# WW 52 versus 12 weeks · Maintained superiority at five years — Evidence Check Verdict 2964 · 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: 2026-10-12 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: 1,267 adults with BMI at least 28 originally allocated in UK primary care; five-year measured/analysis denominators are unverified - Ingredient, formulation and route: Allocation to WW program access for 52 weeks; the intervention’s research identity is weekly group meetings - Dose: Research program duration of 52 weeks; actual attendance and post-program exposure details are unread; this is not implementation guidance - Comparator: Active control with access to the same WW program for 12 weeks; brief intervention is a separate third group - Measured outcome: Five-year 52- versus 12-week between-group weight difference, distinguished from within-group maintained loss, final weight and other clinical outcomes - Duration: 12 months, 24 months and five years are distinguished; program-access duration differs from assessment timing - Questions outside this scope: No new effects, CIs, calculations, verdicts, independence certification, participant totals, product recommendations or diet/exercise/weight-loss/treatment instructions ## Checklist items ### N01 · What are the selected long-term question and original subclaim verdict? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The selected preserved account concerns maintained superiority at five years, original grade D, with the note that the difference of -0.80 kg and 95% CI -2.13 to 0.54 was a null result. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Parent C with 50 points and axes concern the 12-month question. Absent selected-record score, status and axes remain absent; no new verdict is made. - Required materials and conditions: Original wording, grade/note and parent context for maintained superiority at five years - Materials to obtain first: Original subclaim and parent verdict - Further research: Distinguish the original long-term verdict from the parent one-year verdict. - Conditions for verification: Original wording, grade/note and parent context for maintained superiority at five years; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N02 · What duration and comparison does long-term superiority concern? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The five-year result is the WRAP 52- versus 12-week weight difference. Both groups received access to the same active WW program for different durations. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: This is not recast as an effect of five years of continuous participation or the long-term effect of 52 weeks versus brief intervention. - Required materials and conditions: Five-year between-group comparison of allocation to program access for 52 versus 12 weeks - Materials to obtain first: Long-term comparison definition, allocated durations and subsequent participation records - Further research: Present allocated program-access duration separately from five-year assessment timing. - Conditions for verification: Five-year between-group comparison of allocation to program access for 52 versus 12 weeks; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N03 · Which original-trial population does five-year follow-up concern? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The original trial enrolled 1,267 adults with BMI at least 28 in UK primary care; the five-year bibliography concerns follow-up of the same WRAP trial. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: It is not established that all originally allocated participants entered five-year follow-up or retained the same eligibility. Details of the long-term measured population are absent. - Required materials and conditions: Linkage between original allocation and long-term follow-up eligibility/observed populations - Materials to obtain first: Participant flow and characteristics from original allocation to five-year follow-up - Further research: Link the original recruited population with long-term observed/analysis populations. - Conditions for verification: Linkage between original allocation and long-term follow-up eligibility/observed populations; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N04 · Are original allocation denominators distinguished from long-term denominators? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: Original allocation denominators were 211 for brief intervention, 528 for 12 weeks and 528 for 52 weeks. The 823 with measured weight at 12 months concern one year. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Five-year group-specific measured/analysis denominators are absent from the summary; neither 528 nor 823 is used as a five-year denominator. No new totals are calculated. - Required materials and conditions: Group-specific allocation, follow-up, measurement and analysis denominators - Materials to obtain first: Five-year group-specific measurement, analysis and attrition denominator tables - Further research: Separate original allocation, one-year observation and five-year observation denominators. - Conditions for verification: Group-specific allocation, follow-up, measurement and analysis denominators; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N05 · Are long-term missingness, attrition and imputation assumptions verified? Verification status: Unverified Reading scope: Summary read; external materials unread - Current findings: The original materials describe 35% missing measured weight at 12 months and multiple imputation. Long-term bibliography and the five-year effect are present, but five-year missingness details are absent. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: The one-year 35%, 65% and multiple imputation are not automatically applied as five-year values or methods. - Required materials and conditions: Five-year follow-up losses, group-specific reasons, models and sensitivity analysis - Materials to obtain first: Original five-year missingness, imputation and sensitivity-analysis materials - Further research: Present missingness materials and assumptions separately for each time point. - Conditions for verification: Five-year follow-up losses, group-specific reasons, models and sensitivity analysis; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N06 · Are the original intervention identity and research exposure retained? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The parent intervention is the WW program with one group meeting per week for 52 weeks; the comparator also received access to the same program for 12 weeks. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: The original allocated duration is not five years. No new program-use, diet, exercise or treatment instructions are provided. - Required materials and conditions: 52- and 12-week program, meetings, access and actual-use specifications - Materials to obtain first: Duration-specific program specifications, use and attendance materials - Further research: Retain the identities of the research exposure and long-term assessment. - Conditions for verification: 52- and 12-week program, meetings, access and actual-use specifications; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N07 · Are additional exposure and cross-group program use after the program known? Verification status: Unverified Reading scope: Summary read; external materials unread - Current findings: Five-year follow-up assessment is recorded, but participants’ subsequent program use and other weight-management exposure are absent from the summary. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: The five-year difference is not attributed solely to the original duration, and no additional-exposure or treatment-change instructions are created. - Required materials and conditions: Post-program weight management, program use, co-exposure and changes - Materials to obtain first: Records of subsequent programs, accompanying management and changes - Further research: Distinguish the original period from subsequent exposure. - Conditions for verification: Post-program weight management, program use, co-exposure and changes; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N08 · Are the definition and measurement methods for five-year weight verified? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The long-term summary presents the five-year 52- versus 12-week weight difference in kg. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Five-year measurement procedures, equipment, standardization, assessors and possible self-report remain externally unread. The outcome is not replaced by other body-composition results. - Required materials and conditions: Assessment timing, equipment, actual measurement, units and assessors - Materials to obtain first: Five-year measurement methods and original outcome tables - Further research: Present measurement timing, units and methods together. - Conditions for verification: Assessment timing, equipment, actual measurement, units and assessors; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N09 · What difference and interval were directly reported at five years? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The preserved account states a five-year difference of -0.80 kg, 95% CI -2.13 to 0.54, a null result. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: The original materials contain no five-year P value; none is created. No new CI, effect, relative weight loss or individual numerical example is calculated. - Required materials and conditions: Selected between-group difference, confidence interval and analysis comparison - Materials to obtain first: Original five-year between-group comparison results and model tables - Further research: Present the original difference/interval together with the absence of test information. - Conditions for verification: Selected between-group difference, confidence interval and analysis comparison; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N10 · Has a null result been recast as exact zero or equivalence? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The original subclaim and parent counterview state that the five-year difference was null and durable superiority was not established. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Null results do not become exactly equal weights, zero effect, noninferiority or certified equivalence. Prespecified equivalence criteria are absent from the summary. - Required materials and conditions: Superiority question, effect interval, original interpretation and equivalence criteria - Materials to obtain first: Long-term question, analyses and prespecified comparison criteria - Further research: Distinguish unestablished superiority from the scope of an equivalence claim. - Conditions for verification: Superiority question, effect interval, original interpretation and equivalence criteria; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N11 · Are maintained weight loss within each group and between-group superiority the same question? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The preserved long-term value is a 52- versus 12-week between-group weight difference. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Five-year absolute weights, maintained loss and regained weight by group are absent from the summary. A null between-group result does not mean everyone returned to baseline or both groups lost all weight-loss benefits. - Required materials and conditions: Actual group-specific baseline, change, maintenance and between-group differences - Materials to obtain first: Five-year group-specific baseline, change and between-group comparison tables - Further research: Separate within-group maintenance from relative between-group superiority. - Conditions for verification: Actual group-specific baseline, change, maintenance and between-group differences; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N12 · Have original 12-month results been reused as long-term results? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: At 12 months, changes were -4.75 kg for 12 weeks and -6.76 kg for 52 weeks; adjusted difference -2.14 kg, 95% CI -3.05 to -1.22, P<.0001. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: A positive one-year result does not fill the five-year superiority question. No new maintenance rate is calculated from one-year group changes and the five-year difference. - Required materials and conditions: Time-specific separation of one-year and five-year comparisons - Materials to obtain first: Original within-group and between-group results by time point - Further research: Present positive 12-month and null five-year results separately. - Conditions for verification: Time-specific separation of one-year and five-year comparisons; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N13 · Are 24-month and five-year results kept separate? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The 24-month difference is described as -1.32 kg, 95% CI -2.46 to -0.18, P=.0231, a different time point from five years. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: The 24-month P value is not copied as a five-year P value. An intermediate positive result does not become long-term maintenance or independent replication. - Required materials and conditions: Actual estimates, denominators and analyses for intermediate and long-term comparisons - Materials to obtain first: Original 24-month and five-year follow-up/analysis materials - Further research: Present results separately for intermediate and long-term time points. - Conditions for verification: Actual estimates, denominators and analyses for intermediate and long-term comparisons; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N14 · Are the long-term effect of interest and analysis model known? Verification status: Unverified Reading scope: Summary read; external materials unread - Current findings: The preserved counterview and subclaim note contain a five-year between-group difference and CI; details of the long-term model are absent. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: The one-year adjusted model or multiple-imputation method is not assumed to be the long-term model, nor upgraded to an effect of actual attendance or completers. - Required materials and conditions: Adjustment, covariates, analysis population and estimand for the five-year comparison - Materials to obtain first: Five-year model, effect-of-interest and sensitivity-analysis specifications - Further research: Distinguish time-specific estimands and missingness assumptions. - Conditions for verification: Adjustment, covariates, analysis population and estimand for the five-year comparison; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N15 · Are original allocation and five-year follow-up masking/selection effects distinguished? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The original evidence describes a three-arm randomized controlled trial; the five-year citation concerns follow-up of the same trial. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Long-term follow-up is not a new randomized trial. Details of participation/measurement selection and masking remain unread. - Required materials and conditions: Original allocation, follow-up participation, assessor roles and attrition - Materials to obtain first: Long-term follow-up procedures, participant flow and assessor methods - Further research: Present retained original allocation together with limitations of follow-up selection. - Conditions for verification: Original allocation, follow-up participation, assessor roles and attrition; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N16 · Have the prespecified long-term endpoint plan and hierarchy been read? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The original primary endpoint was weight at one year, and prespecified hierarchical testing describes one-year comparisons; the long-term bibliography concerns five-year follow-up. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: The one-year prespecified hierarchy does not certify a five-year confirmatory plan. The long-term plan and change history remain unread. - Required materials and conditions: Long-term assessment plan, SAP, plan changes and multiplicity documents - Materials to obtain first: Long-term follow-up plan, SAP and change history - Further research: Distinguish the original primary plan from long-term plans/reporting. - Conditions for verification: Long-term assessment plan, SAP, plan changes and multiplicity documents; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N17 · Are registration identifiers separated from actual reading of registration/plans? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The identifier is ISRCTN82857232, and the original summary states registration preceded recruitment. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Exact registration dates, additional long-term plans, changes and original documents remain unread. No invented URL/identifier certifies external reading or long-term prespecification. - Required materials and conditions: Actual ISRCTN registration, pre-recruitment plan and long-term update materials - Materials to obtain first: ISRCTN registration history and long-term follow-up documents - Further research: Present the original identifier separately from planning materials for each time point. - Conditions for verification: Actual ISRCTN registration, pre-recruitment plan and long-term update materials; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N18 · Have sample-size assumptions or important differences become long-term criteria? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The original study describes a sample of 1,200 and a 1.3 kg detection assumption, while stating this was not a declared minimum clinically important difference. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: This assumption does not become a five-year MCID, equivalence margin or certified power. Long-term criteria and denominators remain unverified. - Required materials and conditions: Original criteria for five-year importance, power and precision - Materials to obtain first: Long-term sample-size, importance and comparison-criterion materials - Further research: Distinguish one-year detection assumptions from long-term judgment criteria. - Conditions for verification: Original criteria for five-year importance, power and precision; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N19 · Has long-term weight comparison been extended to clinical, functional or economic outcomes? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The follow-up citation title mentions effectiveness and cost-effectiveness, but the preserved result concerns five-year weight comparison. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Disease prevention, mortality, function, quality of life, cost-effectiveness results and hypothetical quantitative examples are not created to fill gaps. - Required materials and conditions: Direct results for weight versus disease, function and economic endpoints - Materials to obtain first: Original long-term clinical, functional and economic endpoint materials - Further research: Present weight superiority separately from other direct endpoints. - Conditions for verification: Direct results for weight versus disease, function and economic endpoints; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N20 · Have follow-up reports from the same cohort been counted as independent replication? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The 2017 main report and 2022 five-year follow-up concern the same WRAP trial; the original citation flag identifies long-term follow-up of the same trial. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Two reports, sibling sheets, groups, time points and registration are not counted as new independent trials or participant totals. Confirmed trial/participant counts remain unrecorded. - Required materials and conditions: Linkage of main report, follow-up, registration and sibling sheets - Materials to obtain first: WRAP report, registration and cohort-linkage materials - Further research: Separate report slots from independent-trial and participant units. - Conditions for verification: Linkage of main report, follow-up, registration and sibling sheets; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N21 · Is there evidence for other independent long-term replication or other programs? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The current preserved summary identifies the main and long-term reports of the same WRAP trial. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: No new durable effects or replication counts are established for other programs, services without a formulation, all weight management or other populations. - Required materials and conditions: Independent long-term follow-up of the same question and direct setting-specific comparisons - Materials to obtain first: Independent long-term replication and applicability materials for the same comparison - Further research: Distinguish follow-up in the same cohort from gaps in independent long-term replication. - Conditions for verification: Independent long-term follow-up of the same question and direct setting-specific comparisons; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N22 · Are original-trial industry, public and nonprofit support all retained? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: Public/nonprofit joint funding, Weight Watchers International industry-partner funding and program-access provision are all recorded. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Mixed support is not relabeled as entirely public or independent. Separate support for the follow-up report is not detailed in the summary. - Required materials and conditions: Funding, program-access support and industry-partner relationships - Materials to obtain first: Original/follow-up funding and program-support disclosures - Further research: Distinguish original-trial support from follow-up-report support. - Conditions for verification: Funding, program-access support and industry-partner relationships; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N23 · Has research funding received by authors’ institutions become company-employee authorship? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The preserved account states that institutions of five authors disclosed receipt of WW research funding. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Institutional support does not establish employee authorship. Follow-up author-specific disclosures, roles and relationships remain externally unread. - Required materials and conditions: Institutional support, employment, author contributions and conflicts of interest - Materials to obtain first: Original/follow-up author disclosures and contribution materials - Further research: Separate institutional support from employment relationships and individual roles. - Conditions for verification: Institutional support, employment, author contributions and conflicts of interest; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N24 · Are analysis, medical writing, publication fees and data/publication control known? Verification status: Unverified Reading scope: Summary read; external materials unread - Current findings: The summary provides mixed funding, program access and institutional-support relationships; the complete long-term analysis/writing/publication roles are absent. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Nonmention does not certify all roles were absent or establish independent replication. - Required materials and conditions: Original/follow-up sponsor and author role disclosures - Materials to obtain first: Long-term analysis, writing, publication and data-control disclosures - Further research: Record reported support separately from unverified roles. - Conditions for verification: Original/follow-up sponsor and author role disclosures; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N25 · Has the main report’s intervention-related adverse-event account become five-year harms evidence? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The safety summary states that no intervention-related adverse events were reported, while an all-event table by group was absent. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: The exact follow-up/recruited-population scope of this statement is not extended to all long-term follow-up. Five-year all-event and related-event materials remain unverified. - Required materials and conditions: Long-term event collection, definitions, group denominators and causal classification - Materials to obtain first: Five-year harms, discontinuation, exposure and classification tables - Further research: Separate the main-report safety statement from long-term harms materials. - Conditions for verification: Long-term event collection, definitions, group denominators and causal classification; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Supplementary condition showing harms/safety-material scope separately from efficacy - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N26 · Does a null five-year result also establish equal safety between durations? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The original advertising interpretation and safety explanation explicitly limit extension to long-term maintenance or equal safety. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Null weight results do not become null harms results, equivalence or confirmed safety. - Required materials and conditions: Direct long-term harms comparisons, denominators, intervals and plans - Materials to obtain first: Duration-specific long-term harms, comparisons and criteria - Further research: Separate the weight-superiority question from safety comparison. - Conditions for verification: Direct long-term harms comparisons, denominators, intervals and plans; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Supplementary condition showing harms/safety-material scope separately from efficacy - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N27 · Is the observation scope sufficient to judge long-term and rare harms? Verification status: Unverified Reading scope: Summary read; external materials unread - Current findings: Long-term bibliography is present, but safety details in the preserved summary are limited. Parent Good safety is an original-verdict record. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Subsequent weight values or parent labels do not fill absence of rare harms, long-term safety or safety in all populations. - Required materials and conditions: Materials on long-term exposure, attrition, rare events and vulnerable populations - Materials to obtain first: Long-term events, exposure and population-specific harms materials - Further research: Present long-term weight observation separately from rare-harm gaps. - Conditions for verification: Materials on long-term exposure, attrition, rare events and vulnerable populations; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Supplementary condition showing harms/safety-material scope separately from efficacy - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R02 ### N28 · Has the current five-year follow-up full text actually been read? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: What was actually read was the complete parent preserved summary. The five-year citation’s Cambridge repository URL and main-report PubMed URL are linked as preserved. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: A repository link does not mean full-text acquisition, reading or content review. All external abstracts, full texts, registration, protocols and SAP remain unread. - Required materials and conditions: Access distinctions between preserved summary, follow-up repository, abstracts, full texts, registration and plans - Materials to obtain first: Each original report, follow-up, registration and planning material - Further research: Display summary reading separately from external nonreading. - Conditions for verification: Access distinctions between preserved summary, follow-up repository, abstracts, full texts, registration and plans; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N29 · Are reference dates, corrections, Korean/English and axes distinct from the selected long-term verdict? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The complete summary retains parent Korean/English, axes, 2026-08-26 reference date, empty corrections/deliberation and the long-term subclaim. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: Absent subclaim score, status and axes are not filled with parent C, 50 points, E+ or other values. The reference date is not the current-review date. - Required materials and conditions: Complete original parent and original long-term subclaim - Materials to obtain first: Original summary and preparation events - Further research: Distinguish parent history, long-term subclaim and preparation date. - Conditions for verification: Complete original parent and original long-term subclaim; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ### N30 · Are candidate states and the existing selected unit distinct from preparation/content review? Verification status: Partly verified Reading scope: Summary read; external materials unread - Current findings: The selected existing subclaim is prepared while distinguishing question and verdict-record links. Candidate pending, eligibility and independence labels are retained as original-selection history. - Why unverified: Preparation displays information, scope and unverified matters in the read preserved materials; this is not completed content review or a new clinical efficacy/harms verdict. - Reason for missing information: A review wait is not executed or activated; completed=false and existing-content review incomplete are displayed. New units number 0 and confirmed independence totals are unrecorded; no treatment/weight-loss instructions are created. - Required materials and conditions: Question/record links, historical candidate values and condition-freeze/application events - Materials to obtain first: Existing question selection and condition-freeze/application preparation events - Further research: Display saved preparation separately from user content review and clinical certification. - Conditions for verification: Question/record links, historical candidate values and condition-freeze/application events; distinguish direct materials, denominators, scope and unverified matters without new effects, verdicts or independence certification. - Why this condition is needed: Preparation condition clearly showing required evidence, current materials and gaps for the selected question - Application exceptions: Retain original values/scope only; other groups, time points, outcomes or formulations do not fill unverified matters. - Remaining uncertainty: External abstracts, full texts, registration, protocols and SAP remain unread; no content review, calculation or new query was performed in this preparation. - Referenced methods: Existing application conditions and preserved methodological links are retained for preparation; this does not indicate completed review of the whole definition. - Related sources: R01, R02 ## Evidence and sources ### R01 Ahern AL, et al. Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial. Lancet. 2017;389:2214-2225. PMID: 28478041. [PubMed](https://pubmed.ncbi.nlm.nih.gov/28478041/) Materials actually read: Preserved JSON summary read; external reports, registration and plans unread Findings recorded in the summary: 52 versus 12 weeks adjusted difference -2.14 kg (95% CI -3.05 to -1.22), P<.0001 Record level: Adjusted 12-month 52- versus 12-week difference, separated from the preceding comparison, within-group changes and long-term results Independent replication: The preserved summary links the WRAP main report and five-year follow-up of the same trial; two papers, three groups, time points, sibling sheets and registration do not certify independent replications or participant totals | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored summary | Summary read | Stored summary read | Summary read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | | External abstract | Not read | External material unread | Not read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | | External full text | Not read | External material unread | Not read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | | Original registration | Not read | External material unread | Not read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | | Protocol/SAP | Not read | External material unread | Not read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | ### R02 Ahern AL, et al. Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of WRAP. Lancet Public Health. 2022. [Official source](https://www.repository.cam.ac.uk/items/2dea5c4c-b430-4ec0-8aa7-1733b508b296) Materials actually read: Preserved JSON summary read; external reports, registration and plans unread Findings recorded in the summary: The 24-month difference was -1.32 kg (95% CI -2.46 to -0.18), P=.0231; at five years the difference was null, -0.80 kg (-2.13 to 0.54). Durable superiority was not established. Record level: Original 24-month and five-year accounts distinguished by time point; the five-year result is preserved in its existing subclaim note Independent replication: The preserved summary links the WRAP main report and five-year follow-up of the same trial; two papers, three groups, time points, sibling sheets and registration do not certify independent replications or participant totals | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored summary | Summary read | Stored summary read | Summary read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | | External abstract | Not read | External material unread | Not read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | | External full text | Not read | External material unread | Not read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | | Original registration | Not read | External material unread | Not read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | | Protocol/SAP | Not read | External material unread | Not read | Material slots do not certify external acquisition, actual reading, link checking or numbers of independent trials; a repository URL also does not mean an external document was obtained | ## 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. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed. - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed. - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed. - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed. - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed. ## What the statuses mean - Partly verified: Some information exists in the preserved review summary; detailed original materials remain unverified. This does not certify a passed review or clinical efficacy. - Unverified: Detailed materials for the selected condition could not be established within the stored scope; this does not mean zero effect, zero studies or safety - Review incomplete: Review of existing content incomplete - Met: Use only within the relevant conditions after existing content review; no automatic designation in this preparation - Not reported: Distinguish only within materials actually read; do not turn unread external materials into unreported findings - Inaccessible: Not applied during this preparation because actual access was not tested - Not applicable: Use with a reason for non-applicability based on an explicit question boundary - Conflicting data: Judge after actual material comparison; review was not performed during this preparation - Insufficient evidence for the conditions: Do not use as a clinical grade encompassing currently unread materials ## Change history 2026-10-12 · 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.