{
  "schema_version": "chamgap-public-evidence-check-1.0",
  "public_id": "v2987-s0",
  "verdict_number": "2987",
  "title": "Oral lactoferrin × day-60 tear-film tests after cataract surgery",
  "view_version": "1.0",
  "view_created_date": "2026-10-16",
  "criteria_version": "1.0",
  "criteria_date": "2026-10-06",
  "review_date": null,
  "legacy_evidence_date": "2026-09-07",
  "review_scope": {
    "materials_read": "Existing review summaries and stored records of methodological application",
    "clinical_papers_directly_read": false,
    "new_clinical_search": false,
    "limitation": "The whole stored parent-verdict summary and selected subclaim were read for production. External papers, abstracts, full texts, registry, protocol, SAP and funding disclosures were not separately read or accessed. Historical review records are not inherited as current clinical verification or a new verdict.",
    "date_meaning": "This is the date the stored materials were checked, not the date of a new search of the clinical literature."
  },
  "claim_context": {
    "population": "Small-incision cataract surgery patients without pre-existing dry eye: 64 randomized and 58 completers. Detailed links among people, operated eyes, both eyes and repeated tests are unverified.",
    "intervention": "Oral lactoferrin 350 mg/day was added to routine postoperative care. Details of formulation, actual exposure, adherence, co-ingredients and product support are unverified.",
    "dose": "350 mg/day for 60 days from the day after surgery identifies existing research exposure. No dosing, cumulative amounts, product, postoperative-care or dry-eye treatment instructions are created.",
    "comparator": "The control received routine postoperative care alone. Routine drops and natural recovery in the historical counterview are distinguished; this is not converted into lactoferrin alone, replacement of drops or a placebo comparison.",
    "endpoint": "Original day-60 tBUT 13.9 versus 7.86 seconds, Schirmer 30.9 versus 15.86 mm, and at least mild OSDI symptoms 26.6% versus 42.8% are preserved separately. Tests, symptoms and function are not combined into the same success; exact effects, CIs, test denominators and hierarchy are unverified.",
    "duration": "Existing results concern 60 days after surgery. Baseline, intermediate times, persistence after treatment, long-term outcomes and time-specific denominators are separately unverified.",
    "excluded_extensions": [
      "Transferring tBUT/Schirmer test differences to the same efficacy for OSDI, daily function, visual recovery or all eye health",
      "Extending day-60 results in a selected population without pre-existing dry eye to all chronic dry eye, other surgery or long-term efficacy",
      "Calculating new differences, effects, CIs, noncompletion rates or event counts from the original 64 randomized/58 completers, 32 per group/28 and 30 analyzed/6 noncompleters, test values or symptom percentages",
      "Adding people, operated eyes, both eyes, tests, repeated measurements, times or two sheets as independent trials or participants",
      "Using nonreporting of selected symptoms, no financial/competing interests reported, parent Good safety/I2 or historical verification to certify overall/long-term safety, independence or completed content review now",
      "Filling absent subclaim score/status/axes from parent C54 or generating dosing, product, surgery, postoperative-care or dry-eye treatment instructions"
    ]
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Evidence condition",
      "question": "What are the selected postoperative tear-film claim and original verdict?",
      "needed": "Day-60 tear-film tests after cataract surgery; existing subclaim verdict",
      "role": "Required",
      "role_reason": "This condition connects Day-60 tear-film tests after cataract surgery; existing subclaim verdict with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Day-60 tear-film tests after cataract surgery; existing subclaim verdict must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Detailed original material is needed on test definitions, surgical population, control, timing, denominators and question boundaries. Missing subclaim values are not filled from the parent. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The selected claim is “Improved tear-film tests 60 days after cataract surgery,” with original grade C and note “Both tBUT and Schirmer differed substantially.” Subclaim score, status and axes are unrecorded and distinguished from the parent test/symptom C54 context.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Detailed original material is needed on test definitions, surgical population, control, timing, denominators and question boundaries. Missing subclaim values are not filled from the parent.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Detailed original material is needed on test definitions, surgical population, control, timing, denominators and question boundaries. Missing subclaim values are not filled from the parent."
    },
    {
      "item_id": "N02",
      "question_type": "Evidence condition",
      "question": "Who were the patients without pre-existing dry eye?",
      "needed": "Small-incision cataract surgery population; exclusion of pre-existing dry eye",
      "role": "Required",
      "role_reason": "This condition connects Small-incision cataract surgery population; exclusion of pre-existing dry eye with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Small-incision cataract surgery population; exclusion of pre-existing dry eye must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Surgical and eligibility criteria, baseline tear-film measures and symptoms, excluded conditions and medicines, group baseline characteristics and actual eye/person denominators are needed. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The existing reader answer describes cataract patients without pre-existing dry eye. The other subclaim, “Treatment of chronic dry-eye disease in general,” retains grade ?. Results are not extended to patients with existing dry eye, other operations or all dry-eye disease.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Surgical and eligibility criteria, baseline tear-film measures and symptoms, excluded conditions and medicines, group baseline characteristics and actual eye/person denominators are needed.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Surgical and eligibility criteria, baseline tear-film measures and symptoms, excluded conditions and medicines, group baseline characteristics and actual eye/person denominators are needed."
    },
    {
      "item_id": "N03",
      "question_type": "Evidence condition",
      "question": "What are the original day-60 tBUT values and units?",
      "needed": "Tear-breakup time; seconds; control",
      "role": "Required",
      "role_reason": "This condition connects Tear-breakup time; seconds; control with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Tear-breakup time; seconds; control must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Test procedures and assessors, group baseline/follow-up values and denominators, adjustment, original effects, CIs, exact P values and rules for averaging repeated measurements are needed. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Day-60 tBUT is recorded as 13.9 seconds in the lactoferrin group and 7.86 seconds in the control group. Original values are preserved; between-group differences, relative improvement and CIs are not newly calculated.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Test procedures and assessors, group baseline/follow-up values and denominators, adjustment, original effects, CIs, exact P values and rules for averaging repeated measurements are needed.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Test procedures and assessors, group baseline/follow-up values and denominators, adjustment, original effects, CIs, exact P values and rules for averaging repeated measurements are needed."
    },
    {
      "item_id": "N04",
      "question_type": "Evidence condition",
      "question": "Is Schirmer test 1 distinguished from tBUT?",
      "needed": "Tear test 1; millimeters; test conditions",
      "role": "Required",
      "role_reason": "This condition connects Tear test 1; millimeters; test conditions with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Tear test 1; millimeters; test conditions must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Actual test methods, timing and conditions, baseline/follow-up tables, group denominators, effects, CIs, P values and tested-eye units are needed. No new instructions for performing the test are given. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Day-60 Schirmer values are 30.9 mm with lactoferrin and 15.86 mm with control; the evidence-list endpoint is Schirmer test 1. Values in seconds, P values and effects from tBUT are not transferred to this test.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Actual test methods, timing and conditions, baseline/follow-up tables, group denominators, effects, CIs, P values and tested-eye units are needed. No new instructions for performing the test are given.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Actual test methods, timing and conditions, baseline/follow-up tables, group denominators, effects, CIs, P values and tested-eye units are needed. No new instructions for performing the test are given."
    },
    {
      "item_id": "N05",
      "question_type": "Evidence condition",
      "question": "Can the OSDI symptom proportion substitute for tear-film tests?",
      "needed": "Objective tests; proportion with at least mild OSDI symptoms",
      "role": "Required",
      "role_reason": "This condition connects Objective tests; proportion with at least mild OSDI symptoms with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Objective tests; proportion with at least mild OSDI symptoms must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: OSDI categories, measurement time, valid denominators, original continuous scores and proportions, effects, CIs and prespecified hierarchy are needed. Objective-test changes are not automatically combined into symptom or functional success. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The preserved proportions with at least mild OSDI symptoms are 26.6% with lactoferrin and 42.8% with control. Symptom proportions, tBUT and Schirmer are separate endpoints; event counts, effects and CIs are not calculated from these percentages.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "OSDI categories, measurement time, valid denominators, original continuous scores and proportions, effects, CIs and prespecified hierarchy are needed. Objective-test changes are not automatically combined into symptom or functional success.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "OSDI categories, measurement time, valid denominators, original continuous scores and proportions, effects, CIs and prespecified hierarchy are needed. Objective-test changes are not automatically combined into symptom or functional success."
    },
    {
      "item_id": "N06",
      "question_type": "Evidence condition",
      "question": "Was lactoferrin added to routine postoperative care?",
      "needed": "Added oral lactoferrin; routine postoperative care",
      "role": "Required",
      "role_reason": "This condition connects Added oral lactoferrin; routine postoperative care with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Added oral lactoferrin; routine postoperative care must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Materials on identical drops and postoperative care in each group, actual treatment changes, adherence, exposure and control procedures are needed. No instructions for surgery, drops, care or treatment replacement are given. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The existing research description compares routine postoperative care alone with added lactoferrin. The counterview also records routine eye drops and natural recovery. This is not changed into a comparison of lactoferrin alone or replacement of routine eye drops.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Materials on identical drops and postoperative care in each group, actual treatment changes, adherence, exposure and control procedures are needed. No instructions for surgery, drops, care or treatment replacement are given.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Materials on identical drops and postoperative care in each group, actual treatment changes, adherence, exposure and control procedures are needed. No instructions for surgery, drops, care or treatment replacement are given."
    },
    {
      "item_id": "N07",
      "question_type": "Evidence condition",
      "question": "What do 350 mg/day, the day after surgery and 60 days describe?",
      "needed": "Oral formulation; research exposure; duration",
      "role": "Required",
      "role_reason": "This condition connects Oral formulation; research exposure; duration with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Oral formulation; research exposure; duration must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Original product quantities, formulation and composition, actual exposure and adherence, controls and intervention deviations are needed. Cumulative amounts and doses are not newly calculated. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The original intervention and product descriptions record oral lactoferrin 350 mg/day for 60 days from the day after small-incision surgery. These identify research exposure and do not create new dosing, cumulative amounts, postoperative-care or product advice.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Original product quantities, formulation and composition, actual exposure and adherence, controls and intervention deviations are needed. Cumulative amounts and doses are not newly calculated.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Original product quantities, formulation and composition, actual exposure and adherence, controls and intervention deviations are needed. Cumulative amounts and doses are not newly calculated."
    },
    {
      "item_id": "N08",
      "question_type": "Evidence condition",
      "question": "Do other vitamin or omega-3 combinations have the same evidence?",
      "needed": "Oral lactoferrin; boundaries between combinations and products",
      "role": "Required",
      "role_reason": "This condition connects Oral lactoferrin; boundaries between combinations and products with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Oral lactoferrin; boundaries between combinations and products must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Materials on the original lactoferrin product, active quantity, composition, source, manufacture and actual control are needed. No product recommendations, combination-product effects or dosing advice are created. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The existing product description states that efficacy of other vitamin or omega-3 combinations was not tested. Gaps in formulation, co-ingredients and manufacturing source remain; equivalence of ordinary products is not certified.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Materials on the original lactoferrin product, active quantity, composition, source, manufacture and actual control are needed. No product recommendations, combination-product effects or dosing advice are created.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Materials on the original lactoferrin product, active quantity, composition, source, manufacture and actual control are needed. No product recommendations, combination-product effects or dosing advice are created."
    },
    {
      "item_id": "N09",
      "question_type": "Evidence condition",
      "question": "What are the 64 randomized patients, 58 completers and group denominators?",
      "needed": "32 allocated per group; 28 and 30 analyzed; 6 noncompleters",
      "role": "Required",
      "role_reason": "This condition connects 32 allocated per group; 28 and 30 analyzed; 6 noncompleters with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for 32 allocated per group; 28 and 30 analyzed; 6 noncompleters must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Group allocation/completion/analysis flow, reasons and times of attrition, valid denominators for each test and OSDI, ITT and missing-data handling are needed. Detailed group tables were not compared this time. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The existing research description records 64 patients allocated 32 per group, with 6 not completing follow-up and 28 and 30 analyzed. Numbers and their original order are preserved; noncompletion rates and estimated event counts are not newly calculated.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Group allocation/completion/analysis flow, reasons and times of attrition, valid denominators for each test and OSDI, ITT and missing-data handling are needed. Detailed group tables were not compared this time.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Group allocation/completion/analysis flow, reasons and times of attrition, valid denominators for each test and OSDI, ITT and missing-data handling are needed. Detailed group tables were not compared this time."
    },
    {
      "item_id": "N10",
      "question_type": "Evidence condition",
      "question": "Are people, operated eyes, both eyes and repeated tests the same unit?",
      "needed": "Participant counts; tested eyes; analysis units",
      "role": "Required",
      "role_reason": "This condition connects Participant counts; tested eyes; analysis units with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Participant counts; tested eyes; analysis units must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Operated side, tested eyes, person-eye links, original monocular/binocular denominators, eye-selection rules and correlation/repeated-measure analyses are needed. Eye counts and participant totals are not newly calculated. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Counts in the existing summary refer to patients or participants. Detailed units for operated eyes, both eyes, selection of tested eyes, correlations between eyes and repeated tests are not established. Two eyes or repeated measurements from one person are not counted as independent participants.",
      "condition_status": "Unverified",
      "status_reason": "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.",
      "missingness": "Operated side, tested eyes, person-eye links, original monocular/binocular denominators, eye-selection rules and correlation/repeated-measure analyses are needed. Eye counts and participant totals are not newly calculated.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Operated side, tested eyes, person-eye links, original monocular/binocular denominators, eye-selection rules and correlation/repeated-measure analyses are needed. Eye counts and participant totals are not newly calculated."
    },
    {
      "item_id": "N11",
      "question_type": "Evidence condition",
      "question": "Are day-60 results distinguished from baseline, other times and persistence?",
      "needed": "Time-specific tests; natural recovery; persistence",
      "role": "Required",
      "role_reason": "This condition connects Time-specific tests; natural recovery; persistence with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Time-specific tests; natural recovery; persistence must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Group baseline/intermediate/day-60/follow-up tables and denominators, between-group changes, CIs and concurrent surgical/drop care are needed. No new follow-up duration or effect is created. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Key numbers concern 60 days after surgery. Differences in changes from baseline, intermediate times, persistence after treatment and denominators at other times are separately unverified. Natural recovery and routine drops retain their original context; day-60 values are not transferred to other times.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Group baseline/intermediate/day-60/follow-up tables and denominators, between-group changes, CIs and concurrent surgical/drop care are needed. No new follow-up duration or effect is created.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Group baseline/intermediate/day-60/follow-up tables and denominators, between-group changes, CIs and concurrent surgical/drop care are needed. No new follow-up duration or effect is created."
    },
    {
      "item_id": "N12",
      "question_type": "Evidence condition",
      "question": "How were simple randomization, open-label design and no placebo recorded?",
      "needed": "Allocation; masked assessment; concurrent care",
      "role": "Required",
      "role_reason": "This condition connects Allocation; masked assessment; concurrent care with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Allocation; masked assessment; concurrent care must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Allocation methods and concealment, assessors and test procedures, matching routine care, missingness, selective reporting and original methods are needed. No new official RoB/GRADE rating or content-review approval is assigned. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The existing design is a single-center nonblinded simple-randomized parallel trial, with open-label, no-placebo completer analysis. Concordant directions in two objective tests do not certify absence of masking, allocation or measurement bias.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Allocation methods and concealment, assessors and test procedures, matching routine care, missingness, selective reporting and original methods are needed. No new official RoB/GRADE rating or content-review approval is assigned.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Allocation methods and concealment, assessors and test procedures, matching routine care, missingness, selective reporting and original methods are needed. No new official RoB/GRADE rating or content-review approval is assigned."
    },
    {
      "item_id": "N13",
      "question_type": "Evidence condition",
      "question": "Are exact effects and CIs for the large test differences verified?",
      "needed": "Original group values; adjusted/change estimates; precision",
      "role": "Required",
      "role_reason": "This condition connects Original group values; adjusted/change estimates; precision with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Original group values; adjusted/change estimates; precision must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Test-specific original tables, between-group estimands, models, variance, CIs, P values, denominators and baseline adjustment are needed. No new effect sizes or hypothetical quantitative examples are created. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Original tBUT values of 13.9 and 7.86 seconds and Schirmer values of 30.9 and 15.86 mm are signals in two objective tests. Exact between-group/change effects, 95% CIs, P values, variance definitions and test denominators absent from this summary are not reconstructed.",
      "condition_status": "Unverified",
      "status_reason": "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.",
      "missingness": "Test-specific original tables, between-group estimands, models, variance, CIs, P values, denominators and baseline adjustment are needed. No new effect sizes or hypothetical quantitative examples are created.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Test-specific original tables, between-group estimands, models, variance, CIs, P values, denominators and baseline adjustment are needed. No new effect sizes or hypothetical quantitative examples are created."
    },
    {
      "item_id": "N14",
      "question_type": "Evidence condition",
      "question": "Is the prespecified hierarchy of both tests and OSDI verified?",
      "needed": "Primary/secondary endpoints; multiplicity; registration and plans",
      "role": "Required",
      "role_reason": "This condition connects Primary/secondary endpoints; multiplicity; registration and plans with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Primary/secondary endpoints; multiplicity; registration and plans must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Registration, protocols, SAPs, amendment histories, test/symptom hierarchy, times and analysis-population materials are needed. Unread material is not converted into failed prespecification or absence of research. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Existing endpoints list tBUT, Schirmer test 1 and OSDI together. Their prespecified primary/secondary hierarchy, multiplicity and registration identifiers/dates are separately unverified. No NCT identifiers or plan URLs are invented.",
      "condition_status": "Unverified",
      "status_reason": "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.",
      "missingness": "Registration, protocols, SAPs, amendment histories, test/symptom hierarchy, times and analysis-population materials are needed. Unread material is not converted into failed prespecification or absence of research.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Registration, protocols, SAPs, amendment histories, test/symptom hierarchy, times and analysis-population materials are needed. Unread material is not converted into failed prespecification or absence of research."
    },
    {
      "item_id": "N15",
      "question_type": "Evidence condition",
      "question": "Can test improvement be extended to treatment of chronic dry eye in general?",
      "needed": "Selected postoperative population; symptoms; function; applicability",
      "role": "Required",
      "role_reason": "This condition connects Selected postoperative population; symptoms; function; applicability with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Selected postoperative population; symptoms; function; applicability must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Direct trials in each condition/population, patient-important symptoms and function, comparators, durations, effects and CIs are needed. No postoperative-care or dry-eye treatment instructions are given. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The existing summary and other subclaim retain exclusion of patients with pre-existing dry eye. Test signals are not established as the same efficacy for all chronic dry-eye disease, eye health, visual recovery or surgical outcomes.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Direct trials in each condition/population, patient-important symptoms and function, comparators, durations, effects and CIs are needed. No postoperative-care or dry-eye treatment instructions are given.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Direct trials in each condition/population, patient-important symptoms and function, comparators, durations, effects and CIs are needed. No postoperative-care or dry-eye treatment instructions are given."
    },
    {
      "item_id": "N16",
      "question_type": "Harm-information gaps supplementing the efficacy table",
      "question": "Is nonreporting of some symptoms the same as long-term safety?",
      "needed": "Diarrhea, appetite loss, rash and constipation; collection scope",
      "role": "Supplementary",
      "role_reason": "This condition connects Diarrhea, appetite loss, rash and constipation; collection scope with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Diarrhea, appetite loss, rash and constipation; collection scope must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Harms-collection definitions and active surveillance, exposure and denominators per group, discontinuation, attrition, other harms and long-term population data are needed. No new harm rates, zero-event examples or treatment advice are created. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Existing explanations record no reported diarrhea, appetite loss, rash or constipation among 58 analyzed patients. This does not certify absence of all harms, long-term safety or the same safety in people with allergies, other illnesses or medicines.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Harms-collection definitions and active surveillance, exposure and denominators per group, discontinuation, attrition, other harms and long-term population data are needed. No new harm rates, zero-event examples or treatment advice are created.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Harms-collection definitions and active surveillance, exposure and denominators per group, discontinuation, attrition, other harms and long-term population data are needed. No new harm rates, zero-event examples or treatment advice are created."
    },
    {
      "item_id": "N17",
      "question_type": "Evidence condition",
      "question": "Were the same trial, eyes and conditions kept out of independent-data totals?",
      "needed": "Shared parent, two subclaims, bibliography and participants",
      "role": "Required",
      "role_reason": "This condition connects Shared parent, two subclaims, bibliography and participants with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Shared parent, two subclaims, bibliography and participants must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Links among reports, cohorts, people, eyes, times, conditions and analysis populations are needed. Material counts are not quality scores or unique-trial counts. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Parent verdict 2987 and its two subclaims share the same original-report context. Two sheets, tear-film tests, conditions, eyes and repeated measurements are not counted as new independent trials or participants. Unique-trial and unique-participant totals remain unverified.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Links among reports, cohorts, people, eyes, times, conditions and analysis populations are needed. Material counts are not quality scores or unique-trial counts.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Links among reports, cohorts, people, eyes, times, conditions and analysis populations are needed. Material counts are not quality scores or unique-trial counts."
    },
    {
      "item_id": "N18",
      "question_type": "Evidence condition",
      "question": "What material was actually read during this production?",
      "needed": "Complete stored summary; external reading scope",
      "role": "Required",
      "role_reason": "This condition connects Complete stored summary; external reading scope with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Complete stored summary; external reading scope must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Actual original texts, supplements, registration, plans and reading records are needed. Historical full-text verification is not inherited as external reading in this work. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The complete parent-verdict JSON summary was read for production and preserved in its original form. External abstracts, full text, registration, protocols and SAPs remain unread. A source URL or PMCID does not establish actual access, reading or fulfillment of a condition.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Actual original texts, supplements, registration, plans and reading records are needed. Historical full-text verification is not inherited as external reading in this work.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Actual original texts, supplements, registration, plans and reading records are needed. Historical full-text verification is not inherited as external reading in this work."
    },
    {
      "item_id": "N19",
      "question_type": "Evidence condition",
      "question": "How far are the original bibliography and registration identifiers linked?",
      "needed": "PMID, PMCID, DOI and registration information",
      "role": "Required",
      "role_reason": "This condition connects PMID, PMCID, DOI and registration information with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for PMID, PMCID, DOI and registration information must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Exact links among the paper, full text and registration, and materials on content and dates are needed. New full-text or registration URLs are not inferred from identifiers. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The original citation's PMID 26557550, PMCID PMC4625269, DOI 10.7860/JCDR/2015/15797.6670 and PubMed URL are linked. No separate registration number is present in the original evidence/citation; actual registration status remains unverified.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Exact links among the paper, full text and registration, and materials on content and dates are needed. New full-text or registration URLs are not inferred from identifiers.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Exact links among the paper, full text and registration, and materials on content and dates are needed. New full-text or registration URLs are not inferred from identifiers."
    },
    {
      "item_id": "N20",
      "question_type": "Evidence condition",
      "question": "Are historical verification statements in both languages distinguished from this review?",
      "needed": "Korean/English texts; existing claim; historical verification scope",
      "role": "Required",
      "role_reason": "This condition connects Korean/English texts; existing claim; historical verification scope with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Korean/English texts; existing claim; historical verification scope must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Content review of original texts, translation, corrections and question boundaries is needed. Historical statements are not labeled as completed content review or independent clinical validation in this work. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Korean/English texts, subclaim and note, and historical statements about PMC full text, bibliography, effect-size and scoring checks are preserved. This work separates stored material; it is not a new clinical review, calculation or verdict.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Content review of original texts, translation, corrections and question boundaries is needed. Historical statements are not labeled as completed content review or independent clinical validation in this work.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Content review of original texts, translation, corrections and question boundaries is needed. Historical statements are not labeled as completed content review or independent clinical validation in this work."
    },
    {
      "item_id": "N21",
      "question_type": "Evidence condition",
      "question": "Are subclaim values distinguished from parent C54, axes and safety?",
      "needed": "Subclaim grade/note; absent score, status and axes",
      "role": "Required",
      "role_reason": "This condition connects Subclaim grade/note; absent score, status and axes with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Subclaim grade/note; absent score, status and axes must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Content review of the selected record and original parent values is needed. No new efficacy grade, score, axes or regrading is created. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Original subclaim grade C and note, and absence of subclaim score, status and axes are retained. Parent C54, Good safety, B/S/R1/I2/E+/B2, unrecorded precision, four false flags and empty override reasons are parent context. They do not fill subclaim values or certify long-term safety or independence.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Content review of the selected record and original parent values is needed. No new efficacy grade, score, axes or regrading is created.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Content review of the selected record and original parent values is needed. No new efficacy grade, score, axes or regrading is created."
    },
    {
      "item_id": "N22",
      "question_type": "Evidence condition",
      "question": "Are the evidence date, correction history and production date distinguished?",
      "needed": "Evidence date; empty correction and deliberation records",
      "role": "Required",
      "role_reason": "This condition connects Evidence date; empty correction and deliberation records with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Evidence date; empty correction and deliberation records must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Actual follow-up/correction sources, complete prechange text and event histories are needed. Missing dates and correction values are not invented. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The original evidence date 2026-09-07, empty corrections array and empty deliberation string are retained. The evidence date is not this production/review date and does not certify absence of external corrections.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Actual follow-up/correction sources, complete prechange text and event histories are needed. Missing dates and correction values are not invented.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Actual follow-up/correction sources, complete prechange text and event histories are needed. Missing dates and correction values are not invented."
    },
    {
      "item_id": "N23",
      "question_type": "Evidence condition",
      "question": "Are funding, product support, employee authors and analysis roles distinguished?",
      "needed": "Four company-related aspects; historical independence statements",
      "role": "Required",
      "role_reason": "This condition connects Four company-related aspects; historical independence statements with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Four company-related aspects; historical independence statements must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Original funding/COI declarations, product support, affiliations and analysis/publication roles are needed. Parent I2 is not promoted to new independence certification. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The original funding wording is “No financial or competing interests reported.” This is not new certification that product support, employee authors and involvement in analysis/reporting were all verified in detail. Original randomization/independence statements also remain historical records.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Original funding/COI declarations, product support, affiliations and analysis/publication roles are needed. Parent I2 is not promoted to new independence certification.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Original funding/COI declarations, product support, affiliations and analysis/publication roles are needed. Parent I2 is not promoted to new independence certification."
    },
    {
      "item_id": "N24",
      "question_type": "Evidence condition",
      "question": "Are allocation, measurement, missingness and selective-reporting details verified?",
      "needed": "Design; endpoint hierarchy; denominators",
      "role": "Required",
      "role_reason": "This condition connects Design; endpoint hierarchy; denominators with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Design; endpoint hierarchy; denominators must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Methods, protocols, SAPs, registration/amendment histories, original tables, effects of interest and denominators are needed. Design labels alone do not certify official RoB/GRADE ratings or review approval. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Open-label, no-placebo completer design and distinctions between objective tests and symptoms are retained. Details of allocation concealment, tested eyes, assessors, denominators, missingness and selective reporting are separately unverified.",
      "condition_status": "Unverified",
      "status_reason": "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.",
      "missingness": "Methods, protocols, SAPs, registration/amendment histories, original tables, effects of interest and denominators are needed. Design labels alone do not certify official RoB/GRADE ratings or review approval.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Methods, protocols, SAPs, registration/amendment histories, original tables, effects of interest and denominators are needed. Design labels alone do not certify official RoB/GRADE ratings or review approval."
    },
    {
      "item_id": "N25",
      "question_type": "Evidence condition",
      "question": "Are actual exposure, concurrent care and repeated measurements verified?",
      "needed": "Research-intervention identity; adherence; co-interventions",
      "role": "Required",
      "role_reason": "This condition connects Research-intervention identity; adherence; co-interventions with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Research-intervention identity; adherence; co-interventions must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Product/formulation quantities, actual exposure, concurrent care, intervention deviations and denominators are needed. No new cumulative calculation, intake, product, eye-health or postoperative-care instructions are created. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "Original oral 350 mg/day for 60 days added to routine postoperative care is preserved as research-identification information. Actual adherence, formulation, eye-drop care, treatment changes and endpoint-specific denominator details are unverified.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Product/formulation quantities, actual exposure, concurrent care, intervention deviations and denominators are needed. No new cumulative calculation, intake, product, eye-health or postoperative-care instructions are created.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Product/formulation quantities, actual exposure, concurrent care, intervention deviations and denominators are needed. No new cumulative calculation, intake, product, eye-health or postoperative-care instructions are created."
    },
    {
      "item_id": "N26",
      "question_type": "Harm-information gaps supplementing the efficacy table",
      "question": "Are the scope of harms reports and actual denominators distinguished?",
      "needed": "Existing safety description; collection/exposure denominators",
      "role": "Supplementary",
      "role_reason": "This condition connects Existing safety description; collection/exposure denominators with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Existing safety description; collection/exposure denominators must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Harms definitions, active collection, actual group exposure/denominators, discontinuation, attrition, severity and original control materials are needed. Existing “Good” safety is not transferred to all populations and durations. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The existing record states no reported diarrhea, appetite loss, rash or constipation among 58 analyzed patients. Group-specific collection/exposure denominators, harms among those lost to follow-up and rates of other harms are separately unverified.",
      "condition_status": "Unverified",
      "status_reason": "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.",
      "missingness": "Harms definitions, active collection, actual group exposure/denominators, discontinuation, attrition, severity and original control materials are needed. Existing “Good” safety is not transferred to all populations and durations.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Harms definitions, active collection, actual group exposure/denominators, discontinuation, attrition, severity and original control materials are needed. Existing “Good” safety is not transferred to all populations and durations."
    },
    {
      "item_id": "N27",
      "question_type": "Harm-information gaps supplementing the efficacy table",
      "question": "What are the boundaries for long-term/rare harms and other populations?",
      "needed": "Original duration; illnesses; medicines; long-term scope",
      "role": "Supplementary",
      "role_reason": "This condition connects Original duration; illnesses; medicines; long-term scope with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Original duration; illnesses; medicines; long-term scope must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Long-term exposure/follow-up, harms surveillance, risk groups, medicines, group denominators, CIs and actual events are needed. No new treatment, intake, surgery or care instructions are given. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "The existing safety description retains the limitation that 60-day postoperative completer results cannot establish long-term safety in people with milk-protein allergy, other illnesses or medicines.",
      "condition_status": "Unverified",
      "status_reason": "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.",
      "missingness": "Long-term exposure/follow-up, harms surveillance, risk groups, medicines, group denominators, CIs and actual events are needed. No new treatment, intake, surgery or care instructions are given.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Long-term exposure/follow-up, harms surveillance, risk groups, medicines, group denominators, CIs and actual events are needed. No new treatment, intake, surgery or care instructions are given."
    },
    {
      "item_id": "N28",
      "question_type": "Evidence condition",
      "question": "What material would trigger a sheet update?",
      "needed": "Distinguishing conditions, observations, original material and verdict changes",
      "role": "Required",
      "role_reason": "This condition connects Distinguishing conditions, observations, original material and verdict changes with the selected question, actual surgical population, oral intervention, routine-care control, tests and symptoms, time points, people and eyes, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing the selected population without pre-existing dry eye from general chronic dry eye, oral add-on treatment from routine care/natural recovery, tBUT/Schirmer/OSDI, people/eyes/repeated tests, times, denominators, exposure, support, harms and unread external material. No new calculations, hypothetical examples, effects, CIs, regrading, independence certification, dosing, product, eye-health, surgery, postoperative-care or dry-eye treatment instructions are created.",
      "criterion": "Material for Distinguishing conditions, observations, original material and verdict changes must be linked to the selected subclaim, parent context, original report, test units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Complete prechange text and records of condition versions, separate application and content review are needed. Added material, revised conditions and verdict changes remain separate events; no new research, calculations or regrading are executed. This records needed materials; no new research was executed.",
      "current_reports": [
        "R01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols and SAPs unread",
      "observation": "This table transfers stored material on day-60 postoperative tear-film tests. Relevant observations can be updated after content review of original tables, measures, times, people, eyes, denominators, actual controls, concurrent care, follow-up, support and harms.",
      "condition_status": "Partly verified",
      "status_reason": "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.",
      "missingness": "Complete prechange text and records of condition versions, separate application and content review are needed. Added material, revised conditions and verdict changes remain separate events; no new research, calculations or regrading are executed.",
      "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.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Complete prechange text and records of condition versions, separate application and content review are needed. Added material, revised conditions and verdict changes remain separate events; no new research, calculations or regrading are executed."
    }
  ],
  "reports": [
    {
      "report_id": "R01",
      "title": "Devendra J, Singh S. Effect of Oral Lactoferrin on Cataract Surgery Induced Dry Eye: A Randomised Controlled Trial. J Clin Diagn Res. 2015;9(10):NC06-NC09. PMID: 26557550. PMCID: PMC4625269. DOI: 10.7860/JCDR/2015/15797.6670.",
      "url": "https://pubmed.ncbi.nlm.nih.gov/26557550/",
      "report_type": "Single-center nonblinded simple-randomized parallel trial",
      "existence": "The stored evidence/citation lists contain the original report bibliography. External public availability and access status are unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registrations and plans unread",
      "study_family": "F01",
      "independent_replication": "Review of existing content remains incomplete. The same report, population, conditions, eyes and repeated measurements are not counted as new independent trials.",
      "observed_result": "Day-60 tBUT 13.9 versus 7.86 seconds; Schirmer 30.9 versus 15.86 mm; at least mild OSDI symptoms 26.6% versus 42.8%",
      "result_level": "Stored efficacy summary; distinguish day-60 postoperative objective tests, separate OSDI symptom proportions and the completer-analysis scope",
      "source_evidence_date": "2026-09-07",
      "materials": [
        {
          "material_type": "Stored summary",
          "public_status": "Preserved copy of the complete parent-verdict stored summary",
          "access_status": "Stored summary read",
          "acquired": true,
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}