# Casein-derived MKP × Orientation: Positive secondary finding and gaps in total-score and multiplicity evidence Verdict 2980 · 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: 2026-10-15 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: 268 community-dwelling Japanese adults aged 40 or older without dementia; intention-to-treat analysis, 134/134. Completion, withdrawal and observed denominators for the selected endpoint are not verified in detail. - Ingredient, formulation and route: Casein hydrolysate tablets containing the casein-derived peptide Met-Lys-Pro (MKP) - Dose: Original study exposure only: MKP 200 μg/day for 24 weeks. No cumulative dose calculation or advice on consuming MKP, milk or products. - Comparator: Dextrin placebo tablets, 134 participants; sensory matching, blinding and concurrent exposures are not verified in detail. - Measured outcome: Secondary Orientation subscale finding, P=.022; distinguished from the primary total score, other subscales, global cognition and clinical function - Duration: 24 weeks; actual adherence, discontinuation, visit-specific follow-up and follow-up after the study are not verified in detail. - Questions outside this scope: Promoting positive Orientation findings into primary total-score success, improved global cognition, dementia prevention or clinical function; Copying group-specific total-score values, d, P or CI limitations into subscale results; Rejudging within-group improvement as an additional effect versus placebo, equivalence, noninferiority or a zero effect; Adding the same paper, registration, people, groups, visits, subscales or related sheets as new independent trials or participants; New calculations, hypothetical quantities, effects, CIs, grades or independence certification, or instructions on MKP, milk or product consumption, cognition or dementia care, or replacement of treatment ## Checklist items ### N01 · Which existing Orientation claim is being presented? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The selected claim is improved Orientation subscale, with original subclaim grade C and a note that P=0.022 does not overturn failure of the primary total score. Subclaim score, status and axes are absent and are retained separately from parent D30 values. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Orientation's exact effect of interest, visit, hierarchy and review of the claim boundary. Parent scores or axes and total-score grade D are not used to overwrite subclaim values. - Required materials and conditions: Separate the selected subscale wording and subclaim grade from parent values - Materials to obtain first: Orientation's exact effect of interest, visit, hierarchy and review of the claim boundary. Parent scores or axes and total-score grade D are not used to overwrite subclaim values. - Further research: Material needed: Orientation's exact effect of interest, visit, hierarchy and review of the claim boundary. Parent scores or axes and total-score grade D are not used to overwrite subclaim values. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on separate the selected subscale wording and subclaim grade from parent values, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect separate the selected subscale wording and subclaim grade from parent values with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N02 · Which population's subscale results are these? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original trial involved 268 community-dwelling Japanese adults aged 40 or older without dementia. The subscale signal is not extended to people with dementia, all cognitive problems, or other ages or regions. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original eligibility and exclusion criteria, baseline cognition and clinical status, comorbidities and medication, and direct outcomes in other populations. - Required materials and conditions: Community-dwelling Japanese adults aged 40 or older without dementia - Materials to obtain first: Original eligibility and exclusion criteria, baseline cognition and clinical status, comorbidities and medication, and direct outcomes in other populations. - Further research: Material needed: Original eligibility and exclusion criteria, baseline cognition and clinical status, comorbidities and medication, and direct outcomes in other populations. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on community-dwelling Japanese adults aged 40 or older without dementia, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect community-dwelling Japanese adults aged 40 or older without dementia with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N03 · Are baseline total scores also baseline Orientation scores? Verification status: Unverified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: Baseline total scores were MKP 4.08±2.17 and placebo 4.10±2.10. Group-specific baseline and final Orientation values and distributions are not established in the summary. Total-score values are not used to create subscale values or floor or ceiling effects. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original Orientation tables, score range and direction, baseline and final distributions, and analyses by clinical status. No new conversion between total and subscale scores or diagnosis. - Required materials and conditions: Baseline distributions of total scores and subscale scores - Materials to obtain first: Original Orientation tables, score range and direction, baseline and final distributions, and analyses by clinical status. No new conversion between total and subscale scores or diagnosis. - Further research: Material needed: Original Orientation tables, score range and direction, baseline and final distributions, and analyses by clinical status. No new conversion between total and subscale scores or diagnosis. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on baseline distributions of total scores and subscale scores, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect baseline distributions of total scores and subscale scores with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N04 · Is study MKP distinguished from ordinary milk? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original intervention was casein-derived Met-Lys-Pro (MKP), 200 μg/day, and the manufacturer supplied casein-hydrolysate tablets containing MKP. This is not converted into amounts of ordinary milk or other products, or their subscale effects. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original tablet composition, MKP quantification, other ingredients, manufacture and adherence, and product identity. Study exposure is identified without consumption or product advice. - Required materials and conditions: Study tablets containing casein-derived MKP - Materials to obtain first: Original tablet composition, MKP quantification, other ingredients, manufacture and adherence, and product identity. Study exposure is identified without consumption or product advice. - Further research: Material needed: Original tablet composition, MKP quantification, other ingredients, manufacture and adherence, and product identity. Study exposure is identified without consumption or product advice. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on study tablets containing casein-derived MKP, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect study tablets containing casein-derived MKP with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N05 · What were the actual control and concurrent exposures? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original record states allocation to MKP or dextrin placebo tablets, 134/134. Actual placebo conditions, contact, diet and medication in both groups, expectations and adherence are not verified in detail. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Placebo and active composition, blinding, concurrent exposures, contact and adherence. Original data specifying the subscale effect of interest for additional benefit versus placebo. - Required materials and conditions: Dextrin placebo and conditions in both groups - Materials to obtain first: Placebo and active composition, blinding, concurrent exposures, contact and adherence. Original data specifying the subscale effect of interest for additional benefit versus placebo. - Further research: Material needed: Placebo and active composition, blinding, concurrent exposures, contact and adherence. Original data specifying the subscale effect of interest for additional benefit versus placebo. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on dextrin placebo and conditions in both groups, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect dextrin placebo and conditions in both groups with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N06 · Is 24-week exposure distinguished from sustained improvement? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The study used 200 μg/day for 24 weeks, with Orientation as a secondary finding from that trial. Actual exposure, adherence and discontinuation, visit-specific analyses and persistence after the study are not verified in detail. Sustained subscale efficacy is not newly established. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Visit-specific subscale analyses, actual exposure, visits and discontinuation, and follow-up after the study. No cumulative dose, number of days, consumption advice or care instructions. - Required materials and conditions: Original duration, actual exposure and post-study follow-up - Materials to obtain first: Visit-specific subscale analyses, actual exposure, visits and discontinuation, and follow-up after the study. No cumulative dose, number of days, consumption advice or care instructions. - Further research: Material needed: Visit-specific subscale analyses, actual exposure, visits and discontinuation, and follow-up after the study. No cumulative dose, number of days, consumption advice or care instructions. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on original duration, actual exposure and follow-up after the study, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect original duration, actual exposure and follow-up after the study with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N07 · Are ITT denominators separated from observed subscale denominators? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The existing evidence list records 268 randomized participants and ITT analysis (134/134). Actual observed and analyzed Orientation denominators, completion, withdrawal and missingness are not verified in detail. ITT is not recast as observation or completion by everyone for the subscale. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Group-specific flow, observed and analyzed denominators by Orientation outcome and visit, reasons for withdrawal and missingness, and handling methods. No new denominator, withdrawal count or rate is calculated. - Required materials and conditions: ITT for 268 participants and Orientation-specific missingness and completion - Materials to obtain first: Group-specific flow, observed and analyzed denominators by Orientation outcome and visit, reasons for withdrawal and missingness, and handling methods. No new denominator, withdrawal count or rate is calculated. - Further research: Material needed: Group-specific flow, observed and analyzed denominators by Orientation outcome and visit, reasons for withdrawal and missingness, and handling methods. No new denominator, withdrawal count or rate is calculated. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on ITT for 268 participants and Orientation-specific missingness and completion, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect ITT for 268 participants and Orientation-specific missingness and completion with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N08 · What exactly did Orientation measure? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original material provides the subscale name Orientation and P=0.022. Items, score range and direction, test version, assessors, visits and details of its relationship to the total score are not established in the summary. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original Orientation test definitions, items and calculations, assessment methods, version, prespecified plans and tables. The name alone is not substituted for measurement of global cognition or daily function. - Required materials and conditions: Subscale definition, scores and interpretation - Materials to obtain first: Original Orientation test definitions, items and calculations, assessment methods, version, prespecified plans and tables. The name alone is not substituted for measurement of global cognition or daily function. - Further research: Material needed: Original Orientation test definitions, items and calculations, assessment methods, version, prespecified plans and tables. The name alone is not substituted for measurement of global cognition or daily function. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on subscale definition, scores and interpretation, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect subscale definition, scores and interpretation with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N09 · Were subscale effect sizes and CIs provided? Verification status: Unverified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original subscale P=0.022 is retained. Group-specific values, exact between-group differences, effect sizes, CIs and variance are not provided in the current stored summary. Total-score d=0.12, P=.302 or before-and-after values are not copied into the subscale. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original group-specific baseline and final Orientation values, effect of interest, effects and CIs, denominators, models and clinical importance. No new effect or CI is calculated from P alone. - Required materials and conditions: Orientation P value and unverified quantitative effects - Materials to obtain first: Original group-specific baseline and final Orientation values, effect of interest, effects and CIs, denominators, models and clinical importance. No new effect or CI is calculated from P alone. - Further research: Material needed: Original group-specific baseline and final Orientation values, effect of interest, effects and CIs, denominators, models and clinical importance. No new effect or CI is calculated from P alone. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on Orientation P value and unverified quantitative effects, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect Orientation P value and unverified quantitative effects with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N10 · Which comparison or model produced the subscale P value? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: Detailed comparisons, models, adjustment and visits underlying Orientation P=0.022 are not specified in the summary. It is not automatically declared to use the same model as the baseline-adjusted total score, and within-group improvement is not transferred into additional between-group benefit. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Exact subscale comparison, analysis population, baseline adjustment or repeated measures, effect of interest and original tables. No new between-group or within-group difference is calculated. - Required materials and conditions: Orientation effect of interest, within-group and between-group comparisons, and adjustment - Materials to obtain first: Exact subscale comparison, analysis population, baseline adjustment or repeated measures, effect of interest and original tables. No new between-group or within-group difference is calculated. - Further research: Material needed: Exact subscale comparison, analysis population, baseline adjustment or repeated measures, effect of interest and original tables. No new between-group or within-group difference is calculated. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on Orientation effect of interest, within-group and between-group comparisons, and adjustment, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect Orientation effect of interest, within-group and between-group comparisons, and adjustment with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N11 · Is the null primary total score retained separately? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original record that the baseline-adjusted total-score result was null, P=.302 and d=.12, with no 95% CI reported, is retained. The original statement that Orientation P=.022 neither means total-score success nor overturns its failure is preserved. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original total-score and subscale outcomes, exact visits, denominators, prespecified hierarchy and plans. Subscale and total-score values and conclusions are not transferred to each other. - Required materials and conditions: Different findings for the global cognition total score and Orientation - Materials to obtain first: Original total-score and subscale outcomes, exact visits, denominators, prespecified hierarchy and plans. Subscale and total-score values and conclusions are not transferred to each other. - Further research: Material needed: Original total-score and subscale outcomes, exact visits, denominators, prespecified hierarchy and plans. Subscale and total-score values and conclusions are not transferred to each other. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on different findings for the global cognition total score and Orientation, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect different findings for the global cognition total score and Orientation with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N12 · Are secondary and exploratory findings distinguished from prespecified plans? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original Korean and English texts disclose Orientation as a secondary finding. The registration citation lists ADAS-Jcog as the prespecified primary endpoint. Orientation's prespecification, exact secondary or exploratory hierarchy, and amendment history have not been established through new reading of the registration or protocol. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Subscale lists and hierarchy, prespecification, amendments and disclosure dates in the complete registration, protocol and SAP. The subscale is not newly designated as a prespecified confirmatory endpoint. - Required materials and conditions: Relationship between the secondary subscale and registered primary endpoint - Materials to obtain first: Subscale lists and hierarchy, prespecification, amendments and disclosure dates in the complete registration, protocol and SAP. The subscale is not newly designated as a prespecified confirmatory endpoint. - Further research: Material needed: Subscale lists and hierarchy, prespecification, amendments and disclosure dates in the complete registration, protocol and SAP. The subscale is not newly designated as a prespecified confirmatory endpoint. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on relationship between the secondary subscale and registered primary endpoint, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect relationship between the secondary subscale and registered primary endpoint with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01, R02 ### N13 · Are multiplicity plans and adjustments verified? Verification status: Unverified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original material explains that one positive subscale is not promoted into a total-score effect. The total number of tests, multiplicity adjustment, allocation of significance levels and selective reporting are not verified in detail. Significance or nonsignificance after adjustment is not newly adjudicated. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Complete outcome and endpoint lists, prespecified testing and multiplicity, adjustment methods, selective reporting, and original comparisons of the paper with plans. No new adjusted P value or hypothetical example. - Required materials and conditions: Testing specifications for multiple subscales and tests - Materials to obtain first: Complete outcome and endpoint lists, prespecified testing and multiplicity, adjustment methods, selective reporting, and original comparisons of the paper with plans. No new adjusted P value or hypothetical example. - Further research: Material needed: Complete outcome and endpoint lists, prespecified testing and multiplicity, adjustment methods, selective reporting, and original comparisons of the paper with plans. No new adjusted P value or hypothetical example. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on testing specifications for multiple subscales and tests, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect testing specifications for multiple subscales and tests with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N14 · Are total-score and Orientation numbers distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: Total scores of 4.08±2.17 to 3.18±1.88 versus 4.10±2.10 to 3.43±2.10, with d=.12, and Orientation P=.022 are different findings. Within-group total-score decreases, d and the absence of reported CIs are not copied into Orientation values, variance or effects. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original tables, scores, variance, effects and CIs, visits, denominators and models for each endpoint. Different subscales are not averaged or added together. - Required materials and conditions: Before-and-after total scores and d versus the subscale P value - Materials to obtain first: Original tables, scores, variance, effects and CIs, visits, denominators and models for each endpoint. Different subscales are not averaged or added together. - Further research: Material needed: Original tables, scores, variance, effects and CIs, visits, denominators and models for each endpoint. Different subscales are not averaged or added together. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on before-and-after total scores and d versus the subscale P value, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect before-and-after total scores and d versus the subscale P value with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N15 · Have other subscale and test findings been newly filled in? Verification status: Unverified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The current stored material distinguishes the total score and Orientation. Other subscale or test names, the number of tests, group-specific results and comparisons are not verified in detail. Unread material is not treated as proof that all other findings were null or absent. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Complete outcome tables, test lists, primary and secondary plans, denominators and visits, and effects and CIs. No new subscale or test results are invented. - Required materials and conditions: Scope of all tests and subscales - Materials to obtain first: Complete outcome tables, test lists, primary and secondary plans, denominators and visits, and effects and CIs. No new subscale or test results are invented. - Further research: Material needed: Complete outcome tables, test lists, primary and secondary plans, denominators and visits, and effects and CIs. No new subscale or test results are invented. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on scope of all tests and subscales, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect scope of all tests and subscales with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N16 · Is the repeat-testing interpretation automatically applied to the subscale? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original material interprets total-score improvement in both groups as a repeat-testing effect. Orientation values in both groups, practice effects, expectations and comparison-model details are unverified. The total-score interpretation is not newly established as a causal mechanism for the subscale. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Endpoint-specific baseline and final values, practice effects and expectations, assessments, effects of interest and models, and original tables. Within-group improvement is not newly calculated as an ingredient-specific effect. - Required materials and conditions: Original total-score interpretation and the Orientation comparison - Materials to obtain first: Endpoint-specific baseline and final values, practice effects and expectations, assessments, effects of interest and models, and original tables. Within-group improvement is not newly calculated as an ingredient-specific effect. - Further research: Material needed: Endpoint-specific baseline and final values, practice effects and expectations, assessments, effects of interest and models, and original tables. Within-group improvement is not newly calculated as an ingredient-specific effect. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on original total-score interpretation and the Orientation comparison, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect original total-score interpretation and the Orientation comparison with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N17 · Is the subscale extended to global cognition, dementia prevention or clinical function? Verification status: Unverified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original material explains that a positive Orientation finding is not evidence of improved global cognition. Separate direct data on dementia prevention, daily function and clinical outcomes are not provided within the preserved scope. These are not established from the subscale signal. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Actual definitions, measurements and follow-up, group-specific denominators, effects and CIs for clinical function or dementia events, and direct confirmatory data relevant to the question. Unread material is not treated as proof that outcomes were not measured. - Required materials and conditions: Directness of the selected subscale for clinical outcomes - Materials to obtain first: Actual definitions, measurements and follow-up, group-specific denominators, effects and CIs for clinical function or dementia events, and direct confirmatory data relevant to the question. Unread material is not treated as proof that outcomes were not measured. - Further research: Material needed: Actual definitions, measurements and follow-up, group-specific denominators, effects and CIs for clinical function or dementia events, and direct confirmatory data relevant to the question. Unread material is not treated as proof that outcomes were not measured. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on directness of the selected subscale for clinical outcomes, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect directness of the selected subscale for clinical outcomes with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N18 · Are the same design and people counted as separate independent replication? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original design statements on computer block allocation, multiple blinding roles and ITT apply to Orientation within the same trial context. Total scores, subscales, visits, groups, references, registration and related sheets are not added as new independent trials or participants. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original links among reports, registration, cohorts and analyses, and endpoint-specific denominators. Strong design statements are not converted into certification of subscale prespecification, confirmation or independence. - Required materials and conditions: Total-score and subscale findings from the same randomized trial - Materials to obtain first: Original links among reports, registration, cohorts and analyses, and endpoint-specific denominators. Strong design statements are not converted into certification of subscale prespecification, confirmation or independence. - Further research: Material needed: Original links among reports, registration, cohorts and analyses, and endpoint-specific denominators. Strong design statements are not converted into certification of subscale prespecification, confirmation or independence. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on total-score and subscale findings from the same randomized trial, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect total-score and subscale findings from the same randomized trial with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01, R02 ### N19 · Is safety separate from subscale efficacy? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original material retains the scope that no serious adverse events attributed to MKP consumption were reported over 24 weeks, together with the milk-protein allergy caution. This is not evidence of Orientation efficacy and is not extended to zero harms of every kind or long-term safety. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Group-specific AE and SAE collection, attribution and discontinuation, exposure and denominators, and allergy and long-term data. No consumption or product advice, or cognition or dementia care instructions. - Required materials and conditions: Related serious adverse events over 24 weeks, allergy and long-term harms - Materials to obtain first: Group-specific AE and SAE collection, attribution and discontinuation, exposure and denominators, and allergy and long-term data. No consumption or product advice, or cognition or dementia care instructions. - Further research: Material needed: Group-specific AE and SAE collection, attribution and discontinuation, exposure and denominators, and allergy and long-term data. No consumption or product advice, or cognition or dementia care instructions. Only the need for material or research is recorded; no new retrieval or research is performed. - Conditions for verification: Present original data on related serious adverse events over 24 weeks, allergy and long-term harms, together with the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope. - Why this condition is needed: This is needed to connect related serious adverse events over 24 weeks, allergy and long-term harms with the selected question, actual population, intervention and control, total scores and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N20 · What materials were actually read in this work? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The complete parent summary was read for production and preserved in its original form. Summary reading refers to the stored summary; the external abstract, full paper, UMIN registration, protocol and SAP remain unread in this work. The existence of a URL is not promoted into reading. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Records of actual acquisition and reading scope, versions and dates. No separate external-link click or access test was performed. - Required materials and conditions: Preserved-summary reading and external paper or registration status - Materials to obtain first: Records of actual acquisition and reading scope, versions and dates. No separate external-link click or access test was performed. - Further research: Material needed: Records of actual acquisition and reading scope, versions and dates. No separate external-link click or access test was performed. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Preserved-summary reading and external paper or registration status. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Preserved-summary reading and external paper or registration status. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01, R02 ### N21 · Are historical registration dates and primary-endpoint names distinguished from current reading? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original Korean and English texts describe prospective registration, with disclosure on 2018-06-04 and a planned start on 2018-06-07. The registration citation describes prespecified ADAS-Jcog and manufacturer funding. Only original dates and statements are retained; actual start, versions and plan agreement are not newly verified. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original registration text and versions, disclosure, start and change dates, ADAS-Jcog naming and endpoint specifications, and funding compared with the paper. The original official URL is retained without clicking it. - Required materials and conditions: UMIN000032833 history and prespecified plans - Materials to obtain first: Original registration text and versions, disclosure, start and change dates, ADAS-Jcog naming and endpoint specifications, and funding compared with the paper. The original official URL is retained without clicking it. - Further research: Material needed: Original registration text and versions, disclosure, start and change dates, ADAS-Jcog naming and endpoint specifications, and funding compared with the paper. The original official URL is retained without clicking it. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: UMIN000032833 history and prespecified plans. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: UMIN000032833 history and prespecified plans. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01, R02 ### N22 · Were protocol, SAP, subscale and multiplicity plans acquired? Verification status: Unverified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: Original registration and historical cross-checking statements are retained. The original protocol and SAP, versions and dates, subscale and multiplicity plans, and clinical thresholds have not been read in this work. A registration statement about the primary endpoint does not establish all secondary plans. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original protocol, SAP, amendments, all outcomes and analyses, multiplicity, clinical thresholds and public-disclosure timing. Unread external material is not assumed to mean a document is absent. - Required materials and conditions: Separate evidence for prespecified plans, analyses and changes - Materials to obtain first: Original protocol, SAP, amendments, all outcomes and analyses, multiplicity, clinical thresholds and public-disclosure timing. Unread external material is not assumed to mean a document is absent. - Further research: Material needed: Original protocol, SAP, amendments, all outcomes and analyses, multiplicity, clinical thresholds and public-disclosure timing. Unread external material is not assumed to mean a document is absent. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Separate evidence for prespecified plans, analyses and changes. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Separate evidence for prespecified plans, analyses and changes. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01, R02 ### N23 · Are company funding, product support, employee authors and research roles separated? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The source records Morinaga Milk study support, manufacture and supply of MKP-containing hydrolysate and placebo tablets, four employee authors N.Y., M.T., K.Y. and F.A., and a supervision fee for N.S. The original limitation that separate public cofunding, medical-writing and publication support were not reported is retained. Design, analysis and data-control details are not newly established. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Individual original records of company funding and products, author employment and supervision fees, design, analysis, data control, other support and conflicts of interest. Absence of public support and all roles are not certified in this work. - Required materials and conditions: Four categories of Morinaga involvement and other support - Materials to obtain first: Individual original records of company funding and products, author employment and supervision fees, design, analysis, data control, other support and conflicts of interest. Absence of public support and all roles are not certified in this work. - Further research: Material needed: Individual original records of company funding and products, author employment and supervision fees, design, analysis, data control, other support and conflicts of interest. Absence of public support and all roles are not certified in this work. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Four categories of Morinaga involvement and other support. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Four categories of Morinaga involvement and other support. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01, R02 ### N24 · Are null, positive secondary and unverified findings distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The null original total-score result, P=.302 and d=.12, is retained alongside the positive secondary Orientation P=.022, which does not overturn failure of the total score. Unverified details of CIs, plans and denominators differ from unread external material. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original endpoint-specific tables, direct measurement and analysis, plans, clinical importance and actual access scope. Null is not replaced with zero effect or equivalence, and unread is not replaced with unreported. - Required materials and conditions: Total-score and subscale findings and material-access states - Materials to obtain first: Original endpoint-specific tables, direct measurement and analysis, plans, clinical importance and actual access scope. Null is not replaced with zero effect or equivalence, and unread is not replaced with unreported. - Further research: Material needed: Original endpoint-specific tables, direct measurement and analysis, plans, clinical importance and actual access scope. Null is not replaced with zero effect or equivalence, and unread is not replaced with unreported. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Total-score and subscale findings and material-access states. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Total-score and subscale findings and material-access states. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N25 · Were the paper and registration counted as separate clinical trials? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: Parent verdict 2980 and the total-score and Orientation sheets share the same Yuda2020 paper, UMIN000032833 registration and 268-person, 24-week trial. The same people, groups, visits, total scores, subscales, references, registration and related sheets are not added as new independent trials or participants. Two linked documents comprise one clinical paper and one registration record, not certified counts of unique trials or participants. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Original references, registration and links to the same cohort, analyses, visits and outcomes. Totals of unique trials and participants remain unrecorded. - Required materials and conditions: Report and registration linkage versus actual trials and participants - Materials to obtain first: Original references, registration and links to the same cohort, analyses, visits and outcomes. Totals of unique trials and participants remain unrecorded. - Further research: Material needed: Original references, registration and links to the same cohort, analyses, visits and outcomes. Totals of unique trials and participants remain unrecorded. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Report and registration linkage versus actual trials and participants. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Report and registration linkage versus actual trials and participants. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01, R02 ### N26 · Is there separate independent confirmation? Verification status: Unverified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The original parent replication axis R1 and independence axis I0 are retained. The paper, registration, subscales in the same participants and related sheets are not certified as new independent replications. No separate replication of harm findings is created in this work. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Confirmatory evidence with question-specific prespecified plans, separate populations and controls, direct endpoints and durations, effects and CIs, and funding or author relationships. No new search or independence verdict. - Required materials and conditions: Distinguish a single manufacturer trial from independent replication - Materials to obtain first: Confirmatory evidence with question-specific prespecified plans, separate populations and controls, direct endpoints and durations, effects and CIs, and funding or author relationships. No new search or independence verdict. - Further research: Material needed: Confirmatory evidence with question-specific prespecified plans, separate populations and controls, direct endpoints and durations, effects and CIs, and funding or author relationships. No new search or independence verdict. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Distinguish a single manufacturer trial from independent replication. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Distinguish a single manufacturer trial from independent replication. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N27 · Are subclaim grades distinguished from original parent scores and axes? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The selected record's grade, note and Korean and English question wording are retained; absent subclaim score, status and axes remain unrecorded. Parent D30, Good safety and B/P/R1/I0/E0/B0/C0 are parent context and are not transferred to the subclaim. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Review of subclaim and parent boundaries and actual correction records. No new score or grade, or official RoB2 or GRADE certification. - Required materials and conditions: Subclaim grade, note and absences versus parent D30 - Materials to obtain first: Review of subclaim and parent boundaries and actual correction records. No new score or grade, or official RoB2 or GRADE certification. - Further research: Material needed: Review of subclaim and parent boundaries and actual correction records. No new score or grade, or official RoB2 or GRADE certification. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Subclaim grade, note and absences versus parent D30. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Subclaim grade, note and absences versus parent D30. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N28 · Are both languages and absent structured fields preserved? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The parent Korean and English texts, evidence and citations, axes and original selected subclaim are retained in the full stored summary. Separate Korean and English classification fields are absent; no new fields are inserted into the original summary. No external comparison with the English paper was performed. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Review material for language-specific terminology, endpoints, visits, original statements and absences. Application-condition descriptions are distinguished from the preserved original record. - Required materials and conditions: Korean and English originals and absent separate classification fields - Materials to obtain first: Review material for language-specific terminology, endpoints, visits, original statements and absences. Application-condition descriptions are distinguished from the preserved original record. - Further research: Material needed: Review material for language-specific terminology, endpoints, visits, original statements and absences. Application-condition descriptions are distinguished from the preserved original record. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Korean and English originals and absent separate classification fields. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Korean and English originals and absent separate classification fields. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N29 · Are the reference date, corrections and historical cross-checking separated from production? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: The 2026-08-26 reference date, empty correction array and deliberation string, and historical cross-checking in the verdict-decision record are retained. The original date and history are not condition-freezing, application, production or completed-content-review dates. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: When actual new corrections or material arise, retain the original text and separate events, conditions, observations and verdict decisions for updates. Historical records are not treated as new quality review. - Required materials and conditions: Original 2026-08-26 reference date and empty corrections - Materials to obtain first: When actual new corrections or material arise, retain the original text and separate events, conditions, observations and verdict decisions for updates. Historical records are not treated as new quality review. - Further research: Material needed: When actual new corrections or material arise, retain the original text and separate events, conditions, observations and verdict decisions for updates. Historical records are not treated as new quality review. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Original 2026-08-26 reference date and empty corrections. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Original 2026-08-26 reference date and empty corrections. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N30 · Which direct material would fill the selected gaps? Verification status: Unverified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: Gaps in the secondary Orientation signal, quantitative effects, CIs, hierarchy and multiplicity are retained. Confirmation of the subscale requires prespecified direct comparison data for that endpoint; it is not converted into total-score success or dementia prevention. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Question-specific prespecified direct effects and CIs, denominators, missingness, measurement, effects of interest, clinical thresholds, multiplicity, separate confirmation, longer-term clinical outcomes and harms. Only material needs are recorded; no research or retrieval is performed. - Required materials and conditions: Prespecified questions, direct effects, CIs, plans and follow-up - Materials to obtain first: Question-specific prespecified direct effects and CIs, denominators, missingness, measurement, effects of interest, clinical thresholds, multiplicity, separate confirmation, longer-term clinical outcomes and harms. Only material needs are recorded; no research or retrieval is performed. - Further research: Material needed: Question-specific prespecified direct effects and CIs, denominators, missingness, measurement, effects of interest, clinical thresholds, multiplicity, separate confirmation, longer-term clinical outcomes and harms. Only material needs are recorded; no research or retrieval is performed. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Prespecified questions, direct effects, CIs, plans and follow-up. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Prespecified questions, direct effects, CIs, plans and follow-up. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ### N31 · Are production, existing content review and practical instructions separated? Verification status: Partly verified Reading scope: Stored summary read; external abstract, full text, registration, protocol and SAP unread - Current findings: This is an application-condition record based on the preserved summary. Existing content and question-boundary review are incomplete; historical candidate pending and eligibility labels are retained as history. Existing review status is recorded as it stands. - Why unverified: An observation from the preserved summary that distinguishes selected and parent claims, paper and registration, and endpoint information. Detailed original data are unverified and review of existing content is incomplete; this is not a passed content review or clinical certification. - Reason for missing information: Existing content review and subsequent actual material and correction records. The original production performed no comparison of clinical source material, external reading, new calculations, grade changes or advice on MKP, milk or products, cognition or dementia care, or treatment replacement. - Required materials and conditions: Production request, historical candidate record and responsibility for existing content review - Materials to obtain first: Existing content review and subsequent actual material and correction records. The original production performed no comparison of clinical source material, external reading, new calculations, grade changes or advice on MKP, milk or products, cognition or dementia care, or treatment replacement. - Further research: Material needed: Existing content review and subsequent actual material and correction records. The original production performed no comparison of clinical source material, external reading, new calculations, grade changes or advice on MKP, milk or products, cognition or dementia care, or treatment replacement. Only material requests and research needs are recorded; no retrieval or research is performed in this work. - Conditions for verification: Show source material and scope for the following evidence need, including the selected-subclaim and parent boundary, reports and endpoints, effect of interest, denominators and external reading scope: Production request, historical candidate record and responsibility for existing content review. - Why this condition is needed: This condition links the evidence need with the selected question, actual population, intervention and control, total score and subscales, hierarchy and effect of interest, denominators and follow-up, reports and harms: Production request, historical candidate record and responsibility for existing content review. - Application exceptions: Distinguish the secondary Orientation P value from unverified group-specific values, effects, CIs, comparison models, prespecified or exploratory hierarchy and multiplicity; also distinguish the null primary total score, other tests, daily function, baseline cognition, population, intervention, control, duration, denominators and harms. Only original numbers are retained. No new calculations, effects, CIs, hypothetical quantities, rejudging, grades, independence certification, consumption advice for MKP, milk or products, cognition or dementia care, or treatment-replacement instructions are produced. - Remaining uncertainty: External original material has not been read and review of existing content is incomplete. Original grades, scores, axes and historical verification or independence statements are not promoted into a new verdict or certification. - Referenced methods: Existing C/E/H distinctions concerning questions, populations, interventions, comparisons, reports and trials, outcomes and denominators, and harms are referenced for production. - Related sources: R01 ## Evidence and sources ### R01 Yuda N, et al. Effect of the Casein-Derived Peptide Met-Lys-Pro on Cognitive Function in Community-Dwelling Adults Without Dementia. Clin Interv Aging. 2020;15:743-754. PMID: 32546992. [PubMed](https://pubmed.ncbi.nlm.nih.gov/32546992/) Materials actually read: Stored summary read; external abstract, full text, registration and plans unread Findings recorded in the summary: 4.08±2.17 to 3.18±1.88 versus 4.10±2.10 to 3.43±2.10; baseline-adjusted P=0.302, d=0.12; 95% CI not reported Record level: Total-score summary in the preserved evidence list; Orientation is linked separately to its subclaim and the original counterview. Independent replication: Parent verdict 2980 and the total-score and Orientation sheets share the same Yuda2020 paper, UMIN000032833 registration and 268-person, 24-week trial context. The same people, groups, visits, total score, subscales, references, registration and related sheets are not added as new independent trials or participants. R01, the paper, and R02, the registration, are documents linked by the same UMIN identifier, not certified counts of unique trials or participants or a certification of independence. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored summary | A preserved local copy of the complete parent summary | Stored summary read | Summary read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | | External abstract | An original identifier, citation or needed-material entry; public availability and access details are unverified. | Unread; no access test performed | Not read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | | External full text | An original identifier, citation or needed-material entry; public availability and access details are unverified. | Unread; no access test performed | Not read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | | Original registration | An original identifier, citation or needed-material entry; public availability and access details are unverified. | Unread; no access test performed | Not read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | | Protocol/SAP | An original identifier, citation or needed-material entry; public availability and access details are unverified. | Unread; no access test performed | Not read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | ### R02 UMIN Clinical Trials Registry. UMIN000032833. [Official source](https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037442) Materials actually read: Stored summary read; external abstract, full text, registration and plans unread Findings recorded in the summary: ADAS-Jcog was the prespecified primary endpoint, and public disclosure preceded the planned start. Record level: Existing citation statement about registration plans; not a new clinical effect or result Independent replication: Parent verdict 2980 and the total-score and Orientation sheets share the same Yuda2020 paper, UMIN000032833 registration and 268-person, 24-week trial context. The same people, groups, visits, total score, subscales, references, registration and related sheets are not added as new independent trials or participants. R01, the paper, and R02, the registration, are documents linked by the same UMIN identifier, not certified counts of unique trials or participants or a certification of independence. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored summary | A preserved local copy of the complete parent summary | Stored summary read | Summary read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | | Original registration | An original identifier, citation or needed-material entry; public availability and access details are unverified. | Unread; no access test performed | Not read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | | Registration amendment history | An original identifier, citation or needed-material entry; public availability and access details are unverified. | Unread; no access test performed | Not read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | | Original protocol | An original identifier, citation or needed-material entry; public availability and access details are unverified. | Unread; no access test performed | Not read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | | Original analysis plan | An original identifier, citation or needed-material entry; public availability and access details are unverified. | Unread; no access test performed | Not read | Only original PubMed and official UMIN URLs and identifiers are retained. No new external reading, access, confirmation of prespecification or certification of fulfillment is claimed. Missing full-text or plan URLs are not guessed. | ## 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 2026-10-15 · Public page/materials 1.0. A public view and materials were prepared from the existing31 items. No new clinical search, verification-status change or scoring was performed.