{ "schema_version": "chamgap-public-evidence-check-1.0", "public_id": "v2984-s1", "verdict_number": "2984", "title": "Green Mediterranean diet × Liver-fat reduction from Mankai or green tea alone", "view_version": "1.0", "view_created_date": "2026-10-15", "criteria_version": "1.0", "criteria_date": "2026-10-06", "review_date": null, "legacy_evidence_date": "2026-09-07", "review_scope": { "materials_read": "Existing review summaries and stored records of methodological application", "clinical_papers_directly_read": false, "new_clinical_search": false, "limitation": "The whole stored parent-verdict summary and selected subclaim were read for production. External papers, abstracts, full texts, registry, protocol, SAP and funding disclosures were not separately read or accessed. Historical review records are not inherited as current clinical verification or a new verdict.", "date_meaning": "This is the date the stored materials were checked, not the date of a new search of the clinical literature." }, "claim_context": { "population": "294 adults with abdominal obesity or dyslipidemia. Retention of 89.8% at 18 months, eligible follow-up MRS of 78% and the original 22% without eligible MRS describe different denominator states. No participant counts or attrition rates are calculated. Group denominators and eligibility or missingness reasons are unverified.", "intervention": "A bundled green-MED pattern. Distinguish physical activity common to three groups and 28 g/day walnuts common to both MED groups from added green-MED exposures of 3-4 cups/day green tea, 100 g/day frozen Mankai and greater red and processed meat restriction. Individual component effects were not separated.", "dose": "Only original research exposure records are preserved. Products, components, actual adherence and correspondence to other products are unverified. No Mankai or green-tea intake, recommended amounts, diets, exercise or energy conversions are created.", "comparator": "Three groups: healthy-diet guidance, conventional MED and green-MED. Weight-adjusted P=.035 describes green-MED versus MED and is not mixed with the HDG comparator in parent classification fields.", "endpoint": "18-month proton-MRS intrahepatic-fat proportional reductions of -38.9/-19.6/-12.2% and weight-adjusted P=.035 concern the bundled pattern. They are not converted into absolute percentage points, between-group differences or Mankai-only or green-tea-only effects. Small standardized-effect wording is historical; exact effects, CIs, denominators and measurement methods are unverified.", "duration": "18-month assessment of a bundled diet. Direct isolated-component trials, long-term clinical liver-disease events and persistence after stopping are not linked.", "excluded_extensions": [ "Classifying activity common to three groups or walnuts common to both MED groups as additions unique to green-MED, or mixing different contrasts", "Attributing simultaneous green-tea, Mankai and meat-restriction changes to Mankai or green tea alone", "Converting -38.9/-19.6/-12.2% proportional reductions into absolute percentage points, new between-group effects, CIs or component efficacy", "Treating 89.8% retention, 78% eligible MRS and original 22% absent imaging as the same attrition rate, or calculating participant counts", "Transferring weight-adjusted P=.035 or historical small standardized-effect wording into isolated causal effects or new grades", "Adding registration, groups, time points or other sheets as independent studies, or inheriting parent C with 46 points, unrecorded precision, axes or historical verification as subclaim values or current review results", "New arithmetic, effects, CIs, hypothetical figures, component or product intake, diets, liver-disease or weight management, or treatment-replacement instructions" ] }, "requirements": [ { "item_id": "N01", "question_type": "Evidence condition", "question": "Selected isolated-component question and original grade", "needed": "Mankai or green-tea wording, note and grade, and the parent dietary verdict", "role": "Required", "role_reason": "This applied condition distinguishes Mankai or green-tea wording, note and grade, and the parent dietary verdict to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Mankai or green-tea wording, note and grade, and the parent dietary verdict. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.5, §4.6.3; limits of this material conversion follow the review scope and internal design", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Record updates distinguishing isolated-component and bundled-diet questions. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The selected existing record is liver-fat reduction from Mankai or green tea alone, grade ?, with a note that individual component effects were not separated. Subclaim score, status and axes are absent and are not filled with parent C with 46 points.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Separate subclaim score, status, axes and direct isolated-component effects are absent from the original material. Review of existing content remains incomplete.", "missingness": "Separate subclaim score, status, axes and direct isolated-component effects are absent from the original material.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "Selected original version and editorial comments" }, { "item_id": "N02", "question_type": "Evidence condition", "question": "Boundary between the bundled diet and component attribution", "needed": "Simultaneously changed components, factor separation and isolated comparisons", "role": "Required", "role_reason": "This applied condition distinguishes Simultaneously changed components, factor separation and isolated comparisons to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Simultaneously changed components, factor separation and isolated comparisons. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M03 §3.2.2–3.2.3; reverse-direction labels and checking adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up research separating component attribution from the bundled pattern. No product or diet instructions are produced. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The original text records results for a package of foods and meat restriction. Its overall descriptions of Mankai, green tea, walnuts and meat restriction are not transferred into efficacy of any one component.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Direct comparisons changing only Mankai or green tea, component-specific effects and interactions are not linked. Review of existing content remains incomplete.", "missingness": "Direct comparisons changing only Mankai or green tea, component-specific effects and interactions are not linked.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "Component-specific comparison designs, denominators and original results" }, { "item_id": "N03", "question_type": "Evidence condition", "question": "Physical activity common to all three groups", "needed": "Common exposures in all groups and actual implementation", "role": "Required", "role_reason": "This applied condition distinguishes Common exposures in all groups and actual implementation to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Common exposures in all groups and actual implementation. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.2–3.2.3; Reverse-direction labels and assessment adaptation are Chamgap design; M03 §3.2.3 and M08 §8.2.2–8.2.3; Chamgap application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material distinguishing common exposures from dietary differences. Exercise instructions are not written. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The original account allocated 294 participants to healthy-diet guidance, MED and green-MED, all undertaking a physical-activity program. Activity is not recast as unique to green-MED or as an isolated-component effect.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Activity specifications, group implementation, contact and actual exposure by period are unverified. Review of existing content remains incomplete.", "missingness": "Activity specifications, group implementation, contact and actual exposure by period are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 group activity, contact and implementation records" }, { "item_id": "N04", "question_type": "Evidence condition", "question": "Walnuts common to both MED groups", "needed": "Common and different food exposures by group", "role": "Required", "role_reason": "This applied condition distinguishes Common and different food exposures by group to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Common and different food exposures by group. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are in-house design; M03 §3.2.3, M08 §8.2.2–8.2.3; in-house application; M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is in-house design", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material disclosing common foods and different components. No intake guidance is provided. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The study condition that both MED groups received 28 g/day walnuts is preserved. The green-MED versus conventional-MED difference is not explained as a walnut-only effect or as walnuts added only in green-MED.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Actual walnut adherence, correspondence with other foods and isolated comparisons are unverified. Review of existing content remains incomplete.", "missingness": "Actual walnut adherence, correspondence with other foods and isolated comparisons are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 food and adherence records for both MED groups and separate component comparisons" }, { "item_id": "N05", "question_type": "Evidence condition", "question": "Study exposures added in green-MED", "needed": "Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures", "role": "Required", "role_reason": "This applied condition distinguishes Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.2–3.2.3; reverse-direction labels and checking adaptations are internally designed; M03 §3.2.3, M08 §8.2.2–8.2.3; internal application; M03 §3.2.1–3.2.4; dose, duration and effect-modification details are internally designed", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material separating planned from actual component exposures. No dose or energy conversions are produced. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Green-MED jointly added 3-4 cups/day green tea, 100 g/day frozen Mankai and greater restriction of red and processed meat. These figures are study conditions, not individual products, recommended amounts or doses establishing isolated efficacy.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Actual adherence, component and product specifications, meat-restriction amounts and individual exposures are unverified. Review of existing content remains incomplete.", "missingness": "Actual adherence, component and product specifications, meat-restriction amounts and individual exposures are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 food and product specifications, actual intake and concurrent restriction records" }, { "item_id": "N06", "question_type": "Evidence condition", "question": "Direct material for Mankai alone", "needed": "Isolated formulation, comparator, population, outcome and denominators", "role": "Required", "role_reason": "This applied condition distinguishes Isolated formulation, comparator, population, outcome and denominators to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Isolated formulation, comparator, population, outcome and denominators. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.6.1–4.6.2 distinctions between studies and reports; cohort and outcome linkage is internal application; M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are internally designed; M15 §15.3.1–15.3.3; internal application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up research separating the isolated-component study specification. No hypothetical reports or effects are created. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The current stored summary concerns the DIRECT-PLUS bundled pattern. Direct liver-fat trials of Mankai alone are not linked in the preserved citation list, and the bundled-group -38.9% is not used as an isolated effect.", "condition_status": "Unverified", "status_reason": "Information currently required is unverified in the stored summary. Mankai-only trials, formulations, exposure, direct comparisons, effects, CIs and denominators are not linked. Review of existing content remains incomplete.", "missingness": "Mankai-only trials, formulations, exposure, direct comparisons, effects, CIs and denominators are not linked.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "Exact reports, plans and original findings for the Mankai-only question" }, { "item_id": "N07", "question_type": "Evidence condition", "question": "Direct material for green tea alone", "needed": "Isolated formulation, comparator, population, outcome and denominators", "role": "Required", "role_reason": "This applied condition distinguishes Isolated formulation, comparator, population, outcome and denominators to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Isolated formulation, comparator, population, outcome and denominators. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.6.1–4.6.2 distinctions between studies and reports; cohort and outcome linkage is internal application; M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are internally designed; M15 §15.3.1–15.3.3; internal application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up research distinguishing isolated components from bundled diets. No intake or treatment instructions are given. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The current stored summary concerns a bundled diet including green tea. Direct liver-fat trials of green tea alone are not linked, and bundled results are not recast as green-tea treatment of fatty liver.", "condition_status": "Unverified", "status_reason": "Information currently required is unverified in the stored summary. Green-tea-only trials, formulations, components, exposure, comparisons, effects, CIs and denominators are not linked. Review of existing content remains incomplete.", "missingness": "Green-tea-only trials, formulations, components, exposure, comparisons, effects, CIs and denominators are not linked.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "Exact reports, plans and original findings for the green-tea-only question" }, { "item_id": "N08", "question_type": "Evidence condition", "question": "Actual population of the parent trial", "needed": "Abdominal obesity or dyslipidemia, eligibility and denominators", "role": "Required", "role_reason": "This applied condition distinguishes Abdominal obesity or dyslipidemia, eligibility and denominators to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Abdominal obesity or dyslipidemia, eligibility and denominators. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.1; detailed population conditions are internally designed. M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; design-specific adaptations are internally designed.", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material distinguishing populations and application boundaries for isolated and bundled questions. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The original text describes 294 adults with abdominal obesity or dyslipidemia. Findings are not extended into isolated-component efficacy in selected liver-disease patients or everyone.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Age, sex, baseline liver fat and disease, recruitment and group allocation and analysis denominators are unverified. Review of existing content remains incomplete.", "missingness": "Age, sex, baseline liver fat and disease, recruitment and group allocation and analysis denominators are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 eligibility, recruitment, baseline characteristics and group flow charts" }, { "item_id": "N09", "question_type": "Evidence condition", "question": "Different conventional-MED and healthy-diet-guidance contrasts", "needed": "Three-group exposures, denominators and comparison specifications", "role": "Required", "role_reason": "This applied condition distinguishes Three-group exposures, denominators and comparison specifications to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Three-group exposures, denominators and comparison specifications. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are internally designed; M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material with disclosed comparator-specific study specifications. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The parent classification fields identify healthy-diet guidance as the comparator, while weight-adjusted P=.035 describes green-MED versus conventional MED. Effects, P values and comparator exposures from different contrasts are not mixed.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Exact contrast-specific estimates, denominators and correspondence of whole diets and contact are unverified. Review of existing content remains incomplete.", "missingness": "Exact contrast-specific estimates, denominators and correspondence of whole diets and contact are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 group diets, contrast-specific original tables and models" }, { "item_id": "N10", "question_type": "Evidence condition", "question": "Intrahepatic-fat MRS and isolated-component results", "needed": "Proton-MRS definitions, units, time points and directness", "role": "Required", "role_reason": "This applied condition distinguishes Proton-MRS definitions, units, time points and directness to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Proton-MRS definitions, units, time points and directness. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.4 and M15 §15.3.1–15.3.3; Question-specific outcome adaptation is Chamgap design; M08 Table 8.2.a and M03 §3.2.4; Chamgap application; M03 §3.2.4; Chamgap interpretation boundary", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material separating measurement methods from component attribution. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "S01 describes 18-month change in intrahepatic fat by proton MRS. Imaging findings are not transferred into direct clinical treatment results for Mankai or green tea alone, or into other MRI-PDFF trials.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. MRS acquisition, reading, location, units, eligibility criteria and isolated-comparison findings are unverified. Review of existing content remains incomplete.", "missingness": "MRS acquisition, reading, location, units, eligibility criteria and isolated-comparison findings are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 MRS methods, reading and eligibility procedures, and separate isolated results" }, { "item_id": "N11", "question_type": "Evidence condition", "question": "Proportional reductions and absolute or between-group effects", "needed": "Group proportional changes, denominators and estimates", "role": "Required", "role_reason": "This applied condition distinguishes Group proportional changes, denominators and estimates to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Group proportional changes, denominators and estimates. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are internally designed; M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material separating units and scope of reported estimates. No new calculations are produced. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Green-MED -38.9%, MED -19.6% and HDG -12.2% are original proportional intrahepatic-fat reductions. They are not recast as absolute percentage points, isolated-component effects, between-group differences or CIs, or new relative or absolute calculations.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Group original values, variances, exact comparative effects and CIs, within-person calculations and denominators are unverified. Review of existing content remains incomplete.", "missingness": "Group original values, variances, exact comparative effects and CIs, within-person calculations and denominators are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 original tables, proportional and absolute definitions, and comparative analyses" }, { "item_id": "N12", "question_type": "Evidence condition", "question": "Weight-adjusted P values and causal component attribution", "needed": "Adjusted models, contrasts, weight changes and effects", "role": "Required", "role_reason": "This applied condition distinguishes Adjusted models, contrasts, weight changes and effects to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Adjusted models, contrasts, weight changes and effects. Stored wording is linked; review of existing content remains incomplete.", "basis": "M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application; M03 §3.2.3, M08 §8.2.2–8.2.3; internal application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up research separating weight change from component attribution. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Weight-adjusted green-MED versus MED P=.035 and similar weight-loss wording concern a bundled-diet comparison. Possibilities beyond weight change do not establish causal effects of Mankai or green tea alone.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Exact adjusted models, coefficients and CIs, weight-analysis denominators and separate mediation or component effects are unverified. Review of existing content remains incomplete.", "missingness": "Exact adjusted models, coefficients and CIs, weight-analysis denominators and separate mediation or component effects are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 adjusted models, weight and liver-fat original tables, and separate component material" }, { "item_id": "N13", "question_type": "Evidence condition", "question": "Historical wording of a small standardized effect", "needed": "Original standardized estimates, denominators and interpretation specifications", "role": "Required", "role_reason": "This applied condition distinguishes Original standardized estimates, denominators and interpretation specifications to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Original standardized estimates, denominators and interpretation specifications. Stored wording is linked; review of existing content remains incomplete.", "basis": "M15 §15.3.1–15.3.3; Chamgap adaptation; M04 §4.5, §4.6.3; limitations of the current material conversion follow the review scope and Chamgap design", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up records separating reported effects from the historical scope of verdict interpretation. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The parent text describes a small standardized effect versus conventional MED. No new standardized values or CIs, isolated-component magnitudes or grades are created from that wording.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Exact standardized estimates, variances, specifications, CIs and relevance thresholds are unverified. Review of existing content remains incomplete.", "missingness": "Exact standardized estimates, variances, specifications, CIs and relevance thresholds are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 original effect tables and historical standardized-effect and interpretation material" }, { "item_id": "N14", "question_type": "Evidence condition", "question": "Retention and eligible MRS have different denominators", "needed": "Randomization, retention, imaging eligibility and group missingness", "role": "Required", "role_reason": "This applied condition distinguishes Randomization, retention, imaging eligibility and group missingness to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Randomization, retention, imaging eligibility and group missingness. Stored wording is linked; review of existing content remains incomplete.", "basis": "M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; Design-specific adaptation is Chamgap design; M08 §8.2.2 and M15 §15.3.1; Chamgap application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material distinguishing retention from imaging-analysis eligibility. No new count or rate calculations are produced. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The original 294 randomized participants, 89.8% retention at 18 months and 78% eligible follow-up MRS are preserved separately. The original 22% without eligible MRS is not recast as 22% trial attrition or exact participant counts.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Group retention, MRS eligibility and missingness, reasons, and selected and analysis denominators are unverified. Review of existing content remains incomplete.", "missingness": "Group retention, MRS eligibility and missingness, reasons, and selected and analysis denominators are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 participant and imaging flows and group eligibility and missingness reasons" }, { "item_id": "N15", "question_type": "Evidence condition", "question": "Missing imaging, analysis populations and sensitivity analyses", "needed": "Missing-data handling, ITT or PP, selection and estimate stability", "role": "Required", "role_reason": "This applied condition distinguishes Missing-data handling, ITT or PP, selection and estimate stability to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Missing-data handling, ITT or PP, selection and estimate stability. Stored wording is linked; review of existing content remains incomplete.", "basis": "M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; Design-specific adaptation is Chamgap design; M08 §8.2.2 and M15 §15.3.1; Chamgap application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material distinguishing missingness from analysis specifications. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Imaging missingness reflected in 78% eligible MRS is recorded as a limitation of the parent verdict. It is not used as proof that everyone completed imaging or as ITT evidence for an isolated-component effect.", "condition_status": "Unverified", "status_reason": "Information currently required is unverified in the stored summary. ITT or PP, imaging-missingness handling, imputation, sensitivity analyses and baseline associations are unverified. Review of existing content remains incomplete.", "missingness": "ITT or PP, imaging-missingness handling, imputation, sensitivity analyses and baseline associations are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 analysis populations, missingness and sensitivity analyses, and SAP" }, { "item_id": "N16", "question_type": "Evidence condition", "question": "Randomization and assessment masking", "needed": "Allocation, concealment, MRS reading, contact and expectations", "role": "Required", "role_reason": "This applied condition distinguishes Allocation, concealment, MRS reading, contact and expectations to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Allocation, concealment, MRS reading, contact and expectations. Stored wording is linked; review of existing content remains incomplete.", "basis": "M08 §8.1–8.2.3; internal application; M08 Table 8.2.a, M03 §3.2.4; internal application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material disclosing lifestyle exposures and imaging-assessment conditions. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The original S01 design is a three-arm 18-month randomized lifestyle trial. The design label does not establish allocation concealment or participant, imaging-reader or analyst masking.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Sequence generation, concealment, reading and analysis masking, and group contact and expectations are unverified. Review of existing content remains incomplete.", "missingness": "Sequence generation, concealment, reading and analysis masking, and group contact and expectations are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 allocation, reading, contact and analysis procedures" }, { "item_id": "N17", "question_type": "Evidence condition", "question": "Actual diets, activity and other concurrent exposures", "needed": "Food, weight, activity and management adherence material", "role": "Required", "role_reason": "This applied condition distinguishes Food, weight, activity and management adherence material to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Food, weight, activity and management adherence material. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.3, M08 §8.2.2–8.2.3; our own application; M08 §8.2.2, M15 §15.3.1; our own application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material distinguishing common from different exposures. No diet or weight-management instructions are given. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Activity common to all three groups, walnuts common to both MED groups and added green-MED components are recorded as originally described. This is not interpreted as a trial isolating components without actual adherence or concurrent-management differences.", "condition_status": "Unverified", "status_reason": "Information currently required is unverified in the stored summary. Group energy intake, whole diets, activity, medications, management and individual adherence are unverified. Review of existing content remains incomplete.", "missingness": "Group energy intake, whole diets, activity, medications, management and individual adherence are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 group diet, activity, concurrent management and adherence records" }, { "item_id": "N18", "question_type": "Evidence condition", "question": "Registration identifier and access to actual plans", "needed": "Original registration identifier, protocol, SAP and changes", "role": "Required", "role_reason": "This applied condition distinguishes Original registration identifier, protocol, SAP and changes to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Original registration identifier, protocol, SAP and changes. Stored wording is linked; review of existing content remains incomplete.", "basis": "Data collection and selection principles in M04 §4.5–4.6; separation of access from reading and the hyperlink contract are internally designed; M08 Table 8.2.a, M04 §4.6.3; internal application; M04 §4.5, §4.6.3; limits of this material conversion reflect the review scope and internal design", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material distinguishing the preserved identifier from actual plan access. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "The original evidence and citation lists identify NCT03020186. The identifier and historical parent registration verification do not establish current registration reading or isolated-component plans before recruitment.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Recruitment and registration timing, protocol, SAP, outcome and component hierarchy, and changes remain unread. Review of existing content remains incomplete.", "missingness": "Recruitment and registration timing, protocol, SAP, outcome and component hierarchy, and changes remain unread.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "NCT03020186 original registration, plans and change history" }, { "item_id": "N19", "question_type": "Evidence condition", "question": "Multiple contrasts and analysis hierarchy", "needed": "Plans for three groups, time points, outcomes and subgroup analyses", "role": "Required", "role_reason": "This applied condition distinguishes Plans for three groups, time points, outcomes and subgroup analyses to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Plans for three groups, time points, outcomes and subgroup analyses. Stored wording is linked; review of existing content remains incomplete.", "basis": "M08 Table 8.2.a, M04 §4.6.3; internal application; M08 §8.2.2, M15 §15.3.1; internal application; M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is internally designed", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material distinguishing all contrasts from component questions. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Multiple bundled-diet contrasts and weight-adjusted analyses are not prespecified primary results for isolated components. Parent MRS classification fields are not used as an isolated-effect hierarchy.", "condition_status": "Unverified", "status_reason": "Information currently required is unverified in the stored summary. Pre-recruitment contrasts, outcomes, subgroup analyses, multiplicity, adjustment and SAP are unverified. Review of existing content remains incomplete.", "missingness": "Pre-recruitment contrasts, outcomes, subgroup analyses, multiplicity, adjustment and SAP are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 complete analysis plans, original tables and separate component study specifications" }, { "item_id": "N20", "question_type": "Evidence condition", "question": "The same trial and absence of linked isolated-component replication", "needed": "Relationships among reports, groups, time points and independent trials", "role": "Required", "role_reason": "This applied condition distinguishes Relationships among reports, groups, time points and independent trials to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Relationships among reports, groups, time points and independent trials. Stored wording is linked; review of existing content remains incomplete.", "basis": "Study/report distinction in M04 §4.6.1–4.6.2; Cohort/outcome linkage is Chamgap application; M04 §4.6.1–4.6.2 and M15 §15.3.1; Chamgap application", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose separate research with the same component study specification. No new totals or independence certification are produced. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "S01 DIRECT-PLUS includes the same trial's 294 participants, three groups, multiple exposures and time points. Groups, components, registration identifiers and other liver-fat sheets are not added as new independent trials, participants or isolated-component replication.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Separate direct Mankai-only or green-tea-only trials and independent-family relationships are not linked. Review of existing content remains incomplete.", "missingness": "Separate direct Mankai-only or green-tea-only trials and independent-family relationships are not linked.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "Report, group and registration relationships, and separate isolated-component trial material" }, { "item_id": "N21", "question_type": "Evidence condition", "question": "18 months and clinical liver-disease events", "needed": "Imaging surrogates, persistence and clinical outcomes", "role": "Required", "role_reason": "This applied condition distinguishes Imaging surrogates, persistence and clinical outcomes to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Imaging surrogates, persistence and clinical outcomes. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.1–3.2.4; dose, persistence and effect-modification details are internally designed; M03 §3.2.4; internally defined extension boundaries; M04 §4.5, §4.6.3; current material-conversion limits follow the review scope and internal design", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up research distinguishing imaging from clinical outcomes. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "18 months is the parent bundled-diet imaging-study duration. The original text records absence of clinical liver-disease events and independent confirmation trials. Long-duration imaging changes do not establish liver-disease treatment or prevention by isolated components.", "condition_status": "Unverified", "status_reason": "Information currently required is unverified in the stored summary. Persistence after stopping, clinical events and long-term isolated-component findings are not linked. Review of existing content remains incomplete.", "missingness": "Persistence after stopping, clinical events and long-term isolated-component findings are not linked.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "Time-specific imaging and clinical events, and separate isolated-component material" }, { "item_id": "N22", "question_type": "Evidence condition", "question": "Application to other populations, foods and products", "needed": "Direct material by eligibility, disease, formulation and exposure", "role": "Required", "role_reason": "This applied condition distinguishes Direct material by eligibility, disease, formulation and exposure to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Direct material by eligibility, disease, formulation and exposure. Stored wording is linked; review of existing content remains incomplete.", "basis": "M03 §3.2.1; detailed population conditions are our own design; M03 §3.2.2–3.2.3; reverse-direction labels and test adaptations are our own design; M03 §3.2.1–3.2.4; dose, duration and effect-modification details are our own design", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose separate material for questions with different populations or products. No intake or treatment instructions are given. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Direct material concerns the bundled pattern in the selected adults. Findings are not extended into isolated efficacy for ordinary green tea, other Mankai products, other diets, liver-disease patients or every population.", "condition_status": "Unverified", "status_reason": "Information currently required is unverified in the stored summary. Identity, exposures and direct liver-fat or clinical material for other populations and products are not linked. Review of existing content remains incomplete.", "missingness": "Identity, exposures and direct liver-fat or clinical material for other populations and products are not linked.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "Direct material for other populations, components and products" }, { "item_id": "N23", "question_type": "Evidence condition", "question": "Mixed funding and product-related roles", "needed": "Original funding, advisory, product-support, employee-authorship and COI material", "role": "Required", "role_reason": "This applied condition distinguishes Original funding, advisory, product-support, employee-authorship and COI material to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Original funding, advisory, product-support, employee-authorship and COI material. Stored wording is linked; review of existing content remains incomplete.", "basis": "Chamgap's own conditions for independence and attribution. The official methodological sections used in this example do not validate every detail of these items.", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material distinguishing support types from roles. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Original wording of public support, California Walnut Commission support, the PI's disclosed Hinoman advisory role and funders' reported lack of involvement in design or analysis is preserved. This is not recast as complete current role or COI verification or isolated-efficacy certification.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Original funder-role disclosures, products or free support, employee authorship, advisory scope and complete COI material are unverified. Review of existing content remains incomplete.", "missingness": "Original funder-role disclosures, products or free support, employee authorship, advisory scope and complete COI material are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 original funding, product-support, affiliation, contribution, advisory and COI material" }, { "item_id": "N24", "question_type": "Harm-information gaps supplementing the efficacy table", "question": "Safety and gaps concerning individuals and products", "needed": "Harm-event collection, exposures, denominators and discontinuation", "role": "Supplementary", "role_reason": "This applied condition distinguishes Harm-event collection, exposures, denominators and discontinuation to connect required material for the selected question with currently available material.", "application_exception": "Address safety-material gaps for the selected subclaim. Diet, isolated-component or imaging findings, or parent safety wording do not determine safety or create harm incidence rates or new use instructions.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Harm-event collection, exposures, denominators and discontinuation. Stored wording is linked; review of existing content remains incomplete.", "basis": "M19 §19.1.2–19.2.4; internal application. M19 §19.1.2–19.2.4; detailed distinctions are internally designed. M19 §19.2 covers design-specific harm questions; detailed temporal relationships are internally designed. M19 §19.2.2–19.2.4 and M03 §3.2.3; internal application. M19 §19.1.2–19.2.4; internal application. M19 §19.2.2–19.2.4 considers design; detailed confounding records are internally designed. M19 §19.1.2–19.2.4 and M04 §4.6.3; internal application. M19 §19.1.2–19.2.4; internal application. Interpretation boundaries are internally defined, informed by M19 principles; no official causality tool is executed.", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Propose follow-up material directly collecting safety information. No diet, liver-disease or weight-management instructions are provided. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Parent safety is unknown, and the original text states that adverse-event ascertainment was not central to the efficacy report. Nut-allergy, caffeine-sensitivity and disease-suitability wording is not used as event rates or isolated-product safety.", "condition_status": "Unverified", "status_reason": "Information currently required is unverified in the stored summary. Event definitions, collection, group denominators, discontinuation and isolated-component, long-term and vulnerable-population harms are unverified. Review of existing content remains incomplete.", "missingness": "Event definitions, collection, group denominators, discontinuation and isolated-component, long-term and vulnerable-population harms are unverified.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "S01 harm events, exposures, denominators and separate component-safety material" }, { "item_id": "N25", "question_type": "Evidence condition", "question": "Original grades, axes, languages, dates and corrections", "needed": "Separation of parent C with 46 points, subclaim ? and historical original values", "role": "Required", "role_reason": "This applied condition distinguishes Separation of parent C with 46 points, subclaim ? and historical original values to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Separation of parent C with 46 points, subclaim ? and historical original values. Stored wording is linked; review of existing content remains incomplete.", "basis": "M04 §4.5, §4.6.3; limits of this material conversion follow the review scope and internal design; M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Update records distinguishing original values, production dates and correction events. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Parent C with 46 points, B/S/R1/I1/E~/B1, unrecorded precision, four false flags and empty override reasons, and the subclaim ? and note are preserved. Korean and English text, 2026-09-07 and empty correction and deliberation values are original records, not inherited as subclaim scores or a current completed review.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Subclaim score, status and axes, new corrections and external comparisons were not produced or performed. Review of existing content remains incomplete.", "missingness": "Subclaim score, status and axes, new corrections and external comparisons were not produced or performed.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "Original versions, corrections and user feedback" }, { "item_id": "N26", "question_type": "Evidence condition", "question": "Historical verification and actual summary reading", "needed": "Scope of historical review, unread material and links", "role": "Required", "role_reason": "This applied condition distinguishes Scope of historical review, unread material and links to connect required material for the selected question with currently available material.", "application_exception": "Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.", "criterion": "Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Scope of historical review, unread material and links. Stored wording is linked; review of existing content remains incomplete.", "basis": "M04 §4.5–4.6 covers material collection and selection; distinctions between access and reading and hyperlink specifications are internally designed. M04 §4.6.1–4.6.2 distinguishes studies and reports; cohort and outcome linkage is an internal application. M04 §4.5 and §4.6.3; current evidence-conversion limits reflect review scope and internal design.", "condition_origin": "Production conditions for turning the preserved account into a table; existing content review remains incomplete, and this is not a record of running an official tool or completing content review", "proposed_research": "Update content distinguishing history from actual access events. This is a proposal; no new investigation, calculation or trial is conducted here.", "current_reports": [ "S01" ], "existence": "Stored summary/bibliography links; external identity unverified", "acquired_read": "Summary read; external material unread", "observation": "Historical full-text, registration and scoring verification is retained as original history. This production used stored summaries and bibliography; papers, registration, protocol, SAP and COI material were unread and access was not attempted. External source links were not tested.", "condition_status": "Partly verified", "status_reason": "Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Detailed historical verification, original-material acquisition, external reading and content review remain pending. Review of existing content remains incomplete.", "missingness": "Detailed historical verification, original-material acquisition, external reading and content review remain pending.", "uncertainty": "This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.", "review_date": null, "reading_status": "Full text not read · Stored summary read", "additional_material": "Original papers, registration and plans by report, historical versions and comments" } ], "reports": [ { "report_id": "S01", "title": "Yaskolka Meir A et al. 2021 DIRECT-PLUS", "url": "https://pubmed.ncbi.nlm.nih.gov/33461965/", "report_type": "Three-arm 18-month randomized lifestyle trial", "existence": "Stored bibliography exists; external identity unverified", "acquired_read": "Summary read; external material unread", "study_family": "RG2984-DIRECT-PLUS-2021", "independent_replication": null, "observed_result": "Green-MED -38.9%, MED -19.6%, HDG -12.2%; weight-adjusted green-MED versus MED P=.035", "result_level": "Outcome wording in the stored summary", "source_evidence_date": "2026-09-07", "materials": [ { "material_type": "Stored summary", "public_status": "Stored file", "access_status": "Stored summary", "acquired": true, "actually_read": "Summary read", "as_of": "2026-09-07", "qualification": "Only stored-summary and bibliographic content was used for production. External material verification/review is not complete." }, { "material_type": "External paper", "public_status": "Public availability unverified; only bibliography links preserved", "access_status": "Unread; access not attempted", "acquired": false, "actually_read": "Not read", "as_of": "2026-09-07", "qualification": "No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status." }, { "material_type": "Registration material", "public_status": "Public availability unverified; only bibliography links preserved", "access_status": "Unread; access not attempted", "acquired": false, "actually_read": "Not read", "as_of": "2026-09-07", "qualification": "No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status." }, { "material_type": "Protocol", "public_status": "Public availability unverified; only bibliography links preserved", "access_status": "Unread; access not attempted", "acquired": false, "actually_read": "Not read", "as_of": "2026-09-07", "qualification": "No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status." }, { "material_type": "Statistical analysis plan", "public_status": "Public availability unverified; only bibliography links preserved", "access_status": "Unread; access not attempted", "acquired": false, "actually_read": "Not read", "as_of": "2026-09-07", "qualification": "No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status." }, { "material_type": "Funding, product-support and COI material", "public_status": "Public availability unverified; only bibliography links preserved", "access_status": "Unread; access not attempted", "acquired": false, "actually_read": "Not read", "as_of": "2026-09-07", "qualification": "No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status." } ], "links": [ { "label": "PubMed", "url": "https://pubmed.ncbi.nlm.nih.gov/33461965/" } ] } ], "method_sources": [ { "id": "M03", "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08", "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03", "section": "§3.1, §3.2.1–3.2.3, MECIR C5/C7/C13", "official_principle": "Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.", "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution" }, { "id": "M04", "version": "Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03", "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04", "section": "§4.5, §4.6.1–4.6.3, MECIR C42", "official_principle": "Distinguish studies from reports and link them; do not omit a study solely because results are unreported.", "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution" }, { "id": "M08", "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10", "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08", "section": "§8.1–8.2.3, Table 8.2.a", "official_principle": "Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.", "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution" }, { "id": "M15", "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08", "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15", "section": "§15.2.4, §15.3.1–15.3.3", "official_principle": "Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.", "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution" }, { "id": "M19", "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10", "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19", "section": "§19.1.2, §19.2.1–19.2.4", "official_principle": "Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.", "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution" } ], "status_dictionary": { "Met": "Status for necessary evidence confirmed after existing content review. No completion is declared in the current presentation.", "Partly verified": "Some information in the stored summary is linked into the table. External comparison/content review is not complete.", "Unverified": "The article leaves this unverified, or required material is absent from the current stored summary. This is distinct from zero, absence or safety.", "Review incomplete": "Existing content review remains incomplete.", "Not reported": "Not reported within the stored material actually read; not extended to the entire primary paper.", "Inaccessible": "Means an actual access failure. Access not attempted here is not assigned this state.", "Not applicable": "Not used as a substitute for an evidence gap.", "Conflicting data": "Requires an observed disagreement under the same comparison criteria; not automatically judged in this production.", "Insufficient evidence for the conditions": "Marks a gap in additional material required by the selected conditions; not a new efficacy grade." }, "study_overlap": { "state": "Unverified", "unique_trial_count": null, "unique_participant_count": null, "reason": "S01 DIRECT-PLUS2021 reports a three-group 18-month lifestyle trial in 294 adults with abdominal obesity or dyslipidemia: healthy-diet guidance, MED and green-MED. Physical activity common to all groups and 28 g/day walnuts common to both MED groups are distinguished from added green-MED exposures of 3-4 cups/day green tea, 100 g/day frozen Mankai and greater meat restriction. Intrahepatic-fat proportional reductions -38.9/-19.6/-12.2% and weight-adjusted green-MED versus MED P=.035 concern the bundled pattern; Mankai-only and green-tea-only effects were not separated. Retention of 89.8%, eligible MRS of 78% and original 22% absent imaging are distinct; no denominator arithmetic is produced. Groups, time points, centers, registration, other sheets or people from one report are not added to unique-trial, participant or independent-replication totals. No new calculations, verdicts, independence certification or diet, intake or treatment instructions are produced." }, "history": [ { "date": "2026-10-15", "kind": "Separation of public-facing pages and materials", "view_version": "1.0", "change": "The reader view and materials were prepared from the existing 26 items. No new clinical search, verification-status changes or scoring were performed." } ], "language": "en", "translation_date": "2026-10-15" }