Psyllium × Ten-week ALT and FibroScan findings: signals, effect size and measurement gaps

Required evidence, verification status and materials actually read
Item	AVerification status	BReading scope	CReview item	DCurrent findings	EWhy unverified	FRequired materials and conditions	GFurther research
1	Partly verified	Full text not readStored summary read	N01 · Evidence conditionWhat is the selected ten-week test question?Required	The selected original wording concerns improved ALT and FibroScan measures over ten weeks, with original grade C. Its note records some positive between-group P values but unclear effect size and prespecified hierarchy. Absent subclaim scores, status and axes are distinguished from parent C50. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Original ten-week ALT and FibroScan improvement	Material needed: Exact ALT/FibroScan endpoints, population, comparator, time points and denominators, and review of the question boundary. Parent scores or axes are not inserted into subclaim values. Only material requests and research needs are recorded; no new search or clinical research is executed here.
2	Partly verified	Full text not readStored summary read	N02 · Evidence conditionWhat was the original ALT result?Required	The original reader answer and research description record covariate-adjusted ALT favoring psyllium, P=.006. Exact group values, changes, adjusted effects, units and 95% CIs are unverified. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Ten-week covariate-adjusted between-group ALT test	Material needed: Original ALT tables, units, assay, baseline/follow-up/change values, covariates, model, group denominators, effects and CIs. No effect sizes or normalization rates are derived from P values. Only material requests and research needs are recorded; no new search or clinical research is executed here.
3	Partly verified	Full text not readStored summary read	N03 · Evidence conditionWhat was the original FibroScan measure?Required	The stored summary describes a favorable FibroScan fibrosis score or fibrosis-related measure, P=.001. Exact measure names, units, equipment, algorithms, test validity and baseline/follow-up/change values cannot be established from the stored summary. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	FibroScan fibrosis score P=.001	Material needed: The actual FibroScan measure and score definition, units, measurement conditions, validity criteria, group tables, denominators, between-group effects and CIs. No particular measurement name or value is invented. Only material requests and research needs are recorded; no new search or clinical research is executed here.
4	Partly verified	Full text not readStored summary read	N04 · Evidence conditionAre FibroScan and MRI/MRS liver-fat measurements the same?Required	Original product information states that FibroScan is not the same measurement as MRI liver fat; the advertising interpretation limits the signal to enzymes and elastography-related measures. Other tests do not fill the unmeasured MRI outcome. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Distinguishing elastography-related measures from MRI and other tests	Material needed: Actual FibroScan measures and separately measured or defined MRI/MRS, other imaging or histology, with their denominators and estimates. A device name alone does not establish liver-fat quantity or histologic improvement. Only material requests and research needs are recorded; no new search or clinical research is executed here.
5	Partly verified	Full text not readStored summary read	N05 · Evidence conditionIs the null AST result retained?Required	Original AST P=.98 is recorded as null. ALT P=.006 and FibroScan P=.001 are not transferred into AST efficacy or success across every liver-function test. Null AST is not proof of zero effect or equivalence. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Separate ALT and AST tests	Material needed: AST baseline/follow-up/change values, group denominators, adjustment models, effects, CIs and prespecified hierarchy. Only material requests and research needs are recorded; no new search or clinical research is executed here.
6	Partly verified	Full text not readStored summary read	N06 · Evidence conditionAre within-group improvement and adjusted between-group comparison the same?Required	The original research description records favorable covariate-adjusted ALT and FibroScan findings. Exact covariates, baseline values, within-group changes and adjusted between-group estimates are unavailable, so P values alone do not reconstruct either effect. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Target effect, covariate adjustment and change estimates	Material needed: Original ANCOVA or analysis model, covariates, prespecification, baseline/follow-up/change values, direct effects, CIs and denominators. No new within-group or between-group values are calculated. Only material requests and research needs are recorded; no new search or clinical research is executed here.
7	Partly verified	Full text not readStored summary read	N07 · Evidence conditionWhat were the actual comparator and common advice?Required	The original intervention was psyllium 10g/day versus ground wheat 10g/day; both groups received weight-loss-diet and physical-activity advice. This add-on contrast is not changed into no treatment, psyllium alone or the same effect without a diet. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Psyllium versus ground wheat with common lifestyle advice	Material needed: Control products and composition, diet/activity advice in both arms, actual intake, activity, weight changes and co-treatment records. Identical advice and identical actual behavior are distinguished. Only material requests and research needs are recorded; no new search or clinical research is executed here.
8	Partly verified	Full text not readStored summary read	N08 · Evidence conditionWho was actually studied?Required	The original population comprised 80 adults with overweight or obesity and MASLD. Detailed diagnosis, liver-disease stage, baseline ALT and weight, medication, comorbidity, sex and age remain separately unverified. Findings are not generalized to other liver diseases, normal weight or advanced disease. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Overweight/obesity, MASLD and eligibility	Material needed: Diagnosis, eligibility, baseline liver disease, imaging, metabolic factors, medication, group baselines, subgroups and test denominators. Only material requests and research needs are recorded; no new search or clinical research is executed here.
9	Partly verified	Full text not readStored summary read	N09 · Evidence conditionDo 80 randomized and 78 completers provide every test denominator?Required	The original record states 80 randomized, 78 completed and ten weeks. Group allocation/completion, valid ALT/FibroScan/AST denominators, withdrawal reasons and timing remain separately unverified. No completion differences or rates are newly calculated. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Allocation, completion, valid tests and dropout	Material needed: Group flow, test- and time-specific denominators, ITT/completer populations, missing-data handling and exposure/withdrawal tables. Overall n is not copied into each group or test. Only material requests and research needs are recorded; no new search or clinical research is executed here.
10	Partly verified	Full text not readStored summary read	N10 · Evidence conditionAre ten-week research exposure and actual adherence verified?Required	Original psyllium 10g/day, ten weeks and control 10g/day are retained only to identify the study. Actual product quantification, manufacturing, intake, concurrent exposures, adherence and total exposure are separately unverified. No cumulative quantities or intake instructions are created. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Oral 10g/day, duration, products and exposure	Material needed: Original products, formulations, composition, actual exposure, adherence, dropout and changes in diet/activity. No psyllium, product or diet instructions are provided. Only material requests and research needs are recorded; no new search or clinical research is executed here.
11	Unverified	Full text not readStored summary read	N11 · Evidence conditionIs the prespecified primary-endpoint hierarchy verified?Required	The original reader answer, grading rationale and flags record unverified prespecified primary hierarchy and registration. Three test endpoints or positive P values do not make all of them prespecified primary successes. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	ALT/AST/FibroScan hierarchy, registration and SAP	Material needed: Initial and amended registration, protocol/SAP, endpoints, time points, multiplicity and analysis plans. Missing registration identifiers or URLs are not invented. Only material requests and research needs are recorded; no new search or clinical research is executed here.
12	Unverified	Full text not readStored summary read	N12 · Evidence conditionAre exact effect sizes, CIs and clinical importance available?Required	Original P=.006, .001 and .98 are present, but exact between-group effect sizes, confidence intervals and clinical importance are unverified. Small significant P values do not establish large quantitative effects, precision or disease improvement. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	P values, estimates, intervals and surrogate-test importance	Material needed: Original models, estimates, CIs, variance, denominators, prespecified importance thresholds and test units. No hypothetical quantitative examples or new effect/CI calculations are produced. Only material requests and research needs are recorded; no new search or clinical research is executed here.
13	Partly verified	Full text not readStored summary read	N13 · Evidence conditionDoes a FibroScan measure establish histologic fibrosis improvement?Required	The original fibrosis-score signal is not changed into histologic fibrosis reversal or reduced MRI/histologic liver fat. The original advertising interpretation cautions against adding MRI or histologic liver-fat results that were not measured. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Separate directness for test scores, histology and disease stage	Material needed: Actual score definitions and tables, separate direct histology/disease-stage evidence, denominators, timing and CIs. Unrecorded histologic outcomes are not assumed. Only material requests and research needs are recorded; no new search or clinical research is executed here.
14	Partly verified	Full text not readStored summary read	N14 · Evidence conditionAre ALT and FibroScan clinical liver-disease outcomes?Required	The original Korean counterview says it is unknown whether the measures translate into cirrhosis or hospitalization; the English counterview says clinical liver events were not tested. Surrogate signals are not converted into disease improvement or event-prevention effects. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Clinical outcomes such as cirrhosis/hospitalization versus surrogates	Material needed: Direct clinical-event types, definitions, adjudication, group events, time at risk, long-term denominators and CIs. Unverified information is not changed into zero events or zero effect. Only material requests and research needs are recorded; no new search or clinical research is executed here.
15	Partly verified	Full text not readStored summary read	N15 · Evidence conditionIs the separate seed trial an efficacy replication?Required	The 2016 citation provides safety support from a Plantago psyllium/Ocimum basilicum seed-intervention and anthropometric trial. It has no separate current efficacy-evidence row and is not counted as replication of the same formulation and ten-week ALT/FibroScan outcomes. R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Akbarian2016 safety support and a different intervention	Material needed: That report's original formulation, duration, population, group effects, harms, denominators and study/cohort relationships. Detailed unverified/unread status is retained. Only material requests and research needs are recorded; no new search or clinical research is executed here.
16	Partly verified	Full text not readStored summary read	N16 · Evidence conditionAre test effects after stopping or over other durations available?Required	The current record concerns a small ten-week surrogate trial. Persistence after stopping and effects in other products, durations, populations or long-term clinical outcomes cannot be established from the stored summary. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Ten weeks, persistence and generalization	Material needed: Follow-up, actual exposure, endpoint-specific denominators/CIs and matching comparator/population data. No maintenance-intake, liver-disease-management or treatment-replacement advice is created. Only material requests and research needs are recorded; no new search or clinical research is executed here.
17	Partly verified	Full text not readStored summary read	N17 · Evidence conditionAre the same citation, population or time points counted as new independent evidence?Required	Parent2985 and both existing subclaims share the Akbarzadeh2026 efficacy-trial context and Akbarian2016 supporting safety citation. Two tables or tests, conditions and time points from the same participants are not added as independent trials or participants. Different citations are also distinguished from unique-trial or independence certification; unique-trial and total unique-participant counts remain unverified. R01 R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Parent/subclaim and report/trial relationships	Material needed: Mapping efficacy/safety reports, cohorts, actual interventions, analysis populations and time points. Material-slot counts are not unique trials, participants or quality scores. Only material requests and research needs are recorded; no new search or clinical research is executed here.
18	Partly verified	Full text not readStored summary read	N18 · Evidence conditionWhat was actually read?Required	The complete parent stored summary was read for production and preserved as a complete byte copy. External abstracts, full texts, registration, protocols and SAPs are unread. URLs or PMCIDs alone do not upgrade reading, access or verification status. R01 R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	The complete parent stored summary and external material	Material needed: Actual acquisition/reading records for full texts, supplements, plans and registration. No separate external-link, screen, web or API checks were performed. Only material requests and research needs are recorded; no new search or clinical research is executed here.
19	Partly verified	Full text not readStored summary read	N19 · Evidence conditionWhere are the original citation and registration identifiers?Required	The 2026 efficacy citation has PMID42621560, PMCID PMC13489564 and DOI10.4103/ijpvm.ijpvm_254_24; the 2016 supporting citation has PMID27761216, PMCID PMC5070040 and DOI10.4103/2008-7802.191865. No separate registration identifier occurs in the two citation/evidence records. R01 R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	PMID, PMCID and DOI for each citation	Material needed: Exact original citations, study/registration identifiers, content and dates. Full-text or registration URLs are not inferred from PMCIDs. Only material requests and research needs are recorded; no new search or clinical research is executed here.
20	Partly verified	Full text not readStored summary read	N20 · Evidence conditionAre bilingual and historical checks distinguished from this review?Required	Original bilingual text, subclaims, notes and historical Codex PubMed/PMC/scoring checks and citation one-line verification statements are preserved. This work concerns production; external material is unread and content/model/question-boundary review remains incomplete. R01 R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Original bilingual text, subclaims and historical verification	Material needed: Original-text, translation, correction and boundary review. Historical checks are not labeled current FULL/QA, new clinical calculation or independent certification. Only material requests and research needs are recorded; no new search or clinical research is executed here.
21	Partly verified	Full text not readStored summary read	N21 · Evidence conditionAre subclaim values distinguished from parent C50 and axes?Required	The selected original grade/note and absence of score/status/axes are retained. Parent C50, Caution, B/S/R1/I2/EX/B2 and unrecorded precision describe parent context. They do not fill selected ten-week ALT/FibroScan scores, axes or independence certification. R01 R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Original subclaim grade/note and absent score/status/axes	Material needed: Review of selected and parent original values. No new scores, axes, efficacy grades or verdict changes. Only material requests and research needs are recorded; no new search or clinical research is executed here.
22	Partly verified	Full text not readStored summary read	N22 · Evidence conditionAre the cut-off, empty corrections and production date distinguished?Required	The original cut-off2026-09-07, empty corrections array and empty deliberation string are retained. They are not production/review dates or certification that no external correction exists. R01 R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Original cut-off and empty correction/deliberation records	Material needed: Subsequent/corrected material, complete pre-change originals and case history. Missing dates or correction values are not invented. Only material requests and research needs are recorded; no new search or clinical research is executed here.
23	Partly verified	Full text not readStored summary read	N23 · Evidence conditionAre funding, support, employee authors and analysis roles distinguished?Required	Core funding information records academic Isfahan University research and no conflicts reported. This does not establish that product support, company employee authors or company analysis/reporting involvement were all verified. Detailed funding for the 2016 supporting citation is not separately present in this stored summary. R01 R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Four company-related areas and report-specific scope	Material needed: Original funding/COI, product/material support, author affiliations and analysis/publication roles for each report. Parent I2 is not upgraded into new independence certification. Only material requests and research needs are recorded; no new search or clinical research is executed here.
24	Unverified	Full text not readStored summary read	N24 · Evidence conditionAre randomization, measurement, missingness and reporting details available?Required	The original core design is block randomization, with limitations involving covariate adjustment and completer-focused analysis. Allocation concealment, masking, test equipment/validity, missingness, prespecification of covariates and selective-reporting details remain separately unverified. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Block allocation, covariates and completer boundaries	Material needed: Original methods, protocol/SAP, registration/amendments, test tables, denominators and models. Design labels or objective tests do not establish official RoB/GRADE completion or completed review. Only material requests and research needs are recorded; no new search or clinical research is executed here.
25	Partly verified	Full text not readStored summary read	N25 · Evidence conditionAre identical lifestyle advice and actual concurrent exposure the same?Required	Weight-loss-diet and physical-activity advice common to both arms is an original condition. Actual diet, activity, weight changes, medication, product exposure, adherence and withdrawal details remain unverified; their joint contribution is not established. R01	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Weight-loss diet, physical activity, adherence and co-management	Material needed: Actual concurrent exposures, weight, diet, activity, baseline/follow-up medication, exposure, adherence and denominators. No diet, intake or liver-disease-management instructions are provided. Only material requests and research needs are recorded; no new search or clinical research is executed here.
26	Partly verified	Full text not readStored summary read	N26 · Harm-information gaps supplementing the efficacy tableWhich formulation and group had withdrawals in the supporting safety citation?Supplementary	The 2016 citation records some withdrawals for constipation, nausea or abdominal pain in a separate NAFLD seed intervention. Exact groups, products, counts, exposure denominators and duration cannot be established from the stored citation. All withdrawals are not assigned to the current psyllium10g/day trial. R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Withdrawals and harms in the 2016 seed intervention	Material needed: That report's formulations/materials, group events, withdrawals, reasons, durations, harm collection and exposure denominators. Other safety citations are not transferred into independent efficacy replication or the original trial's harm rate. Only material requests and research needs are recorded; no new search or clinical research is executed here.
27	Unverified	Full text not readStored summary read	N27 · Harm-information gaps supplementing the efficacy tableAre caution statements, observed harms and long-term safety the same?Supplementary	Original safety wording describes possible gas, bloating, abdominal pain, constipation or nausea and swallowing/narrowing/obstruction concerns. Harm collection, group events, exposure denominators, CIs and long-term/rare harms are separately unverified. Original adequate-fluid wording is preserved without creating new fluid quantities, intake instructions or treatment advice. R01 R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Possible harms, collection, denominators and particular risk groups	Material needed: Report-specific harm definitions, active collection, group exposures/denominators, discontinuation, dropout and long-term risk-group evidence. Caution is not replaced with safe/no harms or a newly established incidence rate. Only material requests and research needs are recorded; no new search or clinical research is executed here.
28	Partly verified	Full text not readStored summary read	N28 · Evidence conditionWhat material would trigger a sheet update?Required	This is a production table of stored ten-week ALT/FibroScan material. Relevant observations can be updated after content review of original tables, actual test names/units, direct imaging/histologic/clinical outcomes, between-group effects, denominators, concurrent exposures and harms. R01 R02	The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.	Original material, conditions, observations and verdict-change events	Material needed: Complete pre-change preservation, original material/condition versions, separate application and content-review records. The source records no QA/tests, web/API or link/screen checks, new calculations, regrading, independence certification, product intake, diet, liver-disease-management or treatment-replacement instructions. Only material requests and research needs are recorded; no new search or clinical research is executed here.

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28 itemsWhat the statuses mean

Assessment scope

Stored-material review date: Not recorded
Original evidence cut-off: 2026-09-07
Scope actually checked: Existing review summaries and stored records of methodological application. Full papers, supplements, registrations, plans and original data were not read.
What the dates mean: This is the date the stored materials were checked, not the date of a new search of the clinical literature.
Population: 80 adults with overweight or obesity and MASLD were randomized; 78 completed. Group/test denominators and detailed eligibility are unverified.
Ingredient, formulation and route: Psyllium 10 g/day added to a weight-loss diet and physical-activity advice
Dose: Psyllium10g/day and ten weeks identify the original study. No new total quantities, product, intake, diet or liver-disease-management advice is created.
Comparator: Ground wheat10g/day. Both groups received the same weight-loss-diet and physical-activity advice. Actual concurrent exposure and adherence details are unverified.
Measured outcome: Actual ten-week ALT and FibroScan measures, distinguished from AST, MRI, histologic and clinical outcomes.
Duration: A ten-week efficacy trial. MRI was not directly measured; post-trial follow-up and direct long-term clinical evidence are unverified.
Questions outside this scope: Transferring ALT/FibroScan findings into direct MRI/MRS or histologic liver-fat outcomes; Combining null AST and unmeasured MRI into the same zero-effect claim; Deriving exact between-group effects/CIs, fibrosis reversal, disease improvement or event prevention from P values; Certifying common advice as identical actual diet/activity/weight or psyllium-alone efficacy; Counting the supporting seed safety citation as identical efficacy replication or copying its harms into the current trial; Adding the same reports, time points, conditions or participants as new independent trials or people; New calculations, hypothetical quantities, grades, independence certification, product intake, diets, liver-disease management or treatment-replacement instructions

Evidence and sources

The links below lead to the sources. A link alone does not mean the original source was read or its latest publication status verified.

R01 · Akbarzadeh Z, Nourian M, Askari G, Maracy MR, Amani R. Benefit of Psyllium with Weight Loss Diet in Preventing Liver Dysfunction in Overweight or Obese Adults with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Int J Prev Med. 2026;17:46. PMID: 42621560. PMCID: PMC13489564. DOI: 10.4103/ijpvm.ijpvm_254_24.

PubMed

Material type: Randomized block design comparing psyllium with ground wheat
Materials actually read: Preserved summary read; external abstracts/full texts/registrations/plans remain unread
Findings recorded in the stored summary: ALT P=.006, FibroScan score P=.001; AST P=.98
Record level: Corresponding efficacy summary in the evidence record; directness for MRI/other endpoints is distinguished by condition rows and report roles.
Study overlap and independent replication: The Akbarzadeh2026 report concerns ten-week add-on psyllium ALT/FibroScan signals, null AST and gaps in effect size and endpoint hierarchy; MRI was not directly measured. The Akbarian2016 citation provides supporting harm/withdrawal information from a separate NAFLD seed-intervention/anthropometric study; it is not replication of current ALT/FibroScan/MRI efficacy. Parent2985 and both existing subclaims share these citations. Tables or tests, conditions and time points from the same participants are not added as new independent trials or people. Different citations do not certify unique trials or independence; unique-trial and total unique-participant counts remain unverified. Links are provisional by citation and actual cohort/independent-study relationships remain unreviewed.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Stored summary	Local preserved copy of the complete parent summary	Stored summary read	Summary read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.
External abstract	Original citation links or required-material slots; external public/access status unverified	Unread; access not attempted	Not read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.
External full text	Original citation links or required-material slots; external public/access status unverified	Unread; access not attempted	Not read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.
Original registration	Original citation links or required-material slots; external public/access status unverified	Unread; access not attempted	Not read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.
Original protocol	Original citation links or required-material slots; external public/access status unverified	Unread; access not attempted	Not read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.

R02 · Akbarian SA, Asgary S, Feizi A, Iraj B, Askari G. Comparative Study on the Effect of Plantago psyllium and Ocimum basilicum Seeds on Anthropometric Measures in Nonalcoholic Fatty Liver Patients. Int J Prev Med. 2016;7:114. PMID: 27761216. PMCID: PMC5070040. DOI: 10.4103/2008-7802.191865.

PubMed

Material type: Supporting safety citation from a separate seed-intervention and anthropometric study
Materials actually read: Preserved summary read; external abstracts/full texts/registrations/plans remain unread
Findings recorded in the stored summary: Some participants withdrew because of constipation, nausea or abdominal pain in a separate NAFLD seed-intervention trial.
Record level: Supporting safety citation; exact groups, formulations, counts, effects and harm denominators are unverified.
Study overlap and independent replication: The Akbarzadeh2026 report concerns ten-week add-on psyllium ALT/FibroScan signals, null AST and gaps in effect size and endpoint hierarchy; MRI was not directly measured. The Akbarian2016 citation provides supporting harm/withdrawal information from a separate NAFLD seed-intervention/anthropometric study; it is not replication of current ALT/FibroScan/MRI efficacy. Parent2985 and both existing subclaims share these citations. Tables or tests, conditions and time points from the same participants are not added as new independent trials or people. Different citations do not certify unique trials or independence; unique-trial and total unique-participant counts remain unverified. Links are provisional by citation and actual cohort/independent-study relationships remain unreviewed.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Stored summary	Local preserved copy of the complete parent summary	Stored summary read	Summary read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.
External abstract	Original citation links or required-material slots; external public/access status unverified	Unread; access not attempted	Not read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.
External full text	Original citation links or required-material slots; external public/access status unverified	Unread; access not attempted	Not read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.
Original registration	Original citation links or required-material slots; external public/access status unverified	Unread; access not attempted	Not read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.
Original protocol	Original citation links or required-material slots; external public/access status unverified	Unread; access not attempted	Not read	Only original PubMed links, PMCIDs and absent/unverified registration information are preserved. No new reading, access, prespecification or verification is certified. Full-text or registration URLs are not inferred.

Report counts versus independent study counts

The Akbarzadeh2026 report concerns ten-week add-on psyllium ALT/FibroScan signals, null AST and gaps in effect size and endpoint hierarchy; MRI was not directly measured. The Akbarian2016 citation provides supporting harm/withdrawal information from a separate NAFLD seed-intervention/anthropometric study; it is not replication of current ALT/FibroScan/MRI efficacy. Parent2985 and both existing subclaims share these citations. Tables or tests, conditions and time points from the same participants are not added as new independent trials or people. Different citations do not certify unique trials or independence; unique-trial and total unique-participant counts remain unverified. Links are provisional by citation and actual cohort/independent-study relationships remain unreviewed.

Review criteria

Version 1.0 · Criteria record date 2026-10-06. These are Chamgap's own application conditions, informed by the referenced methods. They do not constitute official assessment-tool certification or a new efficacy score.

N01 · What is the selected ten-week test question?

Required materials and conditions: Original ten-week ALT and FibroScan improvement
Conditions for verification: Material for Original ten-week ALT and FibroScan improvement must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Original ten-week ALT and FibroScan improvement with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N02 · What was the original ALT result?

Required materials and conditions: Ten-week covariate-adjusted between-group ALT test
Conditions for verification: Material for Ten-week covariate-adjusted between-group ALT test must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Ten-week covariate-adjusted between-group ALT test with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N03 · What was the original FibroScan measure?

Required materials and conditions: FibroScan fibrosis score P=.001
Conditions for verification: Material for FibroScan fibrosis score P=.001 must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects FibroScan fibrosis score P=.001 with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N04 · Are FibroScan and MRI/MRS liver-fat measurements the same?

Required materials and conditions: Distinguishing elastography-related measures from MRI and other tests
Conditions for verification: Material for Distinguishing elastography-related measures from MRI and other tests must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Distinguishing elastography-related measures from MRI and other tests with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N05 · Is the null AST result retained?

Required materials and conditions: Separate ALT and AST tests
Conditions for verification: Material for Separate ALT and AST tests must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Separate ALT and AST tests with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N06 · Are within-group improvement and adjusted between-group comparison the same?

Required materials and conditions: Target effect, covariate adjustment and change estimates
Conditions for verification: Material for Target effect, covariate adjustment and change estimates must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Target effect, covariate adjustment and change estimates with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N07 · What were the actual comparator and common advice?

Required materials and conditions: Psyllium versus ground wheat with common lifestyle advice
Conditions for verification: Material for Psyllium versus ground wheat with common lifestyle advice must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Psyllium versus ground wheat with common lifestyle advice with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N08 · Who was actually studied?

Required materials and conditions: Overweight/obesity, MASLD and eligibility
Conditions for verification: Material for Overweight/obesity, MASLD and eligibility must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Overweight/obesity, MASLD and eligibility with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N09 · Do 80 randomized and 78 completers provide every test denominator?

Required materials and conditions: Allocation, completion, valid tests and dropout
Conditions for verification: Material for Allocation, completion, valid tests and dropout must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Allocation, completion, valid tests and dropout with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N10 · Are ten-week research exposure and actual adherence verified?

Required materials and conditions: Oral 10g/day, duration, products and exposure
Conditions for verification: Material for Oral 10g/day, duration, products and exposure must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Oral 10g/day, duration, products and exposure with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N11 · Is the prespecified primary-endpoint hierarchy verified?

Required materials and conditions: ALT/AST/FibroScan hierarchy, registration and SAP
Conditions for verification: Material for ALT/AST/FibroScan hierarchy, registration and SAP must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects ALT/AST/FibroScan hierarchy, registration and SAP with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N12 · Are exact effect sizes, CIs and clinical importance available?

Required materials and conditions: P values, estimates, intervals and surrogate-test importance
Conditions for verification: Material for P values, estimates, intervals and surrogate-test importance must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects P values, estimates, intervals and surrogate-test importance with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N13 · Does a FibroScan measure establish histologic fibrosis improvement?

Required materials and conditions: Separate directness for test scores, histology and disease stage
Conditions for verification: Material for Separate directness for test scores, histology and disease stage must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Separate directness for test scores, histology and disease stage with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N14 · Are ALT and FibroScan clinical liver-disease outcomes?

Required materials and conditions: Clinical outcomes such as cirrhosis/hospitalization versus surrogates
Conditions for verification: Material for Clinical outcomes such as cirrhosis/hospitalization versus surrogates must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Clinical outcomes such as cirrhosis/hospitalization versus surrogates with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N15 · Is the separate seed trial an efficacy replication?

Required materials and conditions: Akbarian2016 safety support and a different intervention
Conditions for verification: Material for Akbarian2016 safety support and a different intervention must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Akbarian2016 safety support and a different intervention with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N16 · Are test effects after stopping or over other durations available?

Required materials and conditions: Ten weeks, persistence and generalization
Conditions for verification: Material for Ten weeks, persistence and generalization must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Ten weeks, persistence and generalization with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N17 · Are the same citation, population or time points counted as new independent evidence?

Required materials and conditions: Parent/subclaim and report/trial relationships
Conditions for verification: Material for Parent/subclaim and report/trial relationships must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Parent/subclaim and report/trial relationships with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N18 · What was actually read?

Required materials and conditions: The complete parent stored summary and external material
Conditions for verification: Material for The complete parent stored summary and external material must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects The complete parent stored summary and external material with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N19 · Where are the original citation and registration identifiers?

Required materials and conditions: PMID, PMCID and DOI for each citation
Conditions for verification: Material for PMID, PMCID and DOI for each citation must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects PMID, PMCID and DOI for each citation with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N20 · Are bilingual and historical checks distinguished from this review?

Required materials and conditions: Original bilingual text, subclaims and historical verification
Conditions for verification: Material for Original bilingual text, subclaims and historical verification must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Original bilingual text, subclaims and historical verification with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N21 · Are subclaim values distinguished from parent C50 and axes?

Required materials and conditions: Original subclaim grade/note and absent score/status/axes
Conditions for verification: Material for Original subclaim grade/note and absent score/status/axes must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Original subclaim grade/note and absent score/status/axes with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N22 · Are the cut-off, empty corrections and production date distinguished?

Required materials and conditions: Original cut-off and empty correction/deliberation records
Conditions for verification: Material for Original cut-off and empty correction/deliberation records must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Original cut-off and empty correction/deliberation records with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N23 · Are funding, support, employee authors and analysis roles distinguished?

Required materials and conditions: Four company-related areas and report-specific scope
Conditions for verification: Material for Four company-related areas and report-specific scope must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Four company-related areas and report-specific scope with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N24 · Are randomization, measurement, missingness and reporting details available?

Required materials and conditions: Block allocation, covariates and completer boundaries
Conditions for verification: Material for Block allocation, covariates and completer boundaries must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Block allocation, covariates and completer boundaries with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N25 · Are identical lifestyle advice and actual concurrent exposure the same?

Required materials and conditions: Weight-loss diet, physical activity, adherence and co-management
Conditions for verification: Material for Weight-loss diet, physical activity, adherence and co-management must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Weight-loss diet, physical activity, adherence and co-management with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N26 · Which formulation and group had withdrawals in the supporting safety citation?

Required materials and conditions: Withdrawals and harms in the 2016 seed intervention
Conditions for verification: Material for Withdrawals and harms in the 2016 seed intervention must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Supplementary
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Withdrawals and harms in the 2016 seed intervention with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N27 · Are caution statements, observed harms and long-term safety the same?

Required materials and conditions: Possible harms, collection, denominators and particular risk groups
Conditions for verification: Material for Possible harms, collection, denominators and particular risk groups must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Supplementary
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Possible harms, collection, denominators and particular risk groups with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

N28 · What material would trigger a sheet update?

Required materials and conditions: Original material, conditions, observations and verdict-change events
Conditions for verification: Material for Original material, conditions, observations and verdict-change events must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Requirement and applicability: Required
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Why this condition is needed: This condition connects Original material, conditions, observations and verdict-change events with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Referenced methods and the sections actually reviewed

M03 · Cochrane Handbook 6.5 (2024), chapter updated 2023-08

Official methodology · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13

Referenced principle: Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.
Extent of review: 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

Official methodology · §4.5, §4.6.1–4.6.3, MECIR C42

Referenced principle: Distinguish studies from reports and link them; do not omit a study solely because results are unreported.
Extent of review: 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

Official methodology · §8.1–8.2.3, Table 8.2.a

Referenced principle: Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.
Extent of review: 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

Official methodology · §15.2.4, §15.3.1–15.3.3

Referenced principle: Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.
Extent of review: 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

Official methodology · §19.1.2, §19.2.1–19.2.4

Referenced principle: Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.
Extent of review: 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/material version 1.0

Public reader pages and material were prepared from the existing 28 items. No new clinical searches, verification-state changes or scoring were performed.

The stored-material review date (Not recorded) and original evidence cut-off (2026-09-07) were retained unchanged.

Researcher downloads

These materials provide the same evidence, scope and verification status as this page.

View all item details

N01 · What is the selected ten-week test question?

Current findings: The selected original wording concerns improved ALT and FibroScan measures over ten weeks, with original grade C. Its note records some positive between-group P values but unclear effect size and prespecified hierarchy. Absent subclaim scores, status and axes are distinguished from parent C50.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Exact ALT/FibroScan endpoints, population, comparator, time points and denominators, and review of the question boundary. Parent scores or axes are not inserted into subclaim values.
Required materials and conditions: Original ten-week ALT and FibroScan improvement
Materials to obtain first: Exact ALT/FibroScan endpoints, population, comparator, time points and denominators, and review of the question boundary. Parent scores or axes are not inserted into subclaim values.
Further research: Material needed: Exact ALT/FibroScan endpoints, population, comparator, time points and denominators, and review of the question boundary. Parent scores or axes are not inserted into subclaim values. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Original ten-week ALT and FibroScan improvement must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Original ten-week ALT and FibroScan improvement with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N02 · What was the original ALT result?

Current findings: The original reader answer and research description record covariate-adjusted ALT favoring psyllium, P=.006. Exact group values, changes, adjusted effects, units and 95% CIs are unverified.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Original ALT tables, units, assay, baseline/follow-up/change values, covariates, model, group denominators, effects and CIs. No effect sizes or normalization rates are derived from P values.
Required materials and conditions: Ten-week covariate-adjusted between-group ALT test
Materials to obtain first: Original ALT tables, units, assay, baseline/follow-up/change values, covariates, model, group denominators, effects and CIs. No effect sizes or normalization rates are derived from P values.
Further research: Material needed: Original ALT tables, units, assay, baseline/follow-up/change values, covariates, model, group denominators, effects and CIs. No effect sizes or normalization rates are derived from P values. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Ten-week covariate-adjusted between-group ALT test must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Ten-week covariate-adjusted between-group ALT test with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N03 · What was the original FibroScan measure?

Current findings: The stored summary describes a favorable FibroScan fibrosis score or fibrosis-related measure, P=.001. Exact measure names, units, equipment, algorithms, test validity and baseline/follow-up/change values cannot be established from the stored summary.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: The actual FibroScan measure and score definition, units, measurement conditions, validity criteria, group tables, denominators, between-group effects and CIs. No particular measurement name or value is invented.
Required materials and conditions: FibroScan fibrosis score P=.001
Materials to obtain first: The actual FibroScan measure and score definition, units, measurement conditions, validity criteria, group tables, denominators, between-group effects and CIs. No particular measurement name or value is invented.
Further research: Material needed: The actual FibroScan measure and score definition, units, measurement conditions, validity criteria, group tables, denominators, between-group effects and CIs. No particular measurement name or value is invented. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for FibroScan fibrosis score P=.001 must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects FibroScan fibrosis score P=.001 with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N04 · Are FibroScan and MRI/MRS liver-fat measurements the same?

Current findings: Original product information states that FibroScan is not the same measurement as MRI liver fat; the advertising interpretation limits the signal to enzymes and elastography-related measures. Other tests do not fill the unmeasured MRI outcome.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Actual FibroScan measures and separately measured or defined MRI/MRS, other imaging or histology, with their denominators and estimates. A device name alone does not establish liver-fat quantity or histologic improvement.
Required materials and conditions: Distinguishing elastography-related measures from MRI and other tests
Materials to obtain first: Actual FibroScan measures and separately measured or defined MRI/MRS, other imaging or histology, with their denominators and estimates. A device name alone does not establish liver-fat quantity or histologic improvement.
Further research: Material needed: Actual FibroScan measures and separately measured or defined MRI/MRS, other imaging or histology, with their denominators and estimates. A device name alone does not establish liver-fat quantity or histologic improvement. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Distinguishing elastography-related measures from MRI and other tests must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Distinguishing elastography-related measures from MRI and other tests with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N05 · Is the null AST result retained?

Current findings: Original AST P=.98 is recorded as null. ALT P=.006 and FibroScan P=.001 are not transferred into AST efficacy or success across every liver-function test. Null AST is not proof of zero effect or equivalence.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: AST baseline/follow-up/change values, group denominators, adjustment models, effects, CIs and prespecified hierarchy.
Required materials and conditions: Separate ALT and AST tests
Materials to obtain first: AST baseline/follow-up/change values, group denominators, adjustment models, effects, CIs and prespecified hierarchy.
Further research: Material needed: AST baseline/follow-up/change values, group denominators, adjustment models, effects, CIs and prespecified hierarchy. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Separate ALT and AST tests must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Separate ALT and AST tests with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N06 · Are within-group improvement and adjusted between-group comparison the same?

Current findings: The original research description records favorable covariate-adjusted ALT and FibroScan findings. Exact covariates, baseline values, within-group changes and adjusted between-group estimates are unavailable, so P values alone do not reconstruct either effect.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Original ANCOVA or analysis model, covariates, prespecification, baseline/follow-up/change values, direct effects, CIs and denominators. No new within-group or between-group values are calculated.
Required materials and conditions: Target effect, covariate adjustment and change estimates
Materials to obtain first: Original ANCOVA or analysis model, covariates, prespecification, baseline/follow-up/change values, direct effects, CIs and denominators. No new within-group or between-group values are calculated.
Further research: Material needed: Original ANCOVA or analysis model, covariates, prespecification, baseline/follow-up/change values, direct effects, CIs and denominators. No new within-group or between-group values are calculated. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Target effect, covariate adjustment and change estimates must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Target effect, covariate adjustment and change estimates with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N07 · What were the actual comparator and common advice?

Current findings: The original intervention was psyllium 10g/day versus ground wheat 10g/day; both groups received weight-loss-diet and physical-activity advice. This add-on contrast is not changed into no treatment, psyllium alone or the same effect without a diet.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Control products and composition, diet/activity advice in both arms, actual intake, activity, weight changes and co-treatment records. Identical advice and identical actual behavior are distinguished.
Required materials and conditions: Psyllium versus ground wheat with common lifestyle advice
Materials to obtain first: Control products and composition, diet/activity advice in both arms, actual intake, activity, weight changes and co-treatment records. Identical advice and identical actual behavior are distinguished.
Further research: Material needed: Control products and composition, diet/activity advice in both arms, actual intake, activity, weight changes and co-treatment records. Identical advice and identical actual behavior are distinguished. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Psyllium versus ground wheat with common lifestyle advice must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Psyllium versus ground wheat with common lifestyle advice with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N08 · Who was actually studied?

Current findings: The original population comprised 80 adults with overweight or obesity and MASLD. Detailed diagnosis, liver-disease stage, baseline ALT and weight, medication, comorbidity, sex and age remain separately unverified. Findings are not generalized to other liver diseases, normal weight or advanced disease.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Diagnosis, eligibility, baseline liver disease, imaging, metabolic factors, medication, group baselines, subgroups and test denominators.
Required materials and conditions: Overweight/obesity, MASLD and eligibility
Materials to obtain first: Diagnosis, eligibility, baseline liver disease, imaging, metabolic factors, medication, group baselines, subgroups and test denominators.
Further research: Material needed: Diagnosis, eligibility, baseline liver disease, imaging, metabolic factors, medication, group baselines, subgroups and test denominators. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Overweight/obesity, MASLD and eligibility must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Overweight/obesity, MASLD and eligibility with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N09 · Do 80 randomized and 78 completers provide every test denominator?

Current findings: The original record states 80 randomized, 78 completed and ten weeks. Group allocation/completion, valid ALT/FibroScan/AST denominators, withdrawal reasons and timing remain separately unverified. No completion differences or rates are newly calculated.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Group flow, test- and time-specific denominators, ITT/completer populations, missing-data handling and exposure/withdrawal tables. Overall n is not copied into each group or test.
Required materials and conditions: Allocation, completion, valid tests and dropout
Materials to obtain first: Group flow, test- and time-specific denominators, ITT/completer populations, missing-data handling and exposure/withdrawal tables. Overall n is not copied into each group or test.
Further research: Material needed: Group flow, test- and time-specific denominators, ITT/completer populations, missing-data handling and exposure/withdrawal tables. Overall n is not copied into each group or test. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Allocation, completion, valid tests and dropout must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Allocation, completion, valid tests and dropout with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N10 · Are ten-week research exposure and actual adherence verified?

Current findings: Original psyllium 10g/day, ten weeks and control 10g/day are retained only to identify the study. Actual product quantification, manufacturing, intake, concurrent exposures, adherence and total exposure are separately unverified. No cumulative quantities or intake instructions are created.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Original products, formulations, composition, actual exposure, adherence, dropout and changes in diet/activity. No psyllium, product or diet instructions are provided.
Required materials and conditions: Oral 10g/day, duration, products and exposure
Materials to obtain first: Original products, formulations, composition, actual exposure, adherence, dropout and changes in diet/activity. No psyllium, product or diet instructions are provided.
Further research: Material needed: Original products, formulations, composition, actual exposure, adherence, dropout and changes in diet/activity. No psyllium, product or diet instructions are provided. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Oral 10g/day, duration, products and exposure must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Oral 10g/day, duration, products and exposure with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N11 · Is the prespecified primary-endpoint hierarchy verified?

Current findings: The original reader answer, grading rationale and flags record unverified prespecified primary hierarchy and registration. Three test endpoints or positive P values do not make all of them prespecified primary successes.
Verification status: Unverified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Initial and amended registration, protocol/SAP, endpoints, time points, multiplicity and analysis plans. Missing registration identifiers or URLs are not invented.
Required materials and conditions: ALT/AST/FibroScan hierarchy, registration and SAP
Materials to obtain first: Initial and amended registration, protocol/SAP, endpoints, time points, multiplicity and analysis plans. Missing registration identifiers or URLs are not invented.
Further research: Material needed: Initial and amended registration, protocol/SAP, endpoints, time points, multiplicity and analysis plans. Missing registration identifiers or URLs are not invented. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for ALT/AST/FibroScan hierarchy, registration and SAP must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects ALT/AST/FibroScan hierarchy, registration and SAP with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N12 · Are exact effect sizes, CIs and clinical importance available?

Current findings: Original P=.006, .001 and .98 are present, but exact between-group effect sizes, confidence intervals and clinical importance are unverified. Small significant P values do not establish large quantitative effects, precision or disease improvement.
Verification status: Unverified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Original models, estimates, CIs, variance, denominators, prespecified importance thresholds and test units. No hypothetical quantitative examples or new effect/CI calculations are produced.
Required materials and conditions: P values, estimates, intervals and surrogate-test importance
Materials to obtain first: Original models, estimates, CIs, variance, denominators, prespecified importance thresholds and test units. No hypothetical quantitative examples or new effect/CI calculations are produced.
Further research: Material needed: Original models, estimates, CIs, variance, denominators, prespecified importance thresholds and test units. No hypothetical quantitative examples or new effect/CI calculations are produced. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for P values, estimates, intervals and surrogate-test importance must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects P values, estimates, intervals and surrogate-test importance with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N13 · Does a FibroScan measure establish histologic fibrosis improvement?

Current findings: The original fibrosis-score signal is not changed into histologic fibrosis reversal or reduced MRI/histologic liver fat. The original advertising interpretation cautions against adding MRI or histologic liver-fat results that were not measured.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Actual score definitions and tables, separate direct histology/disease-stage evidence, denominators, timing and CIs. Unrecorded histologic outcomes are not assumed.
Required materials and conditions: Separate directness for test scores, histology and disease stage
Materials to obtain first: Actual score definitions and tables, separate direct histology/disease-stage evidence, denominators, timing and CIs. Unrecorded histologic outcomes are not assumed.
Further research: Material needed: Actual score definitions and tables, separate direct histology/disease-stage evidence, denominators, timing and CIs. Unrecorded histologic outcomes are not assumed. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Separate directness for test scores, histology and disease stage must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Separate directness for test scores, histology and disease stage with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N14 · Are ALT and FibroScan clinical liver-disease outcomes?

Current findings: The original Korean counterview says it is unknown whether the measures translate into cirrhosis or hospitalization; the English counterview says clinical liver events were not tested. Surrogate signals are not converted into disease improvement or event-prevention effects.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Direct clinical-event types, definitions, adjudication, group events, time at risk, long-term denominators and CIs. Unverified information is not changed into zero events or zero effect.
Required materials and conditions: Clinical outcomes such as cirrhosis/hospitalization versus surrogates
Materials to obtain first: Direct clinical-event types, definitions, adjudication, group events, time at risk, long-term denominators and CIs. Unverified information is not changed into zero events or zero effect.
Further research: Material needed: Direct clinical-event types, definitions, adjudication, group events, time at risk, long-term denominators and CIs. Unverified information is not changed into zero events or zero effect. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Clinical outcomes such as cirrhosis/hospitalization versus surrogates must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Clinical outcomes such as cirrhosis/hospitalization versus surrogates with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N15 · Is the separate seed trial an efficacy replication?

Current findings: The 2016 citation provides safety support from a Plantago psyllium/Ocimum basilicum seed-intervention and anthropometric trial. It has no separate current efficacy-evidence row and is not counted as replication of the same formulation and ten-week ALT/FibroScan outcomes.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: That report's original formulation, duration, population, group effects, harms, denominators and study/cohort relationships. Detailed unverified/unread status is retained.
Required materials and conditions: Akbarian2016 safety support and a different intervention
Materials to obtain first: That report's original formulation, duration, population, group effects, harms, denominators and study/cohort relationships. Detailed unverified/unread status is retained.
Further research: Material needed: That report's original formulation, duration, population, group effects, harms, denominators and study/cohort relationships. Detailed unverified/unread status is retained. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Akbarian2016 safety support and a different intervention must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Akbarian2016 safety support and a different intervention with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R02

N16 · Are test effects after stopping or over other durations available?

Current findings: The current record concerns a small ten-week surrogate trial. Persistence after stopping and effects in other products, durations, populations or long-term clinical outcomes cannot be established from the stored summary.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Follow-up, actual exposure, endpoint-specific denominators/CIs and matching comparator/population data. No maintenance-intake, liver-disease-management or treatment-replacement advice is created.
Required materials and conditions: Ten weeks, persistence and generalization
Materials to obtain first: Follow-up, actual exposure, endpoint-specific denominators/CIs and matching comparator/population data. No maintenance-intake, liver-disease-management or treatment-replacement advice is created.
Further research: Material needed: Follow-up, actual exposure, endpoint-specific denominators/CIs and matching comparator/population data. No maintenance-intake, liver-disease-management or treatment-replacement advice is created. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Ten weeks, persistence and generalization must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Ten weeks, persistence and generalization with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N17 · Are the same citation, population or time points counted as new independent evidence?

Current findings: Parent2985 and both existing subclaims share the Akbarzadeh2026 efficacy-trial context and Akbarian2016 supporting safety citation. Two tables or tests, conditions and time points from the same participants are not added as independent trials or participants. Different citations are also distinguished from unique-trial or independence certification; unique-trial and total unique-participant counts remain unverified.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Mapping efficacy/safety reports, cohorts, actual interventions, analysis populations and time points. Material-slot counts are not unique trials, participants or quality scores.
Required materials and conditions: Parent/subclaim and report/trial relationships
Materials to obtain first: Mapping efficacy/safety reports, cohorts, actual interventions, analysis populations and time points. Material-slot counts are not unique trials, participants or quality scores.
Further research: Material needed: Mapping efficacy/safety reports, cohorts, actual interventions, analysis populations and time points. Material-slot counts are not unique trials, participants or quality scores. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Parent/subclaim and report/trial relationships must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Parent/subclaim and report/trial relationships with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01 R02

N18 · What was actually read?

Current findings: The complete parent stored summary was read for production and preserved as a complete byte copy. External abstracts, full texts, registration, protocols and SAPs are unread. URLs or PMCIDs alone do not upgrade reading, access or verification status.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Actual acquisition/reading records for full texts, supplements, plans and registration. No separate external-link, screen, web or API checks were performed.
Required materials and conditions: The complete parent stored summary and external material
Materials to obtain first: Actual acquisition/reading records for full texts, supplements, plans and registration. No separate external-link, screen, web or API checks were performed.
Further research: Material needed: Actual acquisition/reading records for full texts, supplements, plans and registration. No separate external-link, screen, web or API checks were performed. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for The complete parent stored summary and external material must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects The complete parent stored summary and external material with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01 R02

N19 · Where are the original citation and registration identifiers?

Current findings: The 2026 efficacy citation has PMID42621560, PMCID PMC13489564 and DOI10.4103/ijpvm.ijpvm_254_24; the 2016 supporting citation has PMID27761216, PMCID PMC5070040 and DOI10.4103/2008-7802.191865. No separate registration identifier occurs in the two citation/evidence records.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Exact original citations, study/registration identifiers, content and dates. Full-text or registration URLs are not inferred from PMCIDs.
Required materials and conditions: PMID, PMCID and DOI for each citation
Materials to obtain first: Exact original citations, study/registration identifiers, content and dates. Full-text or registration URLs are not inferred from PMCIDs.
Further research: Material needed: Exact original citations, study/registration identifiers, content and dates. Full-text or registration URLs are not inferred from PMCIDs. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for PMID, PMCID and DOI for each citation must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects PMID, PMCID and DOI for each citation with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01 R02

N20 · Are bilingual and historical checks distinguished from this review?

Current findings: Original bilingual text, subclaims, notes and historical Codex PubMed/PMC/scoring checks and citation one-line verification statements are preserved. This work concerns production; external material is unread and content/model/question-boundary review remains incomplete.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Original-text, translation, correction and boundary review. Historical checks are not labeled current FULL/QA, new clinical calculation or independent certification.
Required materials and conditions: Original bilingual text, subclaims and historical verification
Materials to obtain first: Original-text, translation, correction and boundary review. Historical checks are not labeled current FULL/QA, new clinical calculation or independent certification.
Further research: Material needed: Original-text, translation, correction and boundary review. Historical checks are not labeled current FULL/QA, new clinical calculation or independent certification. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Original bilingual text, subclaims and historical verification must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Original bilingual text, subclaims and historical verification with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01 R02

N21 · Are subclaim values distinguished from parent C50 and axes?

Current findings: The selected original grade/note and absence of score/status/axes are retained. Parent C50, Caution, B/S/R1/I2/EX/B2 and unrecorded precision describe parent context. They do not fill selected ten-week ALT/FibroScan scores, axes or independence certification.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Review of selected and parent original values. No new scores, axes, efficacy grades or verdict changes.
Required materials and conditions: Original subclaim grade/note and absent score/status/axes
Materials to obtain first: Review of selected and parent original values. No new scores, axes, efficacy grades or verdict changes.
Further research: Material needed: Review of selected and parent original values. No new scores, axes, efficacy grades or verdict changes. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Original subclaim grade/note and absent score/status/axes must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Original subclaim grade/note and absent score/status/axes with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01 R02

N22 · Are the cut-off, empty corrections and production date distinguished?

Current findings: The original cut-off2026-09-07, empty corrections array and empty deliberation string are retained. They are not production/review dates or certification that no external correction exists.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Subsequent/corrected material, complete pre-change originals and case history. Missing dates or correction values are not invented.
Required materials and conditions: Original cut-off and empty correction/deliberation records
Materials to obtain first: Subsequent/corrected material, complete pre-change originals and case history. Missing dates or correction values are not invented.
Further research: Material needed: Subsequent/corrected material, complete pre-change originals and case history. Missing dates or correction values are not invented. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Original cut-off and empty correction/deliberation records must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Original cut-off and empty correction/deliberation records with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01 R02

N23 · Are funding, support, employee authors and analysis roles distinguished?

Current findings: Core funding information records academic Isfahan University research and no conflicts reported. This does not establish that product support, company employee authors or company analysis/reporting involvement were all verified. Detailed funding for the 2016 supporting citation is not separately present in this stored summary.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Original funding/COI, product/material support, author affiliations and analysis/publication roles for each report. Parent I2 is not upgraded into new independence certification.
Required materials and conditions: Four company-related areas and report-specific scope
Materials to obtain first: Original funding/COI, product/material support, author affiliations and analysis/publication roles for each report. Parent I2 is not upgraded into new independence certification.
Further research: Material needed: Original funding/COI, product/material support, author affiliations and analysis/publication roles for each report. Parent I2 is not upgraded into new independence certification. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Four company-related areas and report-specific scope must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Four company-related areas and report-specific scope with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01 R02

N24 · Are randomization, measurement, missingness and reporting details available?

Current findings: The original core design is block randomization, with limitations involving covariate adjustment and completer-focused analysis. Allocation concealment, masking, test equipment/validity, missingness, prespecification of covariates and selective-reporting details remain separately unverified.
Verification status: Unverified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Original methods, protocol/SAP, registration/amendments, test tables, denominators and models. Design labels or objective tests do not establish official RoB/GRADE completion or completed review.
Required materials and conditions: Block allocation, covariates and completer boundaries
Materials to obtain first: Original methods, protocol/SAP, registration/amendments, test tables, denominators and models. Design labels or objective tests do not establish official RoB/GRADE completion or completed review.
Further research: Material needed: Original methods, protocol/SAP, registration/amendments, test tables, denominators and models. Design labels or objective tests do not establish official RoB/GRADE completion or completed review. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Block allocation, covariates and completer boundaries must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Block allocation, covariates and completer boundaries with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N25 · Are identical lifestyle advice and actual concurrent exposure the same?

Current findings: Weight-loss-diet and physical-activity advice common to both arms is an original condition. Actual diet, activity, weight changes, medication, product exposure, adherence and withdrawal details remain unverified; their joint contribution is not established.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Actual concurrent exposures, weight, diet, activity, baseline/follow-up medication, exposure, adherence and denominators. No diet, intake or liver-disease-management instructions are provided.
Required materials and conditions: Weight-loss diet, physical activity, adherence and co-management
Materials to obtain first: Actual concurrent exposures, weight, diet, activity, baseline/follow-up medication, exposure, adherence and denominators. No diet, intake or liver-disease-management instructions are provided.
Further research: Material needed: Actual concurrent exposures, weight, diet, activity, baseline/follow-up medication, exposure, adherence and denominators. No diet, intake or liver-disease-management instructions are provided. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Weight-loss diet, physical activity, adherence and co-management must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Weight-loss diet, physical activity, adherence and co-management with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01

N26 · Which formulation and group had withdrawals in the supporting safety citation?

Current findings: The 2016 citation records some withdrawals for constipation, nausea or abdominal pain in a separate NAFLD seed intervention. Exact groups, products, counts, exposure denominators and duration cannot be established from the stored citation. All withdrawals are not assigned to the current psyllium10g/day trial.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: That report's formulations/materials, group events, withdrawals, reasons, durations, harm collection and exposure denominators. Other safety citations are not transferred into independent efficacy replication or the original trial's harm rate.
Required materials and conditions: Withdrawals and harms in the 2016 seed intervention
Materials to obtain first: That report's formulations/materials, group events, withdrawals, reasons, durations, harm collection and exposure denominators. Other safety citations are not transferred into independent efficacy replication or the original trial's harm rate.
Further research: Material needed: That report's formulations/materials, group events, withdrawals, reasons, durations, harm collection and exposure denominators. Other safety citations are not transferred into independent efficacy replication or the original trial's harm rate. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Withdrawals and harms in the 2016 seed intervention must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Withdrawals and harms in the 2016 seed intervention with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R02

N27 · Are caution statements, observed harms and long-term safety the same?

Current findings: Original safety wording describes possible gas, bloating, abdominal pain, constipation or nausea and swallowing/narrowing/obstruction concerns. Harm collection, group events, exposure denominators, CIs and long-term/rare harms are separately unverified. Original adequate-fluid wording is preserved without creating new fluid quantities, intake instructions or treatment advice.
Verification status: Unverified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Report-specific harm definitions, active collection, group exposures/denominators, discontinuation, dropout and long-term risk-group evidence. Caution is not replaced with safe/no harms or a newly established incidence rate.
Required materials and conditions: Possible harms, collection, denominators and particular risk groups
Materials to obtain first: Report-specific harm definitions, active collection, group exposures/denominators, discontinuation, dropout and long-term risk-group evidence. Caution is not replaced with safe/no harms or a newly established incidence rate.
Further research: Material needed: Report-specific harm definitions, active collection, group exposures/denominators, discontinuation, dropout and long-term risk-group evidence. Caution is not replaced with safe/no harms or a newly established incidence rate. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Possible harms, collection, denominators and particular risk groups must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Possible harms, collection, denominators and particular risk groups with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01 R02

N28 · What material would trigger a sheet update?

Current findings: This is a production table of stored ten-week ALT/FibroScan material. Relevant observations can be updated after content review of original tables, actual test names/units, direct imaging/histologic/clinical outcomes, between-group effects, denominators, concurrent exposures and harms.
Verification status: Partly verified
Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread
Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
Reason for missing information: Complete pre-change preservation, original material/condition versions, separate application and content-review records. The source records no QA/tests, web/API or link/screen checks, new calculations, regrading, independence certification, product intake, diet, liver-disease-management or treatment-replacement instructions.
Required materials and conditions: Original material, conditions, observations and verdict-change events
Materials to obtain first: Complete pre-change preservation, original material/condition versions, separate application and content-review records. The source records no QA/tests, web/API or link/screen checks, new calculations, regrading, independence certification, product intake, diet, liver-disease-management or treatment-replacement instructions.
Further research: Material needed: Complete pre-change preservation, original material/condition versions, separate application and content-review records. The source records no QA/tests, web/API or link/screen checks, new calculations, regrading, independence certification, product intake, diet, liver-disease-management or treatment-replacement instructions. Only material requests and research needs are recorded; no new search or clinical research is executed here.
Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
Conditions for verification: Material for Original material, conditions, observations and verdict-change events must be linked to the selected subclaim, parent context, original report, direct endpoints, time points, comparator and denominators, with unread external material distinguished.
Why this condition is needed: This condition connects Original material, conditions, observations and verdict-change events with the selected question, actual population/intervention/comparator, tests/imaging/histology/clinical outcomes, time points, within- and between-group comparisons, denominators and harms.
Application exceptions: Only original numbers are preserved. Distinguish actual ALT/AST/FibroScan measures, MRI/MRS/other imaging/histology/clinical liver disease, population, intervention, comparator, common advice, denominators, within- and between-group comparisons, duration, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, psyllium/product intake, diets, liver-disease management or treatment-replacement advice is created.
Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.

Related sources R01 R02