trials of letters, postcards, calls and cards as evidence for the intervention class. - Why unverified: 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 all brief contacts are not equated with this eight-postcard exposure. Populations, exposures and endpoints of individual included trials have not been read. - Reason for missing information: Effects of all brief contacts are not equated with this eight-postcard exposure. Populations, exposures and endpoints of individual included trials have not been read. - Required materials and conditions: Review populations, interventions, comparators, eligibility and original-trial mapping - Materials to obtain first: Effects of all brief contacts are not equated with this eight-postcard exposure. Populations, exposures and endpoints of individual included trials have not been read. - Further research: Obtain mappings of included trials, interventions, comparators and populations. - Conditions for verification: Review populations, interventions, comparators, eligibility and original-trial mapping - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R02 ### N16 · Is the review OR for any repetition distinguished from the difference in the direct trial? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original text preserves the review OR for any repetition as 0.87 (95% CI 0.74–1.04). - Why unverified: 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 OR is not converted into the direct trial's proportion difference, RR or person counts. The summary does not provide the number of trials for this endpoint, total participants, periods or heterogeneity. - Reason for missing information: The OR is not converted into the direct trial's proportion difference, RR or person counts. The summary does not provide the number of trials for this endpoint, total participants, periods or heterogeneity. - Required materials and conditions: Pooled effects on people with repetition, intervals, trial-specific denominators, periods and models - Materials to obtain first: The OR is not converted into the direct trial's proportion difference, RR or person counts. The summary does not provide the number of trials for this endpoint, total participants, periods or heterogeneity. - Further research: Obtain endpoint-specific included trials, denominators, periods, models and heterogeneity from the review. - Conditions for verification: Pooled effects on people with repetition, intervals, trial-specific denominators, periods and models - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R02 ### N17 · Are the review results for repeat counts and suicide separated from evidence on the selected people-with-repetition endpoint? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The review separately records suicide OR 0.58 (0.24–1.38) and repeat events per person IRR 0.66 (0.54–0.80). - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Interval levels not separately specified in the original stored summary are not newly added. Suicide and event-count effects are not repurposed as effects on people with repetition. - Reason for missing information: Interval levels not separately specified in the original stored summary are not newly added. Suicide and event-count effects are not repurposed as effects on people with repetition. - Required materials and conditions: Separate materials on endpoint-specific effects, interval levels, denominators and definitions - Materials to obtain first: Interval levels not separately specified in the original stored summary are not newly added. Suicide and event-count effects are not repurposed as effects on people with repetition. - Further research: Obtain each endpoint's definition, included trials, denominators, intervals and prespecified plans separately. - Conditions for verification: Separate materials on endpoint-specific effects, interval levels, denominators and definitions - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R02 ### N18 · Are the review's 14 trials, the Carter trial and sibling sheets protected against double-counting? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original materials explicitly state that synthesis evidence is not double-counted as replication trials in the review's funding field. Subclaim sheets share the Carter materials and parent summary. - Why unverified: 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 14 trials are not declared a new independent replication count, and trials or participants are not added together. The overlap list of included trials has not been read. - Reason for missing information: The 14 trials are not declared a new independent replication count, and trials or participants are not added together. The overlap list of included trials has not been read. - Required materials and conditions: Relationships among original trials, synthesis reports, shared populations and endpoints - Materials to obtain first: The 14 trials are not declared a new independent replication count, and trials or participants are not added together. The overlap list of included trials has not been read. - Further research: Link original-trial lists, shared participants and report relationships from the review without newly certifying independence. - Conditions for verification: Relationships among original trials, synthesis reports, shared populations and endpoints - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01, R02 ### N19 · Are gaps in direct evidence for secondary results, subgroups and repeater analyses retained? Verification status: Unverified Reading scope: Summary read; external materials not read - Current findings: The original materials focus on two coprimary results, an explanation about a small group of repeaters and the review. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Subgroup effects, denominators and P values absent from the original text, including those for sex, age and prior repetition, are not created. Explanations are not upgraded to proof of prespecified subgroup effects. - Reason for missing information: Subgroup effects, denominators and P values absent from the original text, including those for sex, age and prior repetition, are not created. Explanations are not upgraded to proof of prespecified subgroup effects. - Required materials and conditions: Outcome hierarchy, prespecified subgroups, interactions, original effects and denominators - Materials to obtain first: Subgroup effects, denominators and P values absent from the original text, including those for sex, age and prior repetition, are not created. Explanations are not upgraded to proof of prespecified subgroup effects. - Further research: Obtain original secondary-outcome and subgroup plans, interactions, denominators and multiplicity materials. - Conditions for verification: Outcome hierarchy, prespecified subgroups, interactions, original effects and denominators - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N20 · Are nonsignificant results and intervals distinguished from clinically important reductions in repetition? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The preserved subclaim note states that the repeater CI, −7 to 3 percentage points, includes zero. - Why unverified: 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 summary has no prespecified importance threshold, so exclusion of all meaningful effects, equivalence or universal lack of effect is not newly certified. - Reason for missing information: The summary has no prespecified importance threshold, so exclusion of all meaningful effects, equivalence or universal lack of effect is not newly certified. - Required materials and conditions: Importance thresholds, original between-group effects, intervals and prespecified plans - Materials to obtain first: The summary has no prespecified importance threshold, so exclusion of all meaningful effects, equivalence or universal lack of effect is not newly certified. - Further research: Link prespecified clinical thresholds and original plans for each endpoint, population and period when provided. - Conditions for verification: Importance thresholds, original between-group effects, intervals and prespecified plans - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N21 · Are repetition, event counts, suicide deaths and other clinical outcomes kept distinct? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The stored summary records that the trial did not demonstrate fewer suicide deaths. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Reduced repeat-event counts are not extended to fewer deaths, prevention of all repetition or benefits of other clinical treatments. - Reason for missing information: Reduced repeat-event counts are not extended to fewer deaths, prevention of all repetition or benefits of other clinical treatments. - Required materials and conditions: Direct distinction among people with repetition, events, deaths and other treatment outcomes - Materials to obtain first: Reduced repeat-event counts are not extended to fewer deaths, prevention of all repetition or benefits of other clinical treatments. - Further research: Link direct episode definitions, follow-up, denominators and effects separately for each clinical question. - Conditions for verification: Direct distinction among people with repetition, events, deaths and other treatment outcomes - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01, R02 ### N22 · Has guidance for widespread implementation or treatment replacement been avoided? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The preserved text states that the review concluded widespread clinical implementation could not yet be recommended. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. This production is not guidance for personal contact, support actions, treatment changes or methods of repeating the behavior. A specific trial is not extended to every support approach. - Reason for missing information: This production is not guidance for personal contact, support actions, treatment changes or methods of repeating the behavior. A specific trial is not extended to every support approach. - Required materials and conditions: Application boundaries by population, intervention and comparator, and the original verdict context - Materials to obtain first: This production is not guidance for personal contact, support actions, treatment changes or methods of repeating the behavior. A specific trial is not extended to every support approach. - Further research: When direct materials on target populations and support are provided, link them separately for user review. - Conditions for verification: Application boundaries by population, intervention and comparator, and the original verdict context - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01, R02 ### N23 · Are public/nonprofit support and gaps in detailed involvement distinguished? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The Carter study was supported by Hunter Area Health Service, NSW Health and NHMRC. The review records funding as varying among original trials. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Funding labels alone do not establish absence of supplied products/services, employee authors or external analysis roles, and do not newly certify independence. - Reason for missing information: Funding labels alone do not establish absence of supplied products/services, employee authors or external analysis roles, and do not newly certify independence. - Required materials and conditions: Cash funding, supplied products/services, affiliated authors and external analysis roles - Materials to obtain first: Funding labels alone do not establish absence of supplied products/services, employee authors or external analysis roles, and do not newly certify independence. - Further research: Obtain original support, affiliation, study-role and analysis disclosures separately for the trial and review. - Conditions for verification: Cash funding, supplied products/services, affiliated authors and external analysis roles - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01, R02 ### N24 · Are absence of a separate adverse-event endpoint and unknown safety preserved? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The stored summary records that safety was insufficiently assessed without a separate adverse-event endpoint; parent safety is unknown. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. This is not relabelled as zero adverse events, no serious harm or a safe intervention. - Reason for missing information: This is not relabelled as zero adverse events, no serious harm or a safe intervention. - Required materials and conditions: Original harm collection, events by group, exposure, denominators and relatedness data - Materials to obtain first: This is not relabelled as zero adverse events, no serious harm or a safe intervention. - Further research: Obtain original harm collection, events by group, exposure, denominators, relatedness and discontinuation materials. - Conditions for verification: Original harm collection, events by group, exposure, denominators and relatedness data - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01 ### N25 · Are inconclusive mortality results separated from long-term and rare harms? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The trial did not establish reduced suicide mortality; the review records the suicide OR interval as 0.24–1.38. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Nonsignificance is not described as absence of mortality risk. Death counts, harm rates and long-term safety absent from the original text are not created. - Reason for missing information: Nonsignificance is not described as absence of mortality risk. Death counts, harm rates and long-term safety absent from the original text are not created. - Required materials and conditions: Deaths, severity, periods, exposure, effect intervals and direct harm data - Materials to obtain first: Nonsignificance is not described as absence of mortality risk. Death counts, harm rates and long-term safety absent from the original text are not created. - Further research: Obtain endpoint-specific deaths, serious events, observation periods, exposure and direct harm data. - Conditions for verification: Deaths, severity, periods, exposure, effect intervals and direct harm data - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01, R02 ### N26 · Are gaps in harm replication and application to other populations, interventions and contacts retained? Verification status: Unverified Reading scope: Summary read; external materials not read - Current findings: The original study involved a specific population after hospital treatment and a postcard intervention; the review covered various brief contacts. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Absence of harm or efficacy across all contacts and other populations is not newly established, and clinical implementation is not directed. - Reason for missing information: Absence of harm or efficacy across all contacts and other populations is not newly established, and clinical implementation is not directed. - Required materials and conditions: Direct harms by population, exposure and service, and shared-population relationships - Materials to obtain first: Absence of harm or efficacy across all contacts and other populations is not newly established, and clinical implementation is not directed. - Further research: Link direct materials by intervention and population, harm follow-up and report relationships separately. - Conditions for verification: Direct harms by population, exposure and service, and shared-population relationships - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01, R02 ### N27 · Are reading of summaries and external abstracts, full texts, registrations, protocols and SAP distinguished? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The whole stored parent-verdict summary was read for production, linking the two PubMed URLs and the original ACTRN identifier. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Existing links do not indicate completed external acquisition, reading or review. Full texts and plans for the review and original trial have not been read. - Reason for missing information: Existing links do not indicate completed external acquisition, reading or review. Full texts and plans for the review and original trial have not been read. - Required materials and conditions: Original URLs, stored summaries, identifiers and individual actual-access records - Materials to obtain first: Existing links do not indicate completed external acquisition, reading or review. Full texts and plans for the review and original trial have not been read. - Further research: Link user-provided materials to their individual types and access status. - Conditions for verification: Original URLs, stored summaries, identifiers and individual actual-access records - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01, R02 ### N28 · Are the cut-off, original subclaim/parent values, Korean/English texts, corrections and empty fields preserved? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The cut-off 2026-08-26, empty correction and deliberation fields, Korean/English texts, parent C56, unknown safety, true split-coprimary flag and subclaim D are preserved. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. This production date is not substituted as a new clinical-verification date. Original cross-check wording is historical and does not indicate review completion here. - Reason for missing information: This production date is not substituted as a new clinical-verification date. Original cross-check wording is historical and does not indicate review completion here. - Required materials and conditions: Whole stored summary, selected verdict record and original verdict history - Materials to obtain first: This production date is not substituted as a new clinical-verification date. Original cross-check wording is historical and does not indicate review completion here. - Further research: Link new materials and decisions as separate events while preserving the entire original text. - Conditions for verification: Whole stored summary, selected verdict record and original verdict history - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01, R02 ### N29 · Are user-review indicators separated from production and independence status? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: Original review-pending/production-eligible indicators and boundary-review requirements are preserved as history. The original content review remains incomplete; active-pending and completion flags for model, content and boundary reviews are false. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. No new verdict, split or independence certification is made; added verdict units are 0 and the final independence count is not recorded. - Reason for missing information: No new verdict, split or independence certification is made; added verdict units are 0 and the final independence count is not recorded. - Required materials and conditions: Original candidate history and current production/review status - Materials to obtain first: No new verdict, split or independence certification is made; added verdict units are 0 and the final independence count is not recorded. - Further research: Reflect only user-provided decisions and materials as separate events. - Conditions for verification: Original candidate history and current production/review status - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Fewer people with any repetition - Related sources: R01, R02 ## Evidence and sources ### R01 Carter GL, Clover K, Whyte IM, Dawson AH, D'Este C. Postcards from the EDge project: randomised controlled trial of an intervention using postcards to reduce repetition of hospital treated deliberate self poisoning. BMJ. 2005;331:805. PMID: 16183654. [PubMed](https://pubmed.ncbi.nlm.nih.gov/16183654/) Materials actually read: Summary read; external materials not read Findings recorded in the summary: Repeaters 15.1% vs 17.3%, difference −2 percentage points (−7 to 3); events 101 vs 192, IRR 0.55 (0.35–0.87) Record level: Stored review summary; not results from directly reading the original paper or review Independent replication: Original Carter trial; the two subquestions concern the same participants. Synthesis report of 14 trials; overlap among included original trials and endpoint-specific denominators have not been read. Family IDs link relationships and do not certify unique-trial counts; reports, time points, reviews, sibling sheets and shared participants are not newly added as independent materials. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | local_summary | Original source link preserved | Summary read | Summary read | Preserved parent verdict summary | | abstract | Original source link preserved | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | fulltext | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | registration | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | protocol_sap | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | ### R02 Milner AJ, Carter G, Pirkis J, Robinson J, Spittal MJ. Letters, green cards, telephone calls and postcards: systematic and meta-analytic review of brief contact interventions. Br J Psychiatry. 2015;206:184-190. PMID: 25733570. [PubMed](https://pubmed.ncbi.nlm.nih.gov/25733570/) Materials actually read: Summary read; external materials not read Findings recorded in the summary: OR 0.87(0.74~1.04), OR 0.58(0.24~1.38), IRR 0.66(0.54~0.80) Record level: Stored review summary; not results from directly reading the original paper or review Independent replication: Original Carter trial; the two subquestions concern the same participants. Synthesis report of 14 trials; overlap among included original trials and endpoint-specific denominators have not been read. Family IDs link relationships and do not certify unique-trial counts; reports, time points, reviews, sibling sheets and shared participants are not newly added as independent materials. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | local_summary | Original source link preserved | Summary read | Summary read | Preserved parent verdict summary | | abstract | Original source link preserved | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | fulltext | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | registration | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | protocol_sap | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. ## What the statuses mean - Partly verified: Some information exists in the preserved review summary; detailed original materials remain unverified. This does not certify a passed review or clinical efficacy. - 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 ## Change history 2026-10-11 · Public page/materials 1.0. Public pages and materials were created from the existing 29 items. No new clinical search, verification-status change or scoring was performed.