Non-obligatory postcards × hospital-treated repeat-event counts: an evidence checklist

Required evidence, verification status and materials actually read
Item	AVerification status	BReading scope	CReview item	DCurrent findings	EWhy unverified	FRequired materials and conditions	GFurther research
1	Partly verified	Full text not readStored summary read	N01 · Evidence conditionDoes this checklist ask about fewer repeat events?Required	The selected existing question is ‘Fewer repeat events’. Its scope is non-obligatory postcards and repeat events after hospital-treated deliberate self-poisoning. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The final number of independent claims is not established.	Subclaim and parent questions, population, exposure, and repeat-event links	If the question actually changes, record the original question and exclusions separately.
2	Partly verified	Full text not readStored summary read	N02 · Evidence conditionAre the selected C grade and note distinct from the parent C56 and axes?Required	Preserve the selected subclaim grade C and note ‘There were 101 versus 192 events, IRR 0.55.’ Subclaim score, status, and axes are absent and remain null. The parent C56, Unknown safety, and axes are parent history. R01	Original preserved-summary statements were linked for production as partly verified; clinical verification and content review are not complete. The original materials contain no distinct subclaim score, status or axes.	Locations of actual and absent subclaim fields and original parent values	If original subclaim fields are added, separate the original version from the new event.
3	Partly verified	Full text not readStored summary read	N03 · Evidence conditionDo split coprimary outcomes and the past verdict constitute a current review?Required	Preserve the parent axis marking split coprimary outcomes as true, C56 based on those split outcomes, and the applied cross-check as original history. Also retain unrecorded values, false flags, and empty values in the other axes. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. No current RoB2, GRADE, evidence reassessment, or methodological certification has been performed.	Existing Korean and English text, axes, synthesis, and verdict and correction history	If new evidence is requested, retain the original version and a separate update event.
4	Partly verified	Full text not readStored summary read	N04 · Evidence conditionWhich materials were actually read, and which external materials remain unread?Required	The selected claim and the complete designated stored summary were read for production. External abstracts, full texts, registrations, and plans remain unread, and access was not attempted. R01 R02	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. External originals have not been read, and no current comprehensive literature search has been performed.	Acquisition and reading scope and original locations for summaries and external materials	If materials or reading records are provided, record only the actual level for that material entry.
5	Partly verified	Full text not readStored summary read	N05 · Evidence conditionWhat are the original bibliography and registration strings?Required	Preserve Carter 2005 Postcards from the EDge, PMID16183654, and ACTRN012605000050651 in the evidence list. The original registration identifier value for the Milner2015 review, PMID25733570, is ‘Not applicable’. R01 R02	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. DOI, PMCID, external registration content, and the unique trial count are unverified.	Original bibliography, registration and trial identity, and related reports	If the original list is provided, record reports and registrations and whether they belong to the same or different study families.
6	Partly verified	Full text not readStored summary read	N06 · Evidence conditionWho was recruited, and in what setting?Required	The original context is 772 participants aged 16 or older in Newcastle, Australia, after hospital-treated deliberate self-poisoning. These are not direct data for all self-harm or populations in other regions. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Detailed eligibility, baseline condition, and population composition are unverified.	Eligibility and exclusions, prior history, age and sex composition, and care setting	If original population data are provided, distinguish the selected population from gaps for other populations.
7	Partly verified	Full text not readStored summary read	N07 · Evidence conditionWhat was the original research exposure to non-obligatory postcards?Required	The original intervention was a research condition of 8 postcards requiring no reply sent over 12 months. It is not written as a method for a user's supportive actions or treatment. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Actual delivery and receipt and analytical details of contact timing and content are unverified.	Intervention version, planned and actual delivery, and participant contact records	If original exposure data are provided, distinguish planned and actual delivery and research conditions.
8	Partly verified	Full text not readStored summary read	N08 · Evidence conditionWhat were usual care and concurrent treatment or support?Required	The original comparison was postcards in 378 participants versus usual care in 394. The summary lacks details and balance of existing care, psychosocial support, medicines, and follow-up services in both groups. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Specific content and balance of usual care and concurrent exposures are unverified.	Usual-care content, shared and differing support, and concurrent treatment or contact	If original comparison data are provided, distinguish adding postcards from existing treatment conditions.
9	Partly verified	Full text not readStored summary read	N09 · Evidence conditionWhat were the allocation size and actual denominators for event analysis?Required	The original allocation size was 772: postcards 378 and usual care 394. These denominators are given for the proportion of people with repetition, but the effective number of participants and exposure time in the event model require separate verification. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The event model's actual effective denominator, exposure time, and missing-data handling are unverified.	Allocation, observation, completion, and event-model and person-analysis denominators	If original flow and analysis tables are provided, record denominators for person analyses and event and time analyses.
10	Partly verified	Full text not readStored summary read	N10 · Evidence conditionHow were repeat events defined, and what was counted?Required	The original scope was repeat hospital-treated deliberate self-poisoning events counted through a hospital administrative database. The summary lacks details of inclusion of the initial event and criteria for repetition. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The repeat-episode definition, index-event handling, ascertainment rules, and hospital coverage are unverified.	Event definition, same or separate episodes, ascertainment and timing, and counting scope	If original event definitions and data pathways are provided, distinguish repeat events from other outcomes.
11	Partly verified	Full text not readStored summary read	N11 · Evidence conditionWhat were the original total repeat-event counts?Required	Total repeat events were 101 with postcards versus 192 with usual care. Event counts use a different unit from the number of people with repetition. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Detailed counting and timing and the distribution by person are unverified.	Events and people, repeat and initial events, model inclusion and period, and counting rules	If the original event table is provided, distinguish event units from data by person and period.
12	Partly verified	Full text not readStored summary read	N12 · Evidence conditionWhat were the repeat-event IRR and interval?Required	Preserve the original repeat-event IRR0.55 (95% CI0.35–0.87). It is not the RR or OR of people with repetition or an individual's probability of preventing repetition. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Details of the model, exposure time and person denominator, and adjustment are unverified.	Original event-rate model, denominator and time, estimand and interval	If original methods are provided, link the IRR to the actual model, period, and denominator.
13	Unverified	Full text not readStored summary read	N13 · Evidence conditionWhat were the repeat-event model, estimand, overdispersion, and zero-event handling?Required	The original material gives event counts and IRR. The summary lacks the count-model type, individual observation time, correlation of repeated events and overdispersion, zero-event handling, and adjustment. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. The event model's specific methods, assumptions, and sensitivity analyses are unverified.	Original model, estimand, time offset, repeated and zero events, and sensitivity analyses	If the original SAP and methods are provided, distinguish counting from statistical assumptions.
14	Partly verified	Full text not readStored summary read	N14 · Evidence conditionWhat was the outcome for people with at least one repeat event?Supplementary	People with repetition were 57/378 (15.1%) versus 68/394 (17.3%), difference −2 percentage points (95% CI−7 to 3), the original null result. Preserve the D grade and note for the other repeater question as original context. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Details of person-outcome analysis, missing data, and adjustment are unverified.	Person-based criteria and time point, denominator, risk-difference definition, and interval	If the original person-outcome table is provided, distinguish first repetition and repeat-event counts and their denominators.
15	Partly verified	Full text not readStored summary read	N15 · Evidence conditionAre fewer events and fewer people with repetition different outcomes?Required	The original summary explains both results together: repeater prevalence did not fall, while total repeat events did. Its account of fewer episodes among a small group of repeaters is the original interpretation; no quantitative distribution is given. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The distribution by person and separate estimates for a high-frequency group are unverified.	Repeat-event distribution by person, initial and repeated events, and the two estimands	If original distribution and analysis data are provided, distinguish the original interpretation from direct subgroup and person effects.
16	Partly verified	Full text not readStored summary read	N16 · Evidence conditionHow were the two coprimary outcomes related in testing?Required	The original trial describes split results for the two coprimary outcomes: repeater prevalence and repeat events per person. The parent's true flag for split coprimary outcomes is also original history. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Prespecified success and multiplicity rules and direct registration and plan content are unverified.	Prespecified joint outcomes, success rules, multiplicity, and analysis hierarchy	If the original plan is provided, distinguish reported roles from the actual prespecified testing relationship.
17	Partly verified	Full text not readStored summary read	N17 · Evidence conditionWere registration, plans, and prespecified definitions actually read?Required	ACTRN012605000050651 is the original registration identifier in the evidence list. Registration, protocol, and SAP content, registration timing, and changes have not been read in this work. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Actual preregistration, plan, and change content is unverified.	Original registration timing, outcomes and events, model, and change records	If the original registration and plans are provided, record definitions at the time and reported results.
18	Partly verified	Full text not readStored summary read	N18 · Evidence conditionWhat was the original scope of administrative counting and blinding?Required	The existing counterview says administrative database counting limited the impact of unavoidable participant unblinding. Actual blinding of coders, adjudicators, and analysts is absent from the summary. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Coding validation, adjudicator and analyst blinding, and linkage completeness are unverified.	Counting and coding, blinding by role, linkage and misclassification, and data completeness	If original collection methods are provided, distinguish administrative counting from assessment by each role.
19	Unverified	Full text not readStored summary read	N19 · Evidence conditionHow were events outside hospital care or in other hospitals captured?Required	The original result is an administrative count of hospital-treated events. The summary lacks coverage of events without care, other hospitals or regions, and movement or migration. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Direct information on events without care or in other regions and data linkage and capture is unverified.	Data-network coverage, linkage, movement and migration, uncaptured events, and access to care	If original data pathways are provided, record observed hospital events and the scope of uncaptured events.
20	Unverified	Full text not readStored summary read	N20 · Evidence conditionWhat were the details of randomization, concealment, and baseline balance?Required	The original design was a randomized usual-care-controlled trial with 772 participants allocated 378/394. Sequence generation, concealment, stratification, and baseline balance are absent from the summary. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Allocation and concealment and balance in baseline event frequency are unverified.	Allocation process, concealment, baseline risk and past events, and group characteristics	If original methods and baseline tables are provided, distinguish the design label from the actual process.
21	Partly verified	Full text not readStored summary read	N21 · Evidence conditionWhat were the 12-month exposure and actual event follow-up window?Required	Preserve the original research condition of 8 postcards over 12 months. The summary lacks exact start and end of event counting, individual observation time, and follow-up after discontinuation. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Exact follow-up time and censoring for each event and person are unverified.	Exposure and follow-up windows, event timing, individual observation, and discontinuation or movement	If original timing and flow data are provided, distinguish intervention duration from actual analysis time.
22	Unverified	Full text not readStored summary read	N22 · Evidence conditionWhat were postcard receipt, attrition and missing data, and analysis populations?Required	Original allocation and the nominal intervention are available, but the summary lacks actual delivery and receipt, refusal and discontinuation, migration, missing data, and details of ITT and actual-exposure analyses. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Actual contact and adherence, attrition and missing data, and analysis definitions are unverified.	Exposure and analysis flow, discontinuation and non-delivery, missing data, and sensitivity analyses	If original flow and analyses are provided, distinguish allocation from actual contact and event-capture denominators.
23	Unverified	Full text not readStored summary read	N23 · Evidence conditionWhat were effects in frequent repeaters and groups by sex or baseline characteristics?Supplementary	The original interpretation describes fewer episodes among a small group of repeaters. Prespecified interactions and effects and denominators by high frequency, age and sex, or prior history are absent from the summary. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Direct values for the distribution by person and subgroup effect modification are unverified.	Subgroup definitions, distributions, prespecified hypotheses, and interactions and estimates	If original subgroup analyses are provided, distinguish the overall event model from direct results for separate groups.
24	Partly verified	Full text not readStored summary read	N24 · Evidence conditionDo hospital-event counts answer questions about mortality and all clinical outcomes?Supplementary	The existing counterview and product facts explicitly state that the trial did not demonstrate fewer suicide deaths. Fewer events refers to counts of hospital-treated repeat episodes. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Direct mortality and other clinical outcomes, scales, and intervals are unverified.	Direct mortality and other event outcomes, quality of life and function, and burden of care	If direct outcomes are provided, distinguish event counts from the scope of other clinical outcomes.
25	Partly verified	Full text not readStored summary read	N25 · Evidence conditionWhat were the clinical importance and threshold for fewer events?Required	Preserve the original IRR and interval and event and person outcomes. The summary lacks a clinically important event-reduction threshold or individual response criteria. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Prespecified clinical thresholds, individual importance, and direct absolute-difference intervals are unverified.	Originally planned effect size, clinical importance, and absolute and individual outcomes	If relevant plans and criteria are provided, distinguish statistical estimates from clinical scope.
26	Unverified	Full text not readStored summary read	N26 · Evidence conditionWhat were secondary or other outcomes and long-term persistence?Supplementary	The original summary contains only the two joint outcomes and safety and mortality limitations. Complete secondary outcomes, long-term or post-intervention outcomes, and outcomes of changes in existing treatment are absent. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. The complete secondary hierarchy and long-term and post-intervention persistence outcomes are unverified.	Secondary and exploratory outcome lists, discontinuation and long-term follow-up, and direct results	If materials are provided, distinguish joint outcomes from secondary and follow-up reports.
27	Partly verified	Full text not readStored summary read	N27 · Harm informationWhat was the original limitation concerning a separate adverse-event outcome?Supplementary	The original summary says there was no separate adverse-event outcome and safety was not adequately assessed. External original safety materials remain unread. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Direct safety collection, tables, and event values are unverified.	Safety-event definitions, systematic and spontaneous collection, severity, and discontinuation	If original safety materials are provided, distinguish collection, nonreporting, and unread status.
28	Unverified	Full text not readStored summary read	N28 · Harm informationWhat were the denominators for harm events, people, and time?Supplementary	The original allocation of 772 participants and repeat-event and person denominators concern efficacy outcomes. Actual person, time, and event denominators for harm collection are absent from the summary. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Actual harm denominators and event and time data are unverified.	Harm exposure and collection denominators, events and people, and follow-up time	If original safety denominators are provided, record them separately from efficacy denominators.
29	Unverified	Full text not readStored summary read	N29 · Harm informationWhat were the timing relationships of harm onset, discontinuation, and recovery?Supplementary	Only 12 months of contact exposure is an original condition. Harm onset, discontinuation, recovery, and individual observation windows are absent from the summary. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Harm timing, discontinuation and recovery, and observation are unverified.	Event timelines, exposure and discontinuation, recovery, and observation windows	If original timing records are provided, record temporal order of exposure and events and observation limitations.
30	Unverified	Full text not readStored summary read	N30 · Harm informationWhat were actual harm and safety differences versus usual care?Supplementary	The usual-care comparator and efficacy outcomes are available, but actual between-group comparisons of separate adverse events are absent from the summary. Mortality limitations also do not certify absence of harm. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Between-group safety estimates, CI, P, and other harms are unverified.	Between-group safety events, estimates and intervals, definitions, and denominators	If original safety comparisons are provided, distinguish effects and harms, statistical estimates, and original limitations.
31	Unverified	Full text not readStored summary read	N31 · Harm informationWhat were baseline risk, concurrent treatment, and other causes or exposures?Supplementary	Preserve the original population after hospital treatment and the usual-care comparison. Baseline risk, changes in concurrent support and treatment, and alternative explanations for safety events and attribution are absent from the summary. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Alternatives for safety and effect attribution and concurrent treatment details are unverified.	Baseline and concurrent exposure, actual support and treatment, event attribution, and alternatives	If original event and treatment data are provided, distinguish concurrent changes from attribution to the intervention.
32	Unverified	Full text not readStored summary read	N32 · Harm informationWhat were gaps in harm reporting and follow-up and completeness of collection?Supplementary	Administrative counting of hospital events is the original efficacy record. Missingness, discontinuation, reporting pathways, and completeness of separate safety collection are absent from the summary. R01	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Safety surveillance and missingness, loss, and discontinuation data are unverified.	Harm collection and surveillance, discontinuation and loss, and reporting and detection coverage	If original safety flow is provided, distinguish collection from uncaptured and unread information.
33	Unverified	Full text not readStored summary read	N33 · Harm informationDoes the evidence answer independent harm and long-term safety or safety in other populations?Supplementary	Original history records limitations of the separate safety outcome and no demonstrated mortality benefit. Independent harm-study families and direct long-term safety data or data for other populations are absent from the summary. R01 R02	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Independent replication of harms and long-term, rare-harm, and other-population safety are not established.	Unique safety reports and repeated citations, and suitable long-term and population-specific materials	If direct materials are provided, distinguish repeated citations from the same family from separate harm and population records.
34	Partly verified	Full text not readStored summary read	N34 · Harm informationWhat is the narrative scope for safety and clinical use?Supplementary	Preserve the parent's Unknown safety and the original review's conclusion that widespread clinical implementation could not be recommended. Do not turn the research summary into instructions for individual treatment, supportive actions, or repetition. R01 R02	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. There is no direct verification of widespread use, individual treatment selection, or overall safety.	Original scope of applicability and safety judgments and direct clinical outcomes	If new materials within the requested scope are provided, distinguish original research from separate applicability questions.
35	Partly verified	Full text not readStored summary read	N35 · Evidence conditionWere the contact interventions in the 14-trial review the same postcards?Supplementary	The Milner review covered 14 brief-contact trials combining letters, postcards, calls, and cards. It does not verify that all used the same protocol of 8 non-obligatory postcards over 12 months. R02	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Identities and conditions of included trials and inclusion and overlap of the postcard trial remain unread.	Included-study table, original interventions and comparators, populations and periods, and report families	If original inclusion materials are provided, distinguish mixed interventions from their relationship to the original postcard trial.
36	Partly verified	Full text not readStored summary read	N36 · Evidence conditionWhat was the review's OR for any repetition?Supplementary	The review's any-repetition OR0.87 (95% CI0.74–1.04) is the original null result. Its measure and aggregation differ from the person-level risk difference in the original postcard trial. R02	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Contributing trials and participants, model, and conditions for this outcome are unverified.	Contributing trials and person denominators, OR model, definitions and periods, and interval	If original review tables are provided, record contributing materials and measures for this outcome.
37	Partly verified	Full text not readStored summary read	N37 · Evidence conditionAre the review's suicide OR and event IRR the same outcome?Supplementary	The original review pattern is a null suicide OR0.58 (0.24–1.38) and fewer repeat episodes, IRR0.66 (0.54–0.80). Separate suicide, event, and person outcomes. R02	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Contributing data and aggregation, detailed interval confidence levels, and definitions are unverified.	Contributions and denominators by outcome, mortality definition, interval confidence level, and model	If original tables are provided, link each outcome, period, denominator, and uncertainty separately.
38	Unverified	Full text not readStored summary read	N38 · Evidence conditionWhat were the review's pooling model, heterogeneity, and subgroups?Supplementary	The review summarizes the same original pattern, but outcome-specific contributing subsets, pooling model, heterogeneity, and results by contact type and population are absent. R02	Required direct details are absent from the stored summary and remain unverified. External materials have not been read. The pooling model, quantitative heterogeneity, and outcome-specific subsets and group effects are unverified.	Included and contributing lists, model, results and heterogeneity by condition, and prespecified subgroups	If original review tables are provided, distinguish pooled estimates from the distribution of conditions by trial.
39	Partly verified	Full text not readStored summary read	N39 · Evidence conditionAre unique trials, populations, and independent replication established?Required	Preserve parent R1 and the original review's prohibition on double-counting synthesis evidence as history. Unique trial and participant counts are not established because included-study tables and report families have not been directly read. R01 R02	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Unique trials, participant and event totals, and independent replication are not established.	Unique families, original trials and review inclusion, repeated citations, and related reports	Proposal: If original lists are supplied, link each report to the same, different or uncertain study family.
40	Partly verified	Full text not readStored summary read	N40 · Evidence conditionWhat were support and sponsor roles in the original postcard trial?Required	The original summary describes public or nonprofit support from Hunter Area Health Service, NSW Health, and NHMRC. Detailed institutional roles in design, collection, analysis, manuscripts, and publication are absent. R01	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Specific sponsor roles, complete author COI, and data access are unverified.	Support and roles, data access, supply and services, and author declarations	If original declarations are provided, distinguish institutions, actual roles, and interests.
41	Partly verified	Full text not readStored summary read	N41 · Evidence conditionWhat were funding and author and report relationships in the review and original trials?Supplementary	The original review funding field says funding varied by original trial and synthesis evidence must not be double-counted. The review's own support, original declarations, and relationships among individual research teams have not been directly read in this work. R01 R02	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The review's own funding, complete COI, and relationships by trial are unverified.	Review support and COI, trial-specific roles, and author, report, and population relationships	If original declarations and inclusion tables are provided, record funding, author, and family relationships for each material.
42	Partly verified	Full text not readStored summary read	N42 · Evidence conditionAre the reference date, Korean and English text, corrections, empty values, and current production distinct?Required	Preserve the original reference date 2026-08-26, empty corrections array, empty deliberation string, Korean and English text, and true, false, null, and empty values in the parent axes. R01 R02	Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Separate evidence-cutoff and facet values are unrecorded, and no current correction or retraction search has been performed.	Original dates, languages, and corrections and current reading and update scope	If actual update materials are provided, separate the complete original version from change events.

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42 itemsWhat the statuses mean

Assessment scope

Stored-material review date: Not recorded
Original evidence cut-off: 2026-08-26
Scope actually checked: Existing review summaries and stored records of methodological application. Full papers, supplements, registrations, plans and original data were not read.
What the dates mean: This is the date the stored materials were checked, not the date of a new search of the clinical literature.
Population: Newcastle, Australia; 772 participants aged 16 or older after hospital-treated deliberate self-poisoning; detailed composition and eligibility unverified
Ingredient, formulation and route: Historical research exposure to non-obligatory postcards
Dose: Original condition of 8 postcards over 12 months; actual delivery, receipt, and discontinuation unverified. Not instructions for sending, support, or treatment.
Comparator: Usual care; shared care, support, medicines, and specific differences unverified
Measured outcome: Total hospital-treated repeat events and per-person event-model IRR; people with any repetition are a separate joint outcome
Duration: Context of a 12-month contact study; follow-up by person and outcome and long-term persistence unverified
Questions outside this scope: Converting fewer events into fewer repeaters or prevention of repetition for individuals; Extending hospital data to all events without care or other events; Mortality, other clinical outcomes, long-term benefit, or benefit in particular groups; Converting the mixed-contact review into the effect of identical postcards alone or independent replication; Methods of repetition or instructions for individual treatment or supportive actions

Evidence and sources

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

R01 · 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

Material type: Report of the Postcards from the EDge randomized usual-care-controlled trial
Materials actually read: Summary read; external abstracts and full texts not read
Findings recorded in the stored summary: Allocation: 772 participants (378/394). Repeat events: 101 versus 192, IRR0.55 (95% CI0.35–0.87). Any repetition: 57/378 (15.1%) versus 68/394 (17.3%), difference −2 percentage points (95% CI−7 to 3), a null result for the separate joint outcome. Safety and mortality benefit not verified.
Record level: Not recorded
Study overlap and independent replication: The original Carter trial involves the same people, repeat-event and person coprimary outcomes, and sibling, safety, and time-point contexts. These are not added as new participants or trials. The mixed-contact review is a report. Included-study tables and contributing subsets for its 14 original trials and overlap with the original postcard trial remain unread; the review is not double-counted as an independent trial.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Stored summary	Local preserved copy	Local preserved summary acquired	Summary read	The relevant evidence list, bibliography, and Korean and English narrative context from the complete designated stored summary were linked for production. This is not external original-text reading.
External abstract	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Only the original source link was preserved; no current abstract access or reading or link verification was performed.
External full text	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	The original source link connects bibliographic identity and does not mean direct full-text acquisition or reading.
External registration	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Only the original ACTRN string was preserved; registration content, timing, and prespecified plans remain unread.
Required materials: protocol or review plan	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Required scope: event definition and capture, model and time, denominators and missing data, joint hierarchy, actual postcards and existing care, safety, and support/COI; existence, public availability, and acquisition of original plans unverified.
Required material: SAP and analysis methods	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Event and person models, joint hierarchy, missing data and follow-up, or review pooling and contribution plans remain unread.
Required material: outcomes, denominators, and harms	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Outcome-specific events, people, time, flow, subgroup and safety data, or the review's included-study table are needed; other materials are not substituted.
Required materials: funding and COI	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Original sponsor roles, author disclosures, funding by original trial and for the review itself, and relationships have not been directly read.

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

Material type: Report of a systematic review and 14-trial meta-analysis of brief-contact interventions
Materials actually read: Summary read; external abstracts and full texts not read
Findings recorded in the stored summary: 14 trials of letters, postcards, calls, and cards. Any-repetition OR0.87 (95% CI0.74–1.04) and suicide OR0.58 (0.24–1.38) were original null results; repeat episodes declined, IRR0.66 (0.54–0.80). The original conclusion was that widespread clinical implementation could not be recommended.
Record level: Not recorded
Study overlap and independent replication: The original Carter trial involves the same people, repeat-event and person coprimary outcomes, and sibling, safety, and time-point contexts. These are not added as new participants or trials. The mixed-contact review is a report. Included-study tables and contributing subsets for its 14 original trials and overlap with the original postcard trial remain unread; the review is not double-counted as an independent trial.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Stored summary	Local preserved copy	Local preserved summary acquired	Summary read	The relevant evidence list, bibliography, and Korean and English narrative context from the complete designated stored summary were linked for production. This is not external original-text reading.
External abstract	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Only the original source link was preserved; no current abstract access or reading or link verification was performed.
External full text	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	The original source link connects bibliographic identity and does not mean direct full-text acquisition or reading.
External registration	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	The original registration identifier value ‘Not applicable’ is preserved; actual current existence and content of registrations and plans have not been verified.
Required materials: protocol or review plan	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Required scope: included and contributing subsets, interventions, populations and periods, unique families, pooling model and heterogeneity, and support/COI; existence, public availability, and acquisition of original plans unverified.
Required material: SAP and analysis methods	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Event and person models, joint hierarchy, missing data and follow-up, or review pooling and contribution plans remain unread.
Required material: outcomes, denominators, and harms	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Outcome-specific events, people, time, flow, subgroup and safety data, or the review's included-study table are needed; other materials are not substituted.
Required materials: funding and COI	Current public availability and detailed existence remain unverified	Access not attempted; not obtained	Not read	Original sponsor roles, author disclosures, funding by original trial and for the review itself, and relationships have not been directly read.

Report counts versus independent study counts

The original Carter trial involves the same people, repeat-event and person coprimary outcomes, and sibling, safety, and time-point contexts. These are not added as new participants or trials. The mixed-contact review is a report. Included-study tables and contributing subsets for its 14 original trials and overlap with the original postcard trial remain unread; the review is not double-counted as an independent trial.

Review criteria

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

N01 · Does this checklist ask about fewer repeat events?

Required materials and conditions: Subclaim and parent questions, population, exposure, and repeat-event links
Conditions for verification: Preserve the question and its link to the verdict record separately.
Requirement and applicability: Required
Application exceptions: Do not substitute the other repeater question for this outcome or create a new verdict or split.
Why this condition is needed: This condition records the original information and gaps for the question: Does this checklist ask about fewer repeat events?
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are our own design / M03 §3.2.4; our own extension boundary

N02 · Are the selected C grade and note distinct from the parent C56 and axes?

Required materials and conditions: Locations of actual and absent subclaim fields and original parent values
Conditions for verification: Distinguish the actual subclaim C grade from the parent context.
Requirement and applicability: Required
Application exceptions: Do not copy the other subclaim D or parent 56 points and E+/B0/R1/I2 as values specific to this selected row.
Why this condition is needed: This condition records the original information and gaps for the question: Are the selected C grade and note distinct from the parent C56 and axes?
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are our own design / M04 §4.5, §4.6.3; current material-conversion limits reflect review scope and our own design

N03 · Do split coprimary outcomes and the past verdict constitute a current review?

Required materials and conditions: Existing Korean and English text, axes, synthesis, and verdict and correction history
Conditions for verification: Distinguish original history from the incomplete original content review.
Requirement and applicability: Required
Application exceptions: Do not inherit B0, I2, or the cross-check as confirmation that all current conditions are met or that review has passed.
Why this condition is needed: This condition records the original information and gaps for the question: Do split coprimary outcomes and the past verdict constitute a current review?
Referenced methods: M04 §4.5, §4.6.3; current material-conversion limits reflect review scope and our own design / M08 Table 8.2.a, M04 §4.6.3; our own application

N04 · Which materials were actually read, and which external materials remain unread?

Required materials and conditions: Acquisition and reading scope and original locations for summaries and external materials
Conditions for verification: Distinguish reading the local summary from not reading external materials.
Requirement and applicability: Required
Application exceptions: Do not turn an existing URL or past research narrative into current full-text reading or failed access.
Why this condition is needed: This condition is needed to record original information and gaps separately for the question: Which materials were actually read, and which external materials remain unread?
Referenced methods: M04 §4.5–4.6 material-collection and selection principles; separation of access and reading and hyperlink rules are our own design / M04 §4.5, §4.6.3; current material-conversion limits reflect review scope and our own design

N05 · What are the original bibliography and registration strings?

Required materials and conditions: Original bibliography, registration and trial identity, and related reports
Conditions for verification: Preserve original bibliographic and registration identifiers and gaps in direct identity verification.
Requirement and applicability: Required
Application exceptions: Do not change the ACTRN record into a different identifier format or certify comprehensively that the review has no registration.
Why this condition is needed: This condition records the original information and gaps for the question: What are the original bibliography and registration strings?
Referenced methods: M04 §4.6.1–4.6.2 distinguish studies from reports; cohort and outcome links are our own application / M08 Table 8.2.a, M04 §4.6.3; our own application

N06 · Who was recruited, and in what setting?

Required materials and conditions: Eligibility and exclusions, prior history, age and sex composition, and care setting
Conditions for verification: Distinguish the original population and region from detailed applicability conditions.
Requirement and applicability: Required
Application exceptions: Do not extend the hospital-treated population to the same effect for all repetition or other risk populations.
Why this condition is needed: This condition records the original information and gaps for the question: Who was recruited, and in what setting?
Referenced methods: M03 §3.2.1; detailed population conditions are our own design / M03 §3.2.1–3.2.4; dose, persistence and effect-modification details are our own design

N07 · What was the original research exposure to non-obligatory postcards?

Required materials and conditions: Intervention version, planned and actual delivery, and participant contact records
Conditions for verification: Preserve only the original non-obligatory postcards, 8 cards, and 12 months as historical conditions.
Requirement and applicability: Required
Application exceptions: Do not turn the original exposure into postcard wording or instructions for sending, counselling, repetition, or treatment.
Why this condition is needed: This condition records the original information and gaps for the question: What was the original research exposure to non-obligatory postcards?
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction labeling and assessment adaptations are our own design / M03 §3.2.3, M08 §8.2.2–8.2.3; our own application

N08 · What were usual care and concurrent treatment or support?

Required materials and conditions: Usual-care content, shared and differing support, and concurrent treatment or contact
Conditions for verification: Retain the original comparator type and gaps in its actual content.
Requirement and applicability: Required
Application exceptions: Do not redefine usual care as no treatment or support or create instructions to replace treatment.
Why this condition is needed: This condition records the original information and gaps for the question: What were usual care and concurrent treatment or support?
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction labeling and assessment adaptations are our own design / M03 §3.2.3, M08 §8.2.2–8.2.3; our own application / M19 §19.2.2–19.2.4 design considerations; detailed confounding records are our own design

N09 · What were the allocation size and actual denominators for event analysis?

Required materials and conditions: Allocation, observation, completion, and event-model and person-analysis denominators
Conditions for verification: Distinguish allocation size from gaps in each analysis denominator.
Requirement and applicability: Required
Application exceptions: Do not copy 772 as the complete analysis denominator for all harms, secondary outcomes, or events.
Why this condition is needed: This condition records the original information and gaps for the question: What were the allocation size and actual denominators for event analysis?
Referenced methods: M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design / M08 §8.1–8.2.3; our own application

N10 · How were repeat events defined, and what was counted?

Required materials and conditions: Event definition, same or separate episodes, ascertainment and timing, and counting scope
Conditions for verification: Retain the original scope of hospital-treated events and unverified details.
Requirement and applicability: Required
Application exceptions: Do not extend counted events to all events without care, all self-harm, or mortality outcomes.
Why this condition is needed: This condition records the original information and gaps for the question: How were repeat events defined, and what was counted?
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M03 §3.2.4; our own application

N11 · What were the original total repeat-event counts?

Required materials and conditions: Events and people, repeat and initial events, model inclusion and period, and counting rules
Conditions for verification: Keep original event counts separate from person outcomes.
Requirement and applicability: Required
Application exceptions: Do not express 101/192 as counts of different people or newly calculate totals or means.
Why this condition is needed: This condition records the original information and gaps for the question: What were the original total repeat-event counts?
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

N12 · What were the repeat-event IRR and interval?

Required materials and conditions: Original event-rate model, denominator and time, estimand and interval
Conditions for verification: Attribute the original IRR and 95% CI only to the event outcome.
Requirement and applicability: Required
Application exceptions: Do not newly calculate IRR, CI, or P from the original event counts or convert them into a person-level risk effect.
Why this condition is needed: This condition records the original information and gaps for the question: What were the repeat-event IRR and interval?
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are our own design / M15 §15.3.1–15.3.3; our own application

N13 · What were the repeat-event model, estimand, overdispersion, and zero-event handling?

Required materials and conditions: Original model, estimand, time offset, repeated and zero events, and sensitivity analyses
Conditions for verification: Distinguish the original estimate from gaps in direct model information.
Requirement and applicability: Required
Application exceptions: Do not infer a particular model or complete handling of repetition and missing data solely from the IRR notation.
Why this condition is needed: This condition records the original information and gaps for the question: What were the repeat-event model, estimand, overdispersion, and zero-event handling?
Referenced methods: M08 §8.2.2, M15 §15.3.1; our own application / M15 §15.3.1–15.3.3; our own application / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

N14 · What was the outcome for people with at least one repeat event?

Required materials and conditions: Person-based criteria and time point, denominator, risk-difference definition, and interval
Conditions for verification: Retain the original person counts and denominators, percentage points, CI, and null result together.
Requirement and applicability: Supplementary
Application exceptions: Do not erase the person outcome because the event result is positive or newly calculate the original proportions or risk difference.
Why this condition is needed: This condition records the original information and gaps for the question: What was the outcome for people with at least one repeat event?
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design / M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is our own design

N15 · Are fewer events and fewer people with repetition different outcomes?

Required materials and conditions: Repeat-event distribution by person, initial and repeated events, and the two estimands
Conditions for verification: Maintain the boundary between the original positive event result and null person result.
Requirement and applicability: Required
Application exceptions: Do not extend fewer events into a result that repetition was prevented for individuals or the whole population.
Why this condition is needed: This condition records the original information and gaps for the question: Are fewer events and fewer people with repetition different outcomes?
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are our own design / M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is our own design / M03 §3.2.4; our own extension boundary

N16 · How were the two coprimary outcomes related in testing?

Required materials and conditions: Prespecified joint outcomes, success rules, multiplicity, and analysis hierarchy
Conditions for verification: Distinguish the original account of split outcomes from unread plans.
Requirement and applicability: Required
Application exceptions: Do not certify success on all coprimary outcomes or create a new grade based on one positive outcome.
Why this condition is needed: This condition records the original information and gaps for the question: How were the two coprimary outcomes related in testing?
Referenced methods: M08 Table 8.2.a, M04 §4.6.3; our own application / M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is our own design

N17 · Were registration, plans, and prespecified definitions actually read?

Required materials and conditions: Original registration timing, outcomes and events, model, and change records
Conditions for verification: Retain the original identifier and the external unread status.
Requirement and applicability: Required
Application exceptions: Do not elevate a registration string into certification of unique trial identity or prespecification.
Why this condition is needed: This condition records the original information and gaps for the question: Were registration, plans, and prespecified definitions actually read?
Referenced methods: M04 §4.5–4.6 provide collection and selection principles; separating access from reading and the hyperlink convention are our own design / M08 Table 8.2.a, M04 §4.6.3; our own application

N18 · What was the original scope of administrative counting and blinding?

Required materials and conditions: Counting and coding, blinding by role, linkage and misclassification, and data completeness
Conditions for verification: Retain the original measurement strength and gaps in direct process information together.
Requirement and applicability: Required
Application exceptions: Do not certify no bias or complete event ascertainment merely because administrative data were used.
Why this condition is needed: This condition records the original information and gaps for the question: What was the original scope of administrative counting and blinding?
Referenced methods: M08 Table 8.2.a, M03 §3.2.4; our own application / M08 §8.1–8.2.3; our own application

N19 · How were events outside hospital care or in other hospitals captured?

Required materials and conditions: Data-network coverage, linkage, movement and migration, uncaptured events, and access to care
Conditions for verification: Distinguish actual counting coverage from gaps in uncaptured events.
Requirement and applicability: Required
Application exceptions: Do not automatically repurpose administrative events as the total number of all repeat events.
Why this condition is needed: This condition records the original information and gaps for the question: How were events outside hospital care or in other hospitals captured?
Referenced methods: M08 Table 8.2.a, M03 §3.2.4; our own application / M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

N20 · What were the details of randomization, concealment, and baseline balance?

Required materials and conditions: Allocation process, concealment, baseline risk and past events, and group characteristics
Conditions for verification: Separate the original allocation from gaps in direct process information.
Requirement and applicability: Required
Application exceptions: Do not declare all design conditions met based on B0 or the randomized label.
Why this condition is needed: This condition records the original information and gaps for the question: What were the details of randomization, concealment, and baseline balance?
Referenced methods: M08 §8.1–8.2.3; our own application / M03 §3.2.1; detailed population conditions are our own design

N21 · What were the 12-month exposure and actual event follow-up window?

Required materials and conditions: Exposure and follow-up windows, event timing, individual observation, and discontinuation or movement
Conditions for verification: Distinguish the original period from gaps in direct follow-up and model time.
Requirement and applicability: Required
Application exceptions: Do not turn the original 12 months into complete fixed observation for every person and outcome.
Why this condition is needed: This condition records the original information and gaps for the question: What were the 12-month exposure and actual event follow-up window?
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design / M03 §3.2.1–3.2.4; details of dose, duration, and effect modification are our own design / M19 §19.2 concerns harm questions by study design; temporal-relationship details are our own design

N22 · What were postcard receipt, attrition and missing data, and analysis populations?

Required materials and conditions: Exposure and analysis flow, discontinuation and non-delivery, missing data, and sensitivity analyses
Conditions for verification: Retain original conditions and gaps in actual exposure and analysis.
Requirement and applicability: Required
Application exceptions: Do not turn the nominal 8 cards into actual receipt by every person or complete follow-up with zero missing data.
Why this condition is needed: This condition records the original information and gaps for the question: What were postcard receipt, attrition and missing data, and analysis populations?
Referenced methods: M08 §8.2.2, M15 §15.3.1; our own application / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

N23 · What were effects in frequent repeaters and groups by sex or baseline characteristics?

Required materials and conditions: Subgroup definitions, distributions, prespecified hypotheses, and interactions and estimates
Conditions for verification: Distinguish original interpretation from gaps in direct subgroup evidence.
Requirement and applicability: Supplementary
Application exceptions: Do not invent effects or recommended populations for particular sexes or frequent repeaters from the original description of a small group.
Why this condition is needed: This condition records the original information and gaps for the question: What were effects in frequent repeaters and groups by sex or baseline characteristics?
Referenced methods: M03 §3.2.1; detailed population conditions are our own design / M03 §3.2.1–3.2.4; dose, persistence and effect-modification details are our own design

N24 · Do hospital-event counts answer questions about mortality and all clinical outcomes?

Required materials and conditions: Direct mortality and other event outcomes, quality of life and function, and burden of care
Conditions for verification: Maintain original hospital repeat events and separate gaps in clinical outcomes.
Requirement and applicability: Supplementary
Application exceptions: Do not extend fewer events into prevention of mortality, all repetition, or individual clinical benefit.
Why this condition is needed: This condition records the original information and gaps for the question: Do hospital-event counts answer questions about mortality and all clinical outcomes?
Referenced methods: M03 §3.2.4; our own boundary on extensions / M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design

N25 · What were the clinical importance and threshold for fewer events?

Required materials and conditions: Originally planned effect size, clinical importance, and absolute and individual outcomes
Conditions for verification: Distinguish original estimates from gaps in importance criteria.
Requirement and applicability: Required
Application exceptions: Do not convert IRR or counts into new success thresholds, effects, or individual probabilities.
Why this condition is needed: This condition records the original information and gaps for the question: What were the clinical importance and threshold for fewer events?
Referenced methods: M15 §15.3.1–15.3.3; our own application / M03 §3.2.4; our own boundary on extensions

N26 · What were secondary or other outcomes and long-term persistence?

Required materials and conditions: Secondary and exploratory outcome lists, discontinuation and long-term follow-up, and direct results
Conditions for verification: Maintain gaps in outcomes and persistence outside the original scope.
Requirement and applicability: Supplementary
Application exceptions: Do not turn the repeat-event signal into persistence after intervention ends or benefit from replacing treatment.
Why this condition is needed: This condition records the original information and gaps for the question: What were secondary or other outcomes and long-term persistence?
Referenced methods: M08 Table 8.2.a, M04 §4.6.3; our own application / M03 §3.2.1–3.2.4; details of dose, duration, and effect modification are our own design / M03 §3.2.4; our own boundary on extensions

N27 · What was the original limitation concerning a separate adverse-event outcome?

Required materials and conditions: Safety-event definitions, systematic and spontaneous collection, severity, and discontinuation
Conditions for verification: Distinguish original safety-information limitations from currently unread external materials.
Requirement and applicability: Supplementary
Application exceptions: Do not convert no separate outcome or unread status into zero adverse events or a safe intervention.
Why this condition is needed: This condition records the original information and gaps for the question: What was the original limitation concerning a separate adverse-event outcome?
Referenced methods: M19 §19.1.2–19.2.4; detailed distinctions are our own design / M19 §19.1.2–19.2.4; our own application

N28 · What were the denominators for harm events, people, and time?

Required materials and conditions: Harm exposure and collection denominators, events and people, and follow-up time
Conditions for verification: Distinguish gaps in harm denominators from event and person efficacy.
Requirement and applicability: Supplementary
Application exceptions: Do not newly calculate harm incidence from efficacy-event or allocation denominators.
Why this condition is needed: This condition records the original information and gaps for the question: What were the denominators for harm events, people, and time?
Referenced methods: M19 §19.1.2–19.2.4; our own application / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

N29 · What were the timing relationships of harm onset, discontinuation, and recovery?

Required materials and conditions: Event timelines, exposure and discontinuation, recovery, and observation windows
Conditions for verification: Distinguish original exposure time from gaps in direct safety timing.
Requirement and applicability: Supplementary
Application exceptions: Do not establish causality or absence of harm from a single time condition.
Why this condition is needed: This condition records the original information and gaps for the question: What were the timing relationships of harm onset, discontinuation, and recovery?
Referenced methods: M19 §19.2 concerns harm questions by study design; temporal-relationship details are our own design / M19 §19.1.2–19.2.4; our own application

N30 · What were actual harm and safety differences versus usual care?

Required materials and conditions: Between-group safety events, estimates and intervals, definitions, and denominators
Conditions for verification: Distinguish the efficacy comparator from gaps in direct harm comparison.
Requirement and applicability: Supplementary
Application exceptions: Do not turn no difference in repeaters and fewer events into no difference in all harms or absence of harm.
Why this condition is needed: This condition records the original information and gaps for the question: What were actual harm and safety differences versus usual care?
Referenced methods: M19 §19.2.2–19.2.4, M03 §3.2.3; our own application / Chamgap interpretation boundary. It refers to M19 principles and does not constitute use of an official causality tool

N31 · What were baseline risk, concurrent treatment, and other causes or exposures?

Required materials and conditions: Baseline and concurrent exposure, actual support and treatment, event attribution, and alternatives
Conditions for verification: Retain original conditions and gaps in alternative explanations.
Requirement and applicability: Supplementary
Application exceptions: Do not establish that there were no other exposures or that all changes were caused by postcards.
Why this condition is needed: This condition records the original information and gaps for the question: What were baseline risk, concurrent treatment, and other causes or exposures?
Referenced methods: M19 §19.2.2–19.2.4 design considerations; detailed confounding records are our own design / M03 §3.2.3, M08 §8.2.2–8.2.3; our own application

N32 · What were gaps in harm reporting and follow-up and completeness of collection?

Required materials and conditions: Harm collection and surveillance, discontinuation and loss, and reporting and detection coverage
Conditions for verification: Do not convert limitations in harm reporting into zero events.
Requirement and applicability: Supplementary
Application exceptions: Do not guarantee complete safety collection from administrative efficacy counts.
Why this condition is needed: This condition records the original information and gaps for the question: What were gaps in harm reporting and follow-up and completeness of collection?
Referenced methods: M19 §19.1.2–19.2.4, M04 §4.6.3; our own application / M08 §8.2.2, M15 §15.3.1; our own application

N33 · Does the evidence answer independent harm and long-term safety or safety in other populations?

Required materials and conditions: Unique safety reports and repeated citations, and suitable long-term and population-specific materials
Conditions for verification: Retain original limitations and gaps in extensions of safety.
Requirement and applicability: Supplementary
Application exceptions: Do not add reviews, the same population, or sibling outcomes as independent harm replication or overall safety.
Why this condition is needed: This condition records the original information and gaps for the question: Does the evidence answer independent harm and long-term safety or safety in other populations?
Referenced methods: M04 §4.6.1–4.6.2; harm-material adaptations are our own design / M19 §19.1.2–19.2.4; our own application / M03 §3.2.1–3.2.4; details of dose, duration, and effect modification are our own design

N34 · What is the narrative scope for safety and clinical use?

Required materials and conditions: Original scope of applicability and safety judgments and direct clinical outcomes
Conditions for verification: Distinguish original research scope from user actions and treatment implementation.
Requirement and applicability: Supplementary
Application exceptions: Do not create new safety grades, causal certification, methods of repetition, or treatment or supportive-action guidance.
Why this condition is needed: This condition records the original information and gaps for the question: What is the narrative scope for safety and clinical use?
Referenced methods: Chamgap interpretation boundary. It refers to M19 principles and does not constitute use of an official causality tool / M03 §3.2.4; our own boundary on extensions

N35 · Were the contact interventions in the 14-trial review the same postcards?

Required materials and conditions: Included-study table, original interventions and comparators, populations and periods, and report families
Conditions for verification: Distinguish the class review from gaps in direct postcard comparisons.
Requirement and applicability: Supplementary
Application exceptions: Do not add the review's 14 trials to the original trial or repurpose mixed interventions as the effect of identical postcards alone.
Why this condition is needed: This condition records the original information and gaps for the question: Were the contact interventions in the 14-trial review the same postcards?
Referenced methods: M04 §4.6.1–4.6.2 distinguish studies from reports; cohort and outcome links are our own application / M03 §3.2.2–3.2.3; adaptations for reverse-direction markers and tests are our own design / M04 §4.6.1–4.6.2, M15 §15.3.1; our own application

N36 · What was the review's OR for any repetition?

Required materials and conditions: Contributing trials and person denominators, OR model, definitions and periods, and interval
Conditions for verification: Keep the original OR, interval, and null result in the separate review context of person outcomes.
Requirement and applicability: Supplementary
Application exceptions: Do not turn OR into IRR, RR, or a direct postcard effect or add it to the original risk difference.
Why this condition is needed: This condition records the original information and gaps for the question: What was the review's OR for any repetition?
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are our own design / M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is our own design / M15 §15.3.1–15.3.3; our own application

N37 · Are the review's suicide OR and event IRR the same outcome?

Required materials and conditions: Contributions and denominators by outcome, mortality definition, interval confidence level, and model
Conditions for verification: Preserve both original measures and intervals and their differing directions together.
Requirement and applicability: Supplementary
Application exceptions: Do not turn a lower event IRR into fewer deaths or a direct mortality result from the original trial.
Why this condition is needed: This condition records the original information and gaps for the question: Are the review's suicide OR and event IRR the same outcome?
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are our own design / M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is our own design / M03 §3.2.4; our own extension boundary

N38 · What were the review's pooling model, heterogeneity, and subgroups?

Required materials and conditions: Included and contributing lists, model, results and heterogeneity by condition, and prespecified subgroups
Conditions for verification: Maintain the original synthesis and direct gaps in conditions and models.
Requirement and applicability: Supplementary
Application exceptions: Do not declare that all 14 trials contributed to every outcome, had the same effect, or used the same period.
Why this condition is needed: This condition records the original information and gaps for the question: What were the review's pooling model, heterogeneity, and subgroups?
Referenced methods: M04 §4.6.1–4.6.2, M15 §15.3.1; our own application / M08 §8.2.2, M15 §15.3.1; our own application / M03 §3.2.1–3.2.4; dose, persistence and effect-modification details are our own design

N39 · Are unique trials, populations, and independent replication established?

Required materials and conditions: Unique families, original trials and review inclusion, repeated citations, and related reports
Conditions for verification: Distinguish the number of report entries from unrecorded unique totals.
Requirement and applicability: Required
Application exceptions: Do not count reviews, original trials, documents, sibling tables, or repeated events as independent trials.
Why this condition is needed: This condition records the original information and gaps for the question: Are unique trials, populations, and independent replication established?
Referenced methods: M04 §4.6.1–4.6.2 distinction between studies and reports; cohort and outcome linking is our own application / M04 §4.6.1–4.6.2, M15 §15.3.1; our own application / M04 §4.6.1–4.6.2; harm-material adaptations are our own design

N40 · What were support and sponsor roles in the original postcard trial?

Required materials and conditions: Support and roles, data access, supply and services, and author declarations
Conditions for verification: Preserve original support and gaps in roles together.
Requirement and applicability: Required
Application exceptions: Do not turn public support or I2 into current independence review or certification of no interests.
Why this condition is needed: This condition records the original information and gaps for the question: What were support and sponsor roles in the original postcard trial?
Referenced methods: CHAMGAP's own independence and attribution conditions. Official methodological sections used in this pilot do not guarantee every detail of this item / M04 §4.6.1–4.6.2, M15 §15.3.1; our own application

N41 · What were funding and author and report relationships in the review and original trials?

Required materials and conditions: Review support and COI, trial-specific roles, and author, report, and population relationships
Conditions for verification: Distinguish original funding language from gaps in direct relationship information.
Requirement and applicability: Supplementary
Application exceptions: Do not certify independence of teams or populations from bibliographic names or the same pattern alone.
Why this condition is needed: This condition records the original information and gaps for the question: What were funding and author and report relationships in the review and original trials?
Referenced methods: CHAMGAP's own independence and attribution conditions. Official methodological sections used in this pilot do not guarantee every detail of this item / M04 §4.6.1–4.6.2 distinction between studies and reports; cohort and outcome linking is our own application

N42 · Are the reference date, Korean and English text, corrections, empty values, and current production distinct?

Required materials and conditions: Original dates, languages, and corrections and current reading and update scope
Conditions for verification: Retain original history and the incomplete original content review together.
Requirement and applicability: Required
Application exceptions: Do not reuse the original date or cross-check as a current clinical verification date or treat an empty corrections array as comprehensive certification of absence.
Why this condition is needed: This condition records the original information and gaps for the question: Are the reference date, Korean and English text, corrections, empty values, and current production distinct?
Referenced methods: M04 §4.5, §4.6.3; current material-conversion limits reflect review scope and our own design / M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are our own design

Referenced methods and the sections actually reviewed

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

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

Referenced principle: Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.
Extent of review: Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work.

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

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

Referenced principle: Distinguish studies from reports and link them; do not omit a study solely because results are unreported.
Extent of review: Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work.

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

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

Referenced principle: Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.
Extent of review: Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work.

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

Official methodology · §15.2.4, §15.3.1–15.3.3

Referenced principle: Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.
Extent of review: Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work.

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

Official methodology · §19.1.2, §19.2.1–19.2.4

Referenced principle: Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.
Extent of review: Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work.

What the statuses mean

Met: The original content has been reviewed as meeting the conditions. This status is not used in this preparation.
Partly verified: Some information in the stored summary was linked during preparation; clinical verification or review is not complete.
Unverified: Required direct values, definitions or materials have not been established within the current storage and reading scope. This does not mean zero effect, no papers or failed access.
Review incomplete: Review of existing content or actual review incomplete.
Not reported: Used only when original materials were actually read and the outcome was judged unreported. Not used for external materials unread in this work.
Inaccessible: Used only when an actual access attempt has a recorded failure. Not used for access that was not attempted in this work.
Insufficient evidence for the conditions: Indicates insufficient direct materials for the relevant scope or conditions; it is not a new grade.
Not applicable: Used when the reason it does not apply to the original question is stated.
Conflicting data: Retains the scope of conflicting statements in original materials; it is not an arbitrary reassessment.

Change history

2026-10-11 · Public page/material version 1.0

Public pages and materials were created from the existing 42 items. No new clinical search, verification-status change, or scoring was performed.

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

Researcher downloads

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

View all item details

N01 · Does this checklist ask about fewer repeat events?

Current findings: The selected existing question is ‘Fewer repeat events’. Its scope is non-obligatory postcards and repeat events after hospital-treated deliberate self-poisoning.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The final number of independent claims is not established.
Reason for missing information: The final number of independent claims is not established.
Required materials and conditions: Subclaim and parent questions, population, exposure, and repeat-event links
Materials to obtain first: Subclaim and parent questions, population, exposure, and repeat-event links
Further research: If the question actually changes, record the original question and exclusions separately.
Remaining uncertainty: Do not substitute the other repeater question for this outcome or create a new verdict or split. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Preserve the question and its link to the verdict record separately.
Why this condition is needed: This condition records the original information and gaps for the question: Does this checklist ask about fewer repeat events?
Application exceptions: Do not substitute the other repeater question for this outcome or create a new verdict or split.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are our own design / M03 §3.2.4; our own extension boundary

Related sources R01

N02 · Are the selected C grade and note distinct from the parent C56 and axes?

Current findings: Preserve the selected subclaim grade C and note ‘There were 101 versus 192 events, IRR 0.55.’ Subclaim score, status, and axes are absent and remain null. The parent C56, Unknown safety, and axes are parent history.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Original preserved-summary statements were linked for production as partly verified; clinical verification and content review are not complete. The original materials contain no distinct subclaim score, status or axes.
Reason for missing information: The original materials contain no distinct subclaim score, status or axes.
Required materials and conditions: Locations of actual and absent subclaim fields and original parent values
Materials to obtain first: Locations of actual and absent subclaim fields and original parent values
Further research: If original subclaim fields are added, separate the original version from the new event.
Remaining uncertainty: Do not copy the other subclaim D or parent 56 points and E+/B0/R1/I2 as values specific to this selected row. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish the actual subclaim C grade from the parent context.
Why this condition is needed: This condition records the original information and gaps for the question: Are the selected C grade and note distinct from the parent C56 and axes?
Application exceptions: Do not copy the other subclaim D or parent 56 points and E+/B0/R1/I2 as values specific to this selected row.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are our own design / M04 §4.5, §4.6.3; current material-conversion limits reflect review scope and our own design

Related sources R01

N03 · Do split coprimary outcomes and the past verdict constitute a current review?

Current findings: Preserve the parent axis marking split coprimary outcomes as true, C56 based on those split outcomes, and the applied cross-check as original history. Also retain unrecorded values, false flags, and empty values in the other axes.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. No current RoB2, GRADE, evidence reassessment, or methodological certification has been performed.
Reason for missing information: No current RoB2, GRADE, evidence reassessment, or methodological certification has been performed.
Required materials and conditions: Existing Korean and English text, axes, synthesis, and verdict and correction history
Materials to obtain first: Existing Korean and English text, axes, synthesis, and verdict and correction history
Further research: If new evidence is requested, retain the original version and a separate update event.
Remaining uncertainty: Do not inherit B0, I2, or the cross-check as confirmation that all current conditions are met or that review has passed. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish original history from the incomplete original content review.
Why this condition is needed: This condition records the original information and gaps for the question: Do split coprimary outcomes and the past verdict constitute a current review?
Application exceptions: Do not inherit B0, I2, or the cross-check as confirmation that all current conditions are met or that review has passed.
Referenced methods: M04 §4.5, §4.6.3; current material-conversion limits reflect review scope and our own design / M08 Table 8.2.a, M04 §4.6.3; our own application

Related sources R01

N04 · Which materials were actually read, and which external materials remain unread?

Current findings: The selected claim and the complete designated stored summary were read for production. External abstracts, full texts, registrations, and plans remain unread, and access was not attempted.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. External originals have not been read, and no current comprehensive literature search has been performed.
Reason for missing information: External originals have not been read, and no current comprehensive literature search has been performed.
Required materials and conditions: Acquisition and reading scope and original locations for summaries and external materials
Materials to obtain first: Acquisition and reading scope and original locations for summaries and external materials
Further research: If materials or reading records are provided, record only the actual level for that material entry.
Remaining uncertainty: Do not turn an existing URL or past research narrative into current full-text reading or failed access. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish reading the local summary from not reading external materials.
Why this condition is needed: This condition is needed to record original information and gaps separately for the question: Which materials were actually read, and which external materials remain unread?
Application exceptions: Do not turn an existing URL or past research narrative into current full-text reading or failed access.
Referenced methods: M04 §4.5–4.6 material-collection and selection principles; separation of access and reading and hyperlink rules are our own design / M04 §4.5, §4.6.3; current material-conversion limits reflect review scope and our own design

Related sources R01 R02

N05 · What are the original bibliography and registration strings?

Current findings: Preserve Carter 2005 Postcards from the EDge, PMID16183654, and ACTRN012605000050651 in the evidence list. The original registration identifier value for the Milner2015 review, PMID25733570, is ‘Not applicable’.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. DOI, PMCID, external registration content, and the unique trial count are unverified.
Reason for missing information: DOI, PMCID, external registration content, and the unique trial count are unverified.
Required materials and conditions: Original bibliography, registration and trial identity, and related reports
Materials to obtain first: Original bibliography, registration and trial identity, and related reports
Further research: If the original list is provided, record reports and registrations and whether they belong to the same or different study families.
Remaining uncertainty: Do not change the ACTRN record into a different identifier format or certify comprehensively that the review has no registration. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Preserve original bibliographic and registration identifiers and gaps in direct identity verification.
Why this condition is needed: This condition records the original information and gaps for the question: What are the original bibliography and registration strings?
Application exceptions: Do not change the ACTRN record into a different identifier format or certify comprehensively that the review has no registration.
Referenced methods: M04 §4.6.1–4.6.2 distinguish studies from reports; cohort and outcome links are our own application / M08 Table 8.2.a, M04 §4.6.3; our own application

Related sources R01 R02

N06 · Who was recruited, and in what setting?

Current findings: The original context is 772 participants aged 16 or older in Newcastle, Australia, after hospital-treated deliberate self-poisoning. These are not direct data for all self-harm or populations in other regions.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Detailed eligibility, baseline condition, and population composition are unverified.
Reason for missing information: Detailed eligibility, baseline condition, and population composition are unverified.
Required materials and conditions: Eligibility and exclusions, prior history, age and sex composition, and care setting
Materials to obtain first: Eligibility and exclusions, prior history, age and sex composition, and care setting
Further research: If original population data are provided, distinguish the selected population from gaps for other populations.
Remaining uncertainty: Do not extend the hospital-treated population to the same effect for all repetition or other risk populations. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish the original population and region from detailed applicability conditions.
Why this condition is needed: This condition records the original information and gaps for the question: Who was recruited, and in what setting?
Application exceptions: Do not extend the hospital-treated population to the same effect for all repetition or other risk populations.
Referenced methods: M03 §3.2.1; detailed population conditions are our own design / M03 §3.2.1–3.2.4; dose, persistence and effect-modification details are our own design

Related sources R01

N07 · What was the original research exposure to non-obligatory postcards?

Current findings: The original intervention was a research condition of 8 postcards requiring no reply sent over 12 months. It is not written as a method for a user's supportive actions or treatment.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Actual delivery and receipt and analytical details of contact timing and content are unverified.
Reason for missing information: Actual delivery and receipt and analytical details of contact timing and content are unverified.
Required materials and conditions: Intervention version, planned and actual delivery, and participant contact records
Materials to obtain first: Intervention version, planned and actual delivery, and participant contact records
Further research: If original exposure data are provided, distinguish planned and actual delivery and research conditions.
Remaining uncertainty: Do not turn the original exposure into postcard wording or instructions for sending, counselling, repetition, or treatment. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Preserve only the original non-obligatory postcards, 8 cards, and 12 months as historical conditions.
Why this condition is needed: This condition records the original information and gaps for the question: What was the original research exposure to non-obligatory postcards?
Application exceptions: Do not turn the original exposure into postcard wording or instructions for sending, counselling, repetition, or treatment.
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction labeling and assessment adaptations are our own design / M03 §3.2.3, M08 §8.2.2–8.2.3; our own application

Related sources R01

N08 · What were usual care and concurrent treatment or support?

Current findings: The original comparison was postcards in 378 participants versus usual care in 394. The summary lacks details and balance of existing care, psychosocial support, medicines, and follow-up services in both groups.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Specific content and balance of usual care and concurrent exposures are unverified.
Reason for missing information: Specific content and balance of usual care and concurrent exposures are unverified.
Required materials and conditions: Usual-care content, shared and differing support, and concurrent treatment or contact
Materials to obtain first: Usual-care content, shared and differing support, and concurrent treatment or contact
Further research: If original comparison data are provided, distinguish adding postcards from existing treatment conditions.
Remaining uncertainty: Do not redefine usual care as no treatment or support or create instructions to replace treatment. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Retain the original comparator type and gaps in its actual content.
Why this condition is needed: This condition records the original information and gaps for the question: What were usual care and concurrent treatment or support?
Application exceptions: Do not redefine usual care as no treatment or support or create instructions to replace treatment.
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction labeling and assessment adaptations are our own design / M03 §3.2.3, M08 §8.2.2–8.2.3; our own application / M19 §19.2.2–19.2.4 design considerations; detailed confounding records are our own design

Related sources R01

N09 · What were the allocation size and actual denominators for event analysis?

Current findings: The original allocation size was 772: postcards 378 and usual care 394. These denominators are given for the proportion of people with repetition, but the effective number of participants and exposure time in the event model require separate verification.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The event model's actual effective denominator, exposure time, and missing-data handling are unverified.
Reason for missing information: The event model's actual effective denominator, exposure time, and missing-data handling are unverified.
Required materials and conditions: Allocation, observation, completion, and event-model and person-analysis denominators
Materials to obtain first: Allocation, observation, completion, and event-model and person-analysis denominators
Further research: If original flow and analysis tables are provided, record denominators for person analyses and event and time analyses.
Remaining uncertainty: Do not copy 772 as the complete analysis denominator for all harms, secondary outcomes, or events. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish allocation size from gaps in each analysis denominator.
Why this condition is needed: This condition records the original information and gaps for the question: What were the allocation size and actual denominators for event analysis?
Application exceptions: Do not copy 772 as the complete analysis denominator for all harms, secondary outcomes, or events.
Referenced methods: M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design / M08 §8.1–8.2.3; our own application

Related sources R01

N10 · How were repeat events defined, and what was counted?

Current findings: The original scope was repeat hospital-treated deliberate self-poisoning events counted through a hospital administrative database. The summary lacks details of inclusion of the initial event and criteria for repetition.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The repeat-episode definition, index-event handling, ascertainment rules, and hospital coverage are unverified.
Reason for missing information: The repeat-episode definition, index-event handling, ascertainment rules, and hospital coverage are unverified.
Required materials and conditions: Event definition, same or separate episodes, ascertainment and timing, and counting scope
Materials to obtain first: Event definition, same or separate episodes, ascertainment and timing, and counting scope
Further research: If original event definitions and data pathways are provided, distinguish repeat events from other outcomes.
Remaining uncertainty: Do not extend counted events to all events without care, all self-harm, or mortality outcomes. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Retain the original scope of hospital-treated events and unverified details.
Why this condition is needed: This condition records the original information and gaps for the question: How were repeat events defined, and what was counted?
Application exceptions: Do not extend counted events to all events without care, all self-harm, or mortality outcomes.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M03 §3.2.4; our own application

Related sources R01

N11 · What were the original total repeat-event counts?

Current findings: Total repeat events were 101 with postcards versus 192 with usual care. Event counts use a different unit from the number of people with repetition.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Detailed counting and timing and the distribution by person are unverified.
Reason for missing information: Detailed counting and timing and the distribution by person are unverified.
Required materials and conditions: Events and people, repeat and initial events, model inclusion and period, and counting rules
Materials to obtain first: Events and people, repeat and initial events, model inclusion and period, and counting rules
Further research: If the original event table is provided, distinguish event units from data by person and period.
Remaining uncertainty: Do not express 101/192 as counts of different people or newly calculate totals or means. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Keep original event counts separate from person outcomes.
Why this condition is needed: This condition records the original information and gaps for the question: What were the original total repeat-event counts?
Application exceptions: Do not express 101/192 as counts of different people or newly calculate totals or means.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

Related sources R01

N12 · What were the repeat-event IRR and interval?

Current findings: Preserve the original repeat-event IRR0.55 (95% CI0.35–0.87). It is not the RR or OR of people with repetition or an individual's probability of preventing repetition.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Details of the model, exposure time and person denominator, and adjustment are unverified.
Reason for missing information: Details of the model, exposure time and person denominator, and adjustment are unverified.
Required materials and conditions: Original event-rate model, denominator and time, estimand and interval
Materials to obtain first: Original event-rate model, denominator and time, estimand and interval
Further research: If original methods are provided, link the IRR to the actual model, period, and denominator.
Remaining uncertainty: Do not newly calculate IRR, CI, or P from the original event counts or convert them into a person-level risk effect. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Attribute the original IRR and 95% CI only to the event outcome.
Why this condition is needed: This condition records the original information and gaps for the question: What were the repeat-event IRR and interval?
Application exceptions: Do not newly calculate IRR, CI, or P from the original event counts or convert them into a person-level risk effect.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are our own design / M15 §15.3.1–15.3.3; our own application

Related sources R01

N13 · What were the repeat-event model, estimand, overdispersion, and zero-event handling?

Current findings: The original material gives event counts and IRR. The summary lacks the count-model type, individual observation time, correlation of repeated events and overdispersion, zero-event handling, and adjustment.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. The event model's specific methods, assumptions, and sensitivity analyses are unverified.
Reason for missing information: The event model's specific methods, assumptions, and sensitivity analyses are unverified.
Required materials and conditions: Original model, estimand, time offset, repeated and zero events, and sensitivity analyses
Materials to obtain first: Original model, estimand, time offset, repeated and zero events, and sensitivity analyses
Further research: If the original SAP and methods are provided, distinguish counting from statistical assumptions.
Remaining uncertainty: Do not infer a particular model or complete handling of repetition and missing data solely from the IRR notation. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish the original estimate from gaps in direct model information.
Why this condition is needed: This condition records the original information and gaps for the question: What were the repeat-event model, estimand, overdispersion, and zero-event handling?
Application exceptions: Do not infer a particular model or complete handling of repetition and missing data solely from the IRR notation.
Referenced methods: M08 §8.2.2, M15 §15.3.1; our own application / M15 §15.3.1–15.3.3; our own application / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

Related sources R01

N14 · What was the outcome for people with at least one repeat event?

Current findings: People with repetition were 57/378 (15.1%) versus 68/394 (17.3%), difference −2 percentage points (95% CI−7 to 3), the original null result. Preserve the D grade and note for the other repeater question as original context.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Details of person-outcome analysis, missing data, and adjustment are unverified.
Reason for missing information: Details of person-outcome analysis, missing data, and adjustment are unverified.
Required materials and conditions: Person-based criteria and time point, denominator, risk-difference definition, and interval
Materials to obtain first: Person-based criteria and time point, denominator, risk-difference definition, and interval
Further research: If the original person-outcome table is provided, distinguish first repetition and repeat-event counts and their denominators.
Remaining uncertainty: Do not erase the person outcome because the event result is positive or newly calculate the original proportions or risk difference. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Retain the original person counts and denominators, percentage points, CI, and null result together.
Why this condition is needed: This condition records the original information and gaps for the question: What was the outcome for people with at least one repeat event?
Application exceptions: Do not erase the person outcome because the event result is positive or newly calculate the original proportions or risk difference.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design / M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is our own design

Related sources R01

N15 · Are fewer events and fewer people with repetition different outcomes?

Current findings: The original summary explains both results together: repeater prevalence did not fall, while total repeat events did. Its account of fewer episodes among a small group of repeaters is the original interpretation; no quantitative distribution is given.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The distribution by person and separate estimates for a high-frequency group are unverified.
Reason for missing information: The distribution by person and separate estimates for a high-frequency group are unverified.
Required materials and conditions: Repeat-event distribution by person, initial and repeated events, and the two estimands
Materials to obtain first: Repeat-event distribution by person, initial and repeated events, and the two estimands
Further research: If original distribution and analysis data are provided, distinguish the original interpretation from direct subgroup and person effects.
Remaining uncertainty: Do not extend fewer events into a result that repetition was prevented for individuals or the whole population. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Maintain the boundary between the original positive event result and null person result.
Why this condition is needed: This condition records the original information and gaps for the question: Are fewer events and fewer people with repetition different outcomes?
Application exceptions: Do not extend fewer events into a result that repetition was prevented for individuals or the whole population.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are our own design / M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is our own design / M03 §3.2.4; our own extension boundary

Related sources R01

N16 · How were the two coprimary outcomes related in testing?

Current findings: The original trial describes split results for the two coprimary outcomes: repeater prevalence and repeat events per person. The parent's true flag for split coprimary outcomes is also original history.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Prespecified success and multiplicity rules and direct registration and plan content are unverified.
Reason for missing information: Prespecified success and multiplicity rules and direct registration and plan content are unverified.
Required materials and conditions: Prespecified joint outcomes, success rules, multiplicity, and analysis hierarchy
Materials to obtain first: Prespecified joint outcomes, success rules, multiplicity, and analysis hierarchy
Further research: If the original plan is provided, distinguish reported roles from the actual prespecified testing relationship.
Remaining uncertainty: Do not certify success on all coprimary outcomes or create a new grade based on one positive outcome. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish the original account of split outcomes from unread plans.
Why this condition is needed: This condition records the original information and gaps for the question: How were the two coprimary outcomes related in testing?
Application exceptions: Do not certify success on all coprimary outcomes or create a new grade based on one positive outcome.
Referenced methods: M08 Table 8.2.a, M04 §4.6.3; our own application / M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is our own design

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N17 · Were registration, plans, and prespecified definitions actually read?

Current findings: ACTRN012605000050651 is the original registration identifier in the evidence list. Registration, protocol, and SAP content, registration timing, and changes have not been read in this work.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Actual preregistration, plan, and change content is unverified.
Reason for missing information: Actual preregistration, plan, and change content is unverified.
Required materials and conditions: Original registration timing, outcomes and events, model, and change records
Materials to obtain first: Original registration timing, outcomes and events, model, and change records
Further research: If the original registration and plans are provided, record definitions at the time and reported results.
Remaining uncertainty: Do not elevate a registration string into certification of unique trial identity or prespecification. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Retain the original identifier and the external unread status.
Why this condition is needed: This condition records the original information and gaps for the question: Were registration, plans, and prespecified definitions actually read?
Application exceptions: Do not elevate a registration string into certification of unique trial identity or prespecification.
Referenced methods: M04 §4.5–4.6 provide collection and selection principles; separating access from reading and the hyperlink convention are our own design / M08 Table 8.2.a, M04 §4.6.3; our own application

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N18 · What was the original scope of administrative counting and blinding?

Current findings: The existing counterview says administrative database counting limited the impact of unavoidable participant unblinding. Actual blinding of coders, adjudicators, and analysts is absent from the summary.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Coding validation, adjudicator and analyst blinding, and linkage completeness are unverified.
Reason for missing information: Coding validation, adjudicator and analyst blinding, and linkage completeness are unverified.
Required materials and conditions: Counting and coding, blinding by role, linkage and misclassification, and data completeness
Materials to obtain first: Counting and coding, blinding by role, linkage and misclassification, and data completeness
Further research: If original collection methods are provided, distinguish administrative counting from assessment by each role.
Remaining uncertainty: Do not certify no bias or complete event ascertainment merely because administrative data were used. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Retain the original measurement strength and gaps in direct process information together.
Why this condition is needed: This condition records the original information and gaps for the question: What was the original scope of administrative counting and blinding?
Application exceptions: Do not certify no bias or complete event ascertainment merely because administrative data were used.
Referenced methods: M08 Table 8.2.a, M03 §3.2.4; our own application / M08 §8.1–8.2.3; our own application

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N19 · How were events outside hospital care or in other hospitals captured?

Current findings: The original result is an administrative count of hospital-treated events. The summary lacks coverage of events without care, other hospitals or regions, and movement or migration.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Direct information on events without care or in other regions and data linkage and capture is unverified.
Reason for missing information: Direct information on events without care or in other regions and data linkage and capture is unverified.
Required materials and conditions: Data-network coverage, linkage, movement and migration, uncaptured events, and access to care
Materials to obtain first: Data-network coverage, linkage, movement and migration, uncaptured events, and access to care
Further research: If original data pathways are provided, record observed hospital events and the scope of uncaptured events.
Remaining uncertainty: Do not automatically repurpose administrative events as the total number of all repeat events. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish actual counting coverage from gaps in uncaptured events.
Why this condition is needed: This condition records the original information and gaps for the question: How were events outside hospital care or in other hospitals captured?
Application exceptions: Do not automatically repurpose administrative events as the total number of all repeat events.
Referenced methods: M08 Table 8.2.a, M03 §3.2.4; our own application / M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

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N20 · What were the details of randomization, concealment, and baseline balance?

Current findings: The original design was a randomized usual-care-controlled trial with 772 participants allocated 378/394. Sequence generation, concealment, stratification, and baseline balance are absent from the summary.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Allocation and concealment and balance in baseline event frequency are unverified.
Reason for missing information: Allocation and concealment and balance in baseline event frequency are unverified.
Required materials and conditions: Allocation process, concealment, baseline risk and past events, and group characteristics
Materials to obtain first: Allocation process, concealment, baseline risk and past events, and group characteristics
Further research: If original methods and baseline tables are provided, distinguish the design label from the actual process.
Remaining uncertainty: Do not declare all design conditions met based on B0 or the randomized label. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Separate the original allocation from gaps in direct process information.
Why this condition is needed: This condition records the original information and gaps for the question: What were the details of randomization, concealment, and baseline balance?
Application exceptions: Do not declare all design conditions met based on B0 or the randomized label.
Referenced methods: M08 §8.1–8.2.3; our own application / M03 §3.2.1; detailed population conditions are our own design

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N21 · What were the 12-month exposure and actual event follow-up window?

Current findings: Preserve the original research condition of 8 postcards over 12 months. The summary lacks exact start and end of event counting, individual observation time, and follow-up after discontinuation.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Exact follow-up time and censoring for each event and person are unverified.
Reason for missing information: Exact follow-up time and censoring for each event and person are unverified.
Required materials and conditions: Exposure and follow-up windows, event timing, individual observation, and discontinuation or movement
Materials to obtain first: Exposure and follow-up windows, event timing, individual observation, and discontinuation or movement
Further research: If original timing and flow data are provided, distinguish intervention duration from actual analysis time.
Remaining uncertainty: Do not turn the original 12 months into complete fixed observation for every person and outcome. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish the original period from gaps in direct follow-up and model time.
Why this condition is needed: This condition records the original information and gaps for the question: What were the 12-month exposure and actual event follow-up window?
Application exceptions: Do not turn the original 12 months into complete fixed observation for every person and outcome.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design / M03 §3.2.1–3.2.4; details of dose, duration, and effect modification are our own design / M19 §19.2 concerns harm questions by study design; temporal-relationship details are our own design

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N22 · What were postcard receipt, attrition and missing data, and analysis populations?

Current findings: Original allocation and the nominal intervention are available, but the summary lacks actual delivery and receipt, refusal and discontinuation, migration, missing data, and details of ITT and actual-exposure analyses.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Actual contact and adherence, attrition and missing data, and analysis definitions are unverified.
Reason for missing information: Actual contact and adherence, attrition and missing data, and analysis definitions are unverified.
Required materials and conditions: Exposure and analysis flow, discontinuation and non-delivery, missing data, and sensitivity analyses
Materials to obtain first: Exposure and analysis flow, discontinuation and non-delivery, missing data, and sensitivity analyses
Further research: If original flow and analyses are provided, distinguish allocation from actual contact and event-capture denominators.
Remaining uncertainty: Do not turn the nominal 8 cards into actual receipt by every person or complete follow-up with zero missing data. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Retain original conditions and gaps in actual exposure and analysis.
Why this condition is needed: This condition records the original information and gaps for the question: What were postcard receipt, attrition and missing data, and analysis populations?
Application exceptions: Do not turn the nominal 8 cards into actual receipt by every person or complete follow-up with zero missing data.
Referenced methods: M08 §8.2.2, M15 §15.3.1; our own application / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

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N23 · What were effects in frequent repeaters and groups by sex or baseline characteristics?

Current findings: The original interpretation describes fewer episodes among a small group of repeaters. Prespecified interactions and effects and denominators by high frequency, age and sex, or prior history are absent from the summary.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Direct values for the distribution by person and subgroup effect modification are unverified.
Reason for missing information: Direct values for the distribution by person and subgroup effect modification are unverified.
Required materials and conditions: Subgroup definitions, distributions, prespecified hypotheses, and interactions and estimates
Materials to obtain first: Subgroup definitions, distributions, prespecified hypotheses, and interactions and estimates
Further research: If original subgroup analyses are provided, distinguish the overall event model from direct results for separate groups.
Remaining uncertainty: Do not invent effects or recommended populations for particular sexes or frequent repeaters from the original description of a small group. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish original interpretation from gaps in direct subgroup evidence.
Why this condition is needed: This condition records the original information and gaps for the question: What were effects in frequent repeaters and groups by sex or baseline characteristics?
Application exceptions: Do not invent effects or recommended populations for particular sexes or frequent repeaters from the original description of a small group.
Referenced methods: M03 §3.2.1; detailed population conditions are our own design / M03 §3.2.1–3.2.4; dose, persistence and effect-modification details are our own design

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N24 · Do hospital-event counts answer questions about mortality and all clinical outcomes?

Current findings: The existing counterview and product facts explicitly state that the trial did not demonstrate fewer suicide deaths. Fewer events refers to counts of hospital-treated repeat episodes.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Direct mortality and other clinical outcomes, scales, and intervals are unverified.
Reason for missing information: Direct mortality and other clinical outcomes, scales, and intervals are unverified.
Required materials and conditions: Direct mortality and other event outcomes, quality of life and function, and burden of care
Materials to obtain first: Direct mortality and other event outcomes, quality of life and function, and burden of care
Further research: If direct outcomes are provided, distinguish event counts from the scope of other clinical outcomes.
Remaining uncertainty: Do not extend fewer events into prevention of mortality, all repetition, or individual clinical benefit. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Maintain original hospital repeat events and separate gaps in clinical outcomes.
Why this condition is needed: This condition records the original information and gaps for the question: Do hospital-event counts answer questions about mortality and all clinical outcomes?
Application exceptions: Do not extend fewer events into prevention of mortality, all repetition, or individual clinical benefit.
Referenced methods: M03 §3.2.4; our own boundary on extensions / M03 §3.2.4, M15 §15.3.1–15.3.3; outcome adaptations by question are our own design

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N25 · What were the clinical importance and threshold for fewer events?

Current findings: Preserve the original IRR and interval and event and person outcomes. The summary lacks a clinically important event-reduction threshold or individual response criteria.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Prespecified clinical thresholds, individual importance, and direct absolute-difference intervals are unverified.
Reason for missing information: Prespecified clinical thresholds, individual importance, and direct absolute-difference intervals are unverified.
Required materials and conditions: Originally planned effect size, clinical importance, and absolute and individual outcomes
Materials to obtain first: Originally planned effect size, clinical importance, and absolute and individual outcomes
Further research: If relevant plans and criteria are provided, distinguish statistical estimates from clinical scope.
Remaining uncertainty: Do not convert IRR or counts into new success thresholds, effects, or individual probabilities. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish original estimates from gaps in importance criteria.
Why this condition is needed: This condition records the original information and gaps for the question: What were the clinical importance and threshold for fewer events?
Application exceptions: Do not convert IRR or counts into new success thresholds, effects, or individual probabilities.
Referenced methods: M15 §15.3.1–15.3.3; our own application / M03 §3.2.4; our own boundary on extensions

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N26 · What were secondary or other outcomes and long-term persistence?

Current findings: The original summary contains only the two joint outcomes and safety and mortality limitations. Complete secondary outcomes, long-term or post-intervention outcomes, and outcomes of changes in existing treatment are absent.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. The complete secondary hierarchy and long-term and post-intervention persistence outcomes are unverified.
Reason for missing information: The complete secondary hierarchy and long-term and post-intervention persistence outcomes are unverified.
Required materials and conditions: Secondary and exploratory outcome lists, discontinuation and long-term follow-up, and direct results
Materials to obtain first: Secondary and exploratory outcome lists, discontinuation and long-term follow-up, and direct results
Further research: If materials are provided, distinguish joint outcomes from secondary and follow-up reports.
Remaining uncertainty: Do not turn the repeat-event signal into persistence after intervention ends or benefit from replacing treatment. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Maintain gaps in outcomes and persistence outside the original scope.
Why this condition is needed: This condition records the original information and gaps for the question: What were secondary or other outcomes and long-term persistence?
Application exceptions: Do not turn the repeat-event signal into persistence after intervention ends or benefit from replacing treatment.
Referenced methods: M08 Table 8.2.a, M04 §4.6.3; our own application / M03 §3.2.1–3.2.4; details of dose, duration, and effect modification are our own design / M03 §3.2.4; our own boundary on extensions

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N27 · What was the original limitation concerning a separate adverse-event outcome?

Current findings: The original summary says there was no separate adverse-event outcome and safety was not adequately assessed. External original safety materials remain unread.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Direct safety collection, tables, and event values are unverified.
Reason for missing information: Direct safety collection, tables, and event values are unverified.
Required materials and conditions: Safety-event definitions, systematic and spontaneous collection, severity, and discontinuation
Materials to obtain first: Safety-event definitions, systematic and spontaneous collection, severity, and discontinuation
Further research: If original safety materials are provided, distinguish collection, nonreporting, and unread status.
Remaining uncertainty: Do not convert no separate outcome or unread status into zero adverse events or a safe intervention. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish original safety-information limitations from currently unread external materials.
Why this condition is needed: This condition records the original information and gaps for the question: What was the original limitation concerning a separate adverse-event outcome?
Application exceptions: Do not convert no separate outcome or unread status into zero adverse events or a safe intervention.
Referenced methods: M19 §19.1.2–19.2.4; detailed distinctions are our own design / M19 §19.1.2–19.2.4; our own application

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N28 · What were the denominators for harm events, people, and time?

Current findings: The original allocation of 772 participants and repeat-event and person denominators concern efficacy outcomes. Actual person, time, and event denominators for harm collection are absent from the summary.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Actual harm denominators and event and time data are unverified.
Reason for missing information: Actual harm denominators and event and time data are unverified.
Required materials and conditions: Harm exposure and collection denominators, events and people, and follow-up time
Materials to obtain first: Harm exposure and collection denominators, events and people, and follow-up time
Further research: If original safety denominators are provided, record them separately from efficacy denominators.
Remaining uncertainty: Do not newly calculate harm incidence from efficacy-event or allocation denominators. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish gaps in harm denominators from event and person efficacy.
Why this condition is needed: This condition records the original information and gaps for the question: What were the denominators for harm events, people, and time?
Application exceptions: Do not newly calculate harm incidence from efficacy-event or allocation denominators.
Referenced methods: M19 §19.1.2–19.2.4; our own application / M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; adaptations by study design are our own design

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N29 · What were the timing relationships of harm onset, discontinuation, and recovery?

Current findings: Only 12 months of contact exposure is an original condition. Harm onset, discontinuation, recovery, and individual observation windows are absent from the summary.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Harm timing, discontinuation and recovery, and observation are unverified.
Reason for missing information: Harm timing, discontinuation and recovery, and observation are unverified.
Required materials and conditions: Event timelines, exposure and discontinuation, recovery, and observation windows
Materials to obtain first: Event timelines, exposure and discontinuation, recovery, and observation windows
Further research: If original timing records are provided, record temporal order of exposure and events and observation limitations.
Remaining uncertainty: Do not establish causality or absence of harm from a single time condition. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish original exposure time from gaps in direct safety timing.
Why this condition is needed: This condition records the original information and gaps for the question: What were the timing relationships of harm onset, discontinuation, and recovery?
Application exceptions: Do not establish causality or absence of harm from a single time condition.
Referenced methods: M19 §19.2 concerns harm questions by study design; temporal-relationship details are our own design / M19 §19.1.2–19.2.4; our own application

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N30 · What were actual harm and safety differences versus usual care?

Current findings: The usual-care comparator and efficacy outcomes are available, but actual between-group comparisons of separate adverse events are absent from the summary. Mortality limitations also do not certify absence of harm.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Between-group safety estimates, CI, P, and other harms are unverified.
Reason for missing information: Between-group safety estimates, CI, P, and other harms are unverified.
Required materials and conditions: Between-group safety events, estimates and intervals, definitions, and denominators
Materials to obtain first: Between-group safety events, estimates and intervals, definitions, and denominators
Further research: If original safety comparisons are provided, distinguish effects and harms, statistical estimates, and original limitations.
Remaining uncertainty: Do not turn no difference in repeaters and fewer events into no difference in all harms or absence of harm. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish the efficacy comparator from gaps in direct harm comparison.
Why this condition is needed: This condition records the original information and gaps for the question: What were actual harm and safety differences versus usual care?
Application exceptions: Do not turn no difference in repeaters and fewer events into no difference in all harms or absence of harm.
Referenced methods: M19 §19.2.2–19.2.4, M03 §3.2.3; our own application / Chamgap interpretation boundary. It refers to M19 principles and does not constitute use of an official causality tool

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N31 · What were baseline risk, concurrent treatment, and other causes or exposures?

Current findings: Preserve the original population after hospital treatment and the usual-care comparison. Baseline risk, changes in concurrent support and treatment, and alternative explanations for safety events and attribution are absent from the summary.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Alternatives for safety and effect attribution and concurrent treatment details are unverified.
Reason for missing information: Alternatives for safety and effect attribution and concurrent treatment details are unverified.
Required materials and conditions: Baseline and concurrent exposure, actual support and treatment, event attribution, and alternatives
Materials to obtain first: Baseline and concurrent exposure, actual support and treatment, event attribution, and alternatives
Further research: If original event and treatment data are provided, distinguish concurrent changes from attribution to the intervention.
Remaining uncertainty: Do not establish that there were no other exposures or that all changes were caused by postcards. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Retain original conditions and gaps in alternative explanations.
Why this condition is needed: This condition records the original information and gaps for the question: What were baseline risk, concurrent treatment, and other causes or exposures?
Application exceptions: Do not establish that there were no other exposures or that all changes were caused by postcards.
Referenced methods: M19 §19.2.2–19.2.4 design considerations; detailed confounding records are our own design / M03 §3.2.3, M08 §8.2.2–8.2.3; our own application

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N32 · What were gaps in harm reporting and follow-up and completeness of collection?

Current findings: Administrative counting of hospital events is the original efficacy record. Missingness, discontinuation, reporting pathways, and completeness of separate safety collection are absent from the summary.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Safety surveillance and missingness, loss, and discontinuation data are unverified.
Reason for missing information: Safety surveillance and missingness, loss, and discontinuation data are unverified.
Required materials and conditions: Harm collection and surveillance, discontinuation and loss, and reporting and detection coverage
Materials to obtain first: Harm collection and surveillance, discontinuation and loss, and reporting and detection coverage
Further research: If original safety flow is provided, distinguish collection from uncaptured and unread information.
Remaining uncertainty: Do not guarantee complete safety collection from administrative efficacy counts. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Do not convert limitations in harm reporting into zero events.
Why this condition is needed: This condition records the original information and gaps for the question: What were gaps in harm reporting and follow-up and completeness of collection?
Application exceptions: Do not guarantee complete safety collection from administrative efficacy counts.
Referenced methods: M19 §19.1.2–19.2.4, M04 §4.6.3; our own application / M08 §8.2.2, M15 §15.3.1; our own application

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N33 · Does the evidence answer independent harm and long-term safety or safety in other populations?

Current findings: Original history records limitations of the separate safety outcome and no demonstrated mortality benefit. Independent harm-study families and direct long-term safety data or data for other populations are absent from the summary.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. Independent replication of harms and long-term, rare-harm, and other-population safety are not established.
Reason for missing information: Independent replication of harms and long-term, rare-harm, and other-population safety are not established.
Required materials and conditions: Unique safety reports and repeated citations, and suitable long-term and population-specific materials
Materials to obtain first: Unique safety reports and repeated citations, and suitable long-term and population-specific materials
Further research: If direct materials are provided, distinguish repeated citations from the same family from separate harm and population records.
Remaining uncertainty: Do not add reviews, the same population, or sibling outcomes as independent harm replication or overall safety. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Retain original limitations and gaps in extensions of safety.
Why this condition is needed: This condition records the original information and gaps for the question: Does the evidence answer independent harm and long-term safety or safety in other populations?
Application exceptions: Do not add reviews, the same population, or sibling outcomes as independent harm replication or overall safety.
Referenced methods: M04 §4.6.1–4.6.2; harm-material adaptations are our own design / M19 §19.1.2–19.2.4; our own application / M03 §3.2.1–3.2.4; details of dose, duration, and effect modification are our own design

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N34 · What is the narrative scope for safety and clinical use?

Current findings: Preserve the parent's Unknown safety and the original review's conclusion that widespread clinical implementation could not be recommended. Do not turn the research summary into instructions for individual treatment, supportive actions, or repetition.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. There is no direct verification of widespread use, individual treatment selection, or overall safety.
Reason for missing information: There is no direct verification of widespread use, individual treatment selection, or overall safety.
Required materials and conditions: Original scope of applicability and safety judgments and direct clinical outcomes
Materials to obtain first: Original scope of applicability and safety judgments and direct clinical outcomes
Further research: If new materials within the requested scope are provided, distinguish original research from separate applicability questions.
Remaining uncertainty: Do not create new safety grades, causal certification, methods of repetition, or treatment or supportive-action guidance. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish original research scope from user actions and treatment implementation.
Why this condition is needed: This condition records the original information and gaps for the question: What is the narrative scope for safety and clinical use?
Application exceptions: Do not create new safety grades, causal certification, methods of repetition, or treatment or supportive-action guidance.
Referenced methods: Chamgap interpretation boundary. It refers to M19 principles and does not constitute use of an official causality tool / M03 §3.2.4; our own boundary on extensions

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N35 · Were the contact interventions in the 14-trial review the same postcards?

Current findings: The Milner review covered 14 brief-contact trials combining letters, postcards, calls, and cards. It does not verify that all used the same protocol of 8 non-obligatory postcards over 12 months.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Identities and conditions of included trials and inclusion and overlap of the postcard trial remain unread.
Reason for missing information: Identities and conditions of included trials and inclusion and overlap of the postcard trial remain unread.
Required materials and conditions: Included-study table, original interventions and comparators, populations and periods, and report families
Materials to obtain first: Included-study table, original interventions and comparators, populations and periods, and report families
Further research: If original inclusion materials are provided, distinguish mixed interventions from their relationship to the original postcard trial.
Remaining uncertainty: Do not add the review's 14 trials to the original trial or repurpose mixed interventions as the effect of identical postcards alone. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish the class review from gaps in direct postcard comparisons.
Why this condition is needed: This condition records the original information and gaps for the question: Were the contact interventions in the 14-trial review the same postcards?
Application exceptions: Do not add the review's 14 trials to the original trial or repurpose mixed interventions as the effect of identical postcards alone.
Referenced methods: M04 §4.6.1–4.6.2 distinguish studies from reports; cohort and outcome links are our own application / M03 §3.2.2–3.2.3; adaptations for reverse-direction markers and tests are our own design / M04 §4.6.1–4.6.2, M15 §15.3.1; our own application

Related sources R02

N36 · What was the review's OR for any repetition?

Current findings: The review's any-repetition OR0.87 (95% CI0.74–1.04) is the original null result. Its measure and aggregation differ from the person-level risk difference in the original postcard trial.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Contributing trials and participants, model, and conditions for this outcome are unverified.
Reason for missing information: Contributing trials and participants, model, and conditions for this outcome are unverified.
Required materials and conditions: Contributing trials and person denominators, OR model, definitions and periods, and interval
Materials to obtain first: Contributing trials and person denominators, OR model, definitions and periods, and interval
Further research: If original review tables are provided, record contributing materials and measures for this outcome.
Remaining uncertainty: Do not turn OR into IRR, RR, or a direct postcard effect or add it to the original risk difference. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Keep the original OR, interval, and null result in the separate review context of person outcomes.
Why this condition is needed: This condition records the original information and gaps for the question: What was the review's OR for any repetition?
Application exceptions: Do not turn OR into IRR, RR, or a direct postcard effect or add it to the original risk difference.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are our own design / M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is our own design / M15 §15.3.1–15.3.3; our own application

Related sources R02

N37 · Are the review's suicide OR and event IRR the same outcome?

Current findings: The original review pattern is a null suicide OR0.58 (0.24–1.38) and fewer repeat episodes, IRR0.66 (0.54–0.80). Separate suicide, event, and person outcomes.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Contributing data and aggregation, detailed interval confidence levels, and definitions are unverified.
Reason for missing information: Contributing data and aggregation, detailed interval confidence levels, and definitions are unverified.
Required materials and conditions: Contributions and denominators by outcome, mortality definition, interval confidence level, and model
Materials to obtain first: Contributions and denominators by outcome, mortality definition, interval confidence level, and model
Further research: If original tables are provided, link each outcome, period, denominator, and uncertainty separately.
Remaining uncertainty: Do not turn a lower event IRR into fewer deaths or a direct mortality result from the original trial. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Preserve both original measures and intervals and their differing directions together.
Why this condition is needed: This condition records the original information and gaps for the question: Are the review's suicide OR and event IRR the same outcome?
Application exceptions: Do not turn a lower event IRR into fewer deaths or a direct mortality result from the original trial.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are our own design / M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is our own design / M03 §3.2.4; our own extension boundary

Related sources R02

N38 · What were the review's pooling model, heterogeneity, and subgroups?

Current findings: The review summarizes the same original pattern, but outcome-specific contributing subsets, pooling model, heterogeneity, and results by contact type and population are absent.
Verification status: Unverified
Materials actually read: Summary read; external materials not read
Why unverified: Required direct details are absent from the stored summary and remain unverified. External materials have not been read. The pooling model, quantitative heterogeneity, and outcome-specific subsets and group effects are unverified.
Reason for missing information: The pooling model, quantitative heterogeneity, and outcome-specific subsets and group effects are unverified.
Required materials and conditions: Included and contributing lists, model, results and heterogeneity by condition, and prespecified subgroups
Materials to obtain first: Included and contributing lists, model, results and heterogeneity by condition, and prespecified subgroups
Further research: If original review tables are provided, distinguish pooled estimates from the distribution of conditions by trial.
Remaining uncertainty: Do not declare that all 14 trials contributed to every outcome, had the same effect, or used the same period. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Maintain the original synthesis and direct gaps in conditions and models.
Why this condition is needed: This condition records the original information and gaps for the question: What were the review's pooling model, heterogeneity, and subgroups?
Application exceptions: Do not declare that all 14 trials contributed to every outcome, had the same effect, or used the same period.
Referenced methods: M04 §4.6.1–4.6.2, M15 §15.3.1; our own application / M08 §8.2.2, M15 §15.3.1; our own application / M03 §3.2.1–3.2.4; dose, persistence and effect-modification details are our own design

Related sources R02

N39 · Are unique trials, populations, and independent replication established?

Current findings: Preserve parent R1 and the original review's prohibition on double-counting synthesis evidence as history. Unique trial and participant counts are not established because included-study tables and report families have not been directly read.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Unique trials, participant and event totals, and independent replication are not established.
Reason for missing information: Unique trials, participant and event totals, and independent replication are not established.
Required materials and conditions: Unique families, original trials and review inclusion, repeated citations, and related reports
Materials to obtain first: Unique families, original trials and review inclusion, repeated citations, and related reports
Further research: Proposal: If original lists are supplied, link each report to the same, different or uncertain study family.
Remaining uncertainty: Do not count reviews, original trials, documents, sibling tables, or repeated events as independent trials. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish the number of report entries from unrecorded unique totals.
Why this condition is needed: This condition records the original information and gaps for the question: Are unique trials, populations, and independent replication established?
Application exceptions: Do not count reviews, original trials, documents, sibling tables, or repeated events as independent trials.
Referenced methods: M04 §4.6.1–4.6.2 distinction between studies and reports; cohort and outcome linking is our own application / M04 §4.6.1–4.6.2, M15 §15.3.1; our own application / M04 §4.6.1–4.6.2; harm-material adaptations are our own design

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N40 · What were support and sponsor roles in the original postcard trial?

Current findings: The original summary describes public or nonprofit support from Hunter Area Health Service, NSW Health, and NHMRC. Detailed institutional roles in design, collection, analysis, manuscripts, and publication are absent.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Specific sponsor roles, complete author COI, and data access are unverified.
Reason for missing information: Specific sponsor roles, complete author COI, and data access are unverified.
Required materials and conditions: Support and roles, data access, supply and services, and author declarations
Materials to obtain first: Support and roles, data access, supply and services, and author declarations
Further research: If original declarations are provided, distinguish institutions, actual roles, and interests.
Remaining uncertainty: Do not turn public support or I2 into current independence review or certification of no interests. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Preserve original support and gaps in roles together.
Why this condition is needed: This condition records the original information and gaps for the question: What were support and sponsor roles in the original postcard trial?
Application exceptions: Do not turn public support or I2 into current independence review or certification of no interests.
Referenced methods: CHAMGAP's own independence and attribution conditions. Official methodological sections used in this pilot do not guarantee every detail of this item / M04 §4.6.1–4.6.2, M15 §15.3.1; our own application

Related sources R01

N41 · What were funding and author and report relationships in the review and original trials?

Current findings: The original review funding field says funding varied by original trial and synthesis evidence must not be double-counted. The review's own support, original declarations, and relationships among individual research teams have not been directly read in this work.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. The review's own funding, complete COI, and relationships by trial are unverified.
Reason for missing information: The review's own funding, complete COI, and relationships by trial are unverified.
Required materials and conditions: Review support and COI, trial-specific roles, and author, report, and population relationships
Materials to obtain first: Review support and COI, trial-specific roles, and author, report, and population relationships
Further research: If original declarations and inclusion tables are provided, record funding, author, and family relationships for each material.
Remaining uncertainty: Do not certify independence of teams or populations from bibliographic names or the same pattern alone. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Distinguish original funding language from gaps in direct relationship information.
Why this condition is needed: This condition records the original information and gaps for the question: What were funding and author and report relationships in the review and original trials?
Application exceptions: Do not certify independence of teams or populations from bibliographic names or the same pattern alone.
Referenced methods: CHAMGAP's own independence and attribution conditions. Official methodological sections used in this pilot do not guarantee every detail of this item / M04 §4.6.1–4.6.2 distinction between studies and reports; cohort and outcome linking is our own application

Related sources R01 R02

N42 · Are the reference date, Korean and English text, corrections, empty values, and current production distinct?

Current findings: Preserve the original reference date 2026-08-26, empty corrections array, empty deliberation string, Korean and English text, and true, false, null, and empty values in the parent axes.
Verification status: Partly verified
Materials actually read: Summary read; external materials not read
Why unverified: Partial verification links the original narrative in the stored summary for production; it does not constitute clinical verification or completed content review. Separate evidence-cutoff and facet values are unrecorded, and no current correction or retraction search has been performed.
Reason for missing information: Separate evidence-cutoff and facet values are unrecorded, and no current correction or retraction search has been performed.
Required materials and conditions: Original dates, languages, and corrections and current reading and update scope
Materials to obtain first: Original dates, languages, and corrections and current reading and update scope
Further research: If actual update materials are provided, separate the complete original version from change events.
Remaining uncertainty: Do not reuse the original date or cross-check as a current clinical verification date or treat an empty corrections array as comprehensive certification of absence. The original content review remains incomplete, and external original materials have not been directly verified.
Conditions for verification: Retain original history and the incomplete original content review together.
Why this condition is needed: This condition records the original information and gaps for the question: Are the reference date, Korean and English text, corrections, empty values, and current production distinct?
Application exceptions: Do not reuse the original date or cross-check as a current clinical verification date or treat an empty corrections array as comprehensive certification of absence.
Referenced methods: M04 §4.5, §4.6.3; current material-conversion limits reflect review scope and our own design / M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are our own design

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