# Reduced bathing/showering frequency × weekly flare-control cream-use days: evidence checklist Verdict 2947 · 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: Same UK online trial; age at least 1 year and POEM at least 3; baseline cream/respondent information unverified - Ingredient, formulation and route: Original study: once-or-twice-weekly baths/showers, 4-week comparison; no treatment-behavior implementation guidance - Dose: Not recorded - Comparator: At least six times weekly; both arms continued existing moisturizers/topical treatment - Measured outcome: Secondary result of mean flare-control cream-use days per week; distinct from symptoms, worsening, and harms - Duration: Four-week study; exact use-day collection/averaging period unverified - Questions outside this scope: Treating 3-point responders, mean POEM, the 2.2-point power assumption, and cream-use days as the same estimand, threshold, or hierarchy; Elevating 2.2 points to a validated minimal clinically important difference or an importance threshold for responders/use days; Calculating new RD/RR/CI/P/totals from original rates/events, doses/frequencies/amounts from use days, or hypothetical values; Reusing allocation 438 (220/218), primary model 388 (193/195), responders 169/171, or safety 165/168/170 as the unverified cream-use denominator; Using mean P=.30 as responder/cream P, or inheriting the general sensitivity narrative as review of all selected endpoints; Converting reduced cream-use days into symptom/worsening/safety benefit or instructions to reduce/stop treatment; Converting numerical directions of the two safety results or original unreported CI/P into significant worsening, causality, or safety certification; Reusing pediatric crossover 42/40 participants, 2 weeks, different frequency/duration with immediate occlusive moisturization, or SCORAD as direct effects for the current frequency/POEM responder/cream question; Converting pediatric evidence-list 2019/citation 2020 or review evidence-list 2020/citation 2021 year differences into new trials, added citations, or automatic corrections; Summing the same people, arms, weeks, crossover periods, citations, review, related sheets, or 2887/2426 links as new independent trials/participants; Converting registration “could not confirm”/“not applicable,” unreported support, historical public checks, or conflicts into current identity, absence, independence, or external-reading certification; Inheriting parent D30, original axes, or cross-checks as subclaim D grades/C scores/axes or current content review; Extending to optimal frequency, long-term/hot-humid/high-infection-risk settings, or effects/safety of other products/devices; New evidence/reassessment or instructions on bathing/showering frequency, application/moisturization, treatment use, or treatment implementation ## Checklist items ### N01 · Which existing cream-use-day question and verdict are preserved? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The selected existing subclaim is that reducing bathing to once or twice weekly lowers days of flare-control cream use. Its original wording, C grade, and note that the secondary result was not elevated to symptom benefit are preserved. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. The subclaim has no score/status/axis fields; parent D30 does not fill them. Mean POEM and 3-point responders, both D, are separate results. The original content review remains incomplete. - Reason for missing information: The subclaim has no score/status/axis fields; parent D30 does not fill them. Mean POEM and 3-point responders, both D, are separate results. - Required materials and conditions: Separation of the selected C grade/note from parent D30 and other subclaims - Materials to obtain first: Correction records for the selected entry and parent manuscript - Further research: Update the question, assessment record and assessment context separately. This is a proposal; no new investigation, calculation or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Separation of the selected C grade/note from parent D30 and other subclaims. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Separation of the selected C grade/note from parent D30 and other subclaims. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.5, §4.6.3; limits of this material conversion follow the review scope and internal design - Related sources: S01, S02, S03 ### N02 · Who were the actual population, recruits, and respondents? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The original scope was a UK-wide online trial of 438 people aged at least 1 year with POEM scores of at least 3. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Age/diagnosis, baseline cream use, recruitment/exclusions, child proxy responses, and the role of cream-use recorders are unverified. The original content review remains incomplete. - Reason for missing information: Age/diagnosis, baseline cream use, recruitment/exclusions, child proxy responses, and the role of cream-use recorders are unverified. - Required materials and conditions: Age at least 1 year, POEM criterion, online recruitment, baseline, and proxy responses - Materials to obtain first: Recruitment/baseline characteristics and cream-recording procedures - Further research: Record baseline use and representativeness of the selected population within the material scope. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Age at least 1 year, POEM criterion, online recruitment, baseline, and proxy responses. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Age at least 1 year, POEM criterion, online recruitment, baseline, and proxy responses. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M03 §3.2.1; detailed population conditions are Chamgap design; M08 Table 8.2.a, M03 §3.2.4; Chamgap adaptation - Related sources: S01 ### N03 · How did assigned frequency differ from actual exposure? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The comparison of once or twice weekly with at least six times weekly over 4 weeks describes historical study conditions. It does not create instructions on washing frequency or treatment behavior. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Actual bath/shower frequency, duration/temperature, adherence/changes, and additional exposure are unverified. The original content review remains incomplete. - Reason for missing information: Actual bath/shower frequency, duration/temperature, adherence/changes, and additional exposure are unverified. - Required materials and conditions: Once or twice weekly/at least six times weekly, 4 weeks, actual adherence, and changes - Materials to obtain first: Exposure, adherence, and arm-specific change records - Further research: Distinguish material on nominal assignment from actual exposure. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Once or twice weekly/at least six times weekly, 4 weeks, actual adherence, and changes. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Once or twice weekly/at least six times weekly, 4 weeks, actual adherence, and changes. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M03 §3.2.2–3.2.3; Reverse-direction labels and assessment adaptation are Chamgap design; M03 §3.2.3 and M08 §8.2.2–8.2.3; Chamgap application - Related sources: S01 ### N04 · How did common topical treatment relate to the cream endpoint? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Both arms continued usual moisturizers and topical treatment. Reduced use days are not a result instructing cessation of baseline treatment. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Details of concomitant treatment, cream identity/intensity, additional/rescue prescriptions, and arm-specific changes are unverified. The original content review remains incomplete. - Reason for missing information: Details of concomitant treatment, cream identity/intensity, additional/rescue prescriptions, and arm-specific changes are unverified. - Required materials and conditions: Moisturizers, usual topical treatment, selected use days, and arm-specific changes - Materials to obtain first: Treatment/cream-use and change records by arm - Further research: Distinguish frequency effects from concomitant treatment/treatment behavior. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Moisturizers, usual topical treatment, selected use days, and arm-specific changes. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Moisturizers, usual topical treatment, selected use days, and arm-specific changes. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M03 §3.2.3, M08 §8.2.2–8.2.3; own application; M03 §3.2.2–3.2.3; reverse-direction labels and test adaptations are our own design - Related sources: S01 ### N05 · Which question did trial design and allocation assess? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The online pragmatic parallel-group randomized superiority trial allocated 438 people as 220/218. POEM was primary and cream-use days secondary. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Allocation conduct, baseline cream balance, concealment, and secondary-testing plans are unverified. The original content review remains incomplete. - Reason for missing information: Allocation conduct, baseline cream balance, concealment, and secondary-testing plans are unverified. - Required materials and conditions: Online parallel groups, superiority, allocation/concealment, and baseline balance - Materials to obtain first: Allocation/baseline tables and primary/secondary hypothesis plans - Further research: Separate the overall design from the analysis specification of the selected secondary result. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Online parallel groups, superiority, allocation/concealment, and baseline balance. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Online parallel groups, superiority, allocation/concealment, and baseline balance. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M08 §8.1–8.2.3; Chamgap adaptation; M08 Table 8.2.a, M04 §4.6.3; Chamgap adaptation - Related sources: S01 ### N06 · What limits arise from impossible masking and use-day recording? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Participant masking was impossible given assigned frequency; the manuscript did not count it as a separate defect. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Cream-recording methods, self/proxy reports, diaries/recall, assessor/analyst masking, and arm-specific collection differences are unverified. The original content review remains incomplete. - Reason for missing information: Cream-recording methods, self/proxy reports, diaries/recall, assessor/analyst masking, and arm-specific collection differences are unverified. - Required materials and conditions: Recorder, collection method, and participant/assessor/analyst masking - Materials to obtain first: Cream-recording and masking/collection procedures - Further research: Record actual limits of treatment behavior and measurement. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Recorder, collection method, and participant/assessor/analyst masking. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Recorder, collection method, and participant/assessor/analyst masking. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M08 Table 8.2.a, M03 §3.2.4; internal application - Related sources: S01 ### N07 · What unit is a day of flare-control cream use? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The manuscript reports mean days of flare-control cream use per week. This is distinct from amount used, application frequency, potency, or symptom scores. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Medication classification, ingredient/potency, definition of a use day, and averaging/collection periods are unverified. Days are not converted into doses or amounts. The original content review remains incomplete. - Reason for missing information: Medication classification, ingredient/potency, definition of a use day, and averaging/collection periods are unverified. Days are not converted into doses or amounts. - Required materials and conditions: Cream definition, classification of a use day, days per week, and observation period - Materials to obtain first: Use-day definition and recording/results tables - Further research: Preserve the units and period of the treatment-behavior endpoint. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Cream definition, classification of a use day, days per week, and observation period. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Cream definition, classification of a use day, days per week, and observation period. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - 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, M03 §3.2.4; our own application - Related sources: S01 ### N08 · What were the original mean use-day difference and interval? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Original Korean/English values are preserved: mean use was 0.5 days per week lower in the once-or-twice-weekly arm, CI −0.8 to −0.1. The English manuscript describes an adjusted mean. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Arm-specific means/variances, adjustment variables/model, selected-result P value, and analysis denominator are unverified. No new difference/CI/P/total use days are calculated. The original content review remains incomplete. - Reason for missing information: Arm-specific means/variances, adjustment variables/model, selected-result P value, and analysis denominator are unverified. No new difference/CI/P/total use days are calculated. - Required materials and conditions: Arm correspondence, adjustment, direction, and original CI - Materials to obtain first: Adjusted cream results table and statistical analysis plan - Further research: Connect the original difference, direction, and interval with that secondary analysis. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Arm correspondence, adjustment, direction, and original CI. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Arm correspondence, adjustment, direction, and original CI. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M08 §8.2.2, M15 §15.3.1; Chamgap application; M15 §15.3.1–15.3.3; Chamgap application; M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are Chamgap's own design - Related sources: S01 ### N09 · What is the level of secondary-result hierarchy and multiplicity? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The manuscript explicitly described cream-use days as secondary, separate from the null primary symptom result. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Prespecified cream definitions/analysis, number of endpoints, multiplicity adjustment, and change history are unverified. The interval alone does not create a new confirmatory grade. The original content review remains incomplete. - Reason for missing information: Prespecified cream definitions/analysis, number of endpoints, multiplicity adjustment, and change history are unverified. The interval alone does not create a new confirmatory grade. - Required materials and conditions: Prespecified secondary definition, testing hypotheses, multiple comparisons, and changes - Materials to obtain first: Registration, protocol, statistical analysis plan, and secondary hierarchy - Further research: Distinguish material on primary/secondary results from selective reporting/plans. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Prespecified secondary definition, testing hypotheses, multiple comparisons, and changes. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Prespecified secondary definition, testing hypotheses, multiple comparisons, and changes. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M08 Table 8.2.a, M04 §4.6.3; Chamgap adaptation; M15 §15.3.1–15.3.3; Chamgap adaptation - Related sources: S01 ### N10 · Do fewer use days mean symptom benefit or reduced worsening? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The manuscript did not convert 0.5 fewer days per week into primary symptom benefit. The note for selected C preserves that scope. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Reasons for recorded use-day reduction, individual linkage with symptoms/worsening, and importance thresholds are unverified. Reduced treatment use is not elevated to clinical benefit, safety, or instructions for use. The original content review remains incomplete. - Reason for missing information: Reasons for recorded use-day reduction, individual linkage with symptoms/worsening, and importance thresholds are unverified. Reduced treatment use is not elevated to clinical benefit, safety, or instructions for use. - Required materials and conditions: Behavior endpoint, symptoms, worsening/harms, and interpretation scope - Materials to obtain first: Reasons for use days, symptom/worsening linkage, and importance material - Further research: Record behavior change separately from patient outcomes. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Behavior endpoint, symptoms, worsening/harms, and interpretation scope. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Behavior endpoint, symptoms, worsening/harms, and interpretation scope. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is Chamgap design; M03 §3.2.4; Chamgap extrapolation boundary; M15 §15.3.1–15.3.3; Chamgap adaptation - Related sources: S01 ### N11 · What separate results are primary mean POEM and the 2.2-point assumption? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The primary mean POEM difference −0.4 points (95% CI −1.3 to 0.4), P=.30, and exclusion of the assumed 2.2-point sample-size difference are preserved. The 2.2-point value is not a validated minimal clinically important difference. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. These score differences/assumptions are not transferred into effect, importance, or power thresholds for 0.5 use days. The original content review remains incomplete. - Reason for missing information: These score differences/assumptions are not transferred into effect, importance, or power thresholds for 0.5 use days. - Required materials and conditions: Four-week mean, scale, original CI/P, and power assumption - Materials to obtain first: Separate prespecified definitions and result tables for mean POEM/cream - Further research: Keep continuous symptoms and treatment-use days separate. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Four-week mean, scale, original CI/P, and power assumption. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Four-week mean, scale, original CI/P, and power assumption. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are Chamgap design; M15 §15.3.1–15.3.3; Chamgap adaptation; M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is Chamgap design - Related sources: S01 ### N12 · Are 3-point responders mixed with reduced cream use? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Week-4 responders 97/169 (57.4%) versus 91/171 (53.2%), adjusted RD 3.5 percentage points (CI −6.6 to 13.6), and RR 1.06 (CI 0.89 to 1.28) are a separate POEM result. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Responder counts, denominators, and RR are not used as counts/denominators/effects for cream users. Individual linkage between the two results is unverified. The original content review remains incomplete. - Reason for missing information: Responder counts, denominators, and RR are not used as counts/denominators/effects for cream users. Individual linkage between the two results is unverified. - Required materials and conditions: Threshold response, counts/denominators, original RD/RR, and use-day differences - Materials to obtain first: Endpoint-specific denominators and response/use-day linkage - Further research: Record the different units/questions of responders and use days. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Threshold response, counts/denominators, original RD/RR, and use-day differences. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Threshold response, counts/denominators, original RD/RR, and use-day differences. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are Chamgap design; M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are Chamgap design; M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is Chamgap design - Related sources: S01 ### N13 · What were the cream-use-day analysis denominator and missingness? Verification status: Unverified Reading scope: Summary read; external material unread - Current findings: Original values describe 438 people allocated as 220/218 and a primary model of 388 (193/195) with at least one follow-up POEM. - Why unverified: Currently required information in the stored summary is unverified. Arm-specific cream-use-day analysis/recording denominators, reasons for missingness, and handling are unverified. Primary-model, responder, or safety denominators are not automatically reused. The original content review remains incomplete. - Reason for missing information: Arm-specific cream-use-day analysis/recording denominators, reasons for missingness, and handling are unverified. Primary-model, responder, or safety denominators are not automatically reused. - Required materials and conditions: Allocation, recording, completion, analysis, and weekly/week-4 denominators - Materials to obtain first: Cream-endpoint flow and denominator/missingness tables - Further research: Link recorder/time-specific denominators separately if material is supplied. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Allocation, recording, completion, analysis, and weekly/week-4 denominators. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Allocation, recording, completion, analysis, and weekly/week-4 denominators. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; Design-specific adaptation is Chamgap design; M08 §8.2.2 and M15 §15.3.1; Chamgap application - Related sources: S01 ### N14 · Were analysis populations, adjustment, and sensitivity verified for cream? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The manuscript generally states that allocation-based analysis and missing-data sensitivity gave the same conclusion. The English cream result is described as an adjusted mean. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Cream-specific analysis populations/models/sensitivity values and ITT/PP definitions are unverified. General POEM context is not inherited as full confirmation of selected use days. The original content review remains incomplete. - Reason for missing information: Cream-specific analysis populations/models/sensitivity values and ITT/PP definitions are unverified. General POEM context is not inherited as full confirmation of selected use days. - Required materials and conditions: Effect of interest, ITT/PP, model, and missingness/sensitivity scope - Materials to obtain first: Cream analysis/statistical analysis plan and original sensitivity results - Further research: Distinguish endpoint-specific analysis from the general narrative. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Effect of interest, ITT/PP, model, and missingness/sensitivity scope. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Effect of interest, ITT/PP, model, and missingness/sensitivity scope. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M08 §8.2.2 and M15 §15.3.1: in-house application; M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4: design-specific adaptation is in-house. - Related sources: S01 ### N15 · Were registration, plans, and changes actually compared? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: ISRCTN12016473 is preserved as originally recorded. The original summary of secondary cream-use days is linked. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Registration, protocol, statistical analysis plan, and change history remain unread; access was not attempted. An identifier does not establish completed comparison of plans/multiplicity. The original content review remains incomplete. - Reason for missing information: Registration, protocol, statistical analysis plan, and change history remain unread; access was not attempted. An identifier does not establish completed comparison of plans/multiplicity. - Required materials and conditions: ISRCTN, prespecified cream definition, primary/secondary plans, and statistical analysis plan - Materials to obtain first: Registration history, protocol, and SAP - Further research: Separate prespecification, actual reporting, changes, and the level of supplied material. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: ISRCTN, prespecified cream definition, primary/secondary plans, and statistical analysis plan. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: ISRCTN, prespecified cream definition, primary/secondary plans, and statistical analysis plan. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M08 Table 8.2.a, M04 §4.6.3; Chamgap application; M04 §4.5–4.6 principles for collecting and selecting materials; separation of access and reading and hyperlink rules are Chamgap's own design - Related sources: S01 ### N16 · What was declared about NIHR support and noninvolvement? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Original wording gives NIHR Programme Grants for Applied Research, NIHR203279, and no role in design, collection, analysis, publication decisions, or writing. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Contracts/items, actual-role comparisons, and additional support are unverified. Declarations/public funding do not certify every aspect of independence. The original content review remains incomplete. - Reason for missing information: Contracts/items, actual-role comparisons, and additional support are unverified. Declarations/public funding do not certify every aspect of independence. - Required materials and conditions: Funding programme/identifier, roles, and actual verification scope - Materials to obtain first: Original funding and role disclosures - Further research: Separate support and declared noninvolvement from actual verification level. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Funding programme/identifier, roles, and actual verification scope. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Funding programme/identifier, roles, and actual verification scope. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: Chamgap's own conditions for independence and attribution. The official methodological sections used in this example do not validate every detail of these items. - Related sources: S01 ### N17 · What is the scope of unreported commercial supply and personal conflicts? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The manuscript preserves unreported product/device/placebo supply and commercial analysis services, E.J.M./AbbVie consultancy fees, and H.C.W./POEM and L.H./K.S.T./RECAP development disclosures. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Absence, influence, amounts, individual employment/patents, and writing/publication support have not been newly verified. Disclosures do not automatically invalidate results or certify independence. The original content review remains incomplete. - Reason for missing information: Absence, influence, amounts, individual employment/patents, and writing/publication support have not been newly verified. Disclosures do not automatically invalidate results or certify independence. - Required materials and conditions: Products/devices/placebos, analysis services, personal consultancy, and scale development - Materials to obtain first: Personal conflicts, support, and scale/analysis role material - Further research: Separate disclosed items from actual trial/result roles. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Products/devices/placebos, analysis services, personal consultancy, and scale development. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Products/devices/placebos, analysis services, personal consultancy, and scale development. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: Chamgap independence and attribution conditions; the official methodology sections used in this example do not certify all these detailed items; M08 Table 8.2.a, M03 §3.2.4; Chamgap adaptation - Related sources: S01 ### N18 · Is the pediatric crossover trial direct replication of cream-use days? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Cardona’s original scope was a single-masked pediatric crossover trial allocating 42 people with 40 completers, over 2 weeks, with SCORAD primary. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Results with the same cream-use-day definition/comparison, crossover sequence/washout, and period-specific denominators are unverified. It is not counted as the same direct replication. The original content review remains incomplete. - Reason for missing information: Results with the same cream-use-day definition/comparison, crossover sequence/washout, and period-specific denominators are unverified. It is not counted as the same direct replication. - Required materials and conditions: Children, crossover, 2 weeks, 42/40 participants, SCORAD, and different protocol - Materials to obtain first: Pediatric methods, period-specific results, and treatment-behavior material - Further research: Separate other populations, protocols, and crossover periods. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Children, crossover, 2 weeks, 42/40 participants, SCORAD, and different protocol. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Children, crossover, 2 weeks, 42/40 participants, SCORAD, and different protocol. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M04 §4.6.1–4.6.2; distinction between studies and reports; cohort and outcome connections are Chamgap adaptations; M03 §3.2.1; detailed population conditions are Chamgap design; M08 §8.1–8.2.3; Chamgap adaptation; M04 §4.6.1–4.6.2, M15 §15.3.1; Chamgap adaptation - Related sources: S02 ### N19 · To which comparison does the pediatric soak-and-seal result belong? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Historical pediatric conditions were twice daily for 15–20 minutes with immediate occlusive moisturization versus twice weekly for at most 10 minutes. The 21.2-point greater SCORAD reduction (CI 14.9 to 27.6), P<.0001, belongs to that comparison. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. This different protocol is not reused as an effect on current cream-use-day reduction. No application/bathing implementation instructions or POEM/day conversions are created. The original content review remains incomplete. - Reason for missing information: This different protocol is not reused as an effect on current cream-use-day reduction. No application/bathing implementation instructions or POEM/day conversions are created. - Required materials and conditions: Historical frequency/duration, occlusive moisturization, and SCORAD scope - Materials to obtain first: Pediatric intervention/moisturization, scale, and treatment-behavior material - Further research: Distinguish the earlier opposite-direction symptom result from selected use days. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Historical frequency/duration, occlusive moisturization, and SCORAD scope. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Historical frequency/duration, occlusive moisturization, and SCORAD scope. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M03 §3.2.2–3.2.3; reverse-direction marker and test adaptations are Chamgap design; M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are Chamgap design; M04 §4.6.1–4.6.2, M15 §15.3.1; Chamgap adaptation; M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is Chamgap design - Related sources: S02 ### N20 · What remains unverified about pediatric identity, years, registration, and funding? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Evidence-list year 2019, citation issue 2020/DOI 2019, registration field “could not confirm,” the historical classification “Research Support, Non-U.S. Gov't,” and unestablished supporting institution are preserved. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Publication stage and actual registration/institution/conflicts are unverified. Year differences do not add reports/trials, and “could not confirm” is not a registration identifier. The original content review remains incomplete. - Reason for missing information: Publication stage and actual registration/institution/conflicts are unverified. Year differences do not add reports/trials, and “could not confirm” is not a registration identifier. - Required materials and conditions: Evidence-list 2019, citation 2020, original registration wording, and historical abstract support classification - Materials to obtain first: Original bibliographic/publication history and registration/funding material - Further research: Separate historical wording from actual material identity. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Evidence-list 2019, citation 2020, original registration wording, and historical abstract support classification. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Evidence-list 2019, citation 2020, original registration wording, and historical abstract support classification. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M04 §4.6.1–4.6.2; distinction between studies and reports; cohort and outcome connections are Chamgap adaptations; M04 §4.5, §4.6.3; limitations of this conversion follow the review scope and Chamgap design; Chamgap independence and attribution conditions; the official methodology sections used in this example do not certify all these detailed items; M08 Table 8.2.a, M04 §4.6.3; Chamgap adaptation - Related sources: S02 ### N21 · Does the 13-study review concern the same secondary use-day result? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Hua’s review synthesized frequency/eczema severity from 13 prospective studies. Its original conclusion was that daily washing was not worse, but few heterogeneous studies left optimal frequency unclear. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. The same cream-use-day analysis, included populations/treatments/protocols, overlap, and effect-specific denominators are unverified. Synthesized severity and use days are not treated as the same. The original content review remains incomplete. - Reason for missing information: The same cream-use-day analysis, included populations/treatments/protocols, overlap, and effect-specific denominators are unverified. Synthesized severity and use days are not treated as the same. - Required materials and conditions: Included exposures/designs, severity/treatment-behavior endpoints, and heterogeneity - Materials to obtain first: Included studies and endpoint/protocol-specific results - Further research: Separate the background review from the selected secondary behavior question. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Included exposures/designs, severity/treatment-behavior endpoints, and heterogeneity. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Included exposures/designs, severity/treatment-behavior endpoints, and heterogeneity. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M04 §4.6.1–4.6.2; distinction between studies and reports; cohort and outcome connections are Chamgap adaptations; M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are Chamgap design; M04 §4.6.1–4.6.2, M15 §15.3.1; Chamgap adaptation; M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is Chamgap design - Related sources: S03 ### N22 · What are the historical review-year, support, and registration statements? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Evidence-list/manuscript 2020, citation issue 2021/DOI 2020, registration field “not applicable,” and unestablished specific funding are preserved. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Publication-stage differences, support/conflicts, and review plans/registration are unverified in this work. Not applicable or historical public checks are not converted into new verification of registration absence or reading. The original content review remains incomplete. - Reason for missing information: Publication-stage differences, support/conflicts, and review plans/registration are unverified in this work. Not applicable or historical public checks are not converted into new verification of registration absence or reading. - Required materials and conditions: Original 2020/citation 2021, unestablished funding, and not applicable - Materials to obtain first: Bibliographic/publication history and review plans/support - Further research: Distinguish original wording from the identity of newly supplied material. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Original 2020/citation 2021, unestablished funding, and not applicable. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Original 2020/citation 2021, unestablished funding, and not applicable. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M04 §4.5, §4.6.3; limitations of this conversion follow the review scope and Chamgap design; Chamgap independence and attribution conditions; the official methodology sections used in this example do not certify all these detailed items; M08 Table 8.2.a, M04 §4.6.3; Chamgap adaptation; M04 §4.5–4.6; material collection/selection principles; access/reading separation and hyperlink contract are Chamgap design - Related sources: S03 ### N23 · What were the treatment-change-for-worsening and medical-advice results? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Treatment changes 17/165 (10.3%) versus 13/168 (7.7%) and medical advice 20/165 (12.1%) versus 13/170 (7.6%) are separate original results. Both were numerically higher with less-frequent washing. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. They are not substituted as improvement/safety measures for cream-use days. Event definitions, overlap, missingness, and denominator correspondence are unverified; no new incidence or total is calculated. The original content review remains incomplete. - Reason for missing information: They are not substituted as improvement/safety measures for cream-use days. Event definitions, overlap, missingness, and denominator correspondence are unverified; no new incidence or total is calculated. - Required materials and conditions: Safety/behavior events, separate denominators, periods, and separation from cream-use days - Materials to obtain first: Event-specific safety/behavior definitions and denominator tables - Further research: Keep use days, treatment changes for worsening, and medical advice as distinct results. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Safety/behavior events, separate denominators, periods, and separation from cream-use days. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Safety/behavior events, separate denominators, periods, and separation from cream-use days. - Application exceptions: Addresses safety-material gaps for the selected subclaim. POEM, cream-use days, or parent safety wording do not establish safety or generate new harm incidence or instructions on bathing frequency/treatment behavior. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M19 §19.1.2–19.2.4; Chamgap adaptation; M19 §19.1.2–19.2.4; detailed distinctions are Chamgap design; M19 §19.1.2–19.2.4; Chamgap adaptation; M19 §19.1.2–19.2.4, M04 §4.6.3; Chamgap adaptation - Related sources: S01 ### N24 · What is the scope of unreported safety CI/P and causality? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The manuscript records that significant worsening cannot be concluded because between-arm CI/P values for the two safety outcomes were not reported. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. The complete external full text was not read in this work. Numerical direction is not converted into significant worsening, causality, or safety confirmation, and no new CI/P is calculated. The original content review remains incomplete. - Reason for missing information: The complete external full text was not read in this work. Numerical direction is not converted into significant worsening, causality, or safety confirmation, and no new CI/P is calculated. - Required materials and conditions: Between-arm testing, collection, baseline/concomitant treatment, discontinuation, and relatedness - Materials to obtain first: Safety analysis/collection and relatedness/concomitant treatment material - Further research: Separate actual reporting levels for efficacy/behavior and harms. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Between-arm testing, collection, baseline/concomitant treatment, discontinuation, and relatedness. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Between-arm testing, collection, baseline/concomitant treatment, discontinuation, and relatedness. - Application exceptions: Addresses safety-material gaps for the selected subclaim. POEM, cream-use days, or parent safety wording do not establish safety or generate new harm incidence or instructions on bathing frequency/treatment behavior. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M19 §19.1.2–19.2.4; Chamgap adaptation; M19 §19.2.2–19.2.4, M03 §3.2.3; Chamgap adaptation; M19 §19.2.2–19.2.4; design considerations; detailed confounding records are Chamgap design; Chamgap interpretation boundary; M19 is a reference principle, not execution of an official causality tool - Related sources: S01 ### N25 · How are the same reports, populations, and related sheets shared? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The existing two selected sheets share the same stored summary, direct trial, and context reports. Pediatric crossover periods, the same 42/40 participants, and the 13-study review are not summed as separate independent totals. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Review inclusion, related/follow-up report identity, and overlap have not been externally compared. Report counts and original R0/I2 do not newly certify independent replication. The original content review remains incomplete. - Reason for missing information: Review inclusion, related/follow-up report identity, and overlap have not been externally compared. Report counts and original R0/I2 do not newly certify independent replication. - Required materials and conditions: Online trial, pediatric crossover, review, and report/replication relationships - Materials to obtain first: Registration and included/related report tables - Further research: Separate unrecorded unique clinical totals from report/material entries. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Online trial, pediatric crossover, review, and report/replication relationships. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Online trial, pediatric crossover, review, and report/replication relationships. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: Study/report distinction in M04 §4.6.1–4.6.2; Cohort/outcome linkage is Chamgap application; M04 §4.6.1–4.6.2 and M15 §15.3.1; Chamgap application - Related sources: S01, S02, S03 ### N26 · Is the selected result extended to optimal frequency, long-term outcomes, or other products? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The manuscript links to bath additives 2887/water softeners 2426 as separate verdicts, not additional trials. Hot/humid environments, high infection risk, and beyond 4 weeks are scopes to which it did not generalize. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Direct material on long-term cream use, other environments/populations, and products was not retrieved in this work. No instructions on washing frequency, reducing/stopping treatment, or implementing treatment are created. The original content review remains incomplete. - Reason for missing information: Direct material on long-term cream use, other environments/populations, and products was not retrieved in this work. No instructions on washing frequency, reducing/stopping treatment, or implementing treatment are created. - Required materials and conditions: Direct evidence for 4 weeks/population, environments, separate products, and treatment behavior - Materials to obtain first: Material on separate populations/durations and related exposures - Further research: Separate other products, environments, and long-term questions from the current secondary result. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Direct evidence for 4 weeks/population, environments, separate products, and treatment behavior. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Direct evidence for 4 weeks/population, environments, separate products, and treatment behavior. - Application exceptions: Addresses safety-material gaps for the selected subclaim. POEM, cream-use days, or parent safety wording do not establish safety or generate new harm incidence or instructions on bathing frequency/treatment behavior. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M03 §3.2.1–3.2.4; dose, duration and effect-modification details are Chamgap design; M03 §3.2.4; Chamgap extrapolation boundary; M19 §19.1.2–19.2.4; Chamgap adaptation; M19 §19.1.2–19.2.4; Chamgap adaptation - Related sources: S01, S02, S03 ### N27 · What history do parent D30, languages, dates, empty values, and corrections represent? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: Parent D30, original axis C0, false flags and empty grade-override reasons, the bilingual manuscript, 2026-08-26, the empty correction array and empty deliberation string, historical cross-checks, original wording, and year differences are preserved in the complete stored summary. - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Parent D/score/axes are not reused as values of selected C. Original wording/typos were not automatically corrected, and no current search, original-language review, or correction check was performed. The original content review remains incomplete. - Reason for missing information: Parent D/score/axes are not reused as values of selected C. Original wording/typos were not automatically corrected, and no current search, original-language review, or correction check was performed. - Required materials and conditions: Selected C/parent D30, original axes, Korean/English manuscript, and cross-checks/corrections - Materials to obtain first: Correction records and user feedback - Further research: Distinguish the original record from production and amendment events. This is a proposal; no new investigation, calculation or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Selected C/parent D30, original axes, Korean/English manuscript, and cross-checks/corrections. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Selected C/parent D30, original axes, Korean/English manuscript, and cross-checks/corrections. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M04 §4.5, §4.6.3; current material-conversion limits reflect review scope and our own design; M04 §4.6.3, M15 §15.3.1–15.3.3; status distinctions are our own design - Related sources: S01, S02, S03 ### N28 · What is the reading level of summaries and external papers/plans/disclosures? Verification status: Partly verified Reading scope: Summary read; external material unread - Current findings: The complete stored summary and 3 evidence entries/3 citations were read for production and original source links connected. Summaries are marked “summary read” and external material “unread.” - Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. External abstracts/full texts, registration/protocols/statistical analysis plans, and disclosures remain unread; access was not attempted. Historical public checks and link existence are not inherited as acquisition, full-text reading, or review in this work. The original content review remains incomplete. - Reason for missing information: External abstracts/full texts, registration/protocols/statistical analysis plans, and disclosures remain unread; access was not attempted. Historical public checks and link existence are not inherited as acquisition, full-text reading, or review in this work. - Required materials and conditions: Material types, actual acquisition/reading, and original links - Materials to obtain first: Original material and actual reading history for each report - Further research: Update material-specific existence, acquisition, actual reading, and access history separately. This is a proposal; no new investigation, calculation, or trial was performed. - Conditions for verification: Corresponding original material and analysis scope must be supplied, with unverified matters distinguished, for: Material types, actual acquisition/reading, and original links. Stored wording is linked here; the original content review remains incomplete. - Why this condition is needed: A production item connecting required and available material for the selected question by distinguishing: Material types, actual acquisition/reading, and original links. - Application exceptions: Limited to the stored summary for the selected formulation, population, endpoint and period. It does not substitute for numbers from other formulations/trials/endpoints or unread external material. - Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review. - Referenced methods: M04 §4.5–4.6 material collection/selection principles; acquisition/reading separation and hyperlink specifications are internally designed; M04 §4.5, §4.6.3; limits of this material conversion follow the review scope and internal design - Related sources: S01, S02, S03 ## Evidence and sources ### S01 Bradshaw L et al. 2026 Eczema Bathing Study [PubMed](https://pubmed.ncbi.nlm.nih.gov/41208015/) Materials actually read: Summary read; external material unread Findings recorded in the summary: Mean use of 0.5 fewer days per week (95% CI −0.8 to −0.1) in the once-or-twice-weekly arm is preserved. The original English manuscript describes an adjusted mean. Arm-specific means, adjusted models, denominators, P values, and collection definitions are unverified; no new days, doses, differences, or confidence intervals are calculated. Mean POEM, responders, and the two safety outcomes have separate values, denominators, and hierarchies. Record level: Outcome wording in the stored summary Independent replication: The UK online Eczema Bathing Study and ISRCTN12016473 describe a parallel-group superiority trial of 438 people (220/218), aged at least 1 year with POEM scores of at least 3, comparing once or twice weekly with at least six times weekly for 4 weeks. Both arms continued usual moisturizers/topical treatment, participant masking was impossible, and the primary model contained 388 people (193/195). Week-4 responders 169/171, the unverified cream-use-day denominator, and safety-specific denominators 165/168/170 are distinct. The same trial, reports, participants, arms, weeks, and selected sheets sharing the same material are not summed as independent trials/participants. Report/material entries are not totals of unique clinical trials, participants, or independent replications; unique totals remain unrecorded. Cardona’s pediatric single-masked crossover trial preserves the evidence-list year 2019 separately from the citation’s 2020 issue and 2019 DOI. Its 42 allocated participants, 40 completers, 2 weeks, primary SCORAD, and combined bathing frequency/duration with immediate moisturization describe a different protocol. It is not direct replication of the current comparison, POEM responders, or cream-use days. Crossover periods, sequence, washout, publication stage, funding, and registration details are unverified. Selected sheets sharing material and report/material entries are not summed as unique trials, participants, or independent replications; unique totals remain unrecorded. Hua’s synthesis of 13 prospective studies preserves evidence-list/manuscript 2020 separately from citation issue 2021 and DOI 2020. Its original conclusion of few, heterogeneous protocols, eczema severity, and unclear optimal frequency is retained. Included/related trial overlap, population/endpoint denominators, and publication stages remain unverified; it is not counted as independent RCT, responder, or cream-use-day replication. Selected sheets sharing material and report/material entries are not summed as unique trials, participants, or independent replications; unique totals remain unrecorded. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored summary | Stored file | Stored summary | Summary read | Only stored-summary and bibliographic content was used for production. External material verification/review is not complete. | | External paper | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Registration material | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Protocol | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Statistical analysis plan | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Funding, product-support and COI material | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | ### S02 Cardona ID et al. 2019 pediatric soak-and-seal trial [PubMed](https://pubmed.ncbi.nlm.nih.gov/31733336/) Materials actually read: Summary read; external material unread Findings recorded in the summary: In the historical study, twice-daily 15–20-minute soak-and-seal produced a 21.2-point greater SCORAD reduction than twice-weekly bathing for at most 10 minutes (95% CI 14.9 to 27.6), P<0.0001. These values belong to a different protocol/scale and are not converted into POEM points, response rates, or cream-use days. Unverified registration, abstract support classification with supporting institution unestablished, and evidence-list/citation year differences are preserved and not backdated as external verification in this work. Record level: Outcome wording in the stored summary Independent replication: The UK online Eczema Bathing Study and ISRCTN12016473 describe a parallel-group superiority trial of 438 people (220/218), aged at least 1 year with POEM scores of at least 3, comparing once or twice weekly with at least six times weekly for 4 weeks. Both arms continued usual moisturizers/topical treatment, participant masking was impossible, and the primary model contained 388 people (193/195). Week-4 responders 169/171, the unverified cream-use-day denominator, and safety-specific denominators 165/168/170 are distinct. The same trial, reports, participants, arms, weeks, and selected sheets sharing the same material are not summed as independent trials/participants. Report/material entries are not totals of unique clinical trials, participants, or independent replications; unique totals remain unrecorded. Cardona’s pediatric single-masked crossover trial preserves the evidence-list year 2019 separately from the citation’s 2020 issue and 2019 DOI. Its 42 allocated participants, 40 completers, 2 weeks, primary SCORAD, and combined bathing frequency/duration with immediate moisturization describe a different protocol. It is not direct replication of the current comparison, POEM responders, or cream-use days. Crossover periods, sequence, washout, publication stage, funding, and registration details are unverified. Selected sheets sharing material and report/material entries are not summed as unique trials, participants, or independent replications; unique totals remain unrecorded. Hua’s synthesis of 13 prospective studies preserves evidence-list/manuscript 2020 separately from citation issue 2021 and DOI 2020. Its original conclusion of few, heterogeneous protocols, eczema severity, and unclear optimal frequency is retained. Included/related trial overlap, population/endpoint denominators, and publication stages remain unverified; it is not counted as independent RCT, responder, or cream-use-day replication. Selected sheets sharing material and report/material entries are not summed as unique trials, participants, or independent replications; unique totals remain unrecorded. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored summary | Stored file | Stored summary | Summary read | Only stored-summary and bibliographic content was used for production. External material verification/review is not complete. | | External paper | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Registration material | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Protocol | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Statistical analysis plan | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Funding, product-support and COI material | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | ### S03 Hua T et al. 2020 systematic review and meta-analysis [PubMed](https://pubmed.ncbi.nlm.nih.gov/33196889/) Materials actually read: Summary read; external material unread Findings recorded in the summary: The original conclusion was that daily washing was not associated with worse severity, but studies were few and heterogeneous, leaving optimal frequency unclear. This does not verify optimal frequency, all safety, or the selected responder/use-day effects. Gaps in included studies, endpoint-specific values, review support/conflicts/plans, and original year differences are retained. Record level: Outcome wording in the stored summary Independent replication: The UK online Eczema Bathing Study and ISRCTN12016473 describe a parallel-group superiority trial of 438 people (220/218), aged at least 1 year with POEM scores of at least 3, comparing once or twice weekly with at least six times weekly for 4 weeks. Both arms continued usual moisturizers/topical treatment, participant masking was impossible, and the primary model contained 388 people (193/195). Week-4 responders 169/171, the unverified cream-use-day denominator, and safety-specific denominators 165/168/170 are distinct. The same trial, reports, participants, arms, weeks, and selected sheets sharing the same material are not summed as independent trials/participants. Report/material entries are not totals of unique clinical trials, participants, or independent replications; unique totals remain unrecorded. Cardona’s pediatric single-masked crossover trial preserves the evidence-list year 2019 separately from the citation’s 2020 issue and 2019 DOI. Its 42 allocated participants, 40 completers, 2 weeks, primary SCORAD, and combined bathing frequency/duration with immediate moisturization describe a different protocol. It is not direct replication of the current comparison, POEM responders, or cream-use days. Crossover periods, sequence, washout, publication stage, funding, and registration details are unverified. Selected sheets sharing material and report/material entries are not summed as unique trials, participants, or independent replications; unique totals remain unrecorded. Hua’s synthesis of 13 prospective studies preserves evidence-list/manuscript 2020 separately from citation issue 2021 and DOI 2020. Its original conclusion of few, heterogeneous protocols, eczema severity, and unclear optimal frequency is retained. Included/related trial overlap, population/endpoint denominators, and publication stages remain unverified; it is not counted as independent RCT, responder, or cream-use-day replication. Selected sheets sharing material and report/material entries are not summed as unique trials, participants, or independent replications; unique totals remain unrecorded. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored summary | Stored file | Stored summary | Summary read | Only stored-summary and bibliographic content was used for production. External material verification/review is not complete. | | External paper | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Registration material | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Protocol | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Statistical analysis plan | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | | Funding, product-support and COI material | Public availability unverified; only bibliography links preserved | Unread; access not attempted | Not read | No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status. | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Preserved method HTML copies; no current method-content re-review or official tool execution - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Preserved method HTML copies; no current method-content re-review or official tool execution - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Preserved method HTML copies; no current method-content re-review or official tool execution - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Preserved method HTML copies; no current method-content re-review or official tool execution - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Preserved method HTML copies; no current method-content re-review or official tool execution ## What the statuses mean - Met: Status for necessary evidence confirmed after existing content review. No completion is declared in the current presentation. - Partly verified: Some information in the stored summary is linked into the table. External comparison/content review is not complete. - Unverified: The article leaves this unverified, or required material is absent from the current stored summary. This is distinct from zero, absence or safety. - Review incomplete: Existing content review remains incomplete. - Not reported: Not reported within the stored material actually read; not extended to the entire primary paper. - Inaccessible: Means an actual access failure. Access not attempted here is not assigned this state. - Not applicable: Not used as a substitute for an evidence gap. - Conflicting data: Requires an observed disagreement under the same comparison criteria; not automatically judged in this production. - Insufficient evidence for the conditions: Marks a gap in additional material required by the selected conditions; not a new efficacy grade. ## Change history 2026-10-11 · Public page/materials 1.0. Public reader pages and material were prepared from the existing 28 items. No new clinical searches, verification-state changes or scoring were performed.