# Non-obligatory postcards × hospital-treated repeat-event counts: an evidence checklist Verdict 2943 · Evidence Check Stored-material review date: Not recorded Original evidence cut-off: 2026-08-26 Review-criteria version: 1.0 Public page/material preparation date: 2026-10-11 Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect. ## Assessment scope - Population: 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 ## Checklist items ### N01 · Does this checklist ask about fewer repeat events? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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’. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N17 · Were registration, plans, and prespecified definitions actually read? Verification status: Partly verified Reading scope: Summary read; external materials not 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N18 · What was the original scope of administrative counting and blinding? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - Referenced methods: M08 Table 8.2.a, M03 §3.2.4; our own application / M08 §8.1–8.2.3; our own application - Related sources: R01 ### N19 · How were events outside hospital care or in other hospitals captured? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N20 · What were the details of randomization, concealment, and baseline balance? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - Referenced methods: M08 §8.1–8.2.3; our own application / M03 §3.2.1; detailed population conditions are our own design - Related sources: R01 ### N21 · What were the 12-month exposure and actual event follow-up window? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N22 · What were postcard receipt, attrition and missing data, and analysis populations? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N23 · What were effects in frequent repeaters and groups by sex or baseline characteristics? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 ### N24 · Do hospital-event counts answer questions about mortality and all clinical outcomes? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N25 · What were the clinical importance and threshold for fewer events? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - Referenced methods: M15 §15.3.1–15.3.3; our own application / M03 §3.2.4; our own boundary on extensions - Related sources: R01 ### N26 · What were secondary or other outcomes and long-term persistence? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N27 · What was the original limitation concerning a separate adverse-event outcome? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N28 · What were the denominators for harm events, people, and time? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N29 · What were the timing relationships of harm onset, discontinuation, and recovery? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N30 · What were actual harm and safety differences versus usual care? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N31 · What were baseline risk, concurrent treatment, and other causes or exposures? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N32 · What were gaps in harm reporting and follow-up and completeness of collection? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01 ### N33 · Does the evidence answer independent harm and long-term safety or safety in other populations? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01, R02 ### N34 · What is the narrative scope for safety and clinical use? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01, R02 ### N35 · Were the contact interventions in the 14-trial review the same postcards? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Unverified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01, R02 ### N40 · What were support and sponsor roles in the original postcard trial? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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? Verification status: Partly verified Reading scope: Summary read; external materials not read - 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. - 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. - 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. - 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. - 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 - Related sources: R01, R02 ## Evidence and sources ### R01 Carter GL, Clover K, Whyte IM, Dawson AH, D'Este C. Postcards from the EDge project: randomised controlled trial of an intervention using postcards to reduce repetition of hospital treated deliberate self poisoning. BMJ. 2005;331:805. PMID: 16183654. [PubMed](https://pubmed.ncbi.nlm.nih.gov/16183654/) Materials actually read: Summary read; external abstracts and full texts not read Findings recorded in the 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 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. | 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](https://pubmed.ncbi.nlm.nih.gov/25733570/) Materials actually read: Summary read; external abstracts and full texts not read Findings recorded in the 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 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. | 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. | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · 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](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · 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](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · 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](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · 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](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · 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/materials 1.0. Public pages and materials were created from the existing 42 items. No new clinical search, verification-status change, or scoring was performed.