{
  "schema_version": "chamgap-public-criteria-1.0",
  "title": "Isolated tongue resistance training × AHI",
  "language": "en",
  "translation_date": "2026-10-16",
  "criteria_version": "1.0",
  "criteria_date": "2026-10-06",
  "condition_origin": "Chamgap's own application conditions",
  "method_sources": [
    {
      "id": "M03",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03",
      "section": "§3.1, §3.2.1–3.2.3, MECIR C5/C7/C13",
      "official_principle": "Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.",
      "review_level": "Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work."
    },
    {
      "id": "M04",
      "version": "Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04",
      "section": "§4.5, §4.6.1–4.6.3, MECIR C42",
      "official_principle": "Distinguish studies from reports and link them; do not omit a study solely because results are unreported.",
      "review_level": "Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work."
    },
    {
      "id": "M08",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08",
      "section": "§8.1–8.2.3, Table 8.2.a",
      "official_principle": "Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.",
      "review_level": "Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work."
    },
    {
      "id": "M15",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15",
      "section": "§15.2.4, §15.3.1–15.3.3",
      "official_principle": "Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.",
      "review_level": "Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work."
    },
    {
      "id": "M19",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19",
      "section": "§19.1.2, §19.2.1–19.2.4",
      "official_principle": "Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.",
      "review_level": "Methodological principles stated in existing pilot materials and condition templates were referenced. The methodological text was not reviewed again in this work."
    }
  ],
  "status_dictionary": {
    "Met": "The original content has been reviewed as meeting the conditions. This status is not used in this preparation.",
    "Partly verified": "Some information in the stored summary was linked during preparation; clinical verification or review is not complete.",
    "Unverified": "Required direct values, definitions or materials have not been established within the current storage and reading scope. This does not mean zero effect, no papers or failed access.",
    "Review incomplete": "Awaiting user review, or actual review remains incomplete.",
    "Not reported": "Used only when original materials were actually read and the outcome was judged unreported. Not used for external materials unread in this work.",
    "Inaccessible": "Used only when an actual access attempt has a recorded failure. Not used for access that was not attempted in this work.",
    "Insufficient evidence for the conditions": "Indicates insufficient direct materials for the relevant scope or conditions; it is not a new grade.",
    "Not applicable": "Used when the reason it does not apply to the original question is stated.",
    "Conflicting data": "Retains the scope of conflicting statements in original materials; it is not an arbitrary reassessment."
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Evidence condition",
      "question": "What is the scope of the selected tongue-only question?",
      "needed": "Original Korean/English claim and boundaries from multicomponent/parent context",
      "role": "Required",
      "role_reason": "This condition connects Original Korean/English claim and boundaries from multicomponent/parent context with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Original Korean/English claim and boundaries from multicomponent/parent context must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 exposure and the effect of interest for the selected protocol are unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N02",
      "question_type": "Evidence condition",
      "question": "Are subclaim D and parent C46 distinguished?",
      "needed": "Original subclaim D/note and absent score/status",
      "role": "Required",
      "role_reason": "This condition connects Original subclaim D/note and absent score/status with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Original subclaim D/note and absent score/status must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Subclaim score/status fields are absent from the original. Parent values are not copied to fill them. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N03",
      "question_type": "Evidence condition",
      "question": "Are Poncin and Yoshioka populations the same?",
      "needed": "OSA, mild-to-moderate sleep-disordered breathing, eligibility and severity",
      "role": "Required",
      "role_reason": "This condition connects OSA, mild-to-moderate sleep-disordered breathing, eligibility and severity with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for OSA, mild-to-moderate sleep-disordered breathing, eligibility and severity must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Report-specific eligibility, diagnoses, baseline AHI, risks, ages and concurrent-treatment material are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N04",
      "question_type": "Evidence condition",
      "question": "Are tongue elevation, device resistance and multicomponent exercise the same intervention?",
      "needed": "Muscles, components, supervision, tools and adherence",
      "role": "Required",
      "role_reason": "This condition connects Muscles, components, supervision, tools and adherence with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Muscles, components, supervision, tools and adherence must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Protocol-specific intensity, repetitions, tools, supervision and actual adherence are unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N05",
      "question_type": "Evidence condition",
      "question": "What comparisons do sham and no intervention represent?",
      "needed": "Sham movements, contact, time, concurrent therapies and shared care",
      "role": "Required",
      "role_reason": "This condition connects Sham movements, contact, time, concurrent therapies and shared care with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Sham movements, contact, time, concurrent therapies and shared care must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Sham components, no-intervention conditions, contact, concurrent therapy and equal-care material are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N06",
      "question_type": "Evidence condition",
      "question": "Which programs lasted six weeks, eight weeks and three months?",
      "needed": "Report-specific duration, assessment, exposure and later follow-up",
      "role": "Required",
      "role_reason": "This condition connects Report-specific duration, assessment, exposure and later follow-up with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Report-specific duration, assessment, exposure and later follow-up must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 assessment, actual exposure, discontinuation and later-follow-up material are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N07",
      "question_type": "Evidence condition",
      "question": "How was tongue-only primary AHI measured and analyzed?",
      "needed": "AHI definition, units, measurement, original values, denominators and models",
      "role": "Required",
      "role_reason": "This condition connects AHI definition, units, measurement, original values, denominators and models with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for AHI definition, units, measurement, original values, denominators and models must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Report-specific AHI definitions, measurement, original values, units, baselines, denominators and models are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N08",
      "question_type": "Evidence condition",
      "question": "What was the original Poncin primary AHI result?",
      "needed": "Null comparative AHI, hierarchy, effects, CIs and denominators",
      "role": "Required",
      "role_reason": "This condition connects Null comparative AHI, hierarchy, effects, CIs and denominators with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Null comparative AHI, hierarchy, effects, CIs and denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 Poncin effects, P values, CIs, arm denominators and models are needed. Yoshioka values are not copied. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N09",
      "question_type": "Evidence condition",
      "question": "Are secondary ESS and tongue endurance distinguished from AHI?",
      "needed": "Poncin ESS, broad endurance wording, hierarchy and attribution",
      "role": "Required",
      "role_reason": "This condition connects Poncin ESS, broad endurance wording, hierarchy and attribution with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Poncin ESS, broad endurance wording, hierarchy and attribution must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 ESS/endurance values, CIs, units, denominators and exact report attribution of endurance are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N10",
      "question_type": "Evidence condition",
      "question": "What is the scope of Yoshioka AHI P=.44?",
      "needed": "Original null comparative AHI, P value, effects and denominators",
      "role": "Required",
      "role_reason": "This condition connects Original null comparative AHI, P value, effects and denominators with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Original null comparative AHI, P value, effects and denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Yoshioka arm AHI original values, effects, CIs, denominators and models are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N11",
      "question_type": "Evidence condition",
      "question": "What separate result does ESS P=.62 represent?",
      "needed": "Yoshioka ESS, times, denominators and separation from AHI",
      "role": "Required",
      "role_reason": "This condition connects Yoshioka ESS, times, denominators and separation from AHI with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Yoshioka ESS, times, denominators and separation from AHI must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 ESS values, effects, CIs, denominators, plans and times are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N12",
      "question_type": "Evidence condition",
      "question": "Are within-group AHI values from the 31-person multicomponent trial the selected effect?",
      "needed": "Multicomponent exercise-group values and missing comparative estimates",
      "role": "Required",
      "role_reason": "This condition connects Multicomponent exercise-group values and missing comparative estimates with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Multicomponent exercise-group values and missing comparative estimates must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 multicomponent comparative change, CI, meaning of ±, arm denominators and models are unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N13",
      "question_type": "Evidence condition",
      "question": "How are multicomponent registered primary AHI and retrospective-registration wording retained?",
      "needed": "Guimarães NCT00660777, original hierarchy and registration timing",
      "role": "Required",
      "role_reason": "This condition connects Guimarães NCT00660777, original hierarchy and registration timing with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Guimarães NCT00660777, original hierarchy and registration timing must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 multicomponent registration content, dates, plans, changes and recruitment order are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N14",
      "question_type": "Evidence condition",
      "question": "Do tongue strength/endurance, sleepiness and snoring answer AHI?",
      "needed": "Measure definitions, units, primary/secondary hierarchy and clinical links",
      "role": "Required",
      "role_reason": "This condition connects Measure definitions, units, primary/secondary hierarchy and clinical links with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Measure definitions, units, primary/secondary hierarchy and clinical links must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 values, measurement, hierarchy and AHI/clinical mediation links for each measure are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N15",
      "question_type": "Evidence condition",
      "question": "What is the scope of app scores and snoring signals?",
      "needed": "Actual reports, measurement and direct AHI links",
      "role": "Required",
      "role_reason": "This condition connects Actual reports, measurement and direct AHI links with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Actual reports, measurement and direct AHI links must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: App/snoring original-report identity, measurement, values and direct AHI links are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N16",
      "question_type": "Evidence condition",
      "question": "What are exact tongue-only effects, CIs and effects of interest?",
      "needed": "Comparative estimation, adjustment, CIs, models and clinical importance",
      "role": "Required",
      "role_reason": "This condition connects Comparative estimation, adjustment, CIs, models and clinical importance with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Comparative estimation, adjustment, CIs, models and clinical importance must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Effects, CIs, effects of interest, adjustment, importance and equivalence plans are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N17",
      "question_type": "Evidence condition",
      "question": "What uncertainty remains with small samples of 27 and 20?",
      "needed": "Endpoint denominators, intervals, power and follow-up",
      "role": "Required",
      "role_reason": "This condition connects Endpoint denominators, intervals, power and follow-up with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Endpoint denominators, intervals, power and follow-up must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: AHI intervals, sample-size justification, power, importance and observation losses are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N18",
      "question_type": "Evidence condition",
      "question": "What do 27 and 20 represent in each report?",
      "needed": "Original participants, arm allocation, completion and endpoint denominators",
      "role": "Required",
      "role_reason": "This condition connects Original participants, arm allocation, completion and endpoint denominators with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Original participants, arm allocation, completion and endpoint denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Arm allocation, completion, analysis, endpoint denominators and exclusions are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N19",
      "question_type": "Evidence condition",
      "question": "How does Yoshioka completer analysis relate to missingness?",
      "needed": "Allocation, completion, discontinuation, exclusions and endpoint missingness",
      "role": "Required",
      "role_reason": "This condition connects Allocation, completion, discontinuation, exclusions and endpoint missingness with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Allocation, completion, discontinuation, exclusions and endpoint missingness must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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, completion, arm losses, exclusions and measure-specific missingness/handling are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N20",
      "question_type": "Evidence condition",
      "question": "How much is known about random-sequence generation and concealment?",
      "needed": "Original randomized designs and actual generation, recruitment and allocation",
      "role": "Required",
      "role_reason": "This condition connects Original randomized designs and actual generation, recruitment and allocation with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Original randomized designs and actual generation, recruitment and allocation must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 random-sequence generation, concealment, recruitment, allocation and baseline-risk procedures are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N21",
      "question_type": "Evidence condition",
      "question": "What level of sham, participant and assessor masking is known?",
      "needed": "Contact, allocation awareness, measurement and analysis procedures",
      "role": "Required",
      "role_reason": "This condition connects Contact, allocation awareness, measurement and analysis procedures with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Contact, allocation awareness, measurement and analysis procedures must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Masking, allocation awareness, sham content, contact, measurement and analysis procedures are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N22",
      "question_type": "Evidence condition",
      "question": "Are baseline AHI, severity, weight and analysis distinguished?",
      "needed": "Tongue-trial baselines, balance, covariates and adjustment",
      "role": "Required",
      "role_reason": "This condition connects Tongue-trial baselines, balance, covariates and adjustment with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Tongue-trial baselines, balance, covariates and adjustment must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Tongue-only baselines, covariates, balance, adjustment and models are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N23",
      "question_type": "Evidence condition",
      "question": "How were standard therapy, other care and training compared?",
      "needed": "Concurrent therapies, comparators, weight changes, treatment changes and analysis",
      "role": "Required",
      "role_reason": "This condition connects Concurrent therapies, comparators, weight changes, treatment changes and analysis with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Concurrent therapies, comparators, weight changes, treatment changes and analysis must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Standard therapy, concurrent treatment, care, weight changes and analysis handling are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N24",
      "question_type": "Evidence condition",
      "question": "How are actual adherence, tools and intensity linked to results?",
      "needed": "Planned/actual exposure, resistance, supervision, discontinuation and analysis",
      "role": "Required",
      "role_reason": "This condition connects Planned/actual exposure, resistance, supervision, discontinuation and analysis with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Planned/actual exposure, resistance, supervision, discontinuation and analysis must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 intensity, frequency, adherence, supervision, discontinuation, exposure and analysis material are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N25",
      "question_type": "Evidence condition",
      "question": "What are allocation, completer and actual-use effects and missing-data handling?",
      "needed": "ITT/PP, adjustment, missingness, sensitivity and repeated measures",
      "role": "Required",
      "role_reason": "This condition connects ITT/PP, adjustment, missingness, sensitivity and repeated measures with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for ITT/PP, adjustment, missingness, sensitivity and repeated measures must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: ITT/PP, actual use, models, adjustment, missingness and sensitivity material are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N26",
      "question_type": "Evidence condition",
      "question": "What do NCT/UMIN identifiers and the original primary hierarchy establish?",
      "needed": "Tongue-report registration, protocols, primary AHI and secondary outcomes",
      "role": "Required",
      "role_reason": "This condition connects Tongue-report registration, protocols, primary AHI and secondary outcomes with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Tongue-report registration, protocols, primary AHI and secondary outcomes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 content, dates, plans, hierarchy, analysis, recruitment order and change history are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N27",
      "question_type": "Evidence condition",
      "question": "How are tongue-only null results and multicomponent signals preserved together?",
      "needed": "Each comparator, duration, components, endpoints and quantification",
      "role": "Required",
      "role_reason": "This condition connects Each comparator, duration, components, endpoints and quantification with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Each comparator, duration, components, endpoints and quantification must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 comparisons under the same conditions, effects, CIs, independence and quantitative links are unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N28",
      "question_type": "Evidence condition",
      "question": "How do two evidence groups, three bibliographies and historical five RCTs differ?",
      "needed": "Combined summaries, individual bibliography, historical study counts and cohorts",
      "role": "Required",
      "role_reason": "This condition connects Combined summaries, individual bibliography, historical study counts and cohorts with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Combined summaries, individual bibliography, historical study counts and cohorts must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Related/additional reports, cohort overlap and unique-trial/participant totals are unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N29",
      "question_type": "Evidence condition",
      "question": "Which trial and roles do public/university support and device provision concern?",
      "needed": "Report-specific support, COI, devices, design, analysis and independence",
      "role": "Required",
      "role_reason": "This condition connects Report-specific support, COI, devices, design, analysis and independence with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Report-specific support, COI, devices, design, analysis and independence must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Individual attribution of support/device provision, COI, roles, research families and independence material are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N30",
      "question_type": "Evidence condition",
      "question": "Do the studies answer post-training AHI and clinical outcomes?",
      "needed": "Later follow-up, other conditions, subgroups and treatment changes",
      "role": "Required",
      "role_reason": "This condition connects Later follow-up, other conditions, subgroups and treatment changes with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Later follow-up, other conditions, subgroups and treatment changes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Later follow-up, clinical outcomes, other conditions, subgroups and treatment-change material are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N31",
      "question_type": "Evidence condition",
      "question": "What material was actually read here?",
      "needed": "Complete stored summary/bibliography versus external originals",
      "role": "Required",
      "role_reason": "This condition connects Complete stored summary/bibliography versus external originals with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Complete stored summary/bibliography versus external originals must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: External originals remain unread. Access failure or inaccessibility was not established either. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N32",
      "question_type": "Evidence condition",
      "question": "Are historical cross-checking and current review distinguished?",
      "needed": "Original date, empty corrections/deliberation and historical decision",
      "role": "Required",
      "role_reason": "This condition connects Original date, empty corrections/deliberation and historical decision with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Original date, empty corrections/deliberation and historical decision must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Current content-review and new clinical-verification dates are unrecorded; review of existing content remains incomplete. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N33",
      "question_type": "Evidence condition",
      "question": "Are original Korean/English tongue-only, multicomponent, primary and symptom boundaries retained?",
      "needed": "Original subclaim/note, parent Korean/English and safety",
      "role": "Required",
      "role_reason": "This condition connects Original subclaim/note, parent Korean/English and safety with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Original subclaim/note, parent Korean/English and safety must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 translation/correction comparisons between external papers and original Korean/English remain unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N34",
      "question_type": "Evidence condition",
      "question": "How are parent axes and failed primary/positive secondary outcomes retained?",
      "needed": "Parent axes, original flags and absent subclaim axes",
      "role": "Required",
      "role_reason": "This condition connects Parent axes, original flags and absent subclaim axes with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Parent axes, original flags and absent subclaim axes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Selected-subclaim score, status and axes are absent; details of each original endpoint plan are unverified. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N35",
      "question_type": "Evidence condition",
      "question": "Which trial does the one mucosal-abrasion participant belong to?",
      "needed": "Event attribution, definition, collection, adjudication and denominator",
      "role": "Supplementary; required for extending safety conclusions",
      "role_reason": "This condition connects Event attribution, definition, collection, adjudication and denominator with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Event attribution, definition, collection, adjudication and denominator must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Trial attribution, definitions, collection, adjudication, exposure and observation denominators for the abrasion are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N36",
      "question_type": "Evidence condition",
      "question": "What are abrasion onset, stopping/resumption and follow-up times?",
      "needed": "Actual exposure, onset, recovery, stopping, recurrence and follow-up",
      "role": "Supplementary; required for extending safety conclusions",
      "role_reason": "This condition connects Actual exposure, onset, recovery, stopping, recurrence and follow-up with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Actual exposure, onset, recovery, stopping, recurrence and follow-up must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Event, recovery, discontinuation duration, recurrence and later-follow-up times are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N37",
      "question_type": "Evidence condition",
      "question": "Were harms collected equally in sham/no-intervention groups?",
      "needed": "Arm collection, observation, control events and denominators",
      "role": "Supplementary; required for extending safety conclusions",
      "role_reason": "This condition connects Arm collection, observation, control events and denominators with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Arm collection, observation, control events and denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Equal harm collection/observation, control events, denominators and comparative material are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N38",
      "question_type": "Evidence condition",
      "question": "Are exposure/observation denominators and abrasion frequency known?",
      "needed": "Exact trial/arm, actual exposure, follow-up, harms and discontinuation",
      "role": "Supplementary; required for extending safety conclusions",
      "role_reason": "This condition connects Exact trial/arm, actual exposure, follow-up, harms and discontinuation with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Exact trial/arm, actual exposure, follow-up, harms and discontinuation must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Harm attribution, exposure, follow-up, arm denominators and total harm counts are needed. No new frequencies or risks are calculated. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N39",
      "question_type": "Evidence condition",
      "question": "Are tools, training, baseline conditions and event causes distinguished?",
      "needed": "Tools, actual exposure, baseline oral conditions/disease, concurrent care and cause",
      "role": "Supplementary; required for extending safety conclusions",
      "role_reason": "This condition connects Tools, actual exposure, baseline oral conditions/disease, concurrent care and cause with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Tools, actual exposure, baseline oral conditions/disease, concurrent care and cause must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Tools, exposure, baseline conditions, event attribution, timing and causal assessment are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N40",
      "question_type": "Evidence condition",
      "question": "What are stopping, completer analysis and losses to harm follow-up?",
      "needed": "Event stopping/resumption, losses, harm missingness and selective reporting",
      "role": "Supplementary; required for extending safety conclusions",
      "role_reason": "This condition connects Event stopping/resumption, losses, harm missingness and selective reporting with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Event stopping/resumption, losses, harm missingness and selective reporting must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Harm-related stopping, losses, missingness, selective reporting and follow-up losses are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N41",
      "question_type": "Evidence condition",
      "question": "What is known about other populations, independent reports and later harms?",
      "needed": "Same protocol, vulnerable populations, severity and long-term follow-up",
      "role": "Supplementary; required for extending safety conclusions",
      "role_reason": "This condition connects Same protocol, vulnerable populations, severity and long-term follow-up with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Same protocol, vulnerable populations, severity and long-term follow-up must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Independent harm material, vulnerable/severe populations and post-training follow-up are needed. This records needed materials; no new research was executed."
    },
    {
      "item_id": "N42",
      "question_type": "Evidence condition",
      "question": "Are criteria/original preservation distinguished from content review?",
      "needed": "Preserved methodology, condition versions, separate application and actual review scope",
      "role": "Required",
      "role_reason": "This condition connects Preserved methodology, condition versions, separate application and actual review scope with tongue-only AHI, original grade D, report-specific populations, sham/no-intervention controls, six/eight weeks, primary versus secondary outcomes, denominators and harm attribution.",
      "application_exception": "Preserve original numbers, P values and study exposure only. Distinguish multicomponent from tongue-only programs, within-group changes from between-group estimates, primary AHI from secondary ESS/function, and each comparator, duration, denominator and combined summary. Retrospective registration/historical checks do not become current reading or certification of prior plans. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, oral/breathing training, standard-treatment replacement or procedure instructions are created.",
      "criterion": "Material for Preserved methodology, condition versions, separate application and actual review scope must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Update with records of original material, condition versions, separate application, change history and actual review scope. This records needed materials; no new research was executed."
    }
  ]
}