# Reduced bathing/showering frequency × POEM improvement responders of at least 3 points at 4 weeks: 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: UK online recruitment; 438 people aged at least 1 year with POEM scores of at least 3; detailed population/respondent information unverified
- Ingredient, formulation and route: Original study: baths/showers once or twice weekly for 4 weeks; actual exposure/adherence unverified
- Dose: Not recorded
- Comparator: Active lifestyle comparator of at least six times weekly; both arms continued usual moisturizers/topical treatment
- Measured outcome: Week-4 responders improving by at least 3 POEM points; adjusted risk difference/RR, distinct from mean/use days
- Duration: Week-4 responder time point kept separate from the mean of weekly measurements over 4 weeks
- 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 responder question and original verdict are preserved?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The selected question is whether reducing bathing to once or twice weekly increases improvement of at least 3 POEM points. Its D grade and original RR/rate note are preserved. Parent D30 and axes are parent context.
- 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 values do not fill them. Mean POEM D and cream-use days C are other subclaims. The original content review remains incomplete.
- Reason for missing information: The subclaim has no score/status/axis fields; parent values do not fill them. Mean POEM D and cream-use days C are other subclaims.
- Required materials and conditions: Distinction between the selected subclaim, grade/note, and parent context
- Materials to obtain first: Correction records for the selected claim and parent assessment
- Further research: Keep the question and verdict record separate when updating. 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: Distinction between the selected subclaim, grade/note, and parent context. 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: Distinction between the selected subclaim, grade/note, and parent context.
- 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 is the actual population for the responder result?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The original manuscript describes a UK-wide online trial recruiting 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. Diagnostic criteria, age distribution, baseline severity, exclusions, and child respondent/proxy procedures are unverified. The original content review remains incomplete.
- Reason for missing information: Diagnostic criteria, age distribution, baseline severity, exclusions, and child respondent/proxy procedures are unverified.
- Required materials and conditions: Age, diagnosis, baseline POEM, recruitment, and eligibility/exclusions
- Materials to obtain first: Recruitment/eligibility criteria and baseline/respondent characteristics
- Further research: Connect the actual population scope with differences from other populations. 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, diagnosis, baseline POEM, recruitment, and eligibility/exclusions. 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, diagnosis, baseline POEM, recruitment, and eligibility/exclusions.
- 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's own design
- Related sources: S01

### N03 · What were the study frequency and actual bath/shower exposure?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The historical study compared once or twice weekly with at least six times weekly over 4 weeks. This is not guidance on bathing or showering frequency.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Actual frequency, bath/shower proportions, water temperature/duration, and adherence/changes by arm are unverified. The original content review remains incomplete.
- Reason for missing information: Actual frequency, bath/shower proportions, water temperature/duration, and adherence/changes by arm are unverified.
- Required materials and conditions: Assigned frequency, actual frequency, baths/showers, adherence, and duration
- Materials to obtain first: Exposure, adherence, and change records
- Further research: Distinguish 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: Assigned frequency, actual frequency, baths/showers, adherence, and duration. 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: Assigned frequency, actual frequency, baths/showers, adherence, and duration.
- 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 · What were the comparator and treatments common to both arms?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The comparator was an active lifestyle regimen of at least six times weekly. Both arms continued usual moisturizers and topical treatment.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Treatment identity, intensity, adherence, additional/rescue treatment, and changes by arm are unverified. No new effect of common treatment or instruction to change medication is created. The original content review remains incomplete.
- Reason for missing information: Treatment identity, intensity, adherence, additional/rescue treatment, and changes by arm are unverified. No new effect of common treatment or instruction to change medication is created.
- Required materials and conditions: Active lifestyle comparator, moisturizers, topical treatment, and arm differences
- Materials to obtain first: Common/changed treatments by arm and material on the effect of interest
- Further research: Separate the contribution of lifestyle frequency from concomitant treatment. 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: Active lifestyle comparator, moisturizers, topical treatment, and arm 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: Active lifestyle comparator, moisturizers, topical treatment, and arm 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 §3.2.2–3.2.3; 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

### N05 · What were the randomized design and allocation?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: This was an online pragmatic parallel-group randomized superiority trial allocating 438 people as 220/218.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Allocation sequence, concealment, and detailed baseline balance by arm are unverified in this summary. The original content review remains incomplete.
- Reason for missing information: Allocation sequence, concealment, and detailed baseline balance by arm are unverified in this summary.
- Required materials and conditions: Parallel groups, superiority, allocation/concealment, and baseline balance
- Materials to obtain first: Allocation methods and baseline characteristics
- Further research: Distinguish the design label from the verified scope of actual conduct. 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: 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: 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; own application; M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptation is our own design
- Related sources: S01

### N06 · What were the limits of masking and responder measurement?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: Participant masking was impossible given assigned bathing frequency. The original manuscript records that it did not count this 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. Assessor/analyst masking, child proxy responses, and differences between weekly and week-4 collection are unverified. Impossibility alone does not create a new verdict of measurement failure. The original content review remains incomplete.
- Reason for missing information: Assessor/analyst masking, child proxy responses, and differences between weekly and week-4 collection are unverified. Impossibility alone does not create a new verdict of measurement failure.
- Required materials and conditions: Participants/assessors, respondents, and data-collection procedures
- Materials to obtain first: Masking and response-collection procedures
- Further research: Record limits of symptom measurement and behavior change within the source 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: Participants/assessors, respondents, and data-collection procedures. 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: Participants/assessors, respondents, and data-collection procedures.
- 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 outcomes are POEM and improvement of at least 3 points?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: POEM has seven symptom items for the previous week, ranging from 0 to 28 points, with higher scores indicating worse symptoms. The selected result is the proportion improving by at least 3 points at 4 weeks.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Detailed rules for baseline-relative improvement, missing items, the responder analysis plan, and denominator selection are unverified. The original content review remains incomplete.
- Reason for missing information: Detailed rules for baseline-relative improvement, missing items, the responder analysis plan, and denominator selection are unverified.
- Required materials and conditions: Scale, direction, baseline-relative response definition, and time point
- Materials to obtain first: Response definition, scale collection, and analysis plan
- Further research: Keep the continuous mean and threshold response as different estimands. 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: Scale, direction, baseline-relative response definition, and time point. 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: Scale, direction, baseline-relative response definition, and time point.
- 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; outcome adaptation to each question is internally designed; M08 Table 8.2.a, M03 §3.2.4; internal application; M08 Table 8.2.a, M04 §4.6.3; internal application
- Related sources: S01

### N08 · Are the 3-point response threshold and 2.2-point power assumption the same?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The responder threshold is improvement of at least 3 POEM points. The manuscript explicitly describes 2.2 points as the sample-size assumption for the primary mean result, rather than 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. The basis/prespecification of the 3-point responder threshold and the importance of the responder result are unverified. The two thresholds do not replace one another. The original content review remains incomplete.
- Reason for missing information: The basis/prespecification of the 3-point responder threshold and the importance of the responder result are unverified. The two thresholds do not replace one another.
- Required materials and conditions: Threshold response definition, assumed mean difference, and clinical importance
- Materials to obtain first: Original basis for the response threshold and sample-size/planning material
- Further research: Record threshold response, mean effect, and power assumption 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: Threshold response definition, assumed mean difference, and clinical importance. 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 definition, assumed mean difference, and clinical importance.
- 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 result adaptation is our own design; M15 §15.3.1–15.3.3; own application; M08 Table 8.2.a, M04 §4.6.3; own application
- Related sources: S01

### N09 · What were the original responder counts, denominators, and rates?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: Original values for improvement of at least 3 points at 4 weeks are preserved: 97/169 (57.4%) in the once-or-twice-weekly arm versus 91/171 (53.2%) in the at-least-six-times-weekly arm.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Selection/attrition reasons for responder denominators, observation/imputation, and baseline correspondence by arm are unverified. No new total, difference, or rate is calculated. The original content review remains incomplete.
- Reason for missing information: Selection/attrition reasons for responder denominators, observation/imputation, and baseline correspondence by arm are unverified. No new total, difference, or rate is calculated.
- Required materials and conditions: Arm correspondence, responders/denominators, time point, and definition
- Materials to obtain first: Week-4 responder flow/results table
- Further research: Distinguish responder denominators from allocation/primary-model denominators. 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, responders/denominators, time point, and definition. 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, responders/denominators, time point, and definition.
- 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, M19 §19.1.2–19.2.4; design-specific adaptations are Chamgap's own design; M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are Chamgap's own design
- Related sources: S01

### N10 · What estimates are the adjusted risk difference and RR?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The adjusted risk difference of 3.5 percentage points (95% CI −6.6 to 13.6) and adjusted RR 1.06 (95% CI 0.89 to 1.28) are preserved.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Adjustment variables, model, actual included denominator, and responder P value are unverified. No new RD/RR/CI is calculated from the original rates. The original content review remains incomplete.
- Reason for missing information: Adjustment variables, model, actual included denominator, and responder P value are unverified. No new RD/RR/CI is calculated from the original rates.
- Required materials and conditions: Original RD/RR, intervals, adjusted model, and denominator
- Materials to obtain first: Adjusted responder analysis table and statistical analysis plan
- Further research: Keep original rates and adjusted estimands distinct. 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 RD/RR, intervals, adjusted model, and denominator. 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 RD/RR, intervals, adjusted model, and denominator.
- 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

### N11 · What did the record say the nonsignificant responder result meant?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The selected note records the original rate/RR result as null. Its original intervals and D grade are preserved as history.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. No new conclusion of exactly zero effect, equivalence, or exclusion of all important responder benefits is made. Criteria/plans for responder importance are unverified. The original content review remains incomplete.
- Reason for missing information: No new conclusion of exactly zero effect, equivalence, or exclusion of all important responder benefits is made. Criteria/plans for responder importance are unverified.
- Required materials and conditions: Original null interpretation, interval of compatible effects, and importance
- Materials to obtain first: Responder importance, hypotheses, and original conclusions
- Further research: Keep observed intervals and the scope of the original conclusion 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: Original null interpretation, interval of compatible effects, and importance. 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 null interpretation, interval of compatible effects, and importance.
- 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: M15 §15.3.1–15.3.3; Chamgap application; M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is Chamgap's own design
- Related sources: S01

### N12 · Is primary mean POEM being used as a responder value?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The primary outcome was the mean of weekly POEM measurements over 4 weeks. The adjusted difference −0.4 points (95% CI −1.3 to 0.4), P=.30, and exclusion of the assumed 2.2-point difference concern the mean result.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. The mean P=.30, interval, power assumption, and 388-person model are not reused as responder results or denominators. The original content review remains incomplete.
- Reason for missing information: The mean P=.30, interval, power assumption, and 388-person model are not reused as responder results or denominators.
- Required materials and conditions: Primary endpoint, continuous value/threshold response, time point, and denominator
- Materials to obtain first: Primary/secondary endpoint hierarchy and separate result tables
- Further research: Record mean POEM, responders, and cream-use days 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: Primary endpoint, continuous value/threshold response, time point, and denominator. 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: Primary endpoint, continuous value/threshold response, time point, and denominator.
- 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, M04 §4.6.3; Chamgap adaptation; M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is Chamgap design
- Related sources: S01

### N13 · How do allocation, primary-model, and week-4 responder denominators differ?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: Original denominators are preserved separately: 438 randomized as 220/218; the primary model of 388 people (193/195) with at least one follow-up POEM; and responders 169/171.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Exact correspondence between responder denominators and primary-model participants, plus missingness reasons/handling by arm, is unverified. No new missing-data count or rate is calculated. The original content review remains incomplete.
- Reason for missing information: Exact correspondence between responder denominators and primary-model participants, plus missingness reasons/handling by arm, is unverified. No new missing-data count or rate is calculated.
- Required materials and conditions: Allocation, follow-up responses, model, and endpoint-specific analysis denominators
- Materials to obtain first: Endpoint-specific flow diagrams and missingness/denominator tables
- Further research: Distinguish allocation from observed/model/responder analyses. 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, follow-up responses, model, and endpoint-specific analysis 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, follow-up responses, model, and endpoint-specific analysis 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 · Which endpoint did allocation-based analysis and missing-data sensitivity concern?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The original manuscript records the same conclusion from analysis by assigned allocation and missing-data sensitivity analyses.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Responder-specific models/values, ITT/PP definitions, and missingness assumptions are unverified. The general narrative is not treated as confirmation of every responder sensitivity analysis. The original content review remains incomplete.
- Reason for missing information: Responder-specific models/values, ITT/PP definitions, and missingness assumptions are unverified. The general narrative is not treated as confirmation of every responder sensitivity analysis.
- Required materials and conditions: Analysis population, missingness assumptions, sensitivity results, and original scope
- Materials to obtain first: Analysis populations, statistical analysis plan, and endpoint-specific sensitivity results
- Further research: Separate the original general narrative from the verified scope of the selected responder 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: Analysis population, missingness assumptions, sensitivity results, and original 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: Analysis population, missingness assumptions, sensitivity results, and original 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 · Does the cream-use-day result demonstrate responder improvement?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: Mean cream use of 0.5 fewer days per week (95% CI −0.8 to −0.1) in the once-or-twice-weekly arm was secondary. The manuscript did not elevate this to a symptom benefit.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. The cream-use-day denominator/definition, intent, and linkage by responder are unverified. Reduced medication use is not converted into improved POEM response. The original content review remains incomplete.
- Reason for missing information: The cream-use-day denominator/definition, intent, and linkage by responder are unverified. Reduced medication use is not converted into improved POEM response.
- Required materials and conditions: Separation of symptom response, treatment behavior, and secondary use days
- Materials to obtain first: Cream-use days, responder linkage, and prespecified hierarchy
- Further research: Keep behavior endpoints and symptom response as different questions. 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 symptom response, treatment behavior, and secondary 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: Separation of symptom response, treatment behavior, and secondary use days.
- 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; M04 §4.6.3, M15 §15.3.1–15.3.3; separation of statuses is Chamgap design; M03 §3.2.3, M08 §8.2.2–8.2.3; Chamgap adaptation
- Related sources: S01

### N16 · Were responder definitions/multiplicity verified in registration and plans?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The original registration identifier is ISRCTN12016473. The summaries for the primary mean and week-4 responders are linked.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Original registration/planning documents, change histories, prespecified responder definitions, and multiple comparisons remain unread; access was not attempted. An identifier does not complete comparison with plans. The original content review remains incomplete.
- Reason for missing information: Original registration/planning documents, change histories, prespecified responder definitions, and multiple comparisons remain unread; access was not attempted. An identifier does not complete comparison with plans.
- Required materials and conditions: Registration, protocol, statistical analysis plan, primary/secondary hierarchy, and changes
- Materials to obtain first: Registration history, protocol, and SAP
- Further research: Distinguish planned/changed endpoints, analyses, and time points. 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: Registration, protocol, statistical analysis plan, primary/secondary hierarchy, 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: Registration, protocol, statistical analysis plan, primary/secondary hierarchy, 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 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

### N17 · What is the scope of funding and declared noninvolvement?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: NIHR Programme Grants for Applied Research, NIHR203279, and the narrative of no role in design, collection, analysis, publication decisions, or writing are preserved.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Contracts, implementation, checking actual noninvolvement, and additional support are unverified. Public funding/declarations are not converted into certification of independence. The original content review remains incomplete.
- Reason for missing information: Contracts, implementation, checking actual noninvolvement, and additional support are unverified. Public funding/declarations are not converted into certification of independence.
- Required materials and conditions: NIHR programme/identifier, support, and role disclosures
- Materials to obtain first: Original funding and role disclosures
- Further research: Separate support sources, declared roles, and 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: NIHR programme/identifier, support, and role disclosures. 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: NIHR programme/identifier, support, and role disclosures.
- 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

### N18 · What is the scope of unreported product/device/placebo/commercial analysis support?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The manuscript records that product/device/placebo supply and commercial analysis services were not reported.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Actual absence has not been newly verified. Individual employment/patents, writing/publication costs, and all support are unverified. The original content review remains incomplete.
- Reason for missing information: Actual absence has not been newly verified. Individual employment/patents, writing/publication costs, and all support are unverified.
- Required materials and conditions: Product/device/placebo supply, commercial analysis, and writing/publication support
- Materials to obtain first: Support, author, analysis/writing/publication disclosures
- Further research: Distinguish unreported and unverified from absent. 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: Product/device/placebo supply, commercial analysis, and writing/publication support. 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: Product/device/placebo supply, commercial analysis, and writing/publication support.
- 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

### N19 · What were the consultancy-fee and scale-development disclosures?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The manuscript retained as conflicts E.J.M.’s personal fees from AbbVie, H.C.W.’s POEM development, and L.H./K.S.T.’s RECAP development disclosures.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Amounts, periods, contracts, measurement/analysis roles, and influence are unverified. Disclosures are not converted automatically into bias, result exclusion, or a new independence verdict. The original content review remains incomplete.
- Reason for missing information: Amounts, periods, contracts, measurement/analysis roles, and influence are unverified. Disclosures are not converted automatically into bias, result exclusion, or a new independence verdict.
- Required materials and conditions: Personal consultancy fees, POEM/RECAP development, conflicts, and actual roles
- Materials to obtain first: Original personal conflict and scale/analysis role documents
- Further research: Record each disclosure separately from actual trial 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: Personal consultancy fees, POEM/RECAP development, conflicts, and actual roles. 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: Personal consultancy fees, POEM/RECAP development, conflicts, and actual roles.
- 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

### N20 · Does the earlier pediatric crossover trial ask the same responder question?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The stored context describes Cardona’s randomized single-masked crossover trial in 42 children, 40 completers, 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. Age/baseline details, crossover sequence/washout, period-specific denominators, and POEM 3-point responders are unverified. It is not counted as direct replication of the same responder result. The original content review remains incomplete.
- Reason for missing information: Age/baseline details, crossover sequence/washout, period-specific denominators, and POEM 3-point responders are unverified. It is not counted as direct replication of the same responder result.
- Required materials and conditions: Population, crossover design, duration, different protocol, and SCORAD
- Materials to obtain first: Pediatric trial methods and period-specific result tables
- Further research: Do not sum the same children or repeated periods as independent trials/participants. 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: Population, crossover design, duration, different protocol, and SCORAD. 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: Population, crossover design, duration, different protocol, and SCORAD.
- 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

### N21 · What were the opposite direction and SCORAD values of the pediatric protocol?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The historical pediatric study compared twice-daily 15–20-minute soak-and-seal with immediate occlusive moisturization against twice-weekly bathing for at most 10 minutes. The original 21.2-point greater SCORAD reduction (95% CI 14.9 to 27.6), P<.0001, belongs only 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 is not the same frequency-only comparison as the current online trial and is not converted into POEM points or response rates. No implementation instructions are created. The original content review remains incomplete.
- Reason for missing information: This is not the same frequency-only comparison as the current online trial and is not converted into POEM points or response rates. No implementation instructions are created.
- Required materials and conditions: Differences in historical exposure, immediate occlusive moisturization, scale, and duration
- Materials to obtain first: Exposure/moisturization, scale, and crossover analysis material
- Further research: Preserve the opposite result from a different moisturization protocol and scale. 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: Differences in historical exposure, immediate occlusive moisturization, scale, and duration. 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: Differences in historical exposure, immediate occlusive moisturization, scale, and duration.
- 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

### N22 · How are the pediatric report’s years, registration, and support preserved?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The evidence list gives Cardona 2019; the citation gives the 2020 issue and 2019 DOI wording. The original registration field “could not confirm” and historical abstract classification “Research Support, Non-U.S. Gov't” are preserved.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Publication stages underlying the year difference, actual supporting institution/conflicts, and registration are unverified. These are not turned into a new paper/independent trial or an actual registration identifier. The original content review remains incomplete.
- Reason for missing information: Publication stages underlying the year difference, actual supporting institution/conflicts, and registration are unverified. These are not turned into a new paper/independent trial or an actual registration identifier.
- Required materials and conditions: Report identity, evidence-list/citation years, registration records, and funding
- Materials to obtain first: Original bibliographic/publication history and registration/support material
- Further research: Separate year wording, trial identity, and 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: Report identity, evidence-list/citation years, registration records, and funding. 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: Report identity, evidence-list/citation years, registration records, and funding.
- 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

### N23 · Does the review directly answer the same 3-point responder question?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: Hua’s review synthesized bathing/showering frequency and eczema severity from 13 prospective studies. Its original conclusion was that daily washing was not associated with worse severity, but studies were few and heterogeneous and the optimal frequency was unclear.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Direct analysis of the selected POEM 3-point responders/current comparison, trial-specific/population-specific results, and overlap are unverified. The review is not counted as new direct replication. The original content review remains incomplete.
- Reason for missing information: Direct analysis of the selected POEM 3-point responders/current comparison, trial-specific/population-specific results, and overlap are unverified. The review is not counted as new direct replication.
- Required materials and conditions: Included protocols, endpoints, heterogeneity, populations, and designs
- Materials to obtain first: Included studies and protocol/endpoint-specific result tables
- Further research: Distinguish synthesis context from different protocols from the original responder 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 protocols, endpoints, heterogeneity, populations, and designs. 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 protocols, endpoints, heterogeneity, populations, and designs.
- 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

### N24 · What are the review’s year, registration, and funding statements?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The evidence list/manuscript describes the 2020 review; the citation gives the 2021 issue and 2020 DOI. The original registration field “not applicable” and historical statement that specific funding could not be established are preserved.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Differences in publication stage, actual funding/conflicts, and plans/registration have not been externally verified in this work. Not applicable is not used to certify absence of registration. The original content review remains incomplete.
- Reason for missing information: Differences in publication stage, actual funding/conflicts, and plans/registration have not been externally verified in this work. Not applicable is not used to certify absence of registration.
- Required materials and conditions: Citation/evidence-list years, support/plans, and historical access scope
- Materials to obtain first: Bibliographic/publication history and review plans/disclosures
- Further research: Distinguish original years, identity, and access history from new 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: Citation/evidence-list years, support/plans, and historical access 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: Citation/evidence-list years, support/plans, and historical access 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 §4.5, §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

### N25 · What are the original rates/denominators for the two safety outcomes?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: Treatment changes for worsening, 17/165 (10.3%) versus 13/168 (7.7%), and medical advice, 20/165 (12.1%) versus 13/170 (7.6%), are preserved separately. The original narrative describes both as numerically higher in the less-frequent-washing arm.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. These differ from responder denominators 169/171 and primary-model denominators 193/195. Event definitions/exact periods, overlap, and missingness are unverified; no new incidence or total is calculated. The original content review remains incomplete.
- Reason for missing information: These differ from responder denominators 169/171 and primary-model denominators 193/195. Event definitions/exact periods, overlap, and missingness are unverified; no new incidence or total is calculated.
- Required materials and conditions: Treatment changes for worsening, medical advice, people/denominators, and time point
- Materials to obtain first: Outcome-specific safety/behavior definitions and denominator tables
- Further research: Distinguish each outcome’s units from POEM responder units. 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: Treatment changes for worsening, medical advice, people/denominators, and time point. 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: Treatment changes for worsening, medical advice, people/denominators, and time point.
- 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

### N26 · Do numerical safety differences establish significant worsening or 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 absence of all safety concerns, 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 absence of all safety concerns, and no new CI/P is calculated.
- Required materials and conditions: Original unreported CI/P wording, collection, concomitant treatment, and verdict scope
- Materials to obtain first: Safety analysis, collection, and concomitant treatment material
- Further research: Separate actual levels of behavior/worsening records, testing, and causality. 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 unreported CI/P wording, collection, concomitant treatment, and verdict 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: Original unreported CI/P wording, collection, concomitant treatment, and verdict scope.
- 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

### N27 · How are reports, crossover periods, and related sheets shared?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: The online trial, pediatric crossover trial, and review are distinguished by report. The existing two selected sheets share the same stored summary and direct trial. The pediatric 42/40 participants, crossover periods, and 13-study review do not constitute a new total of independent participants.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Included/related reports and identity overlap in the review have not been externally compared. Original R0/I2 are not used as new replication/independence certification. The original content review remains incomplete.
- Reason for missing information: Included/related reports and identity overlap in the review have not been externally compared. Original R0/I2 are not used as new replication/independence certification.
- Required materials and conditions: Citation-to-trial/review-to-result linkage and repeated/included relationships
- Materials to obtain first: Included/related report tables and registration linkage
- Further research: Distinguish unrecorded unique clinical totals from report 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: Citation-to-trial/review-to-result linkage and repeated/included 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: Citation-to-trial/review-to-result linkage and repeated/included 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

### N28 · Are related manuscript links and other products/long-term scopes combined?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: Stored links to bath additives 2887 and water softeners 2426 are separate original verdicts and are not additional trials for this question. The manuscript did not generalize beyond 4 weeks, to hot/humid environments, or to people at high infection risk.
- Why unverified: Only the corresponding stored-summary information is recorded; detailed original material remains unread and the original content review incomplete. Direct material for related manuscripts, long-term outcomes, other environments, and risk groups was not retrieved in this work. No optimal-frequency or treatment-behavior guidance is created. The original content review remains incomplete.
- Reason for missing information: Direct material for related manuscripts, long-term outcomes, other environments, and risk groups was not retrieved in this work. No optimal-frequency or treatment-behavior guidance is created.
- Required materials and conditions: Selected frequency/4-week response, separate manuscripts, climates, and risk groups
- Materials to obtain first: Material on separate exposures/populations and long-term outcomes
- Further research: Separate other products, environments, and durations from the selected 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: Selected frequency/4-week response, separate manuscripts, climates, and risk groups. 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 frequency/4-week response, separate manuscripts, climates, and risk groups.
- 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

### N29 · What is the scope of original verdicts, dates, languages, empty values, and corrections?

Verification status: Partly verified  
Reading scope: Summary read; external material unread

- Current findings: 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 bibliographic 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. Manuscript wording/typos and year differences are not automatically corrected. This is not a new current search, original-paper review, original-language comparison, or correction check. The original content review remains incomplete.
- Reason for missing information: Manuscript wording/typos and year differences are not automatically corrected. This is not a new current search, original-paper review, original-language comparison, or correction check.
- Required materials and conditions: D30, axes/safety, bilingual manuscript, and historical cross-checks/corrections
- Materials to obtain first: New correction records and user feedback
- Further research: Separate original records from production and correction 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: D30, axes/safety, bilingual manuscript, and historical 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: D30, axes/safety, bilingual manuscript, and historical 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

### N30 · What is the reading level of summaries and external original material?

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/plans, and disclosures remain unread; access was not attempted. Historical public-verification wording is not inherited as access/review in this work. The original content review remains incomplete.
- Reason for missing information: External abstracts/full texts, registration/plans, and disclosures remain unread; access was not attempted. Historical public-verification wording is not inherited as access/review in this work.
- Required materials and conditions: Original URLs and status of summaries/papers, registration, protocols, statistical analysis plans, and disclosures
- Materials to obtain first: Original material and actual reading history for each material
- Further research: Distinguish existence, acquisition, actual reading, and access history. 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 URLs and status of summaries/papers, registration, protocols, statistical analysis plans, and disclosures. 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 URLs and status of summaries/papers, registration, protocols, statistical analysis plans, and disclosures.
- 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: Original responder values are preserved: 97/169 (57.4%) versus 91/171 (53.2%); adjusted risk difference 3.5 percentage points (95% CI −6.6 to 13.6); adjusted RR 1.06 (95% CI 0.89 to 1.28). The subclaim D grade and original null note are historical verdicts, rather than new certification of exactly zero effect, equivalence, or exclusion of all important benefit. Original primary mean −0.4 points (95% CI −1.3 to 0.4), P=0.30, the 2.2-point power assumption, and the 388-person model are separate context and are not used as responder P values or denominators.  
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. The public page and data were prepared from the existing 30 items. No new clinical search, verification-status change or scoring was performed.